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sharp pullback in global aid funding could carry a high cost. That is the central warning from a new peer-reviewed study, led by the Barcelona Institute for Global Health (ISGlobal), published in The Lancet Global Health this month.
The researchers estimate that cuts to official development assistance, or ODA, could result in 22.6 million additional deaths by 2030 across 93 low- and middle-income countries. Of those, 5.4 million would be children under five.
That projection is tied to recent funding trends. In 2024, international aid fell for the first time in six years. The United States, United Kingdom, France and Germany - historically among the largest donors - reduced contributions, marking the first major pullback in nearly three decades.
Where the impact could be felt
The analysis, supported by The Rockefeller Foundation and its public charity RF Catalytic Capital, looked at countries that together account for roughly 75% of the world’s population.
Sub-Saharan Africa is identified as particularly exposed. Thirty-eight of the 93 countries assessed are in that region. The study also examined 21 countries in Asia, 12 in Latin America, 12 in the Middle East and North Africa, and 10 in Europe, including Ukraine.
Researchers point to past gains. Between 2002 and 2021, ODA was associated with a 39% reduction in child mortality in those countries. Deaths linked to HIV/AIDS fell by 70%. Fatalities tied to malaria and nutritional deficiencies declined by 56%.
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Davide Rasella, who coordinated the study and is an ICREA Research Professor at ISGlobal and at the Brazilian Institute of Collective Health, said development assistance remains “among the most effective global health interventions available.”
Without sustained funding, the study suggests, progress made over two decades could begin to erode.
Regional risks
A report from The Hindu quoted Deepali Khanna, senior vice president and head of Asia at The Rockefeller Foundation, who highlighted the scale of potential impact in Asia.
“Asia’s scale means that when health systems fail, the human cost is immense,” she said, adding that in 21 countries across the region, decades of development gains are at risk.
Khanna also cautioned that weakened systems could lead to preventable loss of life if financing gaps widen.
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The authors stress that outcomes are not fixed. They argue that stronger domestic financing, combined with targeted international support, could limit the damage.
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