Bill and Melinda Gates pose in front of the Elysee Palace before receiving the award of Commander of the Legion of Honor.
Frederic Stevens—Getty Images
By Jamie Ducharme
February 13, 2018
TIME Health
For more, visit TIME Health.

Bill and Melinda Gates used their 10th annual letter to answer tough questions about their work at the Bill and Melinda Gates Foundation — and to defend funding for health work and international aid, just a day after President Donald Trump’s budget proposed slashing resources to these areas.

The Gates Foundation donates billions of dollars to health and humanitarian causes including vaccine delivery, child and maternal health as well as infectious disease prevention. “These efforts save lives,” Bill Gates wrote in the letter, which was published Tuesday. “They also create U.S. jobs. And they make Americans more secure by making poor countries more stable and stopping disease outbreaks before they become pandemics. The world is not a safer place when more people are sick or hungry.”

Gates also mentioned the “severe cuts” proposed by Trump, apparently in reference to the president’s suggested 2019 budget, which was released on Monday. Under the budget — which is still subject to Congressional approval — the Department of State and USAID, the government’s foreign assistance program, would see a $9 billion drop in funding, a 26% decrease from 2017. The budget did, however, earmark funds for fighting HIV/AIDS, tuberculosis and malaria, and to support some family planning initiatives.

The philosophy behind these decisions, according to the budget, is to “encourage and advance partner countries’ self-reliance in order to become tomorrow’s trading and security partners.”

Gates, in his letter, takes a different stance. “If the U.S. cuts back on its investments abroad,” Gates wrote, “people in other countries will die, and Americans will be worse off.”

Before the Gates letter was published, Melina Gates also spoke out against the Trump administration’s “misguided” take on global health and development. “Budgets are a reflection of our priorities,” she wrote in a statement. “When we cut funding for the programs that are keeping women and children alive, it sends a signal to the world that we do not care about their lives or futures.”

She continued along that vein in the Gates Foundation letter.

“The sanctity of each individual, regardless of race, religion, sexual orientation, or gender, is part of our country’s spirit,” she wrote. “The president has a responsibility to set a good example and empower all Americans through his statements and his policies.”

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