Announced by Gates during the annual Nelson Mandela Lecture at the University of Pretoria on Sunday, the commitment significantly boosts the foundation's funding for initiatives on the continent, which has totaled $9 billion over the last fifteen years. In his remarks, Gates noted the progress African countries have made in reducing child mortality, eradicating polio, and fighting malaria and the HIV/AIDS epidemic and pointed to expanded access to contraceptives, the creation of new vaccines that protect children from pneumonia and severe diarrhea, and investments in strong, community-based primary healthcare systems in Malawi, Ethiopia, and Rwanda as additional signs of progress.
Gates warned, however, that the rate of new HIV infections on the continent remains high, especially among youth in sub-Saharan Africa, while millions remain undiagnosed and/or untreated. "If we fail to act, all the hard-earned gains made in HIV in sub-Saharan Africa over the last fifteen years could be reversed," he said, "particularly given that Africa's young people are entering the age when they are most at risk of HIV."
According to the Nelson Mandela Foundation, two-thirds of the $5 billion would support health initiatives, with the remainder earmarked for efforts to improve agriculture, digital financial inclusion, and sanitation.
"We continue to spend the majority of our money on health-related issues, so [on] tuberculosis, HIV, diarrhea, pneumonia — all the things that affect kids under the age of five," Gates said at a press conference after the lecture. "Malnutrition is a huge area of increased investment for us, and how people run healthcare facilities."