A steep drop in global development assistance could cause 22.6 million additional deaths by 2030 across 93 low- and middle-income countries, including 5.4 million children under the age of five, warns a new peer-reviewed study published in The Lancet Global Health. Conducted by the Barcelona Institute for Global Health (ISGlobal) and supported by The Rockefeller Foundation in association with RF Catalytic Capital, the study underscores the potentially catastrophic human cost of shrinking aid budgets.
The findings show that Sub-Saharan Africa, which includes 38 of the countries studied, would be hardest hit, but the impact would also be felt across Asia (21 countries), Latin America (12), the Middle East and North Africa (12), and Europe (10, including Ukraine). These 93 countries together represent about 75% of the world’s population.
What do researchers say?
Between 2002 and 2021, official development assistance (ODA) made measurable gains in improving global health outcomes, according to ISGlobal’s data. ODA helped cut child mortality by 39%, HIV/AIDS deaths by 70%, and deaths from malaria and nutritional deficiencies by 56%. It also contributed to stronger health systems, better preparedness for disease outbreaks, and wider access to essential care.
“Our analyses show that development assistance is among the most effective global health interventions available,” said Davide Rasella, coordinator of the study and professor at ISGlobal and Brazil’s Institute of Collective Health. “Withdrawing this support now would not only reverse hard-won progress, but also directly translate into millions of preventable adult and child deaths in the coming years.”
Backdrop of the research
The research comes at a time when international aid has declined for the first time in six years, with the United States, United Kingdom, France, and Germany all reducing ODA contributions in 2024—their first major cuts in nearly three decades. The OECD now projects a further 10–18% fall in ODA between 2024 and 2025.
ISGlobal modelled two possible outcomes: a mild defunding scenario, with a 10.6% annual reduction leading to 9.4 million preventable deaths, and a severe defunding scenario, where sustained 15% yearly cuts could result in 22.6 million deaths worldwide by 2030—a toll comparable to the combined populations of Paris, London, and Barcelona.
Dr. Rajiv J. Shah, President of The Rockefeller Foundation, called the findings “a warning of the profound moral cost” of political complacency. “The question before humanity today,” he said, “is whether we will accept a retreat from commitments to feed the hungry and cure the sick—or come together to build new models of cooperation.”
Deepali Khanna, Senior Vice President and Head of Asia at the Foundation, added that Asia’s scale means “when health systems fail, the human cost is immense.” Sustained, smarter assistance, she said, is crucial to protecting vulnerable populations and preserving decades of progress.
ISGlobal’s study builds on its earlier research that found US aid cuts alone could lead to 14 million additional preventable deaths by 2030, reinforcing that budget decisions made today will have irreversible human consequences for years to come.