Funding cuts to the U.S. Agency for International Development (USAID) by the Trump administration could lead to more than 14 million additional deaths globally over the next five years, according to a new study, as the toll of the government’s dismantling of one of the largest aid agencies worldwide unfolds.
USAID cuts may cause 14 million more deaths in next five years, study says
The analysis, published in the Lancet, estimates the agency’s programs saved 91 million lives worldwide over two decades, playing a vital role in global health.
July 1, 2025 The Washington Post
By Kelsey Ables
The study, published Monday in the Lancet, estimates that 91 million deaths in low- to middle-income countries were prevented between 2001 and 2021, owing to USAID, whose programs have played a vital role administering humanitarian and developmental assistance to vulnerable populations around the world.
Through projection models assessing two scenarios — one in which 2023 funding levels continue and another that reflects the cancellation of 83 percent of USAID’s programs announced by the Trump administration — researchers estimated that more than 14 million preventable deaths could occur by 2030, including 4.5 million deaths among children under 5, if cuts continue.
The report captures the potential ripple effect of the United States’ shifting posture globally under an administration that is seeking to reshape the federal government and has quickly stripped funding for long-established programs and agencies it deems unnecessary.
The sudden halt of USAID programs is “deeply undermining the image of the United States around the world,” Davide Rasella, a research professor at the Barcelona Institute for Global Health and coordinator of the study, said in an email.
“The magnitude of USAID’s impact over the past two decades cannot be overstated,” he added, pointing both to USAID’s role in advancing global health and its investment in improving food security, water and sanitation, education and economic opportunities. “These broader interventions have strengthened the resilience of communities, enabling them to thrive well beyond the scope of any single program. The dismantling of these programs now threatens to reverse decades of progress.”
In a news release on the study, Rasella said the resulting shock for many low- and middle-income countries would be “comparable in scale to a global pandemic or a major armed conflict.”
When Secretary of State Marco Rubio announced in March that 83 percent of programs administered by USAID were being eliminated, he celebrated what he called an “overdue and historic reform” by the U.S. DOGE Service, then overseen by billionaire Elon Musk.
The cuts would eliminate programs that “spent tens of billions of dollars in ways that did not serve, (and in some cases even harmed), the core national interests of the United States,” Rubio said at the time.
Rubio has ordered that by Tuesday the agency, which is over 60 years old, be absorbed into the State Department. In a farewell video, former president Barack Obama called the dismantling “a colossal mistake,” the Associated Press reported Monday.
In the Lancet report, researchers write that higher levels of USAID funding were associated with a 15 percent reduction in “all-cause” mortality worldwide over 21 years. The strongest association between levels of USAID funding and mortality was in deaths from HIV/AIDS, which were reduced by 65 percent, the report said. Malaria mortality was also reduced by 51 percent and neglected tropical disease by 50 percent, it said.
Jonas Gamso, a professor at Arizona State University who has studied foreign aid, said in an email that forecasting such numbers “always carries some uncertainty, particularly given the many complex factors that can contribute to health outcomes,” so “we should take the findings with some caution.”
Still, cuts to USAID programs “will inevitably prevent individuals in poor countries from receiving vital resources and lifesaving care,” he said, pointing in particular to reductions in rapid aid, which “create immediate voids that are difficult for local governments to fill.”
James Macinko, a health policy professor at the University of California at Los Angeles and an author on the paper, noted in a statement that U.S. citizens contributed about 17 cents per day to USAID.
“I think most people would support continued USAID funding if they knew just how effective such a small contribution can be to saving millions of lives,” he said.