Bill Gates Slams Elon Musk for “Endangering the World’s Poorest Children” Over Foreign Aid Cuts Tied to DOGE

 

In a rare and blistering public statement, philanthropist and Microsoft co-founder Bill Gates accused Elon Musk of contributing to a global humanitarian crisis by undermining international aid efforts. Gates’ sharp criticism comes in the wake of sweeping budget cuts and agency overhauls enacted by the Department of Government Efficiency (DOGE), an initiative championed by Musk and created to “eliminate bureaucratic waste.”

Speaking at a global health summit in Geneva, Gates did not mince words. “When billionaires play politics with the lives of the world’s most vulnerable, children die,” he said. “The dismantling of USAID and other international programs by DOGE isn’t just bureaucratic tinkering — it’s negligence on a global scale.”

The central point of contention is DOGE’s push to streamline or eliminate several long-standing U.S.-funded international programs. Most notable among them is the now-defunct USAID Global Health Bureau, which historically directed billions in medical aid, vaccine delivery, and health infrastructure across Africa, Southeast Asia, and parts of Latin America.

According to Gates, the collapse of these programs has already begun to take a devastating toll.

A Clash of Visions

DOGE was established during the Trump administration and given new life under a bipartisan efficiency mandate. Musk, brought in as a strategic advisor in 2024, promised to “re-engineer bloated agencies using first principles.” In doing so, he targeted what he termed “aid inefficiency” — calling traditional foreign aid “a black box of corruption and dependency.”

Musk’s approach centered around eliminating intermediaries, digitizing aid through blockchain platforms, and applying private-sector models to public programs. But critics, including Gates, argue that the abrupt shifts have created voids that private innovation cannot yet fill.

“Elon Musk believes you can Uberize humanitarian work,” Gates said. “But there’s no app that replaces the trust, networks, and experience that took decades to build in health ministries and rural clinics.”

While Musk has not publicly responded to Gates’ comments, he previously dismissed criticisms of DOGE as “fearmongering from people who profit from inefficiency.” On X (formerly Twitter), he wrote last month: “The old aid system is broken. Time for a reboot. DOGE is the fix.”

The Real-World Fallout

The fallout from these reforms has been immediate and, according to NGOs on the ground, catastrophic.

Dr. Lillian Owino, a pediatrician working with a children’s health initiative in Kenya, says her clinic was forced to shut down outreach programs after U.S. funding dried up in February. “We lost our maternal care van and had to stop vaccination campaigns in three counties,” she said. “We’ve already seen measles cases quadruple in two months.”

Similarly, in Mozambique, HIV prevention programs funded through the now-dismantled PEPFAR (President's Emergency Plan for AIDS Relief) saw staff layoffs and medical shipment delays after DOGE redirected resources into digital pilot schemes that have yet to reach rural communities.

“Replacing functioning systems with ideas still in beta is reckless,” Gates said. “You don’t experiment with people’s lives like they’re software features.”

Foundation Fights Back

In response to the crisis, the Bill & Melinda Gates Foundation announced an emergency $8 billion acceleration plan to plug critical gaps left by U.S. withdrawals. The foundation, traditionally more measured in its spending pace, is now planning to exhaust the majority of its endowment within Gates’ lifetime.

“It was never supposed to be this way,” Gates remarked. “But when governments abandon responsibility, others must step in — even temporarily.”

Gates has also urged fellow philanthropists and global health donors to increase spending over the next five years to stabilize systems in danger of collapse. “This is not about ideology. It’s about life and death. We can disagree on methods, but we must agree that abandoning children to disease is not an option.”

Ideological Undercurrents

Some experts argue the feud between Gates and Musk symbolizes a deeper philosophical divide in Silicon Valley’s elite: techno-optimism versus institutional pragmatism.

“Elon Musk believes in engineering his way out of any problem,” says Dr. Maria Tolentino, a political economist at Georgetown University. “Bill Gates, while also a technologist, sees the value of institutions, relationships, and long-term policy continuity. DOGE is the flashpoint where those ideologies collide.”

That ideological battle is also playing out globally. Reports have emerged of DOGE-style efficiency reforms being proposed in the U.K., Brazil, and parts of the EU, inspired by Musk’s rhetoric around “post-bureaucratic governance.”

Gates has warned against the growing influence of what he terms “Silicon Sovereignty” — the idea that billionaires can circumvent democratic institutions by shaping policy through personal wealth and public influence.

“Democracy isn’t just voting — it’s shared responsibility,” Gates said. “No one should get to bulldoze institutions with a tweet and a balance sheet.”

Looking Forward

The humanitarian and political consequences of DOGE’s legacy remain uncertain. While some of Musk’s proposed blockchain-based direct aid systems are beginning pilot phases in Latin America, skeptics argue that the speed and scale of rollout have not matched the urgency of needs.

Meanwhile, the Gates Foundation has shifted into what insiders are calling “crisis mode,” with emergency deployments to Ethiopia, Bangladesh, and Yemen already underway.

For now, Gates remains publicly undeterred — and unapologetically confrontational.

“If being labeled a relic of old-world thinking means I care whether a child gets a vaccine,” Gates said, “then I’ll wear that badge with pride.”