Decades of progress — undone – Democracy and society – IPS Journal

Report on Global Aid Reductions and Their Impact on Sustainable Development Goals

Introduction: Progress and Setbacks in Achieving Global Goals

Significant historical progress has been made towards achieving key Sustainable Development Goals (SDGs), particularly SDG 1 (No Poverty) and SDG 3 (Good Health and Well-being). Data indicates a consistent decline in the proportion of the global population living in extreme poverty over the last two centuries, falling from 76 per cent in 1820 to 10 per cent in 2018. However, recent, unprecedented reductions in global aid threaten to reverse these decades-long gains and severely impede progress on the 2030 Agenda for Sustainable Development.

The Nexus of Poverty, Health, and Inequality: A Core SDG Challenge

The Social Gradient in Health and SDG 10

A direct correlation exists between socioeconomic status and health outcomes, a phenomenon known as the social gradient. This gradient illustrates a stepwise deterioration in health for each step down the socioeconomic ladder, directly impacting the achievement of SDG 3. Poverty is a primary driver of premature mortality and increased morbidity, both physical and mental. This systemic issue perpetuates a cycle of disadvantage that directly contravenes the objective of SDG 10 (Reduced Inequalities), as social and economic disparities manifest as critical health inequalities.

Historical Gains in Global Health Metrics Aligned with SDG 3

Despite persistent challenges, global health has seen notable improvements, reflecting progress toward specific SDG 3 targets. Key achievements include:

• A significant reduction in between-region inequalities in premature death over the last two decades.
• A halving of the global under-five mortality rate between 2000 and 2023, from 77 to 37 deaths per 1,000 live births, marking a substantial step towards SDG Target 3.2.
• The most profound drop in child mortality was observed in low-income countries, from 150 to 76 deaths per 1,000 live births.

However, a considerable gap remains to reach the high-income country benchmark of eight deaths per 1,000 live births, indicating that sustained investment is critical.

The Impact of Global Aid Reductions on SDG Implementation

Devastation of Healthcare Infrastructure and Failure of SDG 17

Recent funding cuts have led to the rapid dismantling of essential global health infrastructures. This trend represents a critical failure in SDG 17 (Partnerships for the Goals), as major donor countries retreat from their commitments. The consequences are immediate and long-term, undermining decades of progress.

1. United States: Abrupt halts to USAID-funded projects have been reported across Sub-Saharan Africa.
2. The Global Fund: A confirmed cut of $1.43 billion from its current funding cycle (until 2026) has been announced.
3. United Kingdom: A planned 40 per cent slash to the international aid budget from 2027.
4. France: A 37 per cent reduction in its aid budget.
5. Germany: A €1 billion reduction in its international aid.

Overall, global health aid is projected to decline by 40 per cent in 2025 compared to the 2023 baseline, jeopardizing the entire SDG framework.

Case Studies: The Erosion of SDG Progress in Sub-Saharan Africa

The effects of these funding cuts are already being felt by local organizations, directly impacting progress on SDG 3, SDG 8 (Decent Work and Economic Growth), and SDG 10.

• Burundi: A health organization was forced to terminate HIV care projects covering 70 per cent of the country after its USAID funding was halted. This directly undermines SDG Target 3.3 (end the epidemic of AIDS) and reverses progress made in building community trust and ensuring treatment adherence.
• South Africa: A large organization entirely reliant on USAID funding has closed, resulting in the loss of 3,000 jobs and the termination of healthcare support for up to one million people on HIV/AIDS treatment. This impacts both SDG 3 and SDG 8.
• Cameroon: A project leader reported an 80 per cent funding loss, leading to 79 job losses and the shutdown of projects supporting key populations and over 3,000 orphans, 30 per cent of whom are living with HIV. This regression affects marginalized groups, setting back goals related to health, equality, and social protection.

Analysis and Recommendations for Rebuilding Global Partnerships

Systemic Failure: Over-reliance on Singular Funding Sources

The current crisis exposes a critical vulnerability in the global aid architecture: the over-reliance of many health and poverty-reduction programs on a single funding source, notably the US government. This lack of diversification within the partnership model of SDG 17 has allowed for the rapid and catastrophic collapse of essential services. The long-term stability provided by previous funding models, which enabled infrastructure development and sustained care delivery, has been shattered.

