We Can’t Stop at Almost: How the Goalkeepers are Charting the Roadmap for a Healthier Future 

At a time when progress in global child health is slipping, world leaders, innovators, and changemakers are being called upon to confront a stark reality and a powerful opportunity. At the just concluded Goalkeepers 2025 in New York, over 1,000 government, community, philanthropy, and private-sector leaders gathered under the theme “We Can’t Stop at Almost” to spotlight what it will take to protect hard-won gains and unlock the next wave of breakthroughs for the world’s children. Chiemelie Ezeobi writes that the message was urgent but hopeful: we could be the generation that ends preventable child deaths and consigns some of the deadliest diseases to history by 2045

What if we could be the generation that ends preventable child deaths? This pertinent question was the crux of the just concluded 2025 Goalkeepers annual event in New York where a roomful of innovators, private sector leaders, global changemakers, champions and even government officials gathered to accelerate the 2030 Sustainable Development Goals (SDGs). 

The message was loud- Progress in child health is slipping, and the stakes have never been higher. However, there is hope- the opportunity to change course together is within reach and at the Goalkeepers, that urgency met action. 

Themed “We Can’t Stop at Almost”, the different conversations harped on what it will take to protect past progress and unlock the next wave of breakthroughs for the world’s children.

A Future Hanging in the Balance 

Standing before more than global leaders at this year’s Goalkeepers event in New York, Bill Gates delivered a message as stark as it was hopeful: the future of millions of children hangs in the balance, and humanity must decide whether to rise to the moment or retreat in the face of crisis.

“Humanity is at a crossroads. With millions of children’s lives on the line, global leaders have a once-in-a-generation chance to do something extraordinary,” Gates said, his words echoing through the packed hall. “The choices they make now—whether to go forward with proposed steep cuts to health aid or to give the world’s children the chance they deserve to live a healthy life—will determine what kind of future we leave the next generation.”

A Funding Crisis 

Since 2000, global cooperation has halved child mortality—from 10 million deaths each year to fewer than five million. Vaccines, primary health care, and targeted investments in HIV, tuberculosis, and malaria turned what once seemed impossible into one of humanity’s greatest achievements.

Now, that progress is in jeopardy. According to the Institute for Health Metrics and Evaluation (IHME), global development assistance for health (DAH) fell by 21 per cent between 2024 and 2025, plunging to its lowest point in 15 years. The decline reflects donor nations tightening budgets amid domestic challenges, high debt burdens, and ageing populations.

“If these cuts hold, we could see decades of progress unravel,” Gates warned. “What’s happening to the health of the world’s children is worse than most people realize, but our long-term prospects are better than most people can imagine.”

With key funding decisions looming before the end of the year, Gates pressed leaders to consider the stakes. “An entire generation is alive today thanks to the world’s generosity, smart investments, and the hard work of governments and Global Fund partners. Now, we must go further so the next generation grows up in a world where no child dies from preventable causes.”

A New Pledge

At the heart of his appeal was a significant financial commitment. The Gates Foundation announced a pledge of $912 million to the Global Fund’s 2026–2028 replenishment cycle. Since its creation in 2002, the Global Fund has saved more than 70 million lives and reduced deaths from AIDS, TB, and malaria by over 60%. Every dollar invested, studies show, generates an estimated $19 in health and economic returns.

“This is one of the most effective lifesaving initiatives of the 21st century,” Gates noted. “But it needs strong backing. Governments, philanthropists, and the private sector must step forward in these next weeks and months. Millions of lives depend on it.”

The foundation’s latest pledge brings its total commitment to the Global Fund to nearly $5 billion, making it one of its largest single investments. The replenishment drive, co-hosted by South Africa and the United Kingdom, is widely seen as a litmus test for whether global leaders still have the political will to prioritise health in an era of rising nationalism and tightening budgets.

The Roadmap to a Healthier Future

“We have a roadmap for saving millions of children and making some of the deadliest childhood diseases history by 2045,” Gates asserted. “I’m urging world leaders to invest in the health of all people, especially children, to deliver this future.”

Results from work by the Gates Foundation and the IHME indicate that sustaining global investments in child health and scaling lifesaving innovations could cut child deaths in half again over the next 20 years. 

While the funding crisis loomed large, Gates and his foundation were equally focused on solutions. Alongside the IHME, the Gates Foundation has mapped out a vision for halving child deaths again by 2045. Achieving this, Gates argued, requires a combination of sustained investment in proven tools and bold bets on new science.

