Contributions from the US, Germany, France, Japan and the UK made up about 70% of 2023’s total funds, known as official development assistance, of over $250 billion, researchers, including those from the Barcelona Institute for Global Health (ISGlobal) in Spain, said.
However, 2024 marked the first instance in nearly three decades when the major donors, except Japan, reduced their contributions, with cuts also planned for 2025, the team said.
They added that preliminary projections point to further substantial reductions from the major donor countries, estimated at an overall decline of over 11% from 2025 to 2026.
Higher levels of funding are associated with a 23% reduction in all-cause mortality and 39% in mortality among under-fives, the study found.
Funding from high-income countries is also associated with large declines in death rates from major communicable diseases, including HIV/AIDS, malaria and neglected tropical diseases, and significant declines in tuberculosis, diarrhoeal diseases, and maternal-perinatal causes.
“Official Development Assistance (ODA) funding has played a decisive role in reducing preventable mortality across LMICs over the past two decades, and the abrupt withdrawal of this support threatens to cause millions of avoidable deaths, reversing decades of progress in global health,” the authors wrote.
The team had published a study in July 2025 in The Lancet journal showing that dismantling the United States Agency for International Development (USAID) — the world’s largest funding agency for humanitarian and development aid — could cause 14 million preventable deaths worldwide by 2030, a third of them among children aged under five.
“Effects of overall ODA on global mortality and its projections are less understood,” they said.
“Our models forecast an additional 22.6 million deaths across all ages, including 5.4 million deaths in children younger than five years, by 2030 under a severe defunding scenario; even under a mild defunding scenario, the projected number of excess deaths by 2030 is 9.4 million across all ages and 2.5 million among children younger than five years,” the authors said.
The ‘severe defunding scenario’ analysed the impact of a 15.8% reduction projected for 2025, while the ‘mild defunding scenario’ examined outcomes if current trends continue until 2030.
“Sudden and severe reductions in ODA funding could have catastrophic consequences, with a potential global death toll comparable to — or even exceeding — that of the COVID-19 pandemic,” the authors said.
Also read: US cuts UN humanitarian funding to $2 billion, sharply curbing aid role
“Even modest defunding that simply extends current downward trends is likely to lead to sharp increases in preventable adult and child mortality, potentially resulting in tens of millions of excess deaths in the coming years,” they added.
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