Steep funding cuts to the United States Agency for International Development (USAID) could result in over 1.4 crore preventable deaths by 2030, a third of which could be among children aged under five, according to a study published in The Lancet journal.
The study said the fund cuts could reverse decades of progress and that for many low and middle-income countries, the resulting shock would be comparable in scale to a “global pandemic” or a “major armed conflict”.
In March, US Secretary of State Marco Rubio said President Donald Trump’s administration has cancelled 83 per cent of all programmes at USAID, the world’s largest funding agency for humanitarian and development aid.
The cuts “risk abruptly halting — and even reversing — two decades of progress in health among vulnerable populations,” study coordinator Davide Rasella, research professor at the Barcelona Institute for Global Health (ISGlobal) in Spain, said.
“For many low- and middle-income countries, the resulting shock would be comparable in scale to a global pandemic or a major armed conflict,” Rasella said.
The researchers also estimated that between 2001 and 2021, more than nine crore deaths in low and middle-income countries were prevented because of USAID-supported programmes. About a third of these were among children.
“Our analysis shows that USAID funding has been an essential force in saving lives and improving health outcomes in some of the world’s most vulnerable regions over the past two decades,” first author Daniella Cavalcanti, a postdoctoral researcher at the Federal University of Bahia, Brazil, said.
For the analysis, the researchers used models to forecast impacts due to two scenarios — continuing funding at the 2023-level, or implementing the sharp reduction of 83 per cent announced in March 2025.
“Current steep funding cuts could result in more than 1,40,51,750 additional all-age deaths, including 45,37,157 in children younger than age five years, by 2030,” the authors wrote.
The study also found that USAID-supported programmes were associated with a 15 per cent reduced all-cause mortality and a 32 per cent reduced death rates among children under five.
Further, in countries receiving high levels of USAID support, the strongest impact was found in priority disease areas — deaths from HIV/AIDS fell by 74 per cent, malaria by 53 per cent, and neglected tropical diseases by 51 per cent, compared to countries receiving low or no support.
The research is the first comprehensive analysis to assess the impact of total USAID funding, including support for health care, nutrition, humanitarian aid, development, education, and related sectors, on mortality rates in low and middle-income countries over the past two decades, the study said.
