The United Nations’ 2025 report on progress towards the Sustainable Development Goals states that none of the 17 SDGs will be achieved by 2030.

An analysis of progress towards the various SDG targets shows just how far we are from meeting the commitments made.

With five years to go until the end of the 2030 Agenda, most of the targets are far from being met: only 35% of the 137 SDG targets are showing good or moderate progress, 47% of the targets have made marginal or no progress, and most seriously, 18% of the targets have regressed and are in a worse state than in 2015, when the baseline figures were established.

SDG 3, ensuring healthy lives and promoting well-being for all, is progressing more slowly than the Sustainable Development Goals as a whole. Only 10% of its targets have been met or are on track to be met, whilst 15% show no progress at all.

Since 2000, maternal mortality has fallen by 40% and infant mortality by 52%. However, every day 712 women die from complications related to pregnancy and childbirth, and 13,150 children die from mostly preventable causes, concentrated mainly in impoverished countries.

Inequality in access to healthcare is evident: in 2022, 31% of public health expenditure in low-income countries depended on international aid, which barely bridges the enormous gap with high-income countries, whose health budgets are 70 times larger.

The drastic reduction in Official Development Assistance, overnight, will have immediate consequences for people’s lives and health.

The Trump administration’s decision to end 83% of USAID projects has led to the suspension of numerous health programmes, with the risk of causing up to 14 million additional deaths by 2030, 32% of whom would be children under five, severely affecting low-income countries, where international cooperation is an essential pillar for sustaining fragile health systems.

The scientific evidence on the links between climate change and health is becoming increasingly robust, reinforcing the urgency of adapting health systems to this new reality.

WHO is promoting a Global Action Plan on Climate Change and Health, which aims to foster climate-smart health systems that not only respond to the impacts of climate change but also help to mitigate them, for example by reducing greenhouse gas emissions. Currently, health systems account for 5% of global emissions, which highlights their role in the climate crisis.

This Plan goes beyond the strictly health-related sphere, as it is based on the ‘One Health’ approach, integrating human, animal and planetary health, and calls for profound transformations in our societies, challenging the consumerist model of unlimited growth that currently prevails.

The crisis in multilateralism and the weakening of international institutions pose a direct threat to the ability to coordinate global responses to pandemics and health emergencies.

The withdrawal of some countries from organisations such as WHO, coupled with budget cuts, has undermined their legitimacy and effectiveness, increasing the fragility of the international system at a time when cooperation is needed more than ever.

Reforming and strengthening these institutions is essential to ensure they can respond swiftly, transparently and credibly, whilst encouraging the active participation of all states and civil society in decision-making.

The 6.9% reduction in Official Development Assistance (ODA) in 2024, equivalent to a decrease of $15.119 billion compared to the previous year, constitutes a historic and unprecedented decline in absolute terms and the third-largest percentage drop in the history of the DAC.

In 2024, ODA from DAC countries stood at just 0.33% of Gross National Income (GNI), far short of the international commitment of 0.7% set by the United Nations for 2030.

The fall of 0.04 percentage points compared to 2023 reflects a sustained decline that seriously undermines the credibility of donor countries and the viability of the 2030 Agenda. The fact that only four of the thirty-one DAC countries have met the target highlights a lack of political will and a disconnect between rhetoric and action.

The OECD’s forecast of a 17% reduction in total ODA, combined with the historic cut by the United States (US$50 billion in a single year, equivalent to 92% of its aid) and those announced by several European countries (an additional US$17.5 billion), suggests that 2025 could become the worst year in history for international cooperation.

In 2023, ODA allocated to health by DAC countries fell by 44% compared to 2022, standing at $15.514 billion and reducing its share to 8.7% of total bilateral aid, half that of the previous year.

Allocable ODA for health fell by 34% compared to 2022, dropping back to 2010 levels in total terms and to 2006 levels in the multilateral sphere. We are witnessing a historic setback that takes us back more than a decade.

The cuts affected not only the response to COVID-19, but also key programmes targeting sexually transmitted diseases such as HIV/AIDS. This trend demonstrates that, despite the lessons of the pandemic, there is still no sustained and coherent strategy on global health.

