93 Worldwide at Risk of Losing Nearly 23 Million More People by 2030

ISGlobal, supported by Rockefeller Foundation, analyzed impact of severe global aid cuts in 93 countries where preventable deaths could happen, including: 38 in Sub-Saharan Africa, 12 in MENA, 10 in Europe, 21 in Asia, and 12 in Latin America
New study published in The Lancet finds slashing global aid, particularly by US and European countries, will reverse decades of progress in fighting diseases

BARCELONA, N.Y., Feb. 3, 2026 /PRNewswire/ — The Lancet Global Health published a new peer-reviewed study today by the Barcelona Institute for Global Health (ISGlobal), which warns that a precipitous drop in global aid could lead to 22.6 million additional deaths by 2030 across 93 low- and middle- income countries, including 5.4 million children under the age of five. With support from The Rockefeller Foundation, the analysis demonstrates that Sub-Saharan Africa, which accounts for 38 of the 93 countries analyzed, is particularly at risk, and with 21 of the countries in Asia, 12 in Latin America, 12 in the Middle East and North Africa, and 10 in Europe, including Ukraine, severe cuts to official development assistance (ODA) could be felt globally. ISGlobal’s research also reveals that over the course of 2002-2021, ODA helped reduce child mortality by 39%; prevent HIV/AIDS deaths by 70%, with a 56% reduction in deaths from both malaria and nutritional deficiencies; and increased additional global health outcomes in these 93 countries, which are home to 75% 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—and they are an urgent call to action to all of us to prevent this human suffering,” said Dr. Rajiv J. Shah, President of The Rockefeller Foundation in a Statement on the Human Cost of Foreign Aid Cuts. “The question before humanity today is whether we will accept a global retreat from commitments to feed the hungry, cure the sick, and lift up the most vulnerable define the future 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.”

In 2024 international aid fell for the first time in six years, and the United States, United Kingdom, France, and Germany significantly reduced their ODA contributions for the first time in nearly 30 years. These deep cuts, along with projected cuts in 2025 and 2026, sparked the need to understand what this could mean at the human level for communities all over the world.

“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.

Millions More Lives at Risk:
As the world’s largest donors and other countries around the world continued to slash billions in assistance, the Organisation of Economic Cooperation and Development (OECD) is projecting that ODA could decline by 10%-18% from 2024 to 2025. In order to assess the realized impact of ODA in these countries and project what may happen if current aid cuts continue or worsen, ISGlobal – with support from The Rockefeller Foundation in association with its charitable offshoot, RF Catalytic Capital – examined 20 years of development data between 2002 and 2021 in 93 countries that are home to 6.3 billion people.

“This study exposes the grave reality that many feared after a year of sweeping cuts to global aid. Severe defunding is expected to cause 22.6 million deaths by 2030, which is equivalent to losing the entire population of Zambia,” said William Asiko, Senior Vice President & Head of Africa, The Rockefeller Foundation. “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. The Rockefeller Foundation is working to develop these solutions that can fix our broken aid infrastructure.”

Peer reviewed and published by The Lancet Global Health, 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, models two scenarios over the course of 2025-2030:

Mild defunding scenario. With a 10.6% yearly reduction (corresponding to the average reduction of the last two years, 2024–2025), these cuts could result in 9.4 million preventable deaths, including 2.5 million children younger than five years.
Severe defunding scenario. Based on $32 billion (15.1%) in ODA cuts from 2024 to 2025, with the funding cuts continuing and worsening through the end of this decade, this could cause 5.4 million children younger than age five years to die as part of more than 22.6 million additional deaths of all ages – Roughly equivalent to (1) the populations of greater Barcelona, Paris, and London combined; (2) more than the individual populations of Cairo, Dhaka, Mexico City, Mumbai, and Sao Paulo; (3) or the entire U.S. State of Florida perishing by 2030.

ISGlobal researchers applied a consistent methodological framework that integrates longitudinal panel data with validated country-level microsimulation models to quantify the health consequences of funding reductions across all OECD contributors. As result, the new study also demonstrates that higher global ODA levels in the 93 countries analyzed between 2002 and 2021 contributed to:

Decreasing all-cause mortality by 23%.
Declining child mortality by 39%.
Reducing deaths mortality rates from HIV/AIDS by 70%, nutritional deficiencies by 56%, malaria by 56%, diarrheal diseases by 55%, and neglected tropical diseases by 54%.
Strengthening health systems and supporting disease control and eradication efforts.
Improving preparedness for outbreaks and epidemics.

