International aid: US budget cuts could cause 14 million deaths

The collapse of US funding for international aid, decided by the Donald Trump administration, could lead to more than 14 million additional deaths by 2030 among the most vulnerable, a third of them children, according to a projection published this Tuesday, July ^1, in The Lancet.

For many low- and middle-income countries, the resulting shock would be comparable in magnitude to a global pandemic or major armed conflict."

"They risk abruptly interrupting, or even reversing, two decades of progress in the health of vulnerable populations. For many low- and middle-income countries, the resulting shock would be of a magnitude comparable to that of a global pandemic or a major armed conflict," commented Davide Rasella, co-author of the study and researcher at the Barcelona Institute for Global Health, quoted in a press release.

The publication of this study in the prestigious medical journal coincides with a conference on development financing in Spain bringing together world leaders, with the United States among those absent. This meeting is taking place in a particularly bleak context for development aid, which has been hit hard by the massive funding cuts implemented by Donald Trump since his return to the White House in January.

A chilling assessment

Examining data from 133 countries, the international team of researchers retrospectively estimated that USAID-funded programs prevented 91 million deaths in low- and middle-income countries between 2001 and 2021. According to their modeling, the 83% cut in US funding—a figure announced by the government in early 2025—could lead to more than 14 million additional deaths by 2030, including more than 4.5 million children under the age of five, or about 700,000 additional child deaths per year. USAID-supported programs were linked to a 15% decrease in deaths from all causes, these researchers calculated. For children under 5, the decline in deaths was twice as large (32%).

The greatest impact of this aid was observed for preventable diseases. Mortality from HIV/AIDS was reduced by 74%, malaria by 53%, and neglected tropical diseases by 51% in countries receiving the highest level of aid compared to those with little or no USAID funding, according to the study.

Cutting this funding not only puts lives at risk, it also damages critical infrastructure that took decades to build.”

Francisco Saute, of the Manhica Health Research Center in Mozambique and a co-author of the study, reported seeing firsthand how USAID was helping to fight HIV, malaria, and tuberculosis. “Cutting this funding not only puts lives at risk, it also undermines critical infrastructure that took decades to build,” he said. According to a recently updated tracking tool by Brooke Nichols, a disease modeler at Boston University, nearly 108,000 adults and more than 224,000 children have already died as a result of US aid cuts. That’s 88 deaths per hour, according to the dashboard.

A disastrous domino effect

Other major international donors, mainly European, such as Germany, Great Britain, and France, have announced cuts to their foreign aid budgets in the wake of the United States. This risks "leading to even more deaths in the years to come," warned Caterina Monti, another co-author of the study and a researcher at ISGlobal.

Some fifty heads of state and government—including French President Emmanuel Macron and European Commission President Ursula von der Leyen—are participating in the four-day Financing for Development Conference in Seville, alongside 4,000 civil society representatives. "This is the time to increase, not reduce," aid, Davide Rasella argued.

I think most people would support continued funding for USAID if they knew how effective such a small contribution can be in saving millions of lives."