Wealth Redistribution Policies to Mitigate the Impact of Development Assistance Defunding
Abstract
Background: This study aimed to assess whether the implementation of wealth-redistribution policies proposed in recent high-level international agreements to support development could mitigate the health impact of the current Official Development Assistance (ODA) defunding crisis.
Methods: We conducted an integrated retrospective and forecasting analysis using longitudinal panel data from 59 low-income and lower-middle-income countries (LLMICs). We estimated the association between per-capita ODA and mortality outcomes from 2002 to 2021 using two-way fixed-effects multivariable Poisson regression models with robust standard errors, adjusting for key demographic, socioeconomic, and health-system covariates. We then evaluated ten wealth-redistribution policies with validated country-level microsimulation models to forecast mortality under alternative wealth redistribution scenarios versus defunding through 2030.
Findings: Higher ODA funding levels were associated with a 24% reduction in age-standardised all-cause mortality (rate ratio [RR]:0.76;95%CI:0.67-0.87) and a 33% reduction in under-five mortality (RR:0.67;95%CI:0.50-0.89). Forecasting analyses showed that under the current ODA funding reductions in LLMICs, all ten wealth redistribution policies were associated with millions of averted deaths by 2030: in all ages, from 6,591,984 (95%UI:4,884,075–8,374,138) for a 3% Crypto Tax of the top 10,000 holders to 29,509,934 (95%UI:20,273,842–38,603,961) for a 3% wealth tax on ultra-high-net-worth individuals; in children under-five, from 1,312,912 (95%UI:802,926–1,785,121) to 3,464,607 (95%UI:1,235,930–5,609,331), respectively.
Interpretation: The implementation of wealth-redistribution policies proposed in recent high-level international agreements could mitigate the health consequences of the current ODA defunding crisis, avert millions of deaths, and support the achievement of the Sustainable Development Goals.
Key messages: • The implementation of wealth-redistribution policies proposed in recent high-level international agreements could fully mitigate the health consequences of the current ODA defunding crisis.
• Wealth-redistribution policies proposed in recent high-level international agreements could avert millions of deaths, and support the achievement of the Sustainable Development Goals.
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BibTeX
@article{barreix2026wealth,
title = {{Wealth Redistribution Policies to Mitigate the Impact of Development Assistance Defunding}},
author = {G Barreix and R Anderle and A Ferreira and L Sales and D Pena and C Monti and C García-Vaz and L Esposito and Q Bassat and D Rasella},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.473},
url = {https://doi.org/10.1093/eurpub/ckag169.473},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Wealth Redistribution Policies to Mitigate the Impact of Development Assistance Defunding
AU - G Barreix
AU - R Anderle
AU - A Ferreira
AU - L Sales
AU - D Pena
AU - C Monti
AU - C García-Vaz
AU - L Esposito
AU - Q Bassat
AU - D Rasella
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.473
UR - https://doi.org/10.1093/eurpub/ckag169.473
AB - Background: This study aimed to assess whether the implementation of wealth-redistribution policies proposed in recent high-level international agreements to support development could mitigate the health impact of the current Official Development Assistance (ODA) defunding crisis. Methods: We conducted an integrated retrospective and forecasting analysis using longitudinal panel data from 59 low-income and lower-middle-income countries (LLMICs). We estimated the association between per-capita ODA and mortality outcomes from 2002 to 2021 using two-way fixed-effects multivariable Poisson regression models with robust standard errors, adjusting for key demographic, socioeconomic, and health-system covariates. We then evaluated ten wealth-redistribution policies with validated country-level microsimulation models to forecast mortality under alternative wealth redistribution scenarios versus defunding through 2030. Findings: Higher ODA funding levels were associated with a 24% reduction in age-standardised all-cause mortality (rate ratio [RR]:0.76;95%CI:0.67-0.87) and a 33% reduction in under-five mortality (RR:0.67;95%CI:0.50-0.89). Forecasting analyses showed that under the current ODA funding reductions in LLMICs, all ten wealth redistribution policies were associated with millions of averted deaths by 2030: in all ages, from 6,591,984 (95%UI:4,884,075–8,374,138) for a 3% Crypto Tax of the top 10,000 holders to 29,509,934 (95%UI:20,273,842–38,603,961) for a 3% wealth tax on ultra-high-net-worth individuals; in children under-five, from 1,312,912 (95%UI:802,926–1,785,121) to 3,464,607 (95%UI:1,235,930–5,609,331), respectively. Interpretation: The implementation of wealth-redistribution policies proposed in recent high-level international agreements could mitigate the health consequences of the current ODA defunding crisis, avert millions of deaths, and support the achievement of the Sustainable Development Goals. Key messages: • The implementation of wealth-redistribution policies proposed in recent high-level international agreements could fully mitigate the health consequences of the current ODA defunding crisis. • Wealth-redistribution policies proposed in recent high-level international agreements could avert millions of deaths, and support the achievement of the Sustainable Development Goals.
SN - 1101-1262
SN - 1464-360X
ER -