More than 14 million additional deaths, including 4.5 million children under five, could be recorded globally by 2030 following the closure of the U.S. Agency for International Development (USAID) by the Trump administration. This alarming data was published in a recent study by the international high-impact academic journal, The Lancet. The study, conducted by researchers from Europe, Africa and South America, estimates that between 1.78 million and 2.5 million more people could die each year between 2025 and 2030 due to the ongoing defunding of USAID. These predictions are based on microsimulation models that factor in reductions across the health, education, sanitation, nutrition sectors, and poverty-alleviation initiatives.
“For many low- and middle-income countries, the resulting shock would be comparable to a global pandemic or major armed conflict. Unlike those events, however, this crisis would stem from a conscious and avoidable policy choice,” the authors explained.
91 million lives saved over two decades
The Lancet study examined 133 countries that received USAID assistance between 2001 and 2021 and found that the agency’s support helped to prevent 91.8 million deaths, including over 30 million children under five.
Countries receiving sustained USAID funding saw:
- 74% lower mortality from HIV/AIDS
- 53% from malaria
- 51% from neglected tropical diseases
Notably, the analysis takes into account not only direct health interventions but also USAID’s impact on social determinants of health. Poverty-reduction programs, educational access, clean water initiatives, and nutrition support were all found to play significant roles in lowering death rates.
See also: Collateral damage: How foreign aid cuts endanger global health; what must be done
For example, cash transfer programs reduced adult female mortality by 20% and child mortality by 8%. Every extra year of schooling lowered an adult’s risk of death by 1.9%. Access to clean water and sanitation reduced child deaths by 17%.
A disproportionate price for a modest investment
James Macinko, a co-author of the study, highlighted that this massive impact had been achieved at a relatively low cost.
“We found that the average taxpayer contributed about 18 cents per day to USAID. For this small amount, we’ve been able to translate that into preventing up to 90 million deaths around the world,” he specified.
Broader fallout looms
The researchers caution that the collapse of USAID could spark a broader crisis in global development funding.
In 2023, the U.S. accounted for 43% of global humanitarian aid. Its withdrawal may prompt other donors to follow suit. Several countries, including Belgium, the Netherlands, the UK, and France, have already announced reductions in foreign aid of up to 40%.
The Organisation for Economic Co-operation and Development predicts that in 2025, official development assistance could decline by 9% to 17%.
The cascading effect risks not just halting progress but reversing three decades of health and development gains, especially in fragile and conflict-affected states, the Lancet study warned.
USAID formally dissolved
After its activity was almost fully suspended in January 2025, USAID officially closed on July 1 under Executive Order 14169, which transferred the agency’s functions into the U.S. State Department.
See also: What is USAID and can Trump legally dismantle it?
The U.S. administration justified its dismantling as an effort to eliminate “waste and liberal bias,” stating that it would prioritize domestic expenditure over foreign spending. In 2023 alone, USAID managed $43.4 billion in funding, including $16.8B for governance, $10.5B for humanitarian aid, and $7B for health.
