Foreign aid cuts are reversing progress in saving mothers and babies, with hard-won gains in reducing maternal mortality now under threat as funding for health programmes in some of the world’s poorest countries is slashed. New figures from the World Health Organisation show that the global maternal mortality rate fell by 40 per cent between 2000 and 2023, saving hundreds of thousands of lives each year, but the pace of improvement has slowed dramatically and, in several nations, the trend is already turning backwards.
An estimated 260,000 women died during pregnancy or childbirth in 2023, the equivalent of more than 700 deaths every day or roughly one death every two minutes. The WHO data reveals that the average annual decline in the global maternal mortality rate was just 1.5 per cent between 2013 and 2023, far below the 2.6 per cent recorded between 2000 and 2010 — and this was before the most recent wave of aid cuts by the United States and the United Kingdom took full effect.
The benchmark set by the United Nations Sustainable Development Goal 3.1 is to reduce the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030. The current ratio stands at 197 per 100,000, meaning the world is dramatically off track. To meet the target, an annual rate of reduction of nearly 15 per cent would be required, a pace rarely achieved even in the best-resourced health systems. Seventy-five per cent of maternal deaths are caused by severe bleeding, infections, high blood pressure during pregnancy, complications from delivery, or unsafe abortion — all conditions that are preventable or treatable with basic medical care.
Impact of aid cuts on maternal health services
The consequences of reduced funding are already visible on the ground, particularly in sub-Saharan Africa, which accounted for around 70 per cent of global maternal deaths in 2023 — approximately 182,000 women. The Central African Republic, which has the second-highest rate of neonatal deaths in the world, is a stark example. Along its border with Sudan, where a civil war has entered its fourth year, severe aid cuts have forced midwives to lose their jobs, mobile maternal clinics to close and essential medicines to run out, even as an influx of refugees has dramatically increased the need.
Busayna, 25, fled massacres in Darfur on foot after militants murdered her husband. Now living in a mud hut around 40 miles from the Sudanese border, she told reporters she nearly died while giving birth to her fifth child. She had no money or food and had to walk to the nearest clinic while in labour. Her 35-year-old cousin, who had only just escaped Sudan, died in hospital after giving birth. “We couldn’t afford the medicine or blood she needed from the hospital, so she bled out,” Busayna said. “When I gave birth, we had no money or food as well. I am alone and struggling to provide.”
The head of the hospital where Busayna gave birth, Dr Ngonzo Lezin, said the facility had lost 12 staff members because of funding cuts, including eight from the maternity wards — among them all the midwives. “It is truly a catastrophe for the community. We will return to rudimentary practices, traditional treatments and care at home, which will only increase mortality,” he said from outside the maternity ward. “Our prayer is that someone can step in to support our healthcare system. The number of maternal deaths will rise. The number of child deaths will rise. For me, it is a cry from the heart.” Mobile health clinics funded by USAID that serviced the refugee camp in Birao, where Busayna now lives, were cancelled following US aid cuts last year.
Reproductive rights research group the Guttmacher Institute has estimated that the termination of health programmes by USAID alone likely resulted in 34,000 women and girls dying from complications during pregnancy or birth last year. A separate analysis suggests that a freeze on USAID funding could deny contraceptive care to 11.7 million women and girls, leading to 4.2 million unintended pregnancies and an estimated 8,340 maternal deaths.
A study published in March projected that the termination of USAID programmes by Donald Trump’s administration could cause maternal deaths to increase by an average of 45 per cent across six highly vulnerable countries in West and Central Africa — Burkina Faso, the Central African Republic, Chad, Mali, Niger and Nigeria — within a single year, amounting to approximately 1,000 additional maternal deaths per 100,000 live births. Niger is projected to see the largest proportional rise, at over 90 per cent, while Nigeria faces the largest absolute increase, with more than 300 extra deaths.
Another study, published in BMJ Global Health, found that maternal mortality rates tend to rise during Republican presidencies in the United States. The research, drawing on data spanning 40 years, showed that a switch from a Democratic to a Republican administration is associated with an 11 per cent increase in maternal mortality in countries heavily reliant on US aid — equivalent to around 45 additional deaths per 100,000 live births. This pattern is linked to the reinstatement of the Global Gag Rule, which prohibits funding for organisations that provide abortion services. Under the Trump administration’s policy “Protecting Life in Global Health Assistance”, more than 90 per cent of USAID’s awards for family planning and reproductive health programmes were terminated.
The scale of the US reductions is unprecedented. The Trump administration cut America’s foreign assistance programmes by 57 per cent in 2025 compared with 2024, causing global aid to fall by 23 per cent that year, with a further drop of 5.8 per cent projected for 2026. The US also terminated funding for the United Nations Population Fund, a key agency for family planning and reproductive health, cutting approximately $71 million including $38 million for reproductive and maternal health services in humanitarian settings, and withdrew from the World Health Organisation.
One study published in The Lancet this year projects that the broader impact of aid cuts on health programmes could result in 23 million extra deaths worldwide by 2030.
UK aid cuts deepen the crisis
While the gutting of health programmes under Trump has been unprecedented in scope, the United Kingdom is also making deep reductions that are likely to compound the damage. The UK government is reducing its aid spending by 40 per cent, with plans set out by the foreign secretary, Yvette Cooper, to cut bilateral support for African countries from £1.3 billion a year to £677 million over the next three years — a drop of 56 per cent. Total UK aid spending is expected to fall from £10 billion in 2026-27 to £8.9 billion the following year, before increasing slightly to £9.4 billion in 2028-29.
The cuts will hit bilateral aid to countries including Uganda, Kenya, Tanzania, Zambia, Malawi, Mozambique, Rwanda, Zimbabwe, Ghana, Mauritius, Senegal and Sierra Leone. The money the UK spends on humanitarian crisis relief — for natural disasters and other emergencies — will also be reduced by 15 per cent, to just under £300 million a year. The UK’s aid spending as a share of gross national income is set to fall to 0.3 per cent by 2027-28, the lowest level since 1999, down from the 0.7 per cent target the country once met and the 0.5 per cent it has spent in recent years. Analysis suggests these are the steepest cuts in the G7, even sharper than those implemented by the US under Trump.
Monica Ferro, head of the United Nations Population Fund’s London office, said the work over the last two decades had given the world “hope that finally the world would be on track to reach zero preventable maternal deaths”. She added: “We know that when funding is cut, services are shut down and women die. It is that simple. It may sound cruel, but it is that simple, and we have the evidence to prove it. It is very disappointing. The women and girls who are losing access to services will not forgive us for promising them a world with more dignity and then failing them because funding is being withdrawn.”