Sharp reductions in foreign aid budgets by donor countries such as the UK and US could lead to more than 22 million avoidable deaths by 2030, including 5.4 million children under five, according to new modelling published in the Lancet Global Health.
The study, led by the Barcelona Institute for Global Health (ISGlobal), analysed the link between aid received and death rates from 2002 to 2021. Under a 'severe defunding' scenario where aid falls to half its 2025 levels, 22.6 million excess deaths are forecast. A 'mild defunding' scenario, considered 'not unlikely' based on current trends, would result in 9.4 million excess deaths, including 2.5 million young children.
The UK has already cut aid from 0.5% to 0.3% of GDP by 2028, a reduction of about £6 billion, while the US slashed spending from $68 billion to $32 billion in 2025. Reform UK has suggested cutting Britain's aid budget by a further 90%. Other traditional donors including Germany and Sweden have also announced large cuts.
The researchers found that overseas aid has been directly linked to a 39% reduction in under-five deaths, with particularly strong effects on mortality from HIV/AIDS, malaria, and nutritional deficiencies. Lead author Prof Davide Rasella warned that reallocation of domestic resources 'will never match the level of assistance we have been seeing', and a 'collapse of some health systems' is likely.
Gideon Rabinowitz of Bond, the UK network of NGOs, said the impact is already being felt with closures of programmes focused on HIV, reproductive healthcare, and female genital mutilation. He added: 'ODA funding is one of the most long-term, cost-effective public investments governments can make.'
