Article Impact Level: HIGH Data Quality: STRONG Summary of The Lancet, S0140673625012401. https://doi.org/10.1016/S0140-6736(25)01240-1 Dr. Angela E. Apeagyei et al.
Points
- Development assistance for health peaked at over $80 billion in 2021 but is projected to plummet by 51% to just under $40 billion by 2025.
- The United States is leading these substantial reductions with major cuts to its contributions, followed by significant decreases from the UK, France, and Germany.
- Sub-Saharan Africa, a region heavily reliant on these funds, is anticipated to experience the most severe impact with a 25% drop in aid since last year.
- Under current policies, forecasts indicate that this funding stagnation will continue, with total assistance declining to a projected $36.2 billion by 2030.
- These drastic funding cuts threaten to reverse progress by curtailing programs for HIV/AIDS, malaria, tuberculosis, and essential maternal and child health services worldwide.
Summary
A new analysis quantifies historical and projected trends in development assistance for health (DAH) from 1990 to 2030, finding that the global health financing landscape is entering a period of sustained contraction. Methodologically, the study draws upon data from the OECD Creditor Reporting System, global health agencies, and private philanthropies, employing standardized keyword tagging to categorize disbursements. To forecast future DAH levels, researchers incorporated budget cuts announced by major donors for 2025 and utilized donor-specific funding targets, along with linear regression models, for projections to 2030.
The findings indicate that after peaking at US$80.3 billion in 2021 during the COVID-19 pandemic, DAH fell to $49.6 billion in 2024 and is projected to decline further to $38.4 billion in 2025, a level not seen since 2009. This drop is driven primarily by a 67% reduction in US bilateral aid, with significant cuts also announced by the UK and France. Sensitivity analyses place the 2025 estimate within a range of $36.8 billion to $40.0 billion, contingent upon final U.S. budget decisions. Under current policies, DAH is forecasted to stagnate, reaching $36.2 billion by 2030, with a potential range of $34.5 billion to $37.8 billion.
The interpretation of these findings suggests that substantial reductions in DAH from historically leading donors threaten to widen health disparities and reverse decades of progress, particularly in regions like sub-Saharan Africa, which faces a 25% drop in funding. The analysis highlights an urgent need for recipient countries to enhance domestic resource mobilization, improve efficiency, and reprioritize strategic health investments to mitigate the impact of these cuts and safeguard the gains in global health.
Link to the article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01240-1/abstract
References Apeagyei, A. E., Bisignano, C., Elliott, H., Hay, S. I., Lidral-Porter, B., Nam, S., Shyong, C., Tsakalos, G., Zlavog, B. S., Barış, E., Murray, C. J. L., & Dieleman, J. L. (2025). Tracking development assistance for health, 1990–2030: Historical trends, recent cuts, and outlook. The Lancet, S0140673625012401. https://doi.org/10.1016/S0140-6736(25)01240-1
