Dissolving USAID could lead to an additional 14 million deaths by 2030

“There are places where an AIDS patient or a malnourished child cannot cling to life for several weeks. Death is immediate.” This is the cruel observation of Davide Rasella, a researcher at the Barcelona Institute for Global Health (ISGlobal) and lead author of a study estimating that 14 million people will die worldwide — 4.5 million of them children aged under five — if the funding cuts decreed by Washington continue and USAID is dissolved.

According to the recently published ISGlobal study, in which researchers from Brazil, Mozambique, the United States and Spain participated, these people will die from AIDS, tuberculosis, malaria, diarrhea, respiratory illnesses or malnutrition. These deaths are mostly preventable and also linked, beyond the diseases themselves, to poverty, poor hygiene and sanitation, and a lack of access to basic health services.

“These cuts will cause permanent damage to the health of the most vulnerable populations, especially because they are being implemented abruptly. The system could adapt to a lack of funding, but not if it is done so drastically and against people with no resilience, who have no way of coping with this sudden disappearance of funding,” Rasella adds. “That’s why the terrible impact of the cuts is already being seen in many places.”

According to this study, the suspension of U.S. funding has already caused, for example, 25% of tuberculosis control agencies in 31 countries to halt their work, the World Food Programme (WFP) to decide to close its office for southern Africa in Johannesburg, exposing 27 million people to extreme hunger in the midst of a major drought, and the world to the risk of recording 15 million additional cases and 107,000 deaths due to the suspension of malaria control programs.

The system could adapt to a lack of funding, but not if it is done so drastically and against people with no resilience, who have no way of coping with this sudden disappearance of funding"

Davide Rasella, ISGlobal

Beyond causing these millions of preventable deaths, these cuts also “risk reversing decades of progress in health and socioeconomic development in low- and middle-income countries,” the ISGlobal study insists.

To support their study, the experts first analyzed the positive impact of the work of USAID, which until a few months ago was responsible for 43% of the funds that the world’s governments allocate to development aid. Their conclusions are that programs funded by the U.S. aid agency have helped directly and indirectly prevent more than 91 million deaths worldwide, almost a third of them among children, over the past 20 years.

“USAID contributed to a 15% reduction in global mortality,” the study states. More specifically, its funds reduced the number of deaths from HIV by 74%, deaths from malaria by 53%, and deaths caused by neglected tropical diseases by 51%, according to this research.

Millions of preventable deaths

But at the end of January, Donald Trump decided to freeze development aid funds for 90 days and reassess their relevance. Currently, according to Secretary of State Marco Rubio, 83% of USAID-coordinated programs have been canceled, although the decision is being challenged in court.

“Children will suffer these cuts especially. The paradox is that we always talk about the cost-effectiveness ratio when we invest in health, and there is no more effective action on a global level than saving the life of a child in an African country. They are so vulnerable that with a little money we can save many lives,” Rasella points out.

The main destination of USAID’s budget was sub-Saharan Africa. In practice, a person in a country like Zambia could be vaccinated, attend a public school with trained professionals, receive food assistance, benefit from antiretroviral treatment for AIDS, or participate in a malaria prevention program thanks to USAID’s budget.

“Right now, various studies are being published to calculate the impact of this sudden freeze in funding, and most show similar and equally dramatic results: these cuts from the United States and other foreign aid agencies will cause millions and millions of preventable deaths,” Rasella insists.

The expert points out that other Western countries, such as the United Kingdom, France, the Netherlands, and Belgium, have announced reductions in their development aid, which exacerbates the cooperation financing crisis. Of the 31 countries that make up the Development Assistance Committee (DAC) of the Organisation for Economic Co-operation and Development (OECD), a kind of thermometer for measuring development financing, only four currently exceed the emblematic threshold of 0.7% of their GDP.

There is no more effective action on a global level than saving the life of a child in an African country. They are so vulnerable that with a little money we can save many lives"

Davide Rasella, ISGlobal

Cascade effect

Rasella also warns that the studies being published focus on a few aspects and “do not consider the cascading effect” of the current and future cuts. “There are deaths that cannot be counted in these studies, which focus on the most direct deaths,” he points out. Because the research emphasizes that it’s not just diseases that kill, but also poverty, lack of education, lack of access to health services, and poor hygiene and sanitation.

Specifically, it is worth noting that USAID’s impact on mortality reduction goes beyond its direct funding of health programs and interventions. A substantial part of its influence lies in improving aspects that impact the quality of life of low-income populations. For example, poverty alleviation, education, and access to clean water significantly reduce mortality among children and adults.

The study highlights the proven evidence that cash transfer programs reduce adult female mortality by 20% and child deaths by 8% in low- and middle-income countries. Each additional year of education also reduces the risk of adult mortality by 1.9%, and improving access to safe water, sanitation, and hygiene reduces child mortality by 17%.

Sign up for our weekly newsletter to get more English-language news coverage from EL PAÍS USA Edition