It also warns that at least three out of every four people on the planet live in countries where two decades of development gains could be reversed, where progress against diseases disappears, and where preventable loss of life could happen. The countries analyzed in this study include:

38 countries in Sub-Saharan Africa:
Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Eswatini, Ethiopia, Gabon, Gambia, Ghana, Guinea, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Namibia, Niger, Nigeria, Republic of the Congo, Rwanda, Senegal, Sierra Leone, South Africa, Tanzania, Togo, Uganda, Zambia, and Zimbabwe.
12 countries in the Middle East and North Africa:
Algeria, Djibouti, Egypt, Iran, Iraq, Jordan, Lebanon, Libya, Morocco, Sudan, Tunisia, and Turkiye.
10 countries in Europe:
Albania, Armenia, Belarus, Bosnia and Herzegovina, Georgia, North Macedonia, Moldova, Montenegro, Serbia, and Ukraine.
21 countries in Asia:
Afghanistan, Azerbaijan, Bangladesh, Cambodia, China, India, Indonesia, Kazakhstan, Kyrgyzstan, Laos, Malaysia, Mongolia, Myanmar, Nepal, Pakistan, Philippines, Sri Lanka, Tajikistan, Thailand, Uzbekistan, and Vietnam.
12 countries in Latin America:
Argentina, Bolivia, Brazil, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Paraguay, and Peru.

As a result of the severe realized and projected cuts to ODA, The Rockefeller Foundation is undertaking its mission-driven work around the world – with a focus on Sub-Saharan Africa – to identify country-led solutions to maximize every dollar of remaining aid and to stimulate new investments. This work, along with ISGlobal’s research, is supported by the Foundation’s Build the Shared Future Initiative, through which the 113-year-old philanthropic organization aims to inspire and inform global cooperation and international development work that matches the challenges of the 21st century.

Researchers from ISGlobal – a Barcelona-based institution supported by the “la Caixa” Foundation, together with the Institute of Collective Health at the Federal University of Bahia (UFBA) in Brazil, the Mozambique-based Manhiça Health Research Centre (CISM), and the National Institute of Health (INS) – submitted this report to The Lancet Global Health on 18 November 2025.

It builds on an ISGlobal-led study published last year, which found that the dismantling of the U.S. Agency for International Development (USAID) alone could lead to over 14 million additional preventable deaths by 2030. Both analyses applied the same methodological framework, integrating longitudinal panel data with validated country-level microsimulation models—to quantify the health consequences of funding reductions. While the USAID study focused on a single donor, the new analysis encompasses all OECD contributors, providing a comprehensive assessment of global aid defunding on mortality.

For additional information and download a copy of ISGlobal’s latest study, please visit:
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00008-2/fulltext.

About The Barcelona Institute for Global Health (ISGlobal)
The Barcelona Institute for Global Health, ISGlobal, is the fruit of an innovative alliance between the “la Caixa” Foundation, academic institutions and government bodies to contribute to the efforts undertaken by the international community to address the challenges in global health. ISGlobal is a consolidated hub of excellence in research that has grown out of work first started in the world of health care by the Hospital Clínic and the Parc de Salut MAR and in the academic sphere by the University of Barcelona and Pompeu Fabra University. Its working model is based on the generation of scientific knowledge through Research Programmes and Groups, and its translation through the areas of Education and Training and Analysis and Global Development. Its ultimate goal is to help close the gaps in health disparities between and within different regions of the world. For more information, visit www.isglobal.org.

About The Rockefeller Foundation
Investing $30 billion over the last 113 years to promote the well-being of humanity, The Rockefeller Foundation is a pioneering philanthropy built on unlikely partnerships and innovative solutions that deliver measurable results for people in the United States and around the world. We leverage scientific breakthroughs, artificial intelligence, and new technologies to make big bets across energy, food, health, and finance, including with our charitable offshoot, RF Catalytic Capital (RFCC). For more information, sign up for our newsletter at www.rockefellerfoundation.org/subscribe and follow us on X @RockefellerFdn, Instagram @rockefellerfdn, YouTube @RockefellerFdn, and LinkedIn @the-rockefeller-foundation.

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