• Health
  • global health

Bill and Melinda Gates: President Trump’s Policies Could Endanger Global Aid

3 minute read

Bill and Melinda Gates have warned that the new policies and priorities of President Donald Trump could negatively impact global philanthropy, as they urged Trump and other leaders to continue to prioritize foreign aid.

In interviews ahead of the Tuesday release of their foundation’s annual letter, the Gateses voiced concern about the effects of Trump’s “America First” doctrine and the Mexico City Policy, which Trump reinstated last month.

“We’re concerned that this shift could impact millions of women and girls around the world,” Melinda Gates said in an interview with the Guardian, about the Mexico City Policy. “It’s likely to have a negative effect on a broad range of health programs that provide lifesaving treatment and prevention options to those most in need.”

The Mexico City Policy prohibits the allocation of U.S. foreign aid to any nongovernmental organization abroad that discusses abortion as a family-planning option.

Bill Gates told the Guardian that the expansion of the policy “could create a void that even a foundation like ours can’t fill.” In an interview with USA Today, he also said Trump’s “America First” policy could mean a shift away from prioritizing African stability and American leadership on African issues.

“With this new crowd, and with some of things they want to do fiscally, it just means we’re going to have to tell the story of how amazing this work is,” he said.

Among the achievements cited in their letter, the Gateses said 86% of children worldwide now receive basic vaccines — the highest percentage in history. More than 300 million women in developing countries now use modern methods of contraception — also a first in history. And they predict that polio could finally be eradicated this year.

The couple addressed their 2017 letter to Warren Buffett, who in 2006 donated $30 billion to the foundation — a donation so large that, to quote Bill and Melinda Gates, “it was the biggest single gift anyone ever gave anybody for anything.”

Throughout their letter, the Gateses repeatedly reference Buffett’s love of a good deal.

“Saving children’s lives is the best deal in philanthropy,” they said. “And if you want to know the best deal within the deal — it’s vaccines.”

It’s a line that could function as an appeal to another businessman who famously prides himself on making deals. While Trump has said he is “pro-vaccine,” he has also spread the scientifically debunked claim that vaccinations are linked to autism.

Both Melinda and Bill Gates have said they plan to work with Trump on issues that matter to them, including climate change and foreign aid. And in their letter, they voiced optimism about the state of the world.

“A lot of people feel the world is getting more fragmented, and we all can point to examples of that,” Melinda Gates said in the letter. “But if you look along a timeline, the periods of fragmentation often come when society is digesting its new diversity.”

More Must-Reads from TIME

Write to Katie Reilly at Katie.Reilly@time.com