A stark new study published in The Lancet Global Health has issued a grave warning: continued cuts to international aid budgets by donor nations like the United Kingdom and the United States could lead to more than 22 million avoidable deaths by the end of this decade. The comprehensive modelling suggests that 5.4 million of these projected fatalities would be children under the age of five, reversing decades of hard-won progress in global health.
Progress at Risk of Reversal
Researchers analysed the critical link between official development assistance (ODA) and mortality rates across the developing world from 2002 to 2021. Their findings revealed that overseas aid has been directly responsible for a dramatic 39% reduction in deaths among children under five over the past two decades. This progress, particularly in combating infectious diseases like HIV/AIDS and malaria, as well as nutritional deficiencies, is now in serious jeopardy.
"Unfortunately nobody knows at this stage what is going to happen in the future, especially in foreign aid and assistance," said lead author Professor Davide Rasella of the Barcelona Institute for Global Health (ISGlobal). He emphasised that the study aimed to provide concrete evidence where little existed before, moving beyond analyses of single countries or shorter timeframes to understand the global impact.
Three Scenarios, One Dire Trajectory
The research team forecast three potential futures based on current trends in donor funding. A "business-as-usual" scenario was compared against two defunding models. The "mild defunding" scenario, which researchers describe as "not unlikely" based on recent cuts, projects 9.4 million excess deaths by 2030, including 2.5 million young children.
However, the most alarming "severe defunding" scenario—where aid falls to roughly half of its projected 2025 levels—paints a catastrophic picture: approximately 22.6 million additional deaths, with 5.4 million being under-fives. Professor Rasella noted that this drastic scenario aligns with policies being proposed by right-wing political parties gaining influence in several nations.
Real-World Consequences and Political Choices
The modelling is not merely theoretical; its projections are echoed by on-the-ground realities. Aid cuts have already led to the closure of vital clinics, such as one in Kamarak village, Afghanistan, leaving communities isolated from healthcare. In Mozambique, doctors report shortages of essential antibiotics for children, previously supplied by USAID.
"They have dismantled 300 primary care units in Afghanistan because they were also maintained by USAID," Rasella reported after speaking with medical professionals. "The situation is evolving, and now in many countries things are chaotic."
Major donor nations are implementing significant reductions. The United States slashed its aid spending by more than half in 2025, from $68 billion to $32 billion. In the UK, the government plans to reduce spending from 0.5% to 0.3% of GDP by 2028—a cut of about £6 billion—diverting funds towards increased military expenditure. Reform UK has even suggested cutting Britain's aid budget by a further 90%.
A Call for Reconsideration
Gideon Rabinowitz, Director of Policy and Advocacy at Bond, the UK network for NGOs, stated that the impact of these cuts is already being felt, with programmes addressing HIV, reproductive healthcare, and female genital mutilation being shut down.
"The evidence is clear," Rabinowitz asserted. "ODA funding is one of the most long-term, cost-effective public investments governments can make. It also contributes to making both the UK, and the world, a safer and healthier place for us all—by strengthening global health systems, preventing future pandemics and stopping diseases before they spread."
Eric Pelofsky, Vice-President of The Rockefeller Foundation, which helped fund the research, acknowledged the political difficulty of justifying aid spending to taxpayers. However, he stressed the report underscores a "genuinely concrete reality" to these budgetary decisions, with profound consequences for global stability and moral leadership.
The study serves as a powerful, evidence-based plea to policymakers: the choice to cut foreign aid is, unequivocally, a choice that costs lives on a monumental scale. Researchers and advocates urge the UK and other governments to heed this warning and reconsider their current trajectory.
