Severe cuts to overseas aid budgets could result in 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, described as the most comprehensive to date, warns that recent progress in reducing child mortality from infectious diseases is at risk of being reversed.
Researchers analysed the relationship between aid received and death rates in developing countries from 2002 to 2021, then forecast three scenarios. Under a 'severe defunding' scenario, where aid falls to roughly half its 2025 levels, an estimated 22.6 million excess deaths would occur by 2030. A milder reduction, aligned with recent trends, would still lead to 9.4 million excess deaths, including 2.5 million among under-fives.
The study's lead author, Prof Davide Rasella of the Barcelona Institute for Global Health (ISGlobal), said the milder scenario was 'not unlikely' given current trends, while the more drastic one matched policies advocated by right-wing parties in several countries. Reform UK has suggested cutting Britain's aid budget by a further 90 percent. The United States has already slashed aid spending from $68 billion to $32 billion in 2025, while the UK's spending is set to fall from 0.5 percent to 0.3 percent of GDP by 2028, a reduction of about £6 billion.
The researchers found that overseas aid has previously been linked to a 39 percent reduction in under-five deaths, with particularly strong effects on mortality from HIV/Aids, malaria and nutritional deficiencies. Rasella noted that domestic resources in recipient countries would 'never match' the level of assistance, and warned of a potential collapse of some health systems. He cited examples from his visits, including doctors in rural Mozambique lacking antibiotics for children because USAID stock had been exhausted, and 300 primary care units being dismantled in Afghanistan after USAID support ended.
Eric Pelofsky, vice-president of the Rockefeller Foundation, which helped fund the research, said the funding gaps were 'too huge for any non-government to take on'. He argued the report demonstrated a 'genuinely concrete reality' to aid decisions, with consequences for global stability and moral leadership. Gideon Rabinowitz, director of policy and advocacy at Bond, the UK network of NGOs, said the impact of cuts was already visible through closures of programmes addressing HIV, reproductive healthcare and female genital mutilation. He described ODA funding as 'one of the most long-term, cost-effective public investments governments can make'.
