Fourteen Million People Worldwide at Risk if US Halts Development Aid

An analysis conducted by research centers from various countries and coordinated by Spanish experts has starkly quantified the irreparable damage the United States will inflict on the world if Donald Trump does not reverse his decision to cut the vast majority of the cooperation programs of the United States Agency for International Development (USAID).

The study, published by the prestigious scientific journal The Lancet and coordinated by the Barcelona Institute for Global Health (ISGlobal), warns that the massive decline of these projects would result in the death of more than 14 million people worldwide from diseases that are preventable or for which immunization or therapies exist by 2030.

The tremendous impact of the end of American development aid, which researchers liken to the outcome of a new global pandemic or a war in poor and developing countries, will be better understood if one knows the work USAID has done for global welfare just in this century, from 2001 to 2021, an impact also calculated by these experts.

USAID has funded 40% of all global aid programs this century, which is estimated to have saved 91 million people from near-certain death over these two decades, one-third of them under five years old. The article published in The Lancet estimates that just its medical, nutritional, educational, and sanitation programs have reduced overall mortality by 15% and global child mortality by 32%. Logically, the beneficial impact was greater in the poorest countries, with reductions of 74% in HIV/AIDS mortality, 53% in malaria, 51% in other tropical diseases, and significant decreases in deaths from tuberculosis, malnutrition, diarrhea, respiratory infections, or causes related to pregnancy and childbirth.

The problem is that Trump has ordered this year to end 83% of the programs USAID had underway. If there is no reversal, researchers estimate that in the five years leading up to 2030, the disappearance of the projects will cause the premature death of 14 million people, including more than 4.5 million children under five, equivalent to the preventable death of about 700,000 young children each year, concentrated in the most vulnerable countries.

"There is a risk of abruptly halting—and even reversing—two decades of health progress in vulnerable populations. For many low- and middle-income countries, the impact would be comparable to a global pandemic or a major armed conflict," warns Davide Rasella, a researcher at ISGlobal and coordinator of the study.

"From our field experience, we have seen how USAID's support has strengthened the capacity of local health systems to respond to diseases such as HIV, malaria, or tuberculosis. Cutting this funding now not only endangers lives but also undermines critical infrastructures that have taken decades to build," concludes Francisco Saúte, director-general of the Manhiça Health Research Centre in Mozambique and co-author of the study.

The authors of the work not only warn about the humanitarian catastrophe that the withdrawal of USAID programs signifies but also the real risk of triggering a domino effect in other countries. "The study's results are even more concerning if we consider that other international donors—mainly in the EU—have also announced substantial cuts in their aid budgets, which could lead to even more additional deaths (than already calculated) in the coming years," explains Caterina Monti, a predoctoral researcher at ISGlobal and co-author of the study.