Bill Gates Accuses Elon Musk of ‘Killing the World’s Poorest Children’ in Scathing Criticism of Doge

What happens when the world’s richest man pulls the plug on programs that keep the world’s poorest children alive? That’s not a hypothetical—it’s the question igniting a rare and visceral public feud between two of the most powerful figures on the planet: Elon Musk and Bill Gates.

In a clash that feels less like a policy debate and more like a moral referendum, Gates has accused Musk of wielding his influence not to advance humanity, but to abandon it—specifically, by dismantling the very aid systems that have fought polio, HIV, and malnutrition across dozens of developing countries. “The picture of the world’s richest man killing the world’s poorest children is not a pretty one,” Gates said, and the accusation landed like a thunderclap.

This isn’t just another billionaire spat. Behind the headlines lies a story of shuttered clinics, expired vaccines, and lives cut short—not by lack of innovation, but by the deliberate withdrawal of support. The fallout from the closure of USAID under Musk’s leadership of the Trump administration’s Department of Government Efficiency (DOGE) is already being felt in clinics from Zambia to Gaza.

So how did we get here—and what does it reveal about the fragile lifeline connecting global wealth to global welfare?

The High-Stakes Clash: Two Billionaires, One Global Crisis

Bill Gates and Elon Musk are no strangers to the spotlight—but rarely have their names collided with such intensity over a matter as grave as global child mortality. Gates, co-founder of Microsoft and one of the most prolific philanthropists of the modern era, has spent decades funding life-saving programs in the world’s poorest regions. Musk, on the other hand, has carved his legacy as a technological disruptor, famously skeptical of government institutions and traditional charity.

Their paths crossed sharply when Musk was appointed to lead the Department of Government Efficiency (DOGE), a Trump administration initiative designed to slash federal spending. Under Musk’s leadership, DOGE targeted and dismantled the U.S. Agency for International Development (USAID), long seen as the backbone of American humanitarian outreach abroad.

The consequences of that decision set off a rare public condemnation from Gates—one that was as personal as it was political. In interviews with The Financial Times and The New York Times Magazine, Gates didn’t mince words. He accused Musk of overseeing decisions that have “put the world’s poorest children in the wood chipper,” a pointed reference to Musk’s own metaphor for eliminating bureaucratic inefficiency.

The clash extends beyond differing strategies. It taps into a deeper philosophical divide about responsibility, power, and the role of extreme wealth in shaping global outcomes. Gates has pledged to give away nearly all his wealth and shut down the Gates Foundation by 2045, with plans to spend $200 billion addressing issues like HIV, maternal health, and vaccine distribution. Musk, despite having signed the Giving Pledge in 2012, has long voiced skepticism about institutional philanthropy, once telling Gates the pledge was “bulls***.”

The tension between the two is not new, but this moment marks a turning point. What was once a difference in approach has become a collision over values—with real lives in the balance. Gates’ anger is not abstract: it’s rooted in data, firsthand accounts from shuttered hospitals, and a growing sense that years of progress in global health are being erased with the stroke of a pen.

What Is DOGE and Why Was USAID Dismantled?

In January 2025, President Donald Trump established the Department of Government Efficiency (DOGE) through Executive Order 14158, aiming to streamline federal operations and reduce government spending. Elon Musk, although not officially appointed, was widely recognized as the de facto leader of DOGE, with the administration asserting that he was “in charge” of the initiative .

DOGE’s mandate included embedding teams within federal agencies to identify and eliminate inefficiencies. One of its most significant actions was the dismantling of the U.S. Agency for International Development (USAID), a key institution responsible for administering foreign aid and development assistance globally. USAID had been instrumental in delivering humanitarian aid, supporting health initiatives, and promoting economic development in numerous countries.

The decision to dismantle USAID was met with legal challenges. In March 2025, a federal judge ruled that the actions taken by DOGE to shut down USAID likely violated the Constitution, leading to an indefinite block on further cuts to the agency . Despite this, the administration continued efforts to wind down USAID’s operations, with plans to transfer its remaining functions to the State Department by July 1, effectively reducing its staff from approximately 10,000 to just 15 positions .

