Aid Cuts Threaten Global Eye Care Progress

The past 35 years marked steady progress towards reducing blindness and vision impairment worldwide. While absolute numbers climbed due to population growth, global blindness prevalence declined by half, and moderate to severe vision impairment prevalence rose slightly, driven largely by untreated presbyopia and other age-related diseases in ageing populations.¹

Supporting these gains was a coincidental increase in donor governments’ official foreign development aid to lower-income countries, which more than doubled worldwide from less than $100 billion in 2000 to about $220 billion in 2023. That trend has now reversed. After a 9% drop in 2024, the Organisation for Economic Co-operation and Development (OECD) projects a further decrease of 9–17% in 2025, with more cuts announced through 2027.

The sharpest cuts are from the US, which accounted for about one-quarter of the total contributions over the past decade. And while several donor countries, including Ireland, Korea, and Spain, plan increases, 10 others, including France, Germany, and the UK, are also pulling back. Indeed, the 4 largest donors, which together account for nearly two-thirds of all government donations, all cut aid in 2024, and 2025 may mark the first time they all declined for 2 consecutive years.

As a result, total official development aid is likely to fall to 2020 levels by 2027. “While still above 2019 pre-pandemic levels, the projected cuts risk undoing recent gains at a time of growing needs across countries and territories that receive [official development aid],” according to a June OECD report.²

Looming health crisis

The impact on global health could be devastating. Regarding cuts to programmes funded by the now-dissolved US Agency for International Development (USAID) alone, “[f]orecasting models predicted that the current steep funding cuts could result in more than 14 051 750 (uncertainty interval 8 475 990–19 662 191) additional all-age deaths, including 4 537 157 (3 124 796–5 910 791) in children younger than age 5 years, by 2030,” according to a June study in The Lancet.³

The study also estimated that USAID-funded programmes cut all-cause mortality for all age groups by 15%, and 32% for children aged less than 5 years, saving about 92 million lives from 2001 through 2021. “USAID funding has significantly contributed to the reduction in adult and child mortality across low-income and middle-income countries over the past two decades. […] Unless the abrupt funding cuts announced and implemented in the first half of 2025 are reversed, a staggering number of avoidable deaths could occur.”

Funding for some programmes initially cut has been restored, though mostly for humanitarian aid. And overall cuts remain steep, leaving a fragmented and uncoordinated system.⁴

Though death due to sickness and starvation, particularly AIDS and malaria, is the most severe outcome, funding cuts also significantly harm global eye care. The cuts interfere with the treatment of blinding neglected tropical diseases, including trachoma, onchocerciasis (river blindness), and lymphatic filariasis, leading at least one affected agency to pause anti-blindness and other medication and health support campaigns.

“[T]he suspension of US funding now means this essential work is on pause. Even temporarily suspending mass drug administration means millions of people in vulnerable communities will miss life-saving treatments. These diseases don’t pause—every missed round of mass drug distribution allows them to spread, increasing suffering and disabling pain. Currently 100 million people across 6 African countries that Helen Keller serves are now at risk,” according to a statement on the Helen Keller International website.⁵

More broadly, cutting support for primary care, including vaccinations, leads not only to increased mortality but increased ocular disease related to infections, including malaria, herpes, and measles—which in the first half of 2025 hit a 25-year record for new cases in, of all places, the US, where the disease was considered eradicated in 2000, and vaccination rates have been falling.

Prevention cuts

Funding for health clinics has already led to the closure of some outposts in lower-income countries, particularly in rural areas, according to aid agency reports. Eye screening, access to eyeglasses, and support for hospitals and clinics offering medical and surgical treatment for cataracts, glaucoma, and retinal disease are among the casualties.⁶ Malnutrition and treatable vitamin A deficiencies also contribute to poorer eye health, as do deep cuts in sanitation and clean water assistance.

The cuts have pushed many groups to step up private fundraising as well as advocacy efforts, including Helen Keller International.

“We are fighting for the lives and well-being of our communities. We are in Washington DC, speaking with elected officials to help them understand the full impact of funding pauses. We are rallying together with like-minded partners who don’t want to turn away from children and families. We are speaking with journalists to put a face to those bearing the brunt of US government funding pauses and cuts. And we are working around the clock to invite new donors and trusted friends to act with courage and generosity,” the organisation said in a statement.

We can wish them well—and help with donations and advocacy.

1. The Lancet Global Health, 2021 Feb; 9(2): e130-e14.

2. “Cuts in official development assistance: OECD projections for 2025 and the near term,” OECD Policy Briefs. 26 June 2025. https://www.oecd.org/en/publications/cuts-in-official-development-assistance_8c530629-en.html

3. Cavalcanti DM, et al. The Lancet, Online first. 30 Jun 2025. doi:https://doi.org/10.1016/S0140-6736(25)01186-9

4. Walker AS, Khurana M, Zhang C. “What remains of USAID?,” New York Times, 22 Jun 2025.

5. Helen Keller International. www.helenkellerintl.org

6. Cure Blindness Project. www.cureblindness.org