A Call for Renewed Commitment to the 2030 Agenda

The evidence of past successes in reducing poverty and health inequality confirms that progress is achievable with targeted and sustained investment. To get back on track towards achieving the SDGs, the following actions are urgently required:

1. Develop Resilient Funding Infrastructures: A new global framework for long-term, diversified funding must be established to rebuild what has been destroyed and prevent future collapses.
2. Strengthen Global Partnerships: The Global Fund’s Eighth Replenishment Summit on 21 November 2025 presents a critical opportunity for world leaders to reverse recent budget cuts and recommit to a foundational mechanism for achieving SDG 3.
3. Reaffirm Core SDG Values: A renewed global political leadership must prioritize the values of solidarity, equity, and progress, which are central to the 2030 Agenda, to effectively address global poverty and health inequalities.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 1: No Poverty
   • The article directly addresses poverty, stating that “poverty can be defeated” and noting the historical decline in the proportion of humans living in poverty. It explicitly links poverty to negative health outcomes, describing it as a cause of “premature death and a higher probability of suffering from health conditions.”
2. SDG 3: Good Health and Well-being
   • This is a central theme of the article. It discusses health inequalities, premature death, under-five mortality, and the fight against specific diseases like HIV/AIDS. The text details the devastating impact of funding cuts on healthcare programmes in Sub-Saharan Africa, including the disruption of HIV care, prevention, and treatment services.
3. SDG 10: Reduced Inequalities
   • The article highlights the “social gradient” in health, where socioeconomic disadvantage leads to poorer health outcomes. It also discusses “between-region inequalities in premature death” and the specific vulnerability of “key populations” such as “homosexual individuals, transgender people and drug users,” whose access to care is jeopardized by funding cuts.
4. SDG 17: Partnerships for the Goals
   • The article’s core argument revolves around the instability of global aid and partnerships. It critiques the over-reliance on single funding sources like the US government (USAID) and details the widespread cuts in international aid from the UK, France, and Germany. It calls for “a new set of resilient long-term funding infrastructures” and highlights the role of international mechanisms like the Global Fund.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Under SDG 1 (No Poverty):
   • Target 1.1: By 2030, eradicate extreme poverty for all people everywhere. The article’s opening statement about defeating poverty and its reference to the share of the population unable to afford “the basic necessities of life” falling to 10 per cent in 2018 directly relates to this target.
2. Under SDG 3 (Good Health and Well-being):
   • Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age. The article explicitly mentions this, citing WHO data that “the global rate of under-five mortality halved between 2000 and 2023 from 77 to 37 deaths per 1000 live births.”
   • Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases. The article’s extensive focus on the disruption of HIV care, prevention (PrEP), and treatment in Burundi, South Africa, and Cameroon directly connects to the goal of ending the AIDS epidemic.
   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The collapse of community-based infrastructures that provided HIV testing, counselling, and patient follow-up demonstrates a direct threat to achieving this target.
3. Under SDG 10 (Reduced Inequalities):
   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status. The article highlights how funding cuts specifically shut down projects for “key populations, such as homosexual individuals, transgender people and drug users,” forcing them back into the “dangerous margins of society” and undermining their inclusion and access to care.
4. Under SDG 17 (Partnerships for the Goals):
   • Target 17.2: Developed countries to implement fully their official development assistance commitments. The article details the failure to meet this target by citing “unprecedented reductions in global aid,” including specific cuts by the US (via USAID), the UK (slashed by 40%), France (diminished by 37%), and Germany (€1 billion).

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG 1, Target 1.1:
   • Indicator 1.1.1 (Proportion of population below the international poverty line): The article provides a direct historical measure for this indicator, stating, “The share of the global population not able to afford the basic necessities of life fell from 76 per cent in 1820 to 10 per cent in 2018.”
2. For SDG 3, Target 3.2:
   • Indicator 3.2.1 (Under-five mortality rate): The article explicitly cites this indicator: “The World Health Organisation (WHO) reports that the global rate of under-five mortality halved between 2000 and 2023 from 77 to 37 deaths per 1000 live births.” It also provides rates for low-income (150 to 76) and high-income (8) countries.
3. For SDG 3, Target 3.3:
   • Indicator 3.3.1 (Number of new HIV infections per 1,000 uninfected population): This is implied through the discussion of halting prevention services. The article notes that programmes were “forced to stop providing pre-exposure prophylaxis (PrEP), a highly effective prevention treatment,” which would directly impact the rate of new infections.
4. For SDG 17, Target 17.2:
   • Indicator 17.2.1 (Net official development assistance… as a proportion of donors’ gross national income): The article provides several data points that measure this indicator in practice, though not as a percentage of GNI. It mentions a “$1.43 billion cut” from the Global Fund, the “UK slashed its international aid budget by 40 per cent,” France “diminished its budget by 37 per cent,” and an expected overall “decline by 40 per cent in 2025” for global health aid.

4. Summary Table of SDGs, Targets, and Indicators

Source: ips-journal.eu