Critics argued that the dismantling of USAID undermined decades of progress in global development and humanitarian assistance. The abrupt cessation of programs disrupted the delivery of essential services, including health care, education, and disaster relief, in vulnerable regions worldwide. The move sparked widespread concern among international partners and aid organizations, who emphasized the critical role of USAID in addressing global challenges.

Bill Gates’ Accusations: “Killing the World’s Poorest Children”

Bill Gates didn’t just criticize Elon Musk—he issued one of the most forceful rebukes ever exchanged between two high-profile philanthropists. In back-to-back interviews with The Financial Times and The New York Times Magazine, Gates accused Musk of causing a humanitarian catastrophe by cutting off lifelines to the developing world. His words were sharp and personal: “The picture of the world’s richest man killing the world’s poorest children is not a pretty one.”

Gates’ accusations weren’t metaphorical. He pointed directly to the consequences of Musk-led cuts to USAID under the Department of Government Efficiency (DOGE). The dismantling of the agency, Gates argued, has already led to severe real-world outcomes: expired medications, shuttered clinics, halted vaccine deliveries, and preventable deaths. “It left life-saving food and medicines expiring in warehouses,” he said, describing a cascade of operational breakdowns that followed the defunding.

One especially painful example came from Gaza Province—not the one in the Middle East, but in southern Mozambique—where USAID had funded a maternal HIV prevention program. The initiative aimed to stop transmission of HIV from mothers to newborns, a cornerstone in the global fight against pediatric HIV. According to Gates, DOGE terminated the funding after incorrectly believing the program was linked to distributing condoms to Hamas. The result: the clinic closed, and vulnerable infants were exposed to preventable infection. “I’d love for him to go in and meet the children that have now been infected with HIV because he cut that money,” Gates said.

In countries like Zambia, which had been making progress toward self-sufficient HIV treatment programs through PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief), the sudden halt to funding has been devastating. A recent Lancet study projects that ending such programs prematurely could lead to an additional one million pediatric HIV infections and half a million AIDS-related deaths within just five years. Nature adds that without U.S. global health support, as many as 25 million people could die over the next 15 years.

Gates emphasized that private philanthropy—however large—cannot replace what has been lost. Despite his plan to donate $200 billion through the Gates Foundation before it closes in 2045, he described these efforts as “a drop in the ocean” compared to the $44 billion that USAID managed annually.

The core of Gates’ outrage lies in the scale and speed of the dismantling. Musk, Gates argued, acted “through ignorance,” targeting what he perceived as bureaucratic bloat without recognizing the deeply interwoven systems that keep millions of lives afloat.

The Larger Impact: Health Setbacks and Human Cost

While the political firestorm between Elon Musk and Bill Gates has dominated headlines, the deeper tragedy is unfolding far from boardrooms and press interviews—in under-resourced clinics, rural health centers, and emergency aid depots across the developing world.

The U.S. Agency for International Development (USAID) was more than just a bureaucratic entity. It was, for many communities, the primary channel through which critical health interventions—vaccines, HIV treatment, maternal care—were delivered. With its dismantling under Musk’s DOGE initiative, these lifelines were severed with little warning and no contingency plan.

The immediate consequences have already begun to surface. In Zambia, clinics supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) shut their doors abruptly in January. The halt meant that thousands of people living with HIV were left without antiretroviral medications. According to NPR reporting, many are now presenting with advanced symptoms that had been previously under control. Local health workers, once buoyed by regular shipments of medications and training, now face empty shelves and overwhelmed waiting rooms.

Mozambique, where USAID helped fund a program to prevent the mother-to-child transmission of HIV, is seeing a resurgence of pediatric infections. Without intervention, babies born to HIV-positive mothers have a 15–45% chance of contracting the virus. With intervention, that risk can be reduced to below 5%. But with program funding terminated based on erroneous assumptions, including a debunked claim that funds were being diverted to Hamas, mothers are left without access to prevention treatments.

The ripple effect is daunting. According to a peer-reviewed study in The Lancet, the premature closure of global health programs could result in 1 million additional pediatric HIV infections, 500,000 AIDS-related deaths, and 2.8 million newly orphaned children over the next five years. Another study in Nature warned that ending U.S. global health funding altogether could lead to 25 million deaths over 15 years.

