CONTENTS
1. GLOBAL DEVELOPMENT ASSISTANCE IN A CHANGING WORLD 2
2. TRACKING A HISTORIC DECLINE IN DEVELOPMENT ASSISTANCE 3
3. SPOTLIGHT ON ODA AND DAH REDUCTIONS FROM THE UNITED KINGDOM AND THE UNITED STATES: 8
3.1. THE UNITED KINGDOM: DECLINING ODA 8
3.2. THE UNITED STATES: SIGNIFICANT REDUCTIONS AND SHIFTS IN GLOBAL HEALTH INVESTMENT 9
4. HUMAN COST: REDUCED ODA AND DAH THREATEN MILLIONS OF LIVES11
4.1. MODELLING ESTIMATES: UP TO MILLIONS OF ADDITIONAL DEATHS BY 2040 11
5. GLOBAL FUNDING CUTS CREATE CRISIS FOR MULTILATERAL INSTITUTIONS 14
5.1. MULTILATERAL CONTRIBUTIONS CREATE UNPRECEDENTED FUNDING GAPS 14
6. FUNDING CUTS FORCE MULTILATERALS TO SLASH BUDGETS, STAFF, AND OPERATIONS 17
7. CONCLUDING REMARKS 22
7.1. THE ROLE OF NON-STATE AND NON-WESTERN ACTORS 22

FIGURES
FIGURE 1. ODA AS PERCENT OF GROSS NATIONAL INCOME AMONG DAC COUNTRIES 2018-25* 3
FIGURE 2. ODA AS % GNI 7
FIGURE 3. PERCENT CHANGE IN ODA AS A PERCENT OF GNI BETWEEN 2022 AND 2025 AMONG DAC COUNTRIES 7
FIGURE 4. FORECASTED AVOIDABLE ALL AGE AND CHILD DEATHS RESULTING FROM REDUCTIONS IN USAID FUNDING FROM 2025-30 AN ON ANNUAL BASIS 13
FIGURE 5. TRENDS IN GLOBAL FUNDING FOR HEALTH FROM MULTILATERAL INSTITUTIONS TO COUNTRIES 14
FIGURE 6. CHANGES BETWEEN GAVI 6.0 (2026-30) AND GAVI 5.0 (2021-25) PLEDGES 15

TABLES
TABLE 1. ODA CHANGES FOR 2025 AND BEYOND AMONG HISTORICAL TOP GLOBAL BILATERAL ODA
CONTRIBUTORS 4
TABLE 2. MODELLING ESTIMATES ON MORTALITY IMPACTS FROM FUNDING CUTS 11
TABLE 3. MULTILATERAL BUDGET CHANGES AND IMPLICATIONS 17