SEATTLE, Wash., July 15, 2025 – After 30 years of health improvements around the world, funding cuts to global health could put lifesaving health care at risk between now and 2030, according to the latest annual report, Financing Global Health (FGH), released today by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine in Seattle.
The report incorporates an additional shortfall that's expected due to another proposal under consideration by the US that would immediately cancel previously allocated funds that were approved for the U.S. Agency for International Development (USAID) and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), created 22 years ago by former President George W. Bush. The estimates also factored US cuts to Gavi, the Vaccine Alliance that were announced in June 2025.
The new figures track current and future donor contributions toward health improvement and maintenance in low- and middle-income countries, known as development assistance for health (DAH). In 2021, total DAH reached a record $80 billion due to the COVID-19 pandemic, when the world was unified in pouring resources into health systems to protect all populations. Since then, DAH has steadily declined: it plummeted by 51% to $39 billion by 2025, marking the lowest in 15 years. If current policies remain unchanged, total DAH is forecasted to decline by another 8% to $36 billion by 2030.
"These funding cuts are detrimental to global health, particularly for the most vulnerable populations where DAH has saved countless lives," said lead author Dr. Angela Apeagyei, research assistant professor at IHME. "The drastic and abrupt reduction to DAH could compromise the progress in health that has been achieved globally."
Global financial assistance is critical in regions where resources are limited, and disease burden is high. Enacting cuts to global health initiatives could reduce the treatment and prevention of infectious diseases such as HIV/AIDS, malaria, and tuberculosis, as well as curtail access to maternal, neonatal, and child health services. The budgetary consequences could also impact water safety, sanitation, and food security, which are interconnected and possibly lead to high mortality rates, especially among children.
Since United Nations agencies have been tracking DAH since 1990, the US has been the largest source of funding overall. This year, the US led the way in making the largest reduction of 67%, followed by the UK, France, and Germany. In contrast, Japan increased its DAH by 2%, while Canada made no changes.
The impact of the cuts in low-income countries is substantial, with the greatest reductions to those that heavily rely on DAH funds, mainly in sub-Saharan Africa, which is estimated to face the largest drop of 25% since last year. Forecasts expect another 7% drop in that region over the next five years.
Global health is an issue for all countries, including high-income regions, due to the potential threat of economic, political, and security crises that could arise from an outbreak of infectious diseases. As the world has seen with the COVID pandemic, international boundaries are permeable, and migration and travel can facilitate the rapid spread of disease.
The FGH report is being published concurrently with the peer-reviewed research article Tracking development assistance for health, 1990–2030: historical trends, recent cuts, and outlook published today in The Lancet.
