BRK.A Berkshire Hathaway Inc

By Betsy McKay 

Bill and Melinda Gates have a message to the U.S. and other nations that have recently signaled they will prioritize domestic needs: Don't give up on foreign aid.

The U.S. spends less than 1% of its annual budget on foreign aid, but the money has saved millions of lives, the co-chairs of the Bill & Melinda Gates Foundation said in recent interviews in advance of the release of their widely-read annual letter, which this year lays out significant progress made in global health over the past several years.

Helping people live healthier lives in other countries is in both the U.S.'s and the world's interests, they wrote in an introduction to this year's annual letter, which is written to investor Warren Buffett, their close friend, who donated $30.24 billion worth of Berkshire Hathaway Inc. stock to the Gates Foundation in 2006.

"We have new leadership in the U.S., so we need to engage with them. We have new leadership in the U.K., so we need to engage with them," Mr. Gates said in an interview.

While the administration of President Donald Trump has yet to declare its stance on foreign health aid, Mr. and Mrs. Gates say they are concerned. "Of course I'm worried," Mr. Gates said. "What I'm hoping is that it remains enough of a priority that it at least stays as strong as it is."

The U.S. President's Emergency Plan for AIDS Relief, started by President George W. Bush in 2003 and known as Pepfar, spends about $5.2 billion a year currently on AIDS drugs and care for patients in nearly 60 countries. If funding for that program is cut, "people will die," Mr. Gates said.

A spokesman for the State Department didn't respond to a request for comment. Secretary of State Rex Tillerson expressed support for Pepfar in a Senate confirmation hearing last month.

Wealthy private donors like the Gates Foundation wouldn't be able to fill the gap should U.S. funding for Pepfar stop, Mr. Gates said: "Pepfar alone is as big as our entire foundation -- everything we do."

"Philanthropy is just the catalytic wedge -- we can take the risk, we can take the chances, but philanthropy's money is always small compared to government money," Mrs. Gates said in an interview.

The Gates's annual letter is widely read in global development circles. The couple said they wrote it to Mr. Buffett because he had asked them to reflect on the past decade of their foundation's work.

Investments by the Gates Foundation, governments and others have driven vast improvements, they wrote. Since 1990, the lives of 122 million children under age 5 have been saved by vaccination and better health care, they wrote.

"The world is a better place to live than it has ever been," Mr. Gates wrote in the letter. "Global poverty is going down, childhood deaths are dropping, literacy is rising, the status of women and minorities around the world is improving."

Saving children's lives has economic benefits: Parents can choose to have fewer children, meaning that they can nurture, feed and educate each child better, giving them a better chance to rise out of poverty, they wrote.

Today, 86% of children have received the basic vaccines against common childhood diseases, they wrote. Every dollar invested in immunizations delivers $44 in economic benefits, including the money saved when a parent can't work because a child is sick, they added.

Still, one million babies died in 2015 on the day they were born. And while more than 300 million women in developing countries are using modern contraceptives, there are still at least 225 million more who are asking for them, says Mrs. Gates, for whom expanding access to family planning is a priority.

Mr. and Mrs. Gates outlined in the letter the programs they're funding to address these health challenges. They include Family Planning 2020, a global initiative that the foundation is part of to make contraception available to 120 million more women by 2020.

Write to Betsy McKay at betsy.mckay@wsj.com

(END) Dow Jones Newswires

February 14, 2017 13:43 ET (18:43 GMT)

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