The Lancet study (July 2025) and its 2026 follow-up have faced scrutiny for their methodology and the "absurdity" of their estimates. Critics and subsequent analyses highlight several potential fallacies:
1. The "Single Source" Fallacy
Critics argue the study essentially attributes nearly all global mortality improvements from 2001 to 2021 to USAID.
• Statistical Inconsistency: Total global lives saved during this period (if the 2001 death rate had remained constant) is estimated at roughly 79 million. The Lancet study's claim of 91.8 million lives saved by USAID suggests the agency was responsible for 100% of global progress plus another 11 million lives, ignoring the roles of other donors, domestic governments, and general economic growth.
• Disproportionality: The study attributes 47 million saved lives to progress in China
, which received negligible per capita USAID funding ($0.73/year) compared to least developed countries, where mortality actually increased by 8 million during the same period.
2. Static Policy Assumption
The 2030 projection of 14 million deaths assumes that global funding structures and host-country responses will remain static.
• Lack of Adaptation: Critics in The Lancet itself noted that the simulation fails to account for how governments and other donors reallocate funds, source products locally, or seek new international partners in response to U.S. cuts.
• Resilience Factors: While the authors later acknowledged that "more complex dynamics" (like domestic budget shifts) were not fully modeled, they maintained that these factors would unlikely shift the magnitude of the projected millions of deaths.
3. Misattribution of "Saved" Lives
Critics point out that the study uses a 15% reduction in all-cause mortality as a baseline, but fails to distinguish between deaths prevented by specific health interventions (like HIV or malaria drugs) and deaths prevented by broader social factors.
• Cause vs. Correlation: By focusing on all-cause mortality, the study may be capturing general global trends—such as improvements in agriculture, sanitation, and medical technology—and incorrectly labeling them as direct outcomes of USAID spending.
4. Overlooked Alternative Solutions
U.S. officials and some analysts have dismissed the findings as "outdated thinking," arguing that the study presumes the "old and inefficient" global aid system is the only solution. They suggest that the shift toward trade-based investment and domestic self-reliance could mitigate the long-term impact in ways the study's models do not capture.
1. The "Single Source" Fallacy
Critics argue the study essentially attributes nearly all global mortality improvements from 2001 to 2021 to USAID.
• Statistical Inconsistency: Total global lives saved during this period (if the 2001 death rate had remained constant) is estimated at roughly 79 million. The Lancet study's claim of 91.8 million lives saved by USAID suggests the agency was responsible for 100% of global progress plus another 11 million lives, ignoring the roles of other donors, domestic governments, and general economic growth.
• Disproportionality: The study attributes 47 million saved lives to progress in China
, which received negligible per capita USAID funding ($0.73/year) compared to least developed countries, where mortality actually increased by 8 million during the same period.
2. Static Policy Assumption
The 2030 projection of 14 million deaths assumes that global funding structures and host-country responses will remain static.
• Lack of Adaptation: Critics in The Lancet itself noted that the simulation fails to account for how governments and other donors reallocate funds, source products locally, or seek new international partners in response to U.S. cuts.
• Resilience Factors: While the authors later acknowledged that "more complex dynamics" (like domestic budget shifts) were not fully modeled, they maintained that these factors would unlikely shift the magnitude of the projected millions of deaths.
3. Misattribution of "Saved" Lives
Critics point out that the study uses a 15% reduction in all-cause mortality as a baseline, but fails to distinguish between deaths prevented by specific health interventions (like HIV or malaria drugs) and deaths prevented by broader social factors.
• Cause vs. Correlation: By focusing on all-cause mortality, the study may be capturing general global trends—such as improvements in agriculture, sanitation, and medical technology—and incorrectly labeling them as direct outcomes of USAID spending.
4. Overlooked Alternative Solutions
U.S. officials and some analysts have dismissed the findings as "outdated thinking," arguing that the study presumes the "old and inefficient" global aid system is the only solution. They suggest that the shift toward trade-based investment and domestic self-reliance could mitigate the long-term impact in ways the study's models do not capture.
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