The roadmap centres on three pillars: Strengthening proven initiatives such as the Global Fund and Gavi, the Vaccine Alliance, ensuring countries can access vaccines, medicines, and treatments while building towards sustainability and self-reliance. 

The second roadmap was on Prioritising primary health care systems that detect and treat childhood illnesses early, even when budgets are strained; and finally,Scaling breakthrough innovations, from new malaria-fighting technologies that block parasites in mosquitoes to single-dose treatments, long-acting HIV prevention drugs, maternal vaccines against RSV and GBS, and the use of artificial intelligence to deliver cost-effective care more efficiently.

Honouring Champions of Change

Even amid the warnings, Goalkeepers 2025 was also a celebration of those pushing the boundaries of what’s possible. Spain’s Prime Minister, Pedro Sánchez, received the prestigious Global Goalkeeper Award for expanding Spain’s contributions to global health initiatives, including a 12% increase to the Global Fund and a 30% increase to Gavi.

The foundation also recognised 10 Goalkeepers Champions, from India’s pioneering community health doctors Abhay and Rani Bang, to Nigerian actress Osas Ighodaro, who is driving awareness around malaria, and global advocates like David Beckham, Toni Garrn, and John Green. Each honouree embodied the event’s theme: “We Can’t Stop at Almost.”

“Every year, Goalkeepers unites changemakers to inspire and push one another forward,” said Dawda Jobarteh, deputy director of the Goalkeepers campaign. “Together, we can reimagine a future without preventable child deaths and unlock the next wave of breakthroughs for the world’s children.”

Indeed, We Can’t Stop at Almost 

One key point that resonated throughout was the theme “We Can’t Stop at Almost” and this was constantly re-echoed by both hosts- singer, songwriter, and composer Jon Batiste, who returned as musical curator for the second year with the PS22 elementary school choir, and actress and director Olivia Wilde. Together, they urged the audience to remember that while the world has made progress, “we can’t stop at almost,” which was the event’s theme.

Community champions, scientists, health workers, faith leaders, and activists from Bangladesh, Indonesia, Kenya, Madagascar, Nigeria, Senegal, South Africa, Uganda, and the United States shared powerful stories of resilience and innovation. Several showcased breakthrough technologies already saving lives and moving the world closer to eradicating deadly diseases.

“Every year, Goalkeepers unites changemakers to inspire and push one another forward,” said Dawda Jobarteh, deputy director of the foundation’s Goalkeepers campaign. “Together, we can reimagine a future without preventable child deaths and unlock the next wave of breakthroughs for the world’s children.”

Event session presenters included Rick Warren, pastor and author; El Hadji Mansour Sy, co-president of World Council of Religions for Peace; Ingrid Silva, ballet dancer and activist; Krista Tippett, journalist and author; Latif Nasser, co-host of “Radiolab”; and Budi Gunadi Sadikin, Indonesia’s minister of health.

The event pulsed with energy beyond the speeches as Breakthrough technologies already saving lives in places like Kenya, Indonesia, and Nigeria were showcased alongside deeply personal stories of resilience and innovation while the faith leaders, artists, and health ministers joined forces on stage, underscoring the idea that saving children’s lives is not merely a health agenda but a moral imperative.

Looking Ahead

The momentum will continue in December, when Goalkeepers expands to the Middle East for the first time with a gathering in Abu Dhabi. Before then, the foundation will release its 2025 Goalkeepers Report, offering detailed projections on how current funding choices could alter the trajectory of child survival for decades.

For Gates, the urgency is personal. Earlier this year, he announced that he would give away virtually all his wealth to the foundation, which plans to spend $200 billion over the next 20 years before winding down operations. Its mission for those two decades is clear: end preventable deaths of mothers and babies, eliminate deadly infectious diseases, and lift millions out of poverty.

“The future depends on what we do now,” Gates said. “We can choose to let progress stall, or we can choose to make history again—this time by ensuring every child, everywhere, has the chance to live a healthy life.”

Crossroad for Humanity 

As the applause rose and the event closed, the stakes of Gates’ message lingered. The world is at a crossroads: one path leads to retreat, budget cuts, and lost lives; the other to innovation, solidarity, and the possibility of eradicating diseases that have plagued humanity for centuries.

The question is not whether the world can afford to act, but whether it can afford not to. Indeed, we can’t stop at almost.