Elon Musk’s wood-chipping of the United States Agency for International Development (USAID) is poised to leave piles of bodies behind in its wake, a new study suggests. Scientists have calculated that recent funding cuts to USAID could lead to millions of preventable deaths worldwide over the next half-decade.

An international group of researchers conducted the study, published Monday in the Lancet. They estimated that USAID funding in developing countries has helped save dozens of millions of lives since 2001, while the drastic cuts dictated by Musk and his Department of Government Efficiency (DOGE) could contribute to 14 million deaths in the next five years, including many children under 5 years old.

“Our estimates show that, unless the abrupt funding cuts announced and implemented in the first half of 2025 are reversed, a staggering number of avoidable deaths could occur by 2030,” the researchers wrote.

The renewed Trump administration has gutted many crucial government agencies and departments since January, including the Centers for Disease Control and Prevention. But perhaps none of the cuts have been as vicious as those to the USAID, the agency primarily in charge of distributing the country’s foreign aid.

Though the USAID certainly has its blemishes (government watchdogs have alleged that its funding contributed to widespread fraud during America’s occupation of Afghanistan, for instance), it’s been a net positive for global public health. USAID resources have bolstered programs throughout the world to provide people vaccines, anti-malaria mosquito nets, and other vital medical supplies. One particular USAID-operated initiative, the President’s Emergency Plan for AIDS Relief (PEPFAR), is estimated to have prevented over 5 million children from being born with HIV.

Musk and others within the Trump White House seemed to take a perverse joy in sabotaging the USAID through widescale cuts and layoffs. In early February, Musk bragged on X that he had “spent the weekend feeding USAID into the wood chipper.” While USAID employees have challenged these layoffs in court, arguing they were illegal and unconstitutional, the agency remains critically underfunded and shorthanded.

The study researchers first looked back at the life-saving impact that USAID funding has had globally, then projected how the current loss of resources will change things moving forward. Based on data from over 130 countries, they estimated that USAID funding had likely saved 91 million lives between 2001 and 2021, with the largest reductions in mortality tied to HIV/AIDS, malaria, and neglected tropical diseases. They also forecasted that the DOGE-mandated cuts will result in 14 million preventable deaths by 2030, including 4.5 million deaths of children under 5.

“Our analysis shows that USAID funding has been an essential force in saving lives and improving health outcomes in some of the world’s most vulnerable regions over the past two decades,” said lead author Daniella Cavalcanti, a postdoctoral researcher at the Federal University of Bahia’s Institute of Collective Health in Brazil, in a statement. Scientists from the Barcelona Institute for Global Health in Spain and the University of California, Los Angeles, also contributed to the study.

Musk is no longer officially part of President Donald Trump’s inner circle, his designation as a special government employee having run out in late May. And after a brief ceasefire, he and Trump have continued to throw barbs at each other over the GOP’s Big Beautiful Bill (which itself may lead to many preventable deaths from Medicaid cuts). But DOGE and many of the cuts it’s implemented continue to endure. Other recent reports from aid groups indicate that people are already dying as a result of these funding losses.

Unless things change dramatically, Musk’s legacy will be one stained with the blood of the poor and vulnerable.