More than 14 million of the world’s most vulnerable people—including one-third who are young children—could face death as a direct result of cuts to US foreign aid under the Trump administration, according to research published on Tuesday.
The study, featured in the prestigious medical journal The Lancet, was released as global leaders and business figures gather in Spain this week for a UN conference aimed at revitalising the struggling international aid sector.
Until January, the US Agency for International Development (USAID) was responsible for over 40 percent of global humanitarian funding. However, after Donald Trump returned to the White House, the agency faced dramatic budget cuts. Elon Musk, once a close advisor to Trump and now the world’s richest man, reportedly bragged about putting USAID “through the woodchipper.”
“These funding reductions risk abruptly halting — and even reversing — two decades of progress in health outcomes for vulnerable populations,” warned Davide Rasella, a co-author of the study and researcher at the Barcelona Institute for Global Health (ISGlobal).
The international team analysed data from 133 countries and estimated that USAID funding had prevented 91 million deaths in developing nations between 2001 and 2021. Using modelling techniques, they projected that an 83 percent reduction in funding — a figure announced by the US government earlier this year — could result in more than 14 million preventable deaths by 2030.
Among these, over 4.5 million would be children under the age of five, equating to around 700,000 child deaths annually. To put this in context, roughly 10 million soldiers lost their lives in World War I.
USAID-supported programmes were linked to a 15 percent decrease in overall mortality, with the reduction for children under five nearly double at 32 percent. The funding was especially effective in preventing deaths from diseases such as HIV/AIDS, malaria, and neglected tropical diseases. The study found a 65 percent lower death rate from HIV/AIDS in countries receiving substantial USAID support compared to those with minimal or no funding.
Following the drastic cuts to USAID, several other major donors, including Germany, the UK, and France, have also announced plans to reduce their foreign aid budgets. These reductions, particularly within the European Union, could cause “even more additional deaths in the coming years,” cautioned Caterina Monti, another ISGlobal researcher involved in the study.
However, the researchers emphasised that these projections are based on current aid commitments and could improve if funding is restored or increased.
This week, dozens of world leaders are convening in Seville, Spain, for the largest aid conference in a decade — though notably, the US government will not be attending.
“Now is the time to scale up, not scale back,” Rasella urged.
Prior to the cuts, USAID accounted for just 0.3 percent of total US federal spending. James Macinko of the University of California, Los Angeles, also noted, “US citizens contribute about 17 cents per day to USAID, roughly $64 per year. Most people would support continued funding if they understood how such a modest amount can save millions of lives.”
