Deep cuts to the U.S. Agency for International Development and its potential dismantling under U.S. President Donald Trump could result in about 14 million additional deaths by 2030, according to a study released in a prominent medical journal.

which analyzed data from 133 low- and middle-income countries from 2001 to 2023, estimates that USAID-funded programs helped prevent more than 91 million deaths over the past two decades, including 30 million among children. If the cuts continue, researchers project 1.8 million excess deaths in 2025 alone, with a total of 14 million by 2030 ¡ª including 4.5 million children under the age of five.

¡°U.S. aid cuts ¡ª along with the probable ripple effects on other international donors ¡ª threaten to abruptly halt and reverse one of the most important periods of progress in human development,¡± the study said.

¡°This crisis would stem from a conscious and avoidable policy choice ¡ª one whose burden would fall disproportionately on children and younger populations, and whose consequences could reverberate for decades,¡± it said.

The analysis follows Trump¡¯s Jan. 20 executive order suspending most foreign aid programs. The dismantling of USAID was among the administration¡¯s first major moves after Trump tapped Elon Musk to lead a broad effort to reduce government spending. Nearly all of the agency¡¯s 10,000 staffers have since been forced out.

Secretary of State Marco Rubio has defended the cuts as necessary to fix past failures and root out progressive ideology.

In 2023, the U.S. accounted for 43% of all government humanitarian funding worldwide, up from 39% a decade earlier. USAID managed more than $35 billion in foreign assistance in fiscal 2024, while its operating budget ¡ª including salaries and overhead ¡ª was about $2 billion.

The study found that countries receiving higher levels of USAID support saw a 15% drop in overall mortality and a 32% decline in child mortality. Disease-specific improvements included a 65% reduction in HIV/AIDS deaths, 51% in malaria and 50% in neglected tropical diseases.

Though best known for its health initiatives, USAID also funds education, water and sanitation, nutrition and poverty programs. The study noted that these investments have long-term health impacts. For example, improved sanitation alone can reduce child mortality by 17%.

Shutting down USAID could cost more than $6 billion, including hundreds of millions in legal fees tied to lawsuits over layoffs and program cancellations, according to a draft State Department assessment.