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'Aid cuts could trigger 22.6 million preventable deaths in low and middle income countries by 2030'

Lancet study reveals major donor countries' funding reductions threaten to reverse decades of global health progress

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Preliminary projections indicate substantial additional reductions from major donor countries

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Highlights

  • Landmark research finds humanitarian aid cuts from wealthy nations could cause up to 22.6 m preventable deaths in low and middle-income countries by 2030
  • Five major donors—the US, Germany, France, Japan, and the UK provided 70 per cent of 2023's USD 250 bn development assistance.
  • 2024 marked the first reduction in development aid in nearly three decades.
Cuts to development assistance from high-income nations could prove "catastrophic" for global health, according to research published in The Lancet Global Health journal.
The study estimates up to 22.6 m preventable deaths in Low and Middle-Income Countries (LMICs) by 2030 if current funding reductions continue.

The analysis, conducted by researchers including those from Barcelona Institute for Global Health in Spain, examined Official Development Assistance (ODA)—humanitarian and development aid from wealthy nations.

In 2023, total ODA exceeded USD 250 bn, with the United States, Germany, France, Japan, and the United Kingdom contributing approximately 70 per cent.


However, 2024 represented a significant turning point. For the first time in nearly three decades, major donors except Japan reduced their contributions, with further cuts planned for 2025 and beyond.

Preliminary projections indicate substantial additional reductions from major donor countries, estimated at an overall decline exceeding 11 per cent from 2025 to 2026.

Mortality impact projected

The research demonstrates that higher funding levels correlate with a 23 per cent reduction in all-cause mortality and 39 per cent decrease in deaths among children under five.

Development assistance has particularly impacted major communicable diseases, with large declines in death rates from HIV/AIDS, malaria, and neglected tropical diseases, alongside significant reductions in tuberculosis, diarrhoeal diseases, and maternal-perinatal causes.

"Official Development Assistance funding has played a decisive role in reducing preventable mortality across LMICs over the past two decades, and the abrupt withdrawal of this support threatens to cause millions of avoidable deaths, reversing decades of progress in global health," the authors wrote.

The study examined two scenarios. Under severe defunding implementing the projected 15.8 per cent reduction for 2025, the analysis forecasts 22.6 m additional deaths across all ages, including 5.4 m children under five, by 2030.

Even under mild defunding, where current trends continue, projected excess deaths reach 9.4 m across all ages and 2.5 m among children under five.

The researchers previously published findings in July 2025 showing that dismantling the United States Agency for International Development (USAID) the world's largest humanitarian and development funding agency could cause 14 m preventable deaths worldwide by 2030.

"Sudden and severe reductions in ODA funding could have catastrophic consequences, with a potential global death toll comparable to or even exceeding that of the COVID-19 pandemic," the authors warned.

They added that even modest defunding extending current downward trends would likely cause sharp increases in preventable adult and child mortality, potentially resulting in tens of millions of excess deaths in coming years.

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