Amid concerns over the adverse impacts of aid cuts by USAID in healthcare programmes, the Ministry of Health and Population has sought commitments for budgetary support from various United Nations agencies.

Officials say they have asked the UN bodies—the World Health Organisation, UNICEF and UNFPA—for support in the budget of the upcoming fiscal year. Along with UN agencies, the ministry has also requested aid from the Global Alliance for Vaccine and Immunisation.

“These agencies [UN agencies and GAVI] have been providing us with budgetary support and we sought commitment for the upcoming fiscal year’s budget as well,” said Dr Bibek Kumar Lal, director at the ministry’s Family Welfare Division. “But no agency has as yet made any such commitment.”

Several ongoing healthcare programmes have been affected after the US government suspended nearly all foreign assistance worldwide for three months in the last week of January, soon after Donald Trump assumed presidency.

Many crucial healthcare programmes will be affected if the budget for them is not secured from other sources, officials say.

What concerns health officials is that primary donors including the UN bodies have not been able to commit to budgetary support, as they too have been affected by the USAID aid suspension. Moreover, the government itself has lowered the ceiling of the total budget of the Health Ministry for the upcoming fiscal year by Rs3 billion, which will have adverse long-term effects, according to them.

“It’s already March 19 and we have to furnish the budget plan to the Health Ministry by March 28,” said Lal. “Commitment for budgetary support from aid agencies is included in the budget.”

Health officials say several budgetary commitments made by aid agencies including UN bodies have not been realised in the ongoing fiscal year, and some programmes have been terminated.

Some agencies have expressed their helplessness as they struggle to meet their commitments, according to the officials.

“Either the government has to increase the health budget ceiling or other agencies must contribute,” said Dr Bikash Devkota, secretary for the Health Ministry. “We [health ministry officials] have been trying to convince officials at the Ministry of Finance about the consequences of aid and budget cuts in the health care sector.”

Health officials say they would prioritise essential programmes while preparing the annual budget for the upcoming fiscal year, try to secure funds from other development partners, and urge the finance ministry to increase the health budget.

Nepal has already been feeling the impact of the aid suspension, and officials are bracing for further consequences. Officials say the aid suspension and budget cut could affect Nepal’s major priority health programmes including those related to maternal and child health, immunisation, nutrition, HIV, tuberculosis, epidemic control, non-communicable diseases, and mental health.

Among the terminated programmes are key health surveys, including the micronutrient survey, which was planned over the past 10 years, the lymphatic filariasis transmission survey, and the promotion of exclusive breastfeeding at 18 major hospitals.

Awareness programmes targeting female sex workers, homosexual men, and other high-risk groups have also been halted.

Health officials say an indefinite halt in health surveys and data collection puts the country in the dark about updated health indicators and affects efforts to track progress on Sustainable Development Goals (SDGs) targets.

SDGs, a follow-up on the Millennium Development Goals (MDGs), aim to end poverty and hunger and all forms of inequality in the world by 2030, and Nepal has committed to meeting the goals.

Other affected programmes include ‘outbreak investigation training’ for doctors, neonatal care training for hundreds of doctors and nurses, and various programmes related to the Sustainable Development Goals, including maternal and child health, nutrition, reproductive health, and family planning. Programmes under the Integrated Health Information Management System have also been hit.

Nepal witnessed outbreaks of several diseases including dengue, cholera and diarrheal diseases, and other vector-borne diseases in the past years. As the country has been dealing with new and emerging health challenges, more funds are required to address the new challenges.

Studies show that 71 percent deaths in Nepal are caused by non-communicable diseases, such as heart diseases, chronic obstructive pulmonary disease, lower respiratory infections and stroke.

“USAID used to step in where the government’s investment fell short,” said Dr Prakash Budhathoky, spokesperson for the health ministry. “The health budget must be significantly increased to give continuity to existing healthcare programmes, especially as several vital programmes have already been affected by the USAID funds freeze.”