PHOTO; Courtesy AI
A new peer-reviewed study published in The Lancet Global Health warns that a sharp decline in global development assistance could result in 22.6 million additional deaths by 2030 across 93 low- and middle-income countries, including 5.4 million children under five.
The study, titled “The Impact of Two Decades of Humanitarian and Development Assistance and the Projected Mortality Consequences of Current Defunding to 2030: Retrospective Evaluation and Forecasting Analysis,” was led by the Barcelona Institute for Global Health (ISGlobal) with support from The Rockefeller Foundation.
The research highlights the crucial role that official development assistance (ODA) has played in saving lives over the past two decades.
Between 2002 and 2021, ODA contributed to a 39% reduction in child mortality, a 70% decrease in HIV/AIDS deaths, and a 56% decline in deaths from malaria and nutritional deficiencies across the 93 countries studied, which are home to three-quarters of the world’s population.
“These findings are a warning of the profound moral cost of the zero-sum approach many political leaders are taking,” said Dr. Rajiv J. Shah, President of The Rockefeller Foundation.
“The question before humanity today is whether we will accept a global retreat from commitments to feed the hungry, cure the sick, and lift the most vulnerable or whether we will come together to build new models of cooperation worthy of the tens of millions of people who could lose their lives if we do not.”
Africa at the Forefront of Risk
Among the 93 countries analyzed, 38 are in Sub-Saharan Africa, making the region particularly vulnerable to aid reductions.
Countries such as Nigeria, Ethiopia, Kenya, Uganda, and Zambia rely heavily on external financing for health programmes, including vaccination campaigns, malaria prevention, nutrition support, and maternal and child health services.
“Sub-Saharan Africa is particularly at risk,” the study notes, highlighting that the region’s health systems could face disproportionate impacts if ODA levels continue to fall.
The projected mortality increase would also affect other regions, including 21 countries in Asia, 12 in Latin America, 12 in the Middle East and North Africa, and 10 in Europe, including Ukraine.
Yet, the study also emphasizes that Africa has already benefited significantly from sustained investment.
The measurable gains in child survival, HIV/AIDS reduction, and malaria control show that targeted funding works and that past success provides a roadmap for the future.
Evidence of Progress and Conditional Hope
While the projections are alarming, the study is clear that the loss of life is conditional on continued or worsening aid cuts.
The 22.6 million deaths projected by 2030 are not inevitable; they reflect what could happen under a severe defunding scenario.
“Development assistance is among the most effective global health interventions available,” said Davide Rasella, Coordinator of the study and ICREA Research Professor at ISGlobal.
“Over the past two decades, it has saved an extraordinary number of lives and strengthened fragile welfare states and healthcare systems. Withdrawing this support now would not only reverse hard-won progress, but would translate directly into millions of preventable adult and child deaths in the coming years.”
The study illustrates that sustained ODA is a tool for prevention.
By maintaining and targeting funding toward high-impact interventions such as child health programmes, HIV treatment, malaria control, and nutritional support, governments and international donors have the potential to avert millions of deaths.
In other words, the study provides a clear pathway: what has worked in the past can continue to work if investments are maintained.
Global Lessons and Recommendations
The report’s findings carry both an urgent warning and actionable guidance for policymakers. Among the recommendations:
Protect and sustain ODA funding for high-impact health interventions to prevent reversals of past gains.
Prioritize support for child health, infectious disease control, and nutrition, where past investments have delivered the most measurable results.
Encourage low- and middle-income countries to strengthen domestic financing mechanisms, reducing overreliance on external aid while ensuring critical programmes remain operational.
William Asiko, Senior Vice President & Head of Africa at The Rockefeller Foundation, emphasized the stakes for African nations:
“Africa is expected to bear the brunt of aid cuts, and this data clearly demonstrates the devastating human impact this will have. Philanthropies, civil society, and other groups will not be able to fill the gap left by declining official development assistance, so it is necessary to look for new models that can deliver the greatest impact with reduced funding.”
A Call to Action and Opportunity
Although the report paints a stark picture, it also highlights the life-saving potential of sustained global cooperation.
The historical data demonstrate that ODA can dramatically improve survival rates, prevent disease, and strengthen health systems.
For Africa and other regions heavily dependent on aid, this means that targeted, sustained investment can protect millions of lives.
The Lancet study underscores a simple but powerful truth: the projected humanitarian crisis is preventable, and policymakers have the tools to act now.
By prioritizing development assistance and ensuring resources reach programs with proven impact, the world can protect vulnerable populations and sustain two decades of health gains.
As Dr. Shah concludes, “The question before humanity today is whether we will retreat from our commitments or build new models of cooperation worthy of the lives at stake.”
The answer, the study suggests, could determine whether decades of progress endure or unravel in the next few years.
