Global aid cuts may threaten health gains worldwide, warns Lancet study

Global funding cuts could undo decades of health progress in India and other countries, putting millions of lives at risk by 2030

In an era where the world battles persistent health challenges, decades of progress in saving lives and strengthening health systems now stand at risk. A major new study in The Lancet Global Health paints a stark picture - cuts in global development and health aid could reverse lifesaving gains made in many countries, including India and lead to millions of preventable deaths by 2030. 

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”, the research was led by the Barcelona Institute for Global Health (ISGlobal) and supported by the Rockefeller Foundation.

Two scenarios, millions at risk

The researchers modelled two likely futures to estimate how cutting aid might affect global health by 2030: 

1. Mild defunding scenario: Under a modest reduction in aid, around 10.6 per cent annually, the world could see 9.4 million additional deaths, including 2.5 million children under five. 

2. Severe defunding scenario: With deeper cuts continuing through 2030, 22.6 million extra deaths could occur. Of these, 5.4 million would be children under five.

Why this study matters

For over decades, Official Development Assistance (ODA) - international aid funds for low- and middle-income countries, has played a crucial role in improving health outcomes. This includes:

• Reducing child mortality by nearly 39 per cent
• Decreasing all-cause mortality by 23 per cent
• Preventing 70 per cent of HIV/AIDS deaths
• Cutting deaths from malaria, nutritional deficiencies, diarrheal and neglected tropical diseases by over 50 per cent

Development aid does more than just provide money.

• It supports vaccination campaigns
• Funds medicines and treatment programmes for diseases like HIV/AIDS, malaria and TB
• Strengthens local health systems and workforce capacity
• Improves maternal and child health services
• Improves preparedness for outbreaks and epidemics

But now, with major donors like the United States, United Kingdom, France and Germany reducing aid, there’s a danger that these hard-won gains could be lost.

What this means for India

India is among 21 Asian nations included in the 93-country analysis. While India has made notable strides in healthcare, reducing child and maternal mortality, expanding immunisation, and enhancing disease control, the study’s findings suggest that:

• Progress against diseases such as HIV/AIDS, tuberculosis and malaria may slow or stall.
• Gains in child survival and nutrition could erode.
• Health systems, which rely partly on international funding for crucial programmes, could face severe strain.

India’s healthcare ecosystem has benefited from global partnerships and funding for key interventions, especially in HIV/AIDS prevention, vaccination drives and maternal health programmes. Any break in this funding can make it harder for the country to sustain health programmes, especially when many people still struggle to access quality healthcare and achieve equal health outcomes.

The wider global picture

The projected reversal of health gains isn’t unique to India. From sub-Saharan Africa to Latin America and Southeast Asia, countries that rely on international aid to bolster health systems risk facing:

• Resurgent outbreaks of preventable diseases
• Higher mortality rates among mothers and children
• Weakening of crucial health infrastructure that took decades to build

The study highlights that cuts are happening for the first time in nearly 30 years by the largest donor nations, a shift that jeopardises not only health outcomes but also broader development goals tied to education, nutrition, water and sanitation.

 

“Our analyses show that development assistance is among the most effective global health interventions available. 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. Budget decisions made today in donor countries will have irreversible consequences for millions of people for years to come,” said Davide Rasella, Coordinator of the study, ICREA Research Professor at ISGlobal and at the Brazilian Institute of Collective Health.

Urgent call to action

The authors urge the global community to reconsider current funding decisions, arguing that sustainable investments in health are not just moral imperatives but essential for global stability and prosperity. They stress that:

• Donor countries must restore and expand aid commitments
• Recipient countries should be empowered with smart, resilient financing strategies
• Efforts to achieve the 2030 Sustainable Development Goals hinge on sustained cooperation

"The future of development is locally led, grounded in public-private partnerships, propelled by scientific and technological innovation, and relentlessly focused on measurable results. As countries take on more responsibility, global cooperation and developmental assistance will remain vital, including for communities suffering most acutely through wars, famines, and other humanitarian crises," shared Dr Rajiv J. Shah, President of The Rockefeller Foundation. 

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This report is for informational purposes only and is not a substitute for professional medical advice.