More than 14 million of the world’s most vulnerable people, including over 4.5 million children under five, could die by 2030 due to the abrogation of United States foreign aid under President Donald Trump’s administration, a new study published on Tuesday in ‘The Lancet’ has warned.
The alarming projection came as global leaders and development experts gather in Seville, Spain, this week for the largest aid conference in a decade, hoping to revive a sector battered by funding cuts and donor fatigue.
The U.S. Agency for International Development (USAID) had previously provided more than 40 per cent of global humanitarian assistance.
However, following Trump’s return to the White House in January, foreign aid faced drastic cutbacks.
Within weeks, Trump’s then-senior advisor and billionaire entrepreneur Elon Musk reportedly claimed he had put USAID “through the woodchipper.”
The study’s authors, an international team of researchers led by Davide Rasella of the Barcelona Institute for Global Health (ISGlobal), warned that slashing aid by 83 per cent, as announced earlier this year, would reverse two decades of health progress in low-and middle-income countries.
“For many of these nations, the shock would be on the scale of a global pandemic or major war,” Rasella said in a statement.
Analysing data from 133 countries, the study estimated that U.S. foreign aid helped to prevent 91.8 million deaths between 2001 and 2021, more than the total death toll from World War II.
Among children under five, mortality dropped by 32 per cent in aid-supported regions. Overall, countries receiving substantial USAID support saw a 15 per cent reduction in deaths from all causes.
The study also showed the impact of funding on tackling diseases. Nations receiving high levels of U.S. aid experienced 65 per cent fewer deaths from HIV/AIDS and saw malaria and neglected tropical disease deaths reduced by half.
Francisco Saúte of Mozambique’s Manhiça Health Research Centre, a study co-author, said USAID had been critical in fighting diseases like HIV, malaria, and tuberculosis across Africa.
“Cutting this funding now not only puts lives at risk—it also undermines critical health infrastructure that has taken decades to build,” he cautioned.
An updated death tracker developed by disease modeller Brooke Nichols at Boston University estimates that more than 224,000 children and nearly 108,000 adults have already died due to the ongoing U.S. aid cuts, equivalent to 88 lives lost every hour.
Following Washington’s rollback, several major donors, including France, Germany, and the UK, have also announced cuts to their foreign aid budgets.
These moves, particularly within the European Union, could lead to even more preventable deaths in the coming years, warned ISGlobal researcher Caterina Monti.
However, the study authors noted that the death toll is still based on current pledges and could decline significantly if aid flows are restored. “Now is the time to scale up, not scale back,” Rasella urged.
Despite the urgency, the U.S. government will not be represented at this week’s UN aid summit in Seville.
Before the cuts, USAID accounted for just 0.3 per cent of the U.S. federal budget.
“U.S. citizens contribute about 17 cents per day to USAID—around $64 per year,” said co-author James Macinko of UCLA. “I think most people would support continued USAID funding if they understood how far such a small contribution goes in saving millions of lives.”
