USAID Closure: More than 14 million lives to be lost by 2030

Kampala, Uganda | THE INDEPENDENT | A new study says the dismantling of the US Agency for International Development-USAID  could result in more than 14 million additional deaths by 2030, including 4·5 million deaths among children younger than 5 years.

The US Agency for International Development (USAID) officially closed this week, marking the end of a transformative era in US global health and development leadership—the agency was first founded in 1961 as a mandate from President John F. Kennedy.

(USAID) has been the largest funding agency for humanitarian and development aid worldwide. Findings of a study published in the lancet journal on June 30, 2025 USAID-funded programmes have helped prevent more than 91 million deaths globally, including 30 million deaths among children.

USAID was one of the seven agencies involved in the direct implementation of the President’s Emergency Plan for AIDS Relief (PEPFAR), launched in 2003, and investing an accumulated amount of over $100 billion in the global HIV/AIDS response.In 2023, 60% of PEPFAR’s bilateral HIV assistance was obligated and implemented by USAID.

It said the agency has been the largest donor in absolute terms—providing more than US$55 billion in official development assistance (ODA) in 2023 and accounting for approximately 30% of total Development Assistance Committee (DAC) countries’   It is estimated that USAID programs have saved 90+ million lives in two decades and that if the current cuts continue through 2030, 14 million people who might have otherwise lived could die.

Specifically for HIV, at a time when scientific breakthroughs such as injectable lenacapavir for PrEP could accelerate HIV epidemic control, the dismantling of the global health infrastructure needed to deliver these tools threatens to squander this opportunity towards achieving sustainability.

The USA has been the leading government donor to humanitarian response plans, development aid, and multilateral development banks, mainly through the US Agency for International Development (USAID).

The agency’s aim was twofold: the first was to provide humanitarian assistance, and the second to also assist and support economic growth and self-resilience of developing countries, especially those deemed strategic for the US economic and geopolitical impact.

Between 2017 and 2020, the agency responded to more than 240 natural disasters and crises worldwide; in 2016 alone, the organisation provided food assistance to more than 53 million people across 47 countries.

USAID has been a supporter of the Global Alliance for Vaccines and Immunization (GAVI) and pledged $1·16 billion over 2020–23 to support the organisation. USAID has also been involved in combating malaria through the President’s Malaria Initiative (PMI).

Suspended US contracts for the PMI have halted hundreds of millions of dollars annually to countries such as Nigeria and Uganda, threatening an increase of nearly 15 million additional cases and 107 000 additional deaths globally in just 1 year of a disrupted malaria-control supply chain.     Impact on Humanitarian assistance

The UN World Food Programme has closed its southern Africa office, placing 27 million people at risk of hunger amidst the country’s worst drought in decades.

Moreover, a recent survey has estimated that 79 million people previously targeted for assistance are no longer being reached because of USAID programme cuts, and that the local capacity of national non- governmental organisations has been profoundly affected.

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