In 2024, Spanish ODA reached €4,021 million, an increase of 11.8% compared to the previous year. Although this growth is positive in absolute terms, the percentage of GNI remains at just 0.25%.

This means that Spain remains far from meeting its international, parliamentary and legislative commitments: the 0.55% target set for this parliamentary term ending in 2027 and the 0.7% target set out in the Cooperation Act for 2030.

The gap with the EU average (0.47%) and the DAC average (0.33%) reflects a lack of convergence with international standards and jeopardises the credibility of Spanish cooperation.

Evolution of Spanish gross ODA and percentage of GNI 2006-2024

ODA allocated to health has seen an absolute increase of €29 million, reaching €276.7 million. This growth does not translate into a proportional increase within Spanish cooperation as a whole, where health accounts for a relative share of just 6.87%, clearly below the DAC average of 8.9%.

It is worth noting that, of the total allocated to health, the AECID allocates 96.3 million euros, representing 16.3% of its budget, a percentage that clearly reflects the priority given by the Agency to the health sector, in line with the global challenges we face.

Analysis of trends in Spanish gross ODA for health, 2004–2024

2024 has seen an unprecedented worsening of humanitarian crises, marked by an increase in violence against the civilian population, obstacles to humanitarian access and systematic attacks on health personnel and infrastructure.

The scale of the needs—more than 323 million people requiring assistance—contrasts with a significant reduction in international funding, which has left millions of people in critical situations without support.

Regions such as Eastern and Southern Africa, the Middle East and Asia account for the greatest needs, reflecting how the climate crisis and protracted conflicts are deepening vulnerability and putting the survival of millions of people at risk. Forecasts for 2025 paint a grim picture: more than 305 million people will need humanitarian assistance, whilst food insecurity continues to rise and famine is re-emerging for the first time since 2020.

Against this backdrop, it is incomprehensible that international humanitarian funding fell in 2024 compared to 2023, reaching only $36.367 billion. Although the United States significantly increased its contribution and consolidated its position as the leading donor, accounting for 38.9% of the total, most major donors reduced their contributions, reinforcing a downward trend that critically affects the sector’s capacity to respond to increasingly complex and protracted crises.

The sharp reduction in funding — particularly following the closure of USAID and cuts by other donors — has left the humanitarian sector with an alarming funding gap: by mid-November 2025, only 25.1% of the funds requested to meet humanitarian needs had been received, 21.9% of those requested for food security, and 17.5% for nutrition.

The ‘humanitarian reset’ promoted by OCHA in response to these cuts has focused more on the hyper-prioritisation of resources than on a strategic reform of the system.

As a result, millions of people are left without coverage, whilst the humanitarian space is weakened and increasingly constrained by political and geopolitical interests.

The health sector in humanitarian action is facing a critical funding crisis at a time when health needs have intensified due to conflicts, natural disasters and disease outbreaks.

In 2024, funding allocated to health by the international community fell by $651 million compared to 2023, leaving millions of people without coverage.

This reduction has occurred both in UN appeals —$172 million less than in 2023— and in funding allocated outside the UN system —$479 million less—.

The protection of healthcare in conflicts is enshrined in international humanitarian law. However, attacks and violence against healthcare systems are carried out with total impunity.

Over the last three years, attacks on healthcare in conflict settings have increased alarmingly, both in frequency and severity.

In 2024 alone, 3,623 violent incidents were recorded, with 1,100 medical facilities damaged or destroyed, more than 900 healthcare workers killed in 27 countries and 470 detained in 15 countries.

In 2024, Spanish Cooperation in Humanitarian Action as a whole (AGE, CC. AA. and EE. LL.) fell by 20% compared to 2023, dropping from €213,777,954 to €174,175,615.

This decline once again places the percentage of ODA allocated to humanitarian action below 5%, specifically at 4.33%, representing a fall of 1.6 percentage points compared to the previous year.

The General State Administration (AGE) was primarily responsible for this cut, with a reduction of 24% compared to 2023, whilst Spanish decentralised cooperation (autonomous communities and local authorities) increased its contribution to ODA by €1.4 million, allocating 10.63% of its ODA.

Trend in Spanish ODA Allocated to Humanitarian Action