A peer-reviewed study published in The Lancet warns that the Trump administration’s decision to slash U.S. international development funding by 83% could cause about 14 million additional deaths worldwide by 2030, including more than 4.5 million children under five. The modelling, which examined 133 low- and middle-income countries, found that programmes financed by the U.S. Agency for International Development (USAID) had previously prevented an estimated 91 million deaths between 2001 and 2021. The steepest toll is expected from diseases that had been declining. The researchers project sharp rises in mortality from HIV/AIDS, malaria and tuberculosis if the cuts persist, equating the shock for many countries to the scale of a global pandemic or a major armed conflict. Separate findings from UNAIDS amplify the alarm. In its 2025 Global AIDS Update, the UN agency projects that a permanent suspension of the President’s Emergency Plan for AIDS Relief (PEPFAR) and other donor retrenchment could trigger six million new HIV infections and four million additional AIDS-related deaths between 2025 and 2029. UNAIDS Executive Director Winnie Byanyima called the funding gap a “ticking time bomb”, noting that community services have vanished overnight: Mozambique has lost more than 30,000 health workers and monthly initiation of HIV pre-exposure prophylaxis in Nigeria has collapsed to 6,000 people from 40,000. Evidence of current harm is already emerging. Boston University infectious-disease modeller Brooke Nichols estimates that the shutdown of USAID programmes has so far contributed to more than 332,000 deaths worldwide, including roughly 225,000 children. U.S. Secretary of State Marco Rubio disputes the figures, arguing that other nations should increase their own humanitarian outlays, but offered no alternative mortality estimate. UNAIDS notes that 31.6 million people were receiving antiretroviral therapy in 2024 and credits international aid with saving 27 million lives to date. The agency urges Washington and other donors to restore financing quickly, while encouraging recipient nations to expand domestic health budgets, if global goals to end AIDS and other preventable diseases by 2030 are to remain within reach.