Child malnutrition set to soar as U.S. and other countries slash foreign aid

Children in a hospital in the self-declared autonomous state of Puntland, East Africa, eat a ready-to-use therapeutic food in 2011. Aid organizations worldwide are warning this year’s funding cuts are disrupting supplies of these foods.Sven Torfinn/Redux

Reductions in international aid funding to fight severe malnutrition in children under 5 could lead to 369,000 additional deaths each year, a consortium of experts in nutrition and food systems has warned.

Their report, published today as a Comment in Nature that did not undergo peer review, finds that shrinking budgets could cut off treatment for 2.3 million severely malnourished young children worldwide. Nearly half of the projected additional deaths stem from the loss of support from the United States, which has axed thousands of grants worth tens of billions of dollars in foreign aid since President Donald Trump took office.

“The global community should react” to this crisis, says Robert Akparibo, a global health and nutrition researcher at the University of Sheffield who was not involved in the report. “Funding cuts to reduce investment … for this problem is a cause to worry.”

Children with severe malnutrition consume so little nutritious food that they can barely sustain basic bodily functions. They are at high risk of infections and up to 60% may die unless they receive treatment. That treatment typically includes ready-to-use-foods—energy-dense, peanut-based pastes that can be transported long distances and eaten straight from the packet.

The consortium behind the new report, a Canadian government-funded group called Standing Together for Nutrition, has previously estimated the effects of emergencies such as the COVID-19 pandemic. That crisis strained health systems, increased poverty, and disrupted food supply chains worldwide. But there was still funding for aid organizations to keep working, says Saskia Osendarp, a co-author on the report and executive director of the Micronutrient Forum, which studies and advocates for improvements in nutrition with support from the U.S. and other governments and philanthropic organizations.

This emergency is different, as countries around the world plan to dramatically slash foreign aid. In February, U.K. Prime Minister Keir Starmer announced that to increase defense spending, his government would reduce investment from 0.5% to 0.3% of gross national income—a cut of 40%, representing some £6 billion—by 2027. France recently approved a 35% decrease in aid funding, and other European countries have announced similar plans.

A bigger shock has been the sudden elimination of support from the United States, the world’s largest single-country donor of foreign aid. It disbursed that aid primarily through the U.S. Agency for International Development (USAID), which invested billions in food and nutrition programs annually. After the Trump administration suspended and then abruptly terminated the vast majority of USAID grants this year, many organizations have had to halt projects or shut down altogether.

In Nepal, for example, the USAID Integrated Nutrition project built on earlier successes in reducing malnutrition in the country, operating in nearly 500 municipalities. Workers with the nongovernmental organization (NGO) Helen Keller Intl helped the government identify malnourished children, procure treatment, and transport it to remote areas. Now, some children who previously received treatment are relapsing, and others are becoming newly ill, says Pooja Pandey Rana, who was managing the project. Mothers traveling to health centers have been turned away empty-handed because supplies haven’t arrived, she adds. “It’s heartbreaking.”

A government health worker measures the arm of a severely malnourished child in Nepal’s Banke district. Helen Keller Intl

Other terminated projects include a campaign by the NGO FHI 360 to find and treat children with severe malnutrition in rural areas of Yemen, which has been ravaged by conflict and floods that contaminate drinking water. Workers would drive hours to reach remote communities, some of which have estimated rates of severe malnourishment of about 10% in children under 5.

Although several project leads have told Science it is important for countries move away from dependence on U.S. funding, they express frustration that the drastic changes happened overnight, sending well-established programs into disarray and interrupting life-saving support systems.

To estimate the effect of these cuts on treatments for severely malnourished children, researchers at Standing Together for Nutrition used a “worst case” funding scenario—where all U.S. funding remains blocked and other countries press ahead with stated plans. They also assumed that nutrition funding would be reduced proportionally to its current share of national budgets. They calculate a shortfall of about $704 million for combating malnutrition compared with funds available in 2022—a decrease of 44%—and a reduction of nearly $300 million specifically for treating severe malnutrition.

Edward Frongillo, who co-directs the Global Health Initiative at the University of South Carolina and was not involved in the report, says its analyses and conclusions are supported by decades of evidence showing the effects of malnutrition, as well as the proven success of widely used strategies to save lives.

Osendarp says the report may have underestimated the impact of axed funds because it focuses on treatment for severe malnutrition. Terminated programs for water and food sanitation, agricultural sustainability, transportation, education, and other issues also influence children’s dietary health.

Nutrition experts are now working with local governments to seek alternative sources of support, which could include philanthropic and private donors as well as national health budgets, Osendarp says. She adds that the harm predicted in the report could be lessened if governments reverse or soften planned cuts, or give exemptions to nutrition programs. “We still hope that some of the decisions that have been announced will be modified.”

Akparibo echoes this sentiment. “Investment in nutrition for children, apart from the fact that it is a fundamental human right, is also building future human capital,” he says. “It looks like most governments are not aware of this. … If we don’t prioritize this age group, I don’t know where we are heading to.”