Development cooperation saves lives. The numbers are now in.

By Manuel Hetzel

A landmark study just published in The Lancet Global Health should be read by every political decision-maker, including in Switzerland.

Researchers analysed data on official development assistance (ODA) from 93 low- and middle-income countries, spanning 20 years. The findings are unambiguous and extremely encouraging: development cooperation has been associated with a 23% reduction in mortality and a 39% drop in deaths of small children in recipient countries. Mortality from HIV/AIDS fell by 70%, mortality from malaria by 56%.

These are not abstract statistics. These are tens of millions of human lives saved. Mothers who survived childbirth. Children who grew up. Communities that didn't lose a generation to preventable disease.

Development cooperation is not, as sometimes portrayed, money disappearing into a black hole. Not naive idealism. It is a proven, evidence-based investment in human health and development.

Why cutting development assistance is the wrong choice

I find the current political direction - the slashing of development cooperation budgets, also here in Switzerland - extremely troubling. Reducing development cooperation is not "saving money." It is a choice to let preventable deaths happen, undoing what took a generation to build. And what, in fact, taxpayers should be proud of.

The study predicts that even under conservative defunding scenarios, up to 9.4 million excess deaths could occur by 2030, including 2.5 million children. Under a severe defunding scenario, that figure rises to 22.6 million - including 5.4 million children under five.

Cutting development assistance is often framed as "putting our interests first." The opposite is true. Investment in international cooperation is, in fact, in everybody's interest. Here is why:

Global health security. Infectious diseases don't respect borders. Stronger health systems in high- and low-income countries mean earlier detection and mitigation of outbreaks - be it COVID-19 or Ebola.

Economic opportunity. Healthier, well-educated populations become economic partners, benefitting companies that operate globally. Development cooperation helps build markets.

Migration. Much of the migration pressure we debate endlessly in Europe and elsewhere is rooted in fragile states, poor health, and lack of opportunity. Investing upstream is more humane and more effective than managing the consequences.

Switzerland's international standing. Switzerland often punches above its weight - in diplomacy, in multilateral institutions, even in business - because of our humanitarian tradition and credibility as a development partner. These are Swiss values we should not sacrifice for short-term political gains.

The evidence is there. The choice is political.

Development cooperation is not charity. It is a strategic investment in a healthier, more stable, and more prosperous world - one that Switzerland benefits from as much as anyone. The details of how we engage in development cooperation should, of course, be regularly reviewed and openly discussed. But sweeping budget cuts will eventually hurt ourselves.

The authors of the Lancet study are careful to note that their analysis cannot prove causation beyond doubt. At the same time, their model controls for socio-economic and health-system changes over time, and consistent findings across diseases, regions, and methods make coincidence an unlikely explanation.

I think most people would be proud of contributing to saving lives and to a healthier world. The evidence is there. We should not let hard-won progress quietly unravel.

About the author:

Manuel Hetzel is President of the Swiss Malaria Group, Head of Epidemiology and Intervention Sciences at the Swiss TPH, and Professor of Epidemiology at the University of Basel.

This opinion piece was originally shared as a post on LinkedIn.

Ferreira da Silva et al. (2026). Impact of two decades of humanitarian and development assistance and the projected mortality consequences of current defunding to 2030. The Lancet Global Health. https://doi.org/10.1016/S2214-109X(26)00008-2