Part of the problem is that the stop-work order came at a time when these organizations were already experiencing “shortages in commodities,” Sherwood said. Typically, centers might give a person a six-month supply of antiretroviral drugs. Before the stop-work order, many organizations were only giving one-month supplies. “Almost all of their clients are due to come back and pick up (more) treatments in this 90-day freeze,” she said. “You can really see the panic this has caused.”
The waiver for “life-saving” treatment didn’t do much to remedy this situation. Only 5% of the organizations received funds under the waiver, while the vast majority either were told they didn’t qualify or had not been told they could restart services. “While the waiver might be one important avenue to restart some services, it cannot, on the whole, save the US HIV program,” says Sherwood. “It is very limited in scope, and it has not been widely communicated to the field.”
AmfAR isn’t the only organization tracking the impact of US funding cuts. At the same event, Sara Casey, assistant professor of population and family health at Columbia, presented results of a survey of 101 people who work in organizations reliant on US aid. They reported seeing disruptions to services in humanitarian responses, gender-based violence, mental health, infectious diseases, essential medicines and vaccines, and more. “Many of these should have been eligible for the ‘life-saving’ waivers,” Casey said.
Casey and her colleagues have also been interviewing people in Colombia, Kenya, and Nepal. In those countries, women of reproductive age, newborns and children, people living with HIV, members of the LGBTQI+ community, and migrants are among those most affected by the cuts, she said, and health workers, who are primarily women, are losing their livelihoods.
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