Summary
The US has traditionally been the largest donor to health programmes in low- and middle-income countries. In January 2025 almost all such funding was stopped and prospects for resumption are uncertain. The suddenness of the funding cuts makes it difficult for national programmes to adapt. This preprint* paper estimated the impact of these cuts on outcomes for four health areas that have been a focus of US assistance: HIV, tuberculosis (TB), family planning (FP) and maternal and child health (MCH).
*Note: Preprints are early-stage research papers that have not been peer-reviewed.
Content
The authors conclude that a complete cessation of US funding without replacement by other sources of funding would lead to dramatic increases in deaths from 2025-2040: 15.2 (9.3-20.8) million additional AIDS deaths, 2.2 (1.5-1.9) million additional TB deaths, 7.9 million additional child deaths from other causes, 40-55 million additional unplanned pregnancies and 12-16 million unsafe abortions.
There has been great progress in improving global health in the last few decades. This progress has given hope of reaching many of the ambitious Sustainable Development Goals for 2030. However, the recent funding cuts threaten to change these trajectories and lead to sharp increases in avoidable mortality for the poorest countries. Even a partial restoration of US funding would combat the most severe effects and provide time for national programs to adjust to the new funding landscape.
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