The Lancet: USAID funding cuts could lead to 14 million deaths by 2030

Over 21 years of observation, USAID assistance, the study says, helped reduce overall mortality in low- and middle-income countries (especially in Africa) by 15% and child mortality (under 5) by 32%. According to scientists, this prevented about 91.8 million deaths among all age groups, including 30.4 million deaths among children under 5.

The funding had a particularly significant impact on specific diseases: deaths from HIV/AIDS fell by 65% ​​(25.5 million deaths averted), malaria by 51% (8 million deaths), and neglected tropical diseases by 50% (8.9 million deaths). There were also significant reductions in deaths from tuberculosis, malnutrition, diarrhoeal diseases, lower respiratory infections, and complications of pregnancy and childbirth.

In 2023, the United States accounted for 43% of all government funding for humanitarian programs worldwide, up from about 39% a decade ago, the study authors indicate. According to estimates for 2024, USAID’s budget exceeded $35 billion. The main areas of funding are humanitarian assistance ($9.9 billion) and health ($9.5 billion), and the key recipient region was sub-Saharan Africa ($12.3 billion).

The report indicates that USAID has paid special attention to global health initiatives. The agency allocated $1.16 billion to support the Global Alliance for Vaccines (GAVI) in 2020-2023, was actively involved in the fight against malaria through the President's Malaria Initiative (PMI), and was one of seven agencies implementing the Emergency Plan for AIDS Relief (PEPFAR). Since 2003, more than $100 billion has been allocated to this program, and in 2023, USAID provided 60% of bilateral assistance in PEPFAR.

However, USAID’s financial model, like that of other US federal agencies, is heavily dependent on the political decisions of Congress, the Senate, and other structures of the country, which creates difficulties for long-term planning, the authors of the study complain. For example, in January 2025, the Trump administration issued Executive Order 14169 on the review of foreign aid, suspending all programs except emergency food aid and military support, and in March 2025, it announced an upcoming 83% reduction in funding for USAID programs. If these plans are implemented, there could be an 88% reduction in support for maternal and child health programs, an 87% reduction in funding for epidemiological surveillance, and a 94% loss of funding for family planning programs. These decisions are currently being challenged in court.

The National Institutes of Health (NIH) of the US Department of Health and Human Services (HHS), the main source of funding for medical research, terminated about 780 grants from February 28 to March 28, 2025. Some of them were canceled completely, while for others, additional payments for related projects implemented as additional initiatives were canceled. Among other things, research on vaccination, HIV infection, and others lost grants. The NIH explains the decision by the desire to reduce costs in areas that are not a priority, as well as to stop spending on research "based on non-scientific categories" and not justifying the funds invested in them. At the same time, industry experts are concerned that the reduction of tranches may negatively affect public health.