“I believe the world will keep improving—but it is harder to see that today than it has been in a long time.” That line—lifted from Bill Gates’s 2026 annual letter—sets an unusually urgent tone for a man known for measured optimism.
Gates spends much of the memo celebrating innovation, especially artificial intelligence, which he calls the most society-changing invention humans have made. But his optimism arrives with caveats. Over the past year he argues the world “went backwards” on a critical health metric: deaths of children under five. After a quarter-century of steady decline, those deaths ticked up in 2025 from roughly 4.6 million to 4.8 million, a reversal Gates ties to reduced support from wealthier countries.
A five-year alarm
He doesn’t sugarcoat the consequences. The Gates Foundation’s Goalkeepers team warned—using Institute for Health Metrics and Evaluation data—that if development assistance for health fell 20% from 2024 levels, an additional 12.5 million child deaths could occur by 2045. That kind of modeling turns a policy cut into a human arithmetic: fewer vaccines, fragile supply chains, worse outcomes for the youngest.
Because of that, Gates gives the world a short deadline. “The next five years will be difficult as we try to get back on track and work to scale up new lifesaving tools,” he writes, warning of the possibility of slipping into what he bluntly calls a new Dark Age—unless funding and innovation are pushed faster. It’s not prophecy so much as a challenge: rebuild the fiscal and political will now, or suffer measurable harm.
AI: the engine — and the risk
If funding and policy are one half of Gates’s message, technology is the other. He views artificial intelligence as the accelerator that can deliver breakthroughs in medicine, education, and climate solutions. Yet he is unusually explicit about the downsides. Reflecting on his 2015 TED warning about pandemic preparedness, Gates now argues an even greater danger is synthetic: a non‑government group using open-source AI tools to design a biological weapon.
That is a striking claim, because it reframes AI not just as an economic or cultural disruptor but as a force multiplier for deliberate harm. Governments, labs, and companies will have to wrestle with governance and access: who gets advanced models, under what controls, and how fast safety research runs ahead of misuse. Gates also expects labor-market disruption to accelerate over the next five years; he urges policymakers to use 2026 as a window to prepare compensation, retraining, and social-safety-net strategies.
If you want a sense of how corporate AI activity is moving in parallel, Microsoft itself is building in-house models and tools that show the speed of commercial investment in the space—work that underscores both the promise and the stewardship questions the letter raises. See Microsoft’s recent internal moves on image models for a peek at where capability is heading Microsoft MAI-Image-1. And broader consumer-facing AI features, like the conversational copilots rolling out in mapping and search, demonstrate how quickly these systems are entering everyday life Google Maps Gemini AI copilot.
Philanthropy and public policy
Gates isn’t just pressing governments. He’s also putting his own money where his mouth is. In 2025 he unveiled an unprecedented pledge to donate “virtually all” of his wealth—roughly $100 billion today and projected growth—to the foundation, a commitment structured so much of it must be spent within 20 years. He’s urging fellow billionaires to increase giving, arguing that private philanthropy should help plug gaps left by shrinking public assistance.
That’s controversial in two ways. First, it highlights how concentrated private wealth can become the backstop for global public goods—vaccines, sanitation, basic health systems—when political winds shift. Second, it raises questions about accountability and priority-setting: foundations can move fast, but they don’t replace the legitimacy and scale of public programs.
Climate, too: innovations that must scale
Gates also frames climate as an innovation problem. He applauds recent progress in projected emissions reductions but says more work is needed on “hard-to-abate” sectors like heavy industry and aviation. The same pattern repeats: without government policy to scale technologies, costs stay high and adoption stalls. Gates pledges to increase climate funding even as he keeps child health at the foundation’s center.
Why this matters now
The letter is part alarm, part roadmap. It stitches together three threads: declining development funding, technology that can either save lives or multiply harm, and a massive private pledge that tries to compress decades of giving into two. Whether countries, corporations, and philanthropists cohere around the next five years will determine if Gates’s optimism with footnotes turns into progress or a more troubling reversal.
There’s no single silver-bullet solution here. The path he sketches needs faster, smarter investments in health systems; tighter, international norms for powerful AI capabilities; and renewed political will to scale climate and medical innovations. If those pieces click, the next decade could still be the one Gates hopes for—an era of accelerated gains. If they don’t, the letter argues the cost will show up in very human terms.
Gates’s missive lands like a prompt: treat innovation as opportunity and risk, and treat funding cuts as choices with measurable consequences. The clock he sets—five years—feels short because the problems are urgent. That was the point.