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Global health strains under US aid cuts

Hundreds of thousands have died and millions more face preventable deaths

Updated: 2026-01-21 09:56
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Community midwife assistant Eluby Gwala (left), an HIV testing services provider from Ukwe Health Centre, instructs a client on the use of an HIV self-test kit at an outreach clinic in Lilongwe, Malawi, on Monday. AMOS GUMULIRA/AFP

PARIS — The United States' dismantling of foreign aid, which started a year ago on Tuesday, has caused the preventable deaths of hundreds of thousands of people and will contribute to millions more, researchers have estimated.

Humanitarian efforts to fight diseases such as HIV, malaria and tuberculosis in some of the world's poorest countries have been massively disrupted since US President Donald Trump froze humanitarian aid immediately after being sworn in for a second term on Jan 20 last year.

The freeze was initially said to be temporary. However, in a cost-cutting spree advised by the world's richest person Elon Musk, Trump eliminated 83 percent of programs by the US Agency for International Development, which was then dismantled.

Other major Western donors, including the United Kingdom, France and Germany, then announced deep cuts to their own aid budgets, compounding funding shortfalls for already reeling humanitarian efforts.

Researchers have since been working to estimate the effects of the cuts by Washington, which previously contributed more than 40 percent of all global aid.

Given how crucial the funding has become to so many sectors in developing countries, most numbers are rough estimates based on modeling research.

The Impact Counter website estimates the USAID cuts have so far caused more than 750,000 deaths, more than 500,000 of them children.

That works out to 88 people every hour, according to the analysis by Brooke Nichols, an infectious disease mathematical modeler at Boston University, which has not been peer-reviewed.

Different research conducted by the Barcelona Institute for Global Health projects that more than 22 million people could die from preventable causes by 2030 because of the US and European aid cuts.

The research, first exclusively reported by Agence France-Presse in November, will be published in The Lancet Global Health journal, principal investigator Davide Rasella said.

Other research by the US-based Institute for Health Metrics and Evaluation warned last month that 16 million additional children under the age of 5 would die by 2045 if the aid cuts become permanent.

HIV setback

The US funding cuts are the most significant setback in the fight against HIV in decades, the United Nations has warned.

While the Trump administration has said it resumed critical HIV services under its PEPFAR program, many people in developing countries have lost access to lifesaving HIV drugs such as antiretrovirals.

Impact Counter estimates that more than 170,000 people, including over 16,000 infants, have died because of the disruptions in PEPFAR funding, which stands for the US President's Emergency Plan for AIDS Relief.

A survey released on Tuesday found the cuts have seriously affected the services of 79 community HIV organizations across 47 countries.

Access to drugs that prevent HIV transmission called PrEP has been halved in 80 percent of the organizations, according to a survey by France's Coalition PLUS and other groups.

The aid cuts are also "causing widespread and profound damage" to healthcare infrastructure in many countries, it added.

Rising toll

More than 48,000 people have already died from tuberculosis because of the cuts, according to Impact Counter, which projected this toll would rise to more than 2.2 million by 2030.

More than 160,000 children have died from pneumonia, 150,000 from malnutrition, and 125,000 from diarrhea as a result of the cuts, the site said.

It also estimated that more than 70,000 people — three-fourths of them children — have died from malaria.

However, the true death toll of the slashed aid may never be known.

After the dismantling of USAID, many of the systems that once tracked deaths and diseases in developing countries simply "no longer exist", Caterina Monti, a co-author of the Barcelona Institute for Global Health study, told AFP.

Sarah Shaw, advocacy director of the charity MSI Reproductive Choices, told AFP that USAID funding was "like an iceberg".

Underneath the visible parts — such as money for drugs — the United States provided key funding for transportation, warehouses, software, training and education.

Monti gave the example of a child in a remote area suffering from diarrhea.

The child not only needs access to a medical center with a supply of drugs; they need clean drinking water, proper sanitation and to be informed about the condition in the first place.

"It's a very complex system — if you cut one piece, then the other pieces won't work," Monti said.

Shaw said that over the past year, many charities were able to find supplies still lingering in warehouses.

"But now all of that is gone," she added. "Last year we were running on fumes. This year there will be no fumes."

Agencies via Xinhua

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