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David Miliband, former British foreign secretary and head of the International Rescue Committee (IRC), has warned that cuts to overseas aid by countries such as the US and UK will worsen global economic instability and humanitarian crises. Speaking at the International Monetary Fund and World Bank meetings in Washington, Miliband emphasized that the current global landscape is more interconnected than ever, and untended humanitarian crises can incubate political instability.Miliband expressed regret over the UK's decision to slash its aid budget under Keir Starmer's government, citing that supporting the world's poorest is morally justifiable and a 'good investment for Britain'. He also criticized the US under Donald Trump for 'abandoning' its aid program, which he believes will have far-reaching consequences for global stability.The Middle East conflict, particularly the Iran war, is expected to increase global poverty and displace millions of people. Miliband highlighted that 32.5 million people globally could be plunged into poverty due to the economic fallout from the conflict, with developing countries being hit the hardest. The closure of the Strait of Hormuz has led to soaring global energy and fertilizer prices, posing a 'food security timebomb' that could cause widespread hunger.Western governments, including the US, Germany, France, and the UK, are cutting their aid spending amid elevated borrowing and debt levels. According to the Organisation for Economic Co-operation and Development, rich countries cut aid spending by $174.3 billion in 2025, a decline of almost a quarter from 2024. Miliband argued that now is a critical time for international support, as the evidence shows that aid has a positive impact on reducing poverty.

The Trump administration is formally enlisting foreign governments to support a sweeping reorientation of global development policy, favoring trade over aid. This initiative, set to be introduced at the United Nations later this month, aims to move away from direct aid to poor nations and towards increased trade led by private companies. According to Tommy Pigott, Principal Deputy Spokesperson at the State Department, the initiative rejects what he calls a failed aid model, emphasizing that trade and free market capitalism are the surest paths to prosperity. Pigott also criticized those advocating for 'aid not trade,' suggesting they are supporting a corrupt NGO industrial complex. The initiative's four stated aims include: advancing pro-business reforms in developing economies, facilitating government-to-private sector dialogue to attract investment, highlighting countries that have pursued free-market development, and brokering business partnerships between developing nations and US companies or international organizations. This push comes amid a broader trend of diminishing humanitarian aid globally. OECD preliminary figures show that 26 of 34 donor nations shrank their aid budgets in 2025, with significant cuts in countries like France, Germany, and the United Kingdom. Chatham House estimates that the 17 largest donors are on course to cut more than $60 billion in aid between 2023 and 2026. The UK's commitment to aid is set to decrease to 0.3% of gross national income by 2027, its lowest share since 1999. A study published in The Lancet warns that sustained global aid cuts could result in at least 9.4 million additional deaths by 2030. The Center for Global Development estimates that USAID cuts alone may have already contributed to between 500,000 and a million deaths in 2025. The US mission to the United Nations is expected to host a formal signing event for the declaration before the end of April.

