Bill Gates, the Chair of the Gates Foundation, revealed that the foundation’s $100 billion investment over the past 25 years has been instrumental in improving healthcare systems across Africa, including fostering valuable collaborations in Nigeria and other nations on the continent.
Speaking at “Goalkeepers,” a live event hosted by the Gates Foundation in Lagos on Wednesday, Gates offered a detailed account of the foundation’s work since its inception in 2000. He explained that the central mission from the beginning was grounded in a simple belief—that “all lives have equal value.” A major goal, he said, was “reducing infant mortality globally, especially in Africa.”
Reflecting on the healthcare landscape at the time the foundation began its journey, Gates asked, “Are people taking this seriously, are they making the medicines cheaper, or are they tailoring the medicines to the particular needs of those areas, for example, investing in new malaria tools?” His conclusion was, “And the answer was no.”
He noted that this lack of action inspired the Gates Foundation’s focus. “And so, that became the guiding light for the Gates Foundation,” Gates said, adding that “over 70 percent of what we’ve spent, the $100 billion we’ve spent in these last 25 years, went to global health,” with Africa remaining a core focus throughout that period.
According to him, “Here in Nigeria, we’ve had amazing partners who understand the delivery and the way that we can work and help the government. The government, in the long run, has the responsibility for all of this work. We’re there to accelerate these systems.”
He further emphasized the role of improved health in national development, noting that better healthcare “accelerates the economic growth of a country to a point where it can become self-sufficient.” Gates expressed optimism that the number of child deaths worldwide—currently around five million—could be halved again.
“These next 20 years, you know, the countries in Africa will get to that status. So helping them accelerate that, helping them understand what the unique local challenges are, which things we need to make simpler, and bringing the price down. That’s done as a partnership, and the last 25 years went way better than I expected; that is, childhood death, globally and in Africa, was cut in more than half,” he said.
He added, “We went from almost 10 million worldwide to now less than five million. And I feel confident we can cut that in half again, even though, as you mentioned, right now, we’re in a stunning and completely unjust withdrawal of support from a number of rich governments, including the United States, but even despite that, which is going to make the next four or five years, we’ll have some reversal because it’s just too large and too sudden to overcome. We will get back to incredible progress reducing those.”
Bill Gates also highlighted the significance of affordable, new vaccines in reducing childhood deaths. “And there’s some, you know, very key things that were done there. There were new vaccines that were made cheaper, like rotavirus, pneumococcus, and penta. And Gavi is a group that helps fund most of those costs to make sure they get to all the world’s children.”
He acknowledged other advancements such as “the bed nets for malaria, the preventing HIV transmission from mother to child, you know, a little bit of progress on malnutrition, that will be a big thing in the years ahead.” According to him, “So all that came together, and people started looking at vaccine coverage, and various countries can compare their vaccine coverage.”
“There are some countries in Africa that have over 95 percent vaccine coverage, better than the United States. There are some countries that only have like 50 percent vaccine coverage,” Gates said, suggesting that disparities remain but offering hope for continued progress.
“So, there is hope that we can still make progress even if there’s a decline in the best ideas from all over Africa and sharing them; that alone would be a gigantic thing,” he added.
What you should know
Bill Gates emphasized that the Gates Foundation has spent $100 billion over 25 years—largely focused on global health—with Nigeria playing a key role in its success.
He believes that, despite reduced funding from some wealthy nations, the foundation’s partnerships across Africa can drive further reductions in child mortality and bolster health infrastructure.
