Aid cuts could cause 22 million avoidable deaths, study warns

Cuts to international aid could result in more than 22 million preventable deaths by 2030, including 5.4 million children under the age of five, according to the most comprehensive modelling study to date.

The research, published in The Lancet Global Health, warns that decades of progress in reducing deaths from infectious diseases in low- and middle-income countries is at risk of being reversed due to abrupt reductions in aid budgets by major donor nations, including the United States and the United Kingdom, The Guardian writes. 

Over the past 20 years, international aid has driven dramatic declines in child mortality, particularly from infectious diseases. However, researchers say recent and proposed funding cuts threaten to undermine those gains.

The study analysed data from 2002 to 2021, examining the relationship between official development assistance (ODA) received by countries and their mortality rates. Using this data, researchers modelled three future scenarios: a “business-as-usual” scenario, a “mild defunding” scenario reflecting recent aid reductions, and a “severe defunding” scenario in which aid falls to around half of 2025 levels and remains there through the end of the decade.

Under the severe defunding scenario, researchers projected an additional 22.6 million deaths globally by 2030, including 5.4 million among children under five. Under mild defunding, the study forecast 9.4 million excess deaths, including 2.5 million young children.

That mild scenario was “not unlikely”, based on current trends, said lead author Prof Davide Rasella of the Barcelona Institute for Global Health (ISGlobal), while the “more drastic” scenario fitted with policies outlined by rightwing political parties in the ascendance in many countries. Reform UK has suggested cutting Britain’s aid budget by a further 90%.

Several major donor countries have already announced significant reductions. The United States cut aid spending by more than half in 2025, from $68bn to $32bn. In the UK, aid spending is set to fall from 0.5% to 0.3% of GDP by 2028—around £6bn less—partly to fund increased military expenditure. Germany, Sweden and other traditional donors have also announced cuts.

The researchers found that overseas aid has previously been associated with a 39% reduction in deaths among under-fives, with particularly strong effects on mortality from infectious diseases such as HIV/Aids and malaria, as well as deaths linked to nutritional deficiencies.

“Unfortunately nobody knows at this stage what is going to happen in the future, especially in foreign aid and assistance,” said Rasella.

Previous research on aid reductions has largely focused on specific US-funded programmes, a limited number of recipient countries, or shorter time periods, the authors noted.

“Previous studies on cuts have focused on ‘US-funded programmes, a smaller number of recipient countries, or analysed a shorter timeframe, leaving the effects of overall ODA [official development assistance] on global mortality and its projections less understood’, the researchers said.”

“As a scientist, we try to provide evidence,” said Rasella. “The problem was that there was very small evidence.”

Rasella warned that recipient countries would not be able to compensate for the loss of aid through domestic funding alone, increasing the risk of health system collapse.

“Reallocation of recipient countries’ domestic resources ‘will never match the level of assistance we have been seeing’, he said, while ‘a collapse of some health systems’ was a likely scenario.”

He described witnessing the effects firsthand during visits to low-income countries.

“Rasella said he had visited doctors in rural Mozambique. ‘They were telling me they had no antibiotics any more for children, because all the stock was distributed by USAID,’ he said. ‘They have dismantled 300 primary care units in Afghanistan because they were also maintained by USAID. The situation is evolving, and now in many countries things are chaotic.’”

Eric Pelofsky, vice-president of the Rockefeller Foundation, which helped fund the research, said the funding gaps created by government cuts were too large for philanthropic organisations to fill.

“Eric Pelofsky, vice-president of the Rockefeller Foundation, which helped fund the research, said the chasm of funding gaps were ‘too huge for any non-government to take on’ and so philanthropic organisations were focused on both finding new innovations and ‘focusing the mind of decision-makers on the actual problem’.”

Pelofsky said foreign aid spending could be politically difficult for leaders to justify domestically.

“But I think what this report says is there is a genuinely concrete reality to these decisions, that’s consequential to global stability, consequential to our moral and political leadership in the world.”

In the UK, aid groups say the impact of funding cuts is already being felt on the ground.

Gideon Rabinowitz, director of policy and advocacy at Bond, the UK network of NGOs, said programmes addressing HIV, reproductive healthcare and female genital mutilation had already been closed due to reduced funding.

“The evidence is clear,” he said. “ODA funding is one of the most long-term, cost-effective public investments governments can make. It also contributes to making both the UK, and the world, a safer and healthier place for us all – by strengthening global health systems, preventing future pandemics and stopping diseases before they spread. We urge the UK and other governments to heed this evidence, reconsider these cuts and recognise that their choices are costing lives.”

By Sabina Mammadli