We conclude that aid programs financed by American taxpayers saved approximately three million people annually. As we will see, it’s hard to estimate this precisely, so our “best estimate” of three million could plausibly be closer to two or four million.

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Kenny and Sandefur focused on interventions targeting HIV/AIDS, tuberculosis, malaria, vaccines, and humanitarian assistance. Their estimates range from 2.3 to 5.6 million lives saved annually, with their central estimate of 3.3 million. The breakdown is shown in the chart.

AIDS programs saved the largest number of lives: over 1.5 million per year. Between a quarter and half a million were saved by vaccines, tuberculosis, malaria, and humanitarian response each.

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Since this was just one analysis, it’s worth comparing these results to other estimates. A recent paper, published in The Lancet — which received a lot of attention — estimated that USAID averted 92 million deaths in the 21 years from 2001 to 2021.6 On average, that would be approximately 46 million per decade or 4 to 5 million lives saved annually.

Several experts have flagged methodological limitations in this study, so we would not recommend basing estimates from this paper alone. Still, it does give a similar figure of at least several million per year.

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The State Department administers PEPFAR and says the program has saved 25 million lives. But it’s also worth looking at independent analyses; a recent assessment finds that it has saved between 7.5 and 30 million lives. Again, this highlights how uncertain these estimates are but suggests that the State Department’s estimate of 25 million could be reasonable, as does Kenny and Sandefur’s estimate of around 1.6 million per year.