Bill Gates accuses Elon Musk of causing "thousands of deaths": it's the latest duel between the two magnates.

Bill Gates and Elon Musk have never gotten along particularly well. They've sometimes tolerated each other and even said positive things about each other, but their clash recurs frequently. This latest exchange goes beyond an exchange between billionaires with opposing views.

Gates was blunt in an interview with the Financial Times : cuts to USAID and health programs promoted by the US and Europe could lead to "millions of deaths." Musk, now a key player in the Trump administration, sees this as a necessary optimization of public spending.

In recent years, Elon Musk's influence has extended beyond technology and business . His entry into government, through the Department of Government Efficiency , has been one of the most controversial moves of Donald Trump's second term.

With a direct, provocative, and often contemptuous style, Musk has become the face of a new movement within the American state apparatus. His motto: "do more with less." Under this logic, he has initiated a reengineering of public spending that has prioritized drastic cuts , especially internationally.

The main victim has been the United States Agency for International Development (USAID) , whose primary function for decades has been to channel humanitarian aid, combat pandemics, develop medical infrastructure, and strengthen health systems in low-income countries. Musk called these functions "unnecessary costs," and he hasn't hesitated to say that USAID was sent "to the wood chipper."

Faced with this scenario, Bill Gates has emerged as one of the most vocal critics . Far from his technological disputes with Musk, this time his warning has an ethical and humanitarian impact that goes beyond the ideological debate.

Gates argues that we are in the midst of a global health emergency , and that the cuts driven by the United States and Europe are halting or even reversing years of progress. According to him, an 80% cut in these programs is not a technical measure: " it's a death sentence for millions of people" who depend on these support networks for access to vaccines, treatments, diagnostics, and prevention.

Their outrage was compounded by Musk's recent statements, such as his false claim that the US was spending $50 billion on condoms for Gaza . A hoax that even Musk had to deny days later, but which had contributed to public misinformation about the use of USAID funds.

In the midst of this debate, Gates has announced his decision to donate virtually his entire fortune over the next 20 years and close the Gates Foundation after completing that process. This decision not only represents a radical shift in his philanthropic strategy, but also a form of protest and resistance against what he considers an irresponsible dismantling of global aid.

Since its creation in 2000, the Gates Foundation has invested more than $100 billion in health, education, and innovation. It has worked with governments, universities, and NGOs to develop vaccines such as the rotavirus vaccine, support rapid malaria diagnostics, and distribute tuberculosis treatments.

In Gates' own words, "If healthcare systems collapse, it's not just people who die there ; we also lose eyes and ears that could detect the next pandemic." It's a logic of global healthcare interdependence that, he says, Musk completely ignores.

Musk hasn't responded to Gates' accusations, at least not directly. However, his track record makes it clear that his approach is centered on efficiency and extreme pragmatism . In his view, agencies like USAID are overpriced, bureaucratic structures that offer no measurable returns to the American taxpayer.

But this vision, based on business metrics, doesn't consider the human value of the services offered by these organizations. Healthcare assistance doesn't always translate into "profits." Nor can it be measured in real time. The impact of vaccinating an entire community against measles, or training rural doctors in early cancer diagnosis, isn't included in traditional financial statements .

Gates and Musk have already had several run-ins. A few years ago, the Microsoft co-founder said of the South African, "I let him explain his thinking about the red planet to me, which is a little strange," he added. "It's this crazy idea that stems from the idea that maybe there's a nuclear war on Earth, and then the people on Mars will survive there and come back and, you know, they'll still be alive after we all die."

Another area where the two clearly have irreconcilable differences is their vision for electric vehicles. Gates apparently lectured Musk about the viability of electric trucks, which Tesla is betting heavily on.

"I showed him the numbers," Gates told Isaacson. "It's an area where I clearly knew something he didn't."

Gates also talks about the anger they felt after he shorted Tesla stock, which angered Musk.

"I apologized to him," Gates said at the time. "Once he found out I had bet against his stock, he was very mean to me, but he's mean to a lot of people, so you can't take it too personally," he maintains.

For his part, Musk resorted to childish tactics. In April 2022, he tweeted a cruel jibe comparing Gates to the "pregnant man" emoji, adding the caption "in case you need to lose your excitement fast."