In January, my colleagues and I were reeling from the sudden decision by the US government to suspend almost all funding for foreign aid. Organizations and community partners in the places where we work were stunned, frantically trying to understand if their programs would survive.
Several months after the first announcements of funding freezes, the US government has dismantled the United States Agency for International Development (USAID) and terminated much of its funding of global health and humanitarian programs. Without funding and staffing, many programs won’t survive.
Doctors Without Borders/Médecins Sans Frontières (MSF) teams have witnessed US-funded organizations reducing or canceling vital activities-including vaccination campaigns, protection and care for people caught in areas of conflict, sexual and reproductive health services, the provision of clean water, and adequate sanitation services.
As the impact of these cuts on patients comes into focus, all of us who work in humanitarian action are trying to navigate a new and sudden reality: The aid sector as we knew it no longer exists. The US government had long been the leading supporter of global health and humanitarian programs, responsible for around 40 percent of all related funding. MSF does not receive US government funding. We were not directly affected by these cuts, but our programs face the looming prospect of higher costs for supplies, staffing and logistical support.
While we remain committed to providing medical and humanitarian aid in more than 70 countries across the world, we recognize that we will be affected by the gutting of programs around us. Our teams work closely with other health and humanitarian organizations to deliver vital services, and many of our activities involve programs that have been disrupted due to funding cuts. It will be much more difficult and costly to provide care when so many Ministries of Health have been affected globally and there are fewer community partners overall. We will also be facing fewer places to refer patients for specialized services, as well as shortages and stockouts due to hamstrung supply chains.
We are especially concerned for children, pregnant women, elderly, and other vulnerable people who have the greatest need for humanitarian assistance and will be hit the hardest. Other affected groups including refugees, people living in conflict zones, and people with HIV and tuberculosis, from whom we are already hearing reports of medicine shortages and closed clinics.
In many places, our teams are already seeing a demand for more services and have stepped up to fill in some of the gaps.
In Tigray, Ethiopia, a US-funded organization was forced to stop its mental health services for adults and children with conflict-related trauma. MSF took on the organization’s caseload, nearly doubling the number of mental health patients receiving care in Sheraro.
In Haiti, MSF temporarily stepped in to replace Solidarités International's suspended water and sanitation activities in sites hosting people displaced by the violence in Port-au-Prince.
In MSF's program in San Pedro Sula, Honduras, there has been a 70 percent increase in distribution in prep (PrEP) tablet, a preventive measure for those at high risk of HIV infection, from January to March compared to the previous quarter. Our teams are also seeing an increase of 30 percent in consultations for health services, highlighting the growing demand as USAID funding cuts reduce access to other HIV prevention services.
In South Sudan, while other organizations have had to scale down their presence, MSF teams are responding to a rampant cholera outbreak amid escalating violence. In Akobo County, organizations that received US funding, including Save the Children, suspended mobile clinic activities due to aid cuts. Save the Children reported in early April that at least five children and three adults with cholera died while making the long, hot trek to seek treatment in this part of South Sudan.
MSF teams will continue to run programs, fill gaps where feasible, and document the impact of these funding cuts and policy shifts. Speaking out will require clarity and courage, particularly regarding marginalized communities such as people seeking access to sexual and reproductive health services and safe abortion care, LGBTQI+ people, people caught in conflict, and refugees and migrants.
We are still trying to adjust to this new reality. With your support we will continue this vital work and face a transformed humanitarian aid landscape together. We are fully committed to delivering medical care in this complicated new aid environment. It is thanks to donors like you that we are able to forge ahead during such a challenging time.
We are grateful for your continued support.
Avril Benoît
Chief Executive Officer, MSF USA
Chief Executive Officer, MSF USA
