Bill Gates risked sparking a fresh row with fellow billionaire Elon Musk as he accused him of ‘killing the world’s poorest children’ by closing a major US aid agency.

Musk, who heads up Donald Trump’s Department of Government Efficiency (DOGE), effectively shut down the US Agency for International Development (USAID) in February, saying it was ‘time to die’.

But the Microsoft co-founder, who is ramping up his own philanthropic efforts, has now said Musk’s decision could spell disaster for the world’s most destitute.

‘The picture of the world’s richest man killing the world’s poorest children is not a pretty one,’ Gates told the Financial Times. 

He said the deep cuts to USAID meant desperately needed food and medicines were expiring in warehouses instead of being distributed to those who need it.

Slashing this assistance could lead to a resurgence of diseases such as measles, HIV and polio, he added.

He specifically highlighted cancelled grants to a hospital in Gaza Province in Mozambique that works to prevent women transmitting HIV to their babies.

At the time, Musk was challenged about a White House claim, which he repeated, that it had stopped $50million – equivalent to £40.2million – worth of condoms being sent to the Gaza Strip, confusing it with the Gaza Province in the East African nation.

Musk appeared to concede that could be the case, and responded: ‘I’m not sure we should be sending $50million dollars on condoms anywhere… if it went to Mozambique instead of Gaza, I’m like, OK that’s not as bad, but still you know why are we doing that?’

Gates responded: ‘I’d love for him to go in and meet the children that have now been infected with HIV because he cut that money.’ 

He added that Musk, who branded USAID a ‘criminal organisation’, had no knowledge of what the agency actually did or how it operated. 

It follows comments in February where Gates said ‘USAID plays a super important role’, adding: ‘It’s work that saves millions of lives and helps strengthen relationships for the United States.’

In a thinly veiled swipe at Musk, Gates told CNN that while reviewing the efficiency of each government department wasn’t a ‘mistake’, the idea of ‘going in very quickly and saying that all these people run a criminal organization—that’s not quite as subtle as you’d hope to see.’

This is not the first time that the pair have clashed over aid and philanthropy, however.

In 2012, Musk signed the Giving Pledge, launched by Bill and Melinda Gates and investor Warren Buffett, through which dozens of billionaires promised to give away at least half their wealth. 

Acording to Musk’s biographer, however, he later told Gates that philanthropy was mostly ‘bulls*it’ and that commercial solutions to problems like climate change – like Tesla’s efforts – were more effective.

Musk was also reportedly fustrated that Gates shorted Tesla stock – meaning he would profit when the share price falls – in 2022.

He told him: ‘I cannot take your philanthropy on climate change seriously when you have a massive short position against Tesla, the company doing the most to solve climate change.’

The duo have also clashed on other matters.

In 2023, Gates questioned whether Musk’s goal of colonising Mars was a good use of his money. 

‘It’s actually quite expensive to go to Mars,’ he told the BBC. 

‘You can buy measles vaccines and save lives for a thousand dollars per life saved.’ 

He has also branded Musk’s promotion of right-wing foreign politicians as ‘insane’. The Trump ally has endorsed former Reform UK MP Rupert Lowe amongst others.

‘It’s really insane that he [Musk] can destabilise the political situations in countries ,’ he said in January.

‘I think in the US, foreigners aren’t allowed to give money; other countries maybe should adopt safeguards to make sure super-rich foreigners aren’t distorting their elections.’