Aid cuts could lead to millions of deaths by decade’s end, new study finds

A new study published in The Lancet estimates that by the end of the decade, between 9.4 million and 22.6 million people could die as a result of foreign aid cuts by the United States and other Western donors. “The evidence indicates that an abrupt and severe contraction of this funding could have grave repercussions, potentially resulting in a global death toll approaching — or even exceeding — that of the COVID-19 pandemic,” reads the study, which was published Monday and written by researchers from Brazil, Mozambique, and Spain. Drawing on two decades of data from 93 countries, the study models two scenarios: a severe funding contraction that could result in 22.6 million deaths, and a “milder” scenario that would lead to 9.4 million deaths. The latter, explained the study’s coordinator Davide Rasella, is a continuation of the current downward trends, and one that would result in the deaths of 2.5 million children under 5 alone. Even so, the study represents a slightly better picture than the researchers’ initial findings published in July, which found that more than 14 million people could die as a result of cuts to the U.S. Agency for International Development alone by 2030. Today’s study expands on the earlier report, pulling in funding reductions from the United Kingdom, France, Germany, the Netherlands, Belgium, and other donors, while also updating assumptions about U.S. aid cuts. “They announced a reduction of 83% of the programs,” said Rasella, a research professor at the Barcelona Institute for Global Health, or ISGlobal, referring to U.S. Secretary of State Marco Rubio’s assertions about USAID in March 2025. “Things are a little bit volatile, but new estimates seem to say that it is less than a 40% reduction.” Even under the milder scenario, the authors stress that the projected deaths far exceed baseline trends, and amount to a major reversal of gains created over the past 20 years — especially among the poorest countries in the world. And with aid budgets still in flux, funding outcomes beyond 2025 remain highly uncertain. Between 2023 and 2026, the researchers noted that official development assistance in the United States, the United Kingdom, and Germany is estimated to fall by 51.1%, 38.9%, and 36%, respectively. “This isn’t an academic discussion in Washington about what would be best for the world,” said Eric Pelofsky, the vice president of The Rockefeller Foundation, which supported the study. “These are life and death decisions, and I think Davide’s analysis puts the truth to that in a very concrete way.” The more severe funding scenario, according to The Rockefeller Foundation, would result in a death toll roughly the size of Barcelona, Paris, and London — or to put it in another hemisphere, the entire U.S. state of Florida. That includes the deaths of 5.4 million children under the age of 5, the study states. Those projections are echoed by other researchers. Late last year, the Washington-based Center for Global Development think tank estimated that 1.6 million people will die every year as a result of U.S. cuts to health and humanitarian aid, if funding obligations do not change. And at Boston University, global health professor Brooke Nichols found that over 787,000 people have already died from cuts to USAID’s health programs alone. “The important thing in science is when you have other groups, independent groups, converging in their estimates,” said Rasella. “They are not, of course, the same, because the methodology is different, and the number of countries is different, etc. But we are all speaking of several millions of deaths.” The study also delves into the impact of foreign assistance over the years. Higher levels of official development assistance were associated with a 23% drop in mortality among people of all ages, and a nearly 40% reduction in death for children under the age of 5. It was also linked to declines in disease, the study found, with rates at 70% for HIV/AIDS, 56% for malaria, 56% for nutritional deficiencies, and 54% for neglected tropical diseases. “The urgency that Davide is articulating has to bring everybody to the table, and hopefully, in some ways, it may compel governments to reconsider some of their decisions,” said Pelofsky.