Amid uncertainties over the resumption of funding for many healthcare programmes, especially training those funded by USAID, the Ministry of Health and Population is considering holding meetings and training virtually in the upcoming fiscal year.

USAID, the principal donor for healthcare programmes, which used to provide financial support for almost all healthcare training and awareness programmes, suspended its funding after the US government halted nearly all foreign assistance worldwide for three months in the last week of January. This followed Donald Trump’s return to the White House for a second term as president.

“We are informed that meetings, orientations and training would be virtual in coming days,” said an official at the Department of Health Services asking not to be named, as he is not authorised to speak to the media. “If funding from other aid agencies is not secured, there will be no option but to hold meetings virtually.”

Nepal is already feeling the impact of USAID’s funding suspension, and officials say they are bracing for further consequences. Health officials say the abrupt aid cut has affected not only ongoing programmes but also planned ones and policymaking, which could have long-term consequences.

Moreover, the government itself is preparing to lower the ceiling for healthcare budget for the upcoming fiscal year by Rs3 billion, which could have irreversible impacts on healthcare, warn public health experts. The government does not allocate a budget for training and meetings, and the routine health budget, which is around four percent of the national budget, is insufficient to fund crucial training and meetings, according to them.

“I have also heard about the virtual meetings, but I am not sure about the effectiveness of such meetings and training programmes,” said Dr Bibek Kumar Lal, director at the Family Welfare Division under the Department of Health Services. “People keep walking into the room and disturbing online sessions, and most health offices lack the infrastructure or even separate rooms for such training.”

Health officials say many UN agencies, including the World Health Organisation, have already shifted planned in-person meetings to virtual formats due to the USAID funding cut.

But several health officials say conducting virtual training programmes, especially those directly linked to human health, is nearly impossible.

“Virtual training doesn’t work for life-saving skills training, such as skilled birth attandance, improving competencies of health workers in identifying and managing complications during labour, birth, and the postpartum period,” said Nisha Joshi, a public health officer at the Family Welfare division. “We hope that these issues will be considered while making budget allocations.”

The funding freeze has disrupted multiple healthcare programmes, many of which relied directly on USAID grants or indirectly on dozens of non-governmental organisations.

“Impacts of fund cuts may seem insignificant in the initial stage, but the consequences will be severe in the long run,” warned Lal. “The progress made through years of efforts will be jeopardised if we discontinue ongoing programmes.”

Some of the suspended crucial health programmes include a planned six-day training for medical officers serving in all district hospitals across the country. These doctors were supposed to get training to save neonates either born in hospitals where they work or brought in for treatment. Similarly, a 15-day neonatal care training for hundreds of nurses serving in district hospitals has also been cancelled.

Other affected programmes include outbreak investigation training for doctors, schemes for non-communicable diseases, and key health surveys—such as a planned micronutrient survey, health facility survey, demographic health survey, surveillance of vaccine-preventable diseases, a lymphatic filariasis transmission survey, a nationwide survey of female community health volunteers, interactive sessions with cancer survivor children and their parents, promotion of exclusive breastfeeding at 18 major hospitals, and awareness programmes targeting female sex workers, homosexual men, and other high-risk groups.

Likewise, due to USAID budget cuts, various programmes related to the Sustainable Development Goals, including maternal and child health, nutrition, reproductive health, and family planning have also been hit. So have programmes under the Integrated Health Information Management System.

Health officials said the health budget must be significantly increased to give continuity to existing healthcare programmes, especially as several vital ones have already been affected by the USAID funds freeze.

“The healthcare sector needs at least 10 percent of the national budget,” said Dr Prakash Budhathoky, spokesperson at the Ministry of Health and Population. “In the past, aid agencies funded sectors where the government would put money, but when they suspend funding, the government should shoulder the responsibility to give continuity to the crucial programmes.”