Western Aid Cuts Could Cause 22.6 Million Preventable Deaths by 2030, New Study Warns

New research warns of catastrophic human cost from simultaneous Western aid cuts

New research submitted to The Lancet Global Health warns that concurrent reductions in development assistance by the United States, the United Kingdom, France and Germany could lead to roughly 22.6 million excess preventable deaths by 2030, including an estimated 5.4 million children under five, if cuts are severe. The study — prepared by teams from Spain, Brazil and Mozambique — is awaiting peer review.

Scope and methodology

The authors base their projections on historical relationships between official development assistance and declines in mortality from preventable causes such as HIV/AIDS, malaria and tuberculosis. To reflect uncertainty about which programs are cut and the possibility of additional shocks (wars, economic downturns, climate disasters), the study reports a central estimate of 22.6 million excess deaths with a plausible range of 16.3 to 29.3 million. A milder defunding scenario would still produce an estimated 9.4 million excess deaths by 2030.

Why simultaneous cuts matter

Co-author Gonzalo Fanjul, policy and development director at the Barcelona Institute for Global Health (ISGlobal), said this is the first time in three decades that France, Germany, the UK and the US are all reducing aid at the same time. While European reductions are smaller than the proposed or enacted US cuts, their combined effect represents a major shock to the global aid architecture.

"When you combine all of them, the blow to the global aid system is extraordinary. It's absolutely unprecedented," Fanjul told AFP.

The researchers stress that beyond the immediate termination of specific projects, cuts would erode the institutional capacities and long-term systems for health and disease control that have been built up over decades of international cooperation.

Political context and responses

The report updates an earlier analysis that focused primarily on sweeping proposals in the United States, including calls by some policymakers to sharply reduce or repurpose foreign assistance and proposals to restructure or scale back agencies such as the U.S. Agency for International Development (USAID). The authors note that some U.S. proposals would have represented dramatic reductions from prior levels of assistance.

Some U.S. lawmakers and officials have defended narrower aid priorities. For example, Senator Marco Rubio and other critics have argued that assistance should align more closely with clearly defined national interests. In congressional testimony, such critics have disputed claims that cuts would translate directly into increased deaths and have characterized parts of the aid sector as an "NGO industrial complex." The study's authors counter that these budgetary choices have real human consequences.

Donor trends and global impact

According to the research, several major European donors have trimmed aid in recent years amid domestic budget pressures and a shift toward higher defense spending following Russia's invasion of Ukraine. Among large donors, Japan's assistance has remained relatively steady over the past two years. The researchers warn that even temporary funding gaps can produce long-lasting damage by dismantling surveillance systems, supply chains, and workforce capacities critical for controlling infectious disease.

Voices from the study

Davide Rasella, the study's principal investigator, contrasted budget choices with other policy priorities, noting that relatively modest political decisions can have outsized human costs. "Policymakers change budgets and they really have no perception how many lives are at stake," he said.

The research was funded by the Rockefeller Foundation and Spain's science ministry. A Rockefeller Foundation spokesperson said the foundation "looks forward to the publication of the peer-reviewed numbers, which will make even clearer the human cost of inaction and the profound opportunity we have to save lives," calling the data "an urgent alarm for the world."

Caveats and next steps

The authors emphasize that their results are projections based on historical data and modeling assumptions. The manuscript has been submitted for peer review, and its estimates depend on how funding reductions unfold, which programs are affected, and whether additional external shocks occur. Policymakers, humanitarian organizations and donor governments will be watching peer review and subsequent analyses closely as they assess the human consequences of budget decisions.

Key figures: Central estimate: 22.6 million excess deaths by 2030 (including 5.4 million children under five). Uncertainty range: 16.3–29.3 million. Milder scenario: 9.4 million excess deaths.