The exclusion comes amid heightened scrutiny of the Gates Foundation's past associations with Jeffrey Epstein, the convicted sex offender who died in 2019. The Susan Thompson Buffett Foundation, based in Omaha, has long focused on reproductive health, education and other causes. For the Gates Foundation, the loss of Buffett's regular midyear contribution represents a notable change in funding flow after two decades of support. For the first time in 20 years, none of the midyear allocation is going to the Gates Foundation. The exclusion of the Gates Foundation from this year's list stands as the most visible marker of that transition to date.