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US plans to slash spending on a flagship campaign against malaria threaten millions more cases and tens of thousands of extra deaths in Africa this year, according to new research on the potential impact of global aid cuts.
Scientists project that full funding of the President’s Malaria Initiative (PMI) would stop more than 13 million people on the continent contracting the mosquito-borne disease in 2025, but Donald Trump’s administration proposes to nearly halve its budget.
The study published in The Lancet underscores fears over the impact on global health of steep cuts to development assistance by Washington and some European capitals.
“International aid budgets are under increasing pressure and difficult decisions must be made to protect the progress that has been made,” said Peter Gething, the research’s senior author and co-head of the Malaria Atlas Project at The Kids Research Institute Australia.
“At full strength, we estimated that PMI could prevent nearly 14 million malaria cases and save more than 100,000 lives in Africa this year, by protecting vulnerable populations with bed nets, insecticidal spraying and antimalarial drugs.”
The PMI, which was launched 20 years ago under President George W Bush, has invested more than $9bn via the US Agency for International Development.
Congress appropriated about $800 million for it last year alone, but the Trump administration proposes to cut its annual budget by 47 per cent.
The Lancet study looks at projected contributions of a fully-funded PMI to crucial malaria control measures, such as insecticide treatment of bed nets, preventive medication for children at the height of the malaria season, and routine treatment.
It found the PMI would account for a big part of the total malaria response in 27 African countries this year, averting an estimated 11.3 per cent of cases and 37.5 per cent of deaths that would have occurred otherwise.
International efforts have helped significantly reduce deaths from malaria, although children under the age of five still account for three-quarters of deaths in Africa.
There were 263 million cases of the disease and just under 600,000 deaths from it worldwide in 2023. An estimated 2.2 billion cases of malaria and 12.7 million deaths have been averted by interventions since 2000, according to the World Health Organization.
The proposed cuts to the PMI would be “devastating”, said Martin Edlund, chief executive of Malaria No More, a non-profit group campaigning to eradicate the disease.
“It would reverse hard-won progress, hinder the rollout of new innovations, like breakthrough vaccines, and risk dangerous malaria outbreaks in vulnerable regions,” Edlund said. “By fighting malaria, the US promotes regional stability, advances American interests abroad, and strengthens its soft power.”
The Global Fund to Fight Aids, Tuberculosis and Malaria, which relies on the US for a third of its resources, urged the Trump administration to continue the PMI’s long-running support for efforts to tackle the disease.
“Together, PMI and the Global Fund account for 93 per cent of external financing for malaria — a vital lifeline for countries with limited fiscal space,” said Peter Sands, the fund’s executive director.
“Domestic investments are growing, and malaria programmes are strengthening health systems — but global solidarity remains essential to avoid losing ground.”
