On Dec. 27, Bill Gates, the billionaire philanthropist, made a trip to Mar-a-Lago for dinner with Donald J. Trump. Some people around him were surprised that he had decided to go, but Mr. Gates wants to talk to whoever will listen.
The dinner lasted three hours, and Mr. Trump seemed to enjoy himself, a person close to him said. They talked about polio — an interest of both men — and Mr. Gates left the meeting “frankly impressed” by the incoming president’s interest in global health.
Or so he told The Wall Street Journal. His comments, which he reiterated to some friends, did not age well. Less than a month after the Mar-a-Lago dinner, Mr. Trump was inaugurated and immediately went to work tearing down the global health infrastructure that undergirds the work of Mr. Gates’s foundation.
Next week, the Gates Foundation, marking its 25th anniversary, plans to celebrate its achievements, including helping to cut global child mortality in half since 2000. At what should be a moment of self-congratulation, however, the foundation, which gives away $9 billion each year, is facing grave threats to both its work and its future.
Two days after Mr. Trump froze all U.S. foreign assistance, Elon Musk began to dismantle the United States Agency for International Development, which delivers aid around the world — including vaccines, treatments and technologies created in labs bankrolled by the Gates Foundation.
At the same time, the Trump administration has been on a campaign of retribution against institutions — universities, big law firms — that it perceives as too liberal. Philanthropies have been on edge, assuming they will be the next target of his ire. They are concerned that the president will use his law enforcement agencies to paralyze charitable institutions through investigations. And they fear a challenge to their tax-exempt status — a threat that Mr. Trump made explicitly against Harvard University when it refused to bend to his demands.
At the risk-averse Gates Foundation, officials have asked aides to put next to nothing in emails or other written materials, especially anything that Trump officials could take out of context. Some employees have locked down public social media accounts and shifted much of their work to Telegram or Signal, encrypted messaging apps. (Alex Reid, a spokeswoman for the foundation, said employees had always been encouraged to be careful about communications.)
The cautious partnership that Mr. Gates tried to initiate at Mar-a-Lago flamed out, but he has continued to make his case. He has met with the White House chief of staff, several cabinet secretaries, the National Security Council and members of Congress.
“It’s a very wide tent of champions that we are trying to enlist,” Mark Suzman, the foundation’s chief executive, said in an interview.
Mr. Gates hoped to find an ally in Secretary of State Marco Rubio, a vocal champion of efforts to fight malaria and child poverty in the past. But Mr. Rubio, who oversees foreign assistance, has declined to meet or speak with Mr. Gates since the election, the foundation said.
This article is based on interviews with two dozen friends and advisers of Mr. Gates, current and former Gates Foundation employees and their associates, and foundation grant recipients, most of whom spoke on the condition of anonymity to discuss a powerful foundation.
The changes in Washington’s approach have left Mr. Gates at sea, say current foundation employees and others who have talked with him. People who know him describe Mr. Gates as data-driven, sometimes to a fault, and they say he has struggled to align the apparent new rules of the game with the way he sees the world.
“In my experience, Bill is a rational thinker who wants to optimize for lives saved, so this chaotic world where people are acting off of spitefulness and vengeance is at odds with that,” said Orin Levine, a former director of vaccine delivery at the foundation. “To be shellshocked and in this completely foreign environment is a double whammy.”
Harsh Blows and a Muted Response
The foundation, which is based in Seattle, was started by Mr. Gates and his former wife, Melinda French Gates. They divorced in 2021, but ran the foundation together until 2024. The nation’s biggest philanthropy, it has a $75 billion endowment. It employs more than 2,000 people and has offices around the developing world that can rival the power of the governments where they operate.
As big as it is, it can’t operate on its own. It doesn’t deliver services directly, but funds the development of strategies and technologies and then works with governments, aid agencies and the private sector to disseminate them.
The dismantling of U.S.A.I.D. was the first gut punch, but not the last. Deep cuts at the Centers for Disease Control and Prevention and at the National Institutes of Health followed. Both were major funders of global health. Most of the architecture of U.S.-funded global health care has been either radically diminished or destroyed.
Programs that have been Mr. Gates’s priorities for decades were wiped out: vaccine research for malaria; deliveries of therapeutic food packets developed by the foundation to malnourished children; and African programs to deliver H.I.V. prevention technologies that the foundation helped invent.
One particularly harsh blow was the Trump administration’s decision to end support for Gavi, an organization that helps the poorest countries buy childhood immunizations. Mr. Gates was Gavi’s co-creator, and at times his foundation has been its largest funder.
The news that the United States might withdraw from Gavi produced the foundation’s most pointed response since the Trump administration began cutting foreign aid. On X, Mr. Suzman, the chief executive, said he was “deeply disturbed” by the news, “if true.” The wording of that post, which went on to suggest the dire consequences of cuts, was debated intensely beforehand by advisers, according to a person who was involved.