These are not abstract projections. They represent individuals—children losing access to vaccines, patients missing HIV refills, pregnant women with no prenatal care, and communities witnessing the return of diseases once on the brink of eradication. For example, resurgence in measles outbreaks has already been reported in parts of sub-Saharan Africa where USAID once supported immunization drives.

Experts are clear: the humanitarian cost of dismantling USAID cannot be offset by private philanthropy alone. While Gates has pledged up to $200 billion over the next two decades through the Gates Foundation, he admits it is not enough. “The shortfall created from the cuts to USAID was $44 billion last year alone,” Gates stated, underscoring the magnitude of the vacuum left behind.

Philanthropy vs. Efficiency: Clashing Worldviews

Bill Gates has spent the better part of two decades building a philanthropic model that focuses on long-term investment in public health, education, and poverty reduction. He’s a staunch believer in institutional partnerships and data-driven strategies—operating under the principle that solving systemic problems requires consistent, well-funded interventions. The Gates Foundation, founded in 2000, has already spent over $100 billion and plans to double that amount before closing its doors in 2045.

Gates’ view is one of accountability through collaboration. He sees philanthropy not as a moral luxury but as a responsibility—particularly for those whose fortunes were built atop global markets. “There are too many urgent problems to solve,” Gates wrote in a 2024 open letter. “People will say a lot of things about me when I die, but I am determined that ‘he died rich’ will not be one of them.”

Elon Musk, by contrast, has long been skeptical of traditional philanthropy. He once told Gates directly that the Giving Pledge—a non-binding commitment to donate at least half one’s wealth—was “bulls***.” His approach to impact is rooted in disruption: favoring bold, high-risk bets like space exploration, AI, and private-sector innovation over institutional charity. His defenders argue that Musk’s efficiency-oriented mindset, exemplified by DOGE, is about cutting waste and eliminating bloated bureaucracies.

From Musk’s perspective, USAID represented inefficiency and corruption. His decision to dismantle it was framed not as cruelty, but as a correction—a necessary overhaul of what he saw as a broken system. In a now-infamous tweet, he labeled the agency a “criminal organization” and claimed, “It’s time for it to die.”

This tension between targeted, humanitarian intervention and sweeping systemic overhaul is at the core of their disagreement. Gates sees value in steady, patient work—disease eradication, maternal health programs, education funding. Musk sees government institutions as outdated and believes innovation should be the engine of progress.

Critics of Musk’s approach argue that his methods—no matter how well-intentioned—fail to account for the fragility of real human lives. The shutdown of clinics, the abrupt end to medication deliveries, the loss of vital infrastructure can’t be “reengineered” overnight. Humanitarian aid isn’t a rocket launch—it requires trust, continuity, and an understanding that efficiency in theory does not always translate into equity in practice.

What makes this clash so consequential is that both men hold extraordinary influence—not just over markets and media, but over the distribution of global resources. Their choices, philosophies, and even personal biases ripple outward in life-altering ways for millions.

A Wake-Up Call for Global Aid and Public Policy

The fallout from the dismantling of USAID and the Gates–Musk conflict is more than a headline—it is a sobering reminder of just how fragile the global safety net can be when public institutions are undermined and philanthropy is politicized. Behind the billion-dollar numbers and ideological posturing are very real consequences: missed vaccinations, untreated diseases, preventable deaths.

For all the debates over efficiency versus bureaucracy, or private charity versus government aid, the core truth remains: lives are saved when global health systems are adequately funded, trusted, and maintained. And they are lost when those systems are gutted without a plan to replace them.

Gates’ warning is clear. No amount of private giving, however generous, can substitute for sustained government leadership. Philanthropy can catalyze innovation and plug gaps—but it cannot shoulder the weight of global development alone. The $200 billion he plans to give is staggering, yet even he admits it’s not enough to fill the void left by USAID’s $44 billion annual reach.

At a time when pandemics, climate displacement, and growing inequality demand more—not less—global cooperation, this moment should prompt serious reflection. Aid is not charity; it is a lifeline. And when politics trumps policy, or when efficiency becomes an excuse for abandonment, the world’s most vulnerable suffer first and most.

This is not just a story about two billionaires—it’s a test of collective priorities. Will governments recommit to global welfare? Will citizens demand that the powerful act with foresight and responsibility, not just boldness and ego?

Because in the end, efficiency may cut costs. But only empathy saves lives.