WeeklySA_AdminPROJECTIONS: The Donald Trump administration this week announced the official end of USAID – days after a landmark study warned the closure would cause 2,4 million preventable deaths every year…
By Monk Nkomo
The abrupt closure of the United States Agency for International Development (USAID) by the Donald Trump administration
The massive cuts in healthcare funding mostly for poorer countries in Africa, would result in a crisis, including 14 million additional deaths over five years – whose consequences would reverberate throughout the world for decades.
This is the warning by researchers in a study published in the Lancet Journal, in which they evaluated the impact of two decades of USAID interventions and projected the effects of defunding on mortality up to the year 2030.
Researchers estimated that over the past two decades, USAID-funded programmes had helped prevent more than 91 million deaths globally including 30 million deaths among children. Projections suggested that ongoing deep funding cuts – combined with the potential dismantling of the agency – could result in more than 14 million additional deaths by the year 2030, which would include 4, 5 million deaths among children younger than five years.
‘’For many of the lower -middle-income countries, the resulting shock from these cuts would be similar in scale to a global pandemic or a major armed conflict. Unlike those events, however, this crisis would stem from a conscious and avoidable policy choice – one whose burden would fall disproportionately on children and younger populations and whose consequences could reverberate for decades.’’
USAID funding, researchers found, has had a crucial role in improving global health particularly by reducing mortality from poverty-related diseases and saving the lives of millions of adults and children.
The new study followed an announcement by the Trump administration on January 20 this year which released Executive Order 14169 re-evaluating and re-aligning the United States Foreign Aid which suspended existing foreign aid programmes, except for emergency food assistance and military aid worldwide with African countries the hardest hit by the decision . On March 10 this year, it was announced that 83 percent of the programmes run by USAID would be cancelled.
‘’ USAID funding has significantly contributed to the reduction in adult and child mortality across low-income and middle-income countries over the past two decades. Our estimates show that unless the abrupt funding cuts announced and implemented in the first half of 2025 are reversed, a staggering number of avoidable deaths could occur by 2030.’’
These cuts were currently being challenged in court and the outcome of the process was uncertain, at least for the current fiscal year. ‘’ Assuming the cancellations stand, this could include a potential 88 percent cut in support to maternal and child health aid, 87 percent to epidemics and emerging diseases surveillance as well as 94 percent cuts to programming for family planning and reproductive health’’, researchers added.
The decision by the Trump administration to shut down the USAID has been strongly criticised by former USA Presidents, Barack Obama and George W Bush who warned that the closure could result in “a staggering number” of avoidable deaths. Obama described the decision as ‘’ a colossal mistake, a travesty and a tragedy’’. Bush lauded the USAID workers for having saved millions of lives.
The USAID cuts had also significantly impacted public health particularly HIV/AIDS programmes in South Africa which led to heavy job losses, service disruptions and potential increases in new infections and deaths. The cuts had also affected other areas like Tuberculosis treatment, immunizations and community-based healthcare.
The Trump administration’s decision had also compounded cuts by other donors pushing both humanitarian and development systems to the brink of collapse. The researchers said reductions in spending by other international donors would potentially lead to even more additional deaths.
Several western donors had announced reductions in their aid budgets. They included the United Kingdom ( 40%), France (37%), Netherlands (30%) and Belgium (25 %). ‘’This represented a substantial funding crisis in the humanitarian and development aid sector’’, researchers said.
The USAID, which was established by President John F Kennedy in 1961, has been the largest funding agency for humanitarian and development aid worldwide.
This new study is the first comprehensive analysis to assess the impact of total USAID funding including support for health care, nutrition, humanitarian aid, development, education and related sectors on mortality in poorer countries over the past two decades.
The study also disaggregated effects by age group and cause of death. Importantly it was the only study to integrate retrospective evaluations with forecasting models that projected the effects of current and proposed funding cuts of children and all-age mortality to the year 2030.
Following the announcement of the termination of more than 83 percent of USAID’s programmes, humanitarian organisations have raised serious concerns about the absence of adequate notice or planning for a phased transition.
‘’ Without time to implement adaptive responses, the most severe effects cannot be mitigated. The short-term, medium-term and long- term consequences for public health, economic development and societal stability could be profound.’’
THE UNAIDS PREVENTED NEARLY 100 MILLION DEATHS
• A total 91,839 663 deaths including 30, 391 980 in children younger than 5 years, were prevented through the USAID funding over a period of 21 years.
• The USAID responded to more than 240 natural disasters and crises worldwide in 2017 and 2020.
• In 2016 alone, the organization provided food assistance to more than 53 million people across 47 countries.
• USAID funding was associated with 65 percent reduction in mortality from HIV/AIDS which represented 25, 5 million deaths.
• It was involved in the reduction of eight million deaths from malaria
• USAID was also involved in the fifty percent reduction ( 8,9 million deaths ) from neglected tropical diseases
• Significant decreases were also observed in mortality from Tuberculosis, nutritional deficiencies, diarrheal diseases, lower respiratory inspections, maternal and perinatal conditions.
• USAID was one of 7 agencies involved in the direct implementation of the President’s Emergency Plan for Aids Relief (PEPFAR), launched in 2023 and invested an accumulated amount of 100 billon dollars in the global HIV/Aids response.
