Report - The projected mortality consequences of current defunding to 2030: Shared by John Gilmartin

Lancet have evaluated the effects of official development aid cuts at USAID as well as several other major donor organizations.  The short answer, Devastating. Millions of deaths especially among children under five.

If these estimates are close to correct, we will witness a new holocaust.  In my experience reading estimates of deaths caused by various catastrophic events, the early estimates will be lower than the actual deaths.

John Gilmartin

Impact of Two Decades of Humanitarian and Development Assistance and the Projected Mortality Consequences of Current Defunding to 2030: Retrospective Evaluation and Forecasting Analysis

Andrea Ferreira da Silva, Rodrigo Volmir Rezende Anderle, Gonzalo Barreix Sibils, Lucas de Oliveira Ferreira de Sales, Daiana Pena, Caterina Monti, Claudia Garcia Vaz, Hugo-Alejandro Santa-Ramírez, Gabriela Dos Santos de Jesus, Daniella Medeiros Cavalcanti, Ariel Nhacolo, Ivalda Macicame, Quique Bassat, Davide Rasella

Lancet Global Health, February 2, 2026

Click here for the article

Click here for the full report in pdf

Main points

Retrospective Analysis (2002-2021) of gains:

1. Overall Mortality Reductions:
   • 23% reduction in age-standardized all-cause mortality with high ODA funding levels
   • 39% reduction in under-5 mortality
   • 33% reduction in under-1 year mortality
2. Disease-Specific Mortality Reductions:
   • HIV/AIDS: 70% reduction
   • Malaria: 56% reduction
   • Nutritional deficiencies: 56% reduction
   • Diarrhoeal diseases: 55% reduction
   • Neglected tropical diseases: 54% reduction
   • Tuberculosis: 39% reduction
   • Lower respiratory infections: 42% reduction
   • Maternal causes: 30% reduction
3. Dose-Response Relationship:
   • All associations showed clear dose-response patterns according to funding levels (baseline, low, intermediate, high)

Projected Impacts of ODA Defunding (2025-2030):

4. Severe Defunding Scenario:
   • 22.6 million additional deaths across all ages by 2030
   • 5.4 million deaths among children under 5 years
5. Mild Defunding Scenario:
   • 9.4 million additional deaths across all ages by 2030
   • 2.5 million deaths among children under 5 years
6. Stratified Effects:
   • Stronger impacts in low-income countries (29% reduction) and lower-middle-income countries (25%)
   • More pronounced effects among women (27%) than men (23%)

Summary

Researchers analyzed official development assistance (ODA) funding from OECD donors across 93 low- and middle-income countries from 2002-2021, then projected mortality impacts under different defunding scenarios through 2030. 

High ODA funding levels were associated with a 23% reduction in age-standardized all-cause mortality and 39% reduction in under-5 mortality. 

The study found particularly strong effects on mortality from HIV/AIDS (70% reduction), malaria (56%), nutritional deficiencies (56%), and neglected tropical diseases (54%). 

Under a severe defunding scenario, models project 22.6 million additional deaths by 2030, including 5.4 million children under five. Even under a mild defunding scenario continuing current downward trends, excess deaths would reach 9.4 million overall and 2.5 million among children under five by 2030.

Quotes

"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."

"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 dismantling of USAID has triggered widespread alarm among humanitarian and development organisations, which have criticised the lack of adequate notice and the absence of a structured plan for a phased transition."

"Beyond the immediate and dramatic human toll, these funding cuts risk reversing decades of hard-won progress in development and global health, particularly in the most vulnerable countries."