The United States has been proposing unusual bilateral health agreements to developing countries, mostly in Africa, in exchange for access to sensitive health data and critical minerals. These deals have sparked concerns of exploitation and have been met with resistance from several countries.In November, the US approached Zimbabwean authorities with a proposal that would have provided over $300m in funding in return for sensitive health data. However, Harare felt that the negotiations were 'lopsided' and promptly pulled out.Zambia also pushed back against a similar proposal, citing 'problematic' clauses that sought access to the country's minerals, including copper, cobalt, and lithium. The US had offered $1bn in funding over five years, but Lusaka requested a review of the proposal.Several African countries, including Nigeria and Kenya, have signed the health pacts, but the terms agreed remain unclear.Data or mineral demands in return for health aid are unprecedented in the history of US-Africa relations. Policy experts argue that tying crucial funding to sensitive national assets could have negative consequences for African nations and the US itself.'Supporting global health has clear benefits to the United States in terms of prevention of pandemics that can affect Americans too,' said Sarang Shidore, Africa director at the Quincy Institute for Responsible Statecraft. 'Linking such aid to payoffs in the extraction of critical minerals smacks of exploitative practices.'African nations have long relied on US funding to foot many of their health bills. In 2024, African countries received $5.4bn in US assistance, largely spent on humanitarian, health, and disaster needs.However, the US has argued that aid cuts suit its America First agenda, which prioritizes national interests. The stance has been met with criticism, with some economists arguing that aid is often ineffective and causes overreliance.Washington is now focused on government-to-government deals, which have typically required governments to take on an increasing share of their own health budgets in the next four to five years.Some analysts see this as a positive move to reduce overdependence on foreign funding and force governments to prioritize health spending in their budgets. However, the clauses that Washington is demanding to leverage its aid for data, rare earth elements, and other minerals have caused widespread outrage in some countries.In the case of Zambia, the US reportedly asked for access to the country's critical minerals in return for $1bn over five years. The US also asked for a one-way data-sharing agreement for 10 years.If Lusaka fails to ink a deal, US aid funding to the country will be discontinued, which could mean losing the remnants of funding Zambia still receives from the PEPFAR programme.

The UK government's recent announcement to make significant cuts to direct aid to Africa and the Middle East has been met with deep disappointment. This move is seen as a moral dereliction of duty, betraying the world's most marginalised, and a false economy that will bring greater instability to the world and make people less safe. The cut in aid to 0.3% of gross national income (GNI) from 2027 breaks Labour's 2024 manifesto pledge to restore development spending at the level of 0.7% of GNI “as soon as fiscal circumstances allow”. The UK is making the steepest proportion of aid cuts among G7 nations. As James Mattis, Donald Trump's defence secretary, once said: “If you don’t fund the state department fully, then I need to buy more ammunition ultimately.” This highlights the shortsightedness of cutting aid, which could lead to more conflict, famine, and persecution. The UK itself benefits materially from these investments. The recent inquiry by the all-party parliamentary group on global health and security on international health worker recruitment highlights the extent to which the NHS and wider economy rely on the skills, expertise, and partnerships rooted in the global south. The UK has saved £14bn in training costs through international recruitment and continues to depend on globally trained health professionals. Investment in global vaccination, disease surveillance, and research helps stop outbreaks before they spread internationally and place pressure on health systems. Preventing disease at source is one of the smartest investments we can make to protect patients in Britain. The situation in Somalia, on the edge of famine, underscores the importance of sustained investment in global development. Two consecutive failed rainy seasons have left 6.5 million people in crisis, more than double the number a year ago. The UK's humanitarian relief in Somalia is welcome, but the scrapping of nature funding and cuts to climate aid risk compromising its own strategy of preventing crisis before it takes hold.

A staggering 4.9 million children died in 2024, with the majority of these deaths being preventable, according to a new UN report. The report warns that aid cuts could hinder the global goal of ending preventable child deaths. Progress towards ending preventable deaths of children under five by 2030 has slowed by 60% since 2015. UN experts are calling for sustained investment in health systems to reach this target. “No child should die from diseases that we know how to prevent,” said Unicef executive director Catherine Russell. “But we see worrying signs that progress in child survival is slowing – and at a time where we’re seeing further global budget cuts.” The report highlights that Sub-Saharan Africa and South Asia have persistently had the worst rates of child death, largely due to newborn deaths. The most common causes of death were premature birth, pneumonia, and trauma during birth. Infectious diseases, including malaria, were also a major cause. 100,000 children died directly from severe acute malnutrition – with the highest numbers in Pakistan, Somalia, and Sudan. Aid cuts are threatening to close lifesaving facilities, humanitarian workers warn. “We are not moving far enough or fast enough and leaving 5 million [children] under the age of five vulnerable,” said Abdurahman Sharif, senior humanitarian affairs director at Save the Children. Aid cuts have affected 6,600 health facilities, with a third forced to close. Experts warn that without sustained investment, progress in reducing child deaths will slow further, and gains could begin to reverse.