The foundation has always been measured in its public statements, but it has labored to be as politically neutral as possible since Mr. Trump won the election, people close to it say. Some employees and allies have expressed frustration that Mr. Gates and the organization that leads much of the world’s global health work have been muted in their response to what the employees see as a catastrophic level of cuts. Other than the post on X, Mr. Suzman has made a few careful statements related to Trump administration actions, such as the value of the World Health Organization and reproductive health care.
Haters in the White House
For people now in Trump’s inner circle, the Gates Foundation has been a popular punching bag. When Vice President JD Vance was running for the Senate in 2021, he called the Gates Foundation, the Ford Foundation and the Harvard endowment “cancers on American society” because they received tax-exempt status to fund what he said was “radical left-wing ideology.” Stephen Miller, Mr. Trump’s powerful policy adviser, has attacked the foundation’s focus on racial equity and funding “the most hateful, toxic and Marxist ideologies.”
And then there is Mr. Musk. The richest man in the world, he once signed the Giving Pledge, a Gates-operated philanthropic commitment. Now he taunts Mr. Gates on X, and has called his climate philanthropy hypocritical because he believes Mr. Gates has shorted the stock of Tesla, the electric automaker that Mr. Musk runs.
As head of such a large and influential foundation, Mr. Gates is greeted around the world as a head of state might be, and has held himself out as assiduously nonpolitical. That changed in 2024 when he made a $50 million donation to support Kamala Harris’s presidential campaign.
After Mr. Trump was elected, Mr. Gates set out to make amends. In private conversations, according to a person who has heard him, Mr. Trump has name-checked Mr. Gates when he recalls the tech billionaires who used to despise him and now, as Mr. Trump says, want to be his friend.
Still, the administration has monitored and been briefed on the Gates Foundation’s ties to a liberal donor network called Arabella Advisors, a person close to the White House said.
Mr. Suzman has told friends that he believes the Trump administration would target the foundation in various ways, primarily by stripping its tax-exempt status, two people who have spoken with him said.
The foundation’s work, Mr. Suzman said in an interview, is nonpartisan. “What we work on — saving kids from preventable deaths, trying to halt infectious diseases, providing opportunities for the poorest and most vulnerable — is the absolute core of what charitable status exists to provide for,” he said.
Federal law bars the president from using the Internal Revenue Service to punish his enemies, but outside conservative groups are testing the waters. Edward Blum, who has made a career of challenging affirmative action, filed a complaint with the I.R.S. against the Gates Foundation. He claimed that a fellowship program for students of color amounted to “invidious racial discrimination” that made the foundation “ineligible for tax-exempt status.”
In fact, the foundation had changed the fellowship admissions policy months earlier, Ms. Reid, the spokeswoman, said.
But the foundation did not make the change public until it was asked for comment on an opinion piece by Mr. Blum that The Wall Street Journal had published. The way it came out looked like caving, and was portrayed that way in right-wing media.
Philanthropy leaders are also nervous about an executive order in January that directed the attorney general to identify institutions, including “foundations with assets of $500 million or more” that could be investigated for their diversity, equity and inclusion programs.
The Gates Foundation, like other corporations and institutions, has taken steps to de-emphasize its D.E.I. work. It laid off several members of its diversity team and retired the title of chief diversity, equity and inclusion officer. In a public appearance in February, Mr. Gates said D.E.I. initiatives had sometimes “gone too far.”
A Failure of Imagination
The potential consequences of a significant disruption of the foundation’s work are immense — with the United States withdrawing from the World Health Organization, for example, the foundation is now the body’s largest funder. Hundreds of scientists, aid groups and government ministers have turned to the foundation with panicked requests for help to preserve research and programs since the disruptions began in January. It is increasingly viewed as the last actor with both the resources and commitment to help.
Mr. Suzman said the foundation’s priority advocacy effort was preservation of U.S. funding for Gavi and for the Global Fund to Fight AIDS, Tuberculosis and Malaria, a major organization funded by governments, philanthropies and the private sector. He also said the foundation had committed an initial $30 million for countries in Africa and Asia for efforts to assess the holes left by the U.S.A.I.D. cuts and to plan to restructure essential services.
But Mr. Suzman acknowledged that the foundation would have to adapt, now that the world’s largest aid agency had been gutted and other high-income nations were also reducing aid.
In planning sessions around the election, foundation leaders tossed out various ways that Mr. Trump could change global aid. When the idea of a gutted U.S.A.I.D. was suggested, it was dismissed as too sensational, two people with knowledge of those sessions said. Instead, the foundation’s planning focused on a U.S. withdrawal from the W.H.O. and a slashing of support for contraception and other reproductive health care.
Mr. Suzman said the foundation had tried to anticipate what the new government might bring, but did not foresee the scale of the change. A senior strategist for the foundation confessed to a former colleague that they had a failure of imagination.
At a TED conference this month in Vancouver, British Columbia, Mr. Gates’s foundation passed out lapel buttons emblazoned with a buzzword of his philanthropy. But it is one that feels discordant with the landscape the foundation faces: “Optimistic.”