A Haitian woman and her children at a makeshift shelter n Port-au-Prince, Haiti, June 4, 2023.
Copyright 2023 The Associated Press. All Rights Reserved
Women and girls are at the forefront of aid cuts impacting reproductive healthcare for generations to come.
When women in Haiti asked where they could turn for help, Shoko Arakaki had no answer.
The director of the humanitarian response division at the United Nations Population Fund (UNFPA) visited the Caribbean nation in July. There she witnessed the consequences of international aid cuts for survivors of sexual violence in a country where rape by armed gangs is widespread.
Women and girls were struggling to access emergency contraception and other essential medical care. “We have to just say, ‘I’m sorry … we have to close.’ And then when they ask, ‘Where can we go?’ we don’t have an answer,” she told Swissinfo.
Haiti is far from an isolated case. From Afghanistan and Yemen to Sudan and Myanmar, funding shortages threaten reproductive healthcare and protection services for women and girls. UNFPA warns that between tento 12 million women and girls could lose access if funding gaps persist. As major donors scale back assistance, frontline organisations are forced to cut services and seek alternative sources of funding.
Without timely medical care, sexual violence survivors face the risk of unwanted pregnancies, sexually transmitted infections and life-altering complications. But Arakaki warns the consequences can extend far beyond the individual, affecting generations to come.
“There are long, long-term consequences,” she said back in Geneva. “In a lot of cases, she’s kicked out of the family. So she doesn’t even have an income, and she doesn’t have any family or relatives to rely on. And so that population goes immediately into extreme poverty.”
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Children growing up in such circumstances may become more vulnerable to exploitation and recruitment by criminals, perpetuating cycles of poverty and violence. For Arakaki, the dynamic underscores the importance of prevention programmes, often among the first casualties of shrinking aid budgets.
“If something happened to a woman’s body, it’s too late,” she stressed. “It’s too late.”
Growing needs, shrinking resources
The crisis comes amid a broader retreat from international aid. Assistance was already declining when the United States, historically the world’s largest humanitarian donor, began dismantling its foreign assistance programme in early 2025. Other major donors, including Germany, France, the United Kingdom, and Switzerland, followed suit.
The OECD estimates that development assistance fell by 23.1%, to $174.3 billion (CHF144 billion) in 2025, the sharpest annual decline on record. The cuts come as armed conflicts worldwide have more than doubled over the past 15 years, reaching over 130 in 2026, according to the International Committee of the Red Cross (ICRC). Humanitarian needs are mounting just as the resources available to meet them are shrinking.
International aid cuts, according to humanitarian workers, disproportionately threaten women and girls, with 95% of US sexual and reproductive health funding cut in 2025, compared with substantial but smaller reductions in some other aid categories.
Published in July, the UN Women report Beyond the Breaking Point highlighted how funding cuts are threatening the very survival of frontline women’s organisations worldwide. Based on a survey of 855 organisations across 52-crisis affected settings, it found 84% reported rising demand for assistance, and 88% cannot meet existing needs.
Nearly one million women and girls have lost access to previously available services, according to UN Women. Half of the organisations it surveyed have been forced to turn people away or introduce waiting lists. Some 77% have laid off staff, while 65% rely on unpaid work to keep services running. Four in ten feared closure or suspension within a year.
“Conflict-related sexual violence doubled in 2025,” said Sofia Caltrop, UN Women’s chief of humanitarian action at a press briefing in Geneva in July. Yet nearly two-thirds of women’s organisations report that safe spaces and gender-based violence services have been significantly reduced or are no longer available in their communities.
“This is a cruel paradox,” she said.
Beyond immediate humanitarian needs, the cuts threaten to reverse longer-term progress on gender equality, Caltrop warned. Women’s participation in decision-making is declining, while advocacy initiatives are being abandoned. Among women’s organisations supported by UN Women, nine in ten report rising poverty, eight in ten an increase in girls dropping out of school, and seven in ten a rise in child marriage.
An airport staffer stands beside a banner showing images of late leukemia patients during a press conference at Sana’a airport, in Sana’a, Yemen, 05 August 2026. Houthi-run health and aviation authorities in Sana’a have called on the United Nations and humanitarian groups to pressure the Saudi-led coalition to end the decade-long restrictions imposed on Yemen’s airports amid the country’s worsening humanitarian and health crises.
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Yemen’s healthcare system at breaking point
In Yemen, the impact of shrinking aid budgets is particularly stark. Yemen’s public health system has long depended on UN agencies and international humanitarian funding to survive. Already weakened by years of conflict and mass displacement of over five million people, the majority of them women and children, it now faces the prospect of collapse as dwindling donor support compounds longstanding operational challenges.
According to a Yemeni humanitarian worker who wanted to remain anonymous, as he was speaking on background, public health facilities depended on international assistance for 80–100% of their operational needs. Key UN agencies — including UNFPA, UNICEF and WHO — were critical to keeping health centres open, supplying essential medicines and providing operational stipends.
But sharp funding cuts have pushed Yemen’s already fragile healthcare system over a cliff. One UNFPA partner notes support for health facilities fell from 35 across six governorates in 2025, to just three. “The number of uncomplicated deliveries[in hospitals or heatlhcare facilities] used to reach 38,000, but in 2026, after the support was cut off, it dropped to 3,000,” explained the humanitarian worker.
The US designation of the Houthis, who control most of the country’s populated areas, as a terrorist organisation, complicated the situation. The Houthis themselves also restrict aid operations and have detained dozens of UN and NGO staff. With civil service salaries frozen or issued as sporadic half-wages every four to five months, and no new government recruitment occurring since 2011, healthcare workers receive no regular income from state institutions.
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Six out of ten births in Yemen take place without a skilled attendant, according to UNFPA. One woman dies every two hours from childbirth or pregnancy-related causes. “We depend on UNFPA support for reproductive health in general,” said Aden-based Maaly Mohammed of the Field Medical Foundation, which implements reproductive health programmes for UNFPA and is operating on minimal funding until year end. “There is a risk of collapse of the sector because of funding shortages.”
The humanitarian crisis has deepened amid escalating conflict, she notes, with more than 250,000 Yemenis displaced since the summer. In some areas, overstretched and understaffed health facilities are struggling to meet the needs of displaced people and host communities, while in others, facilities have been forced to close.
Women’s organisations forced to make painful choices
For Fós Feminista, a Global South-led alliance working with nearly 200 partners, the cuts have forced difficult decisions.
Swetha Sridhar, associate director at the alliance, described having to prioritise “the things that feel more urgent or most urgent” rather than “safeguarding comprehensiveness.”
“That’s not an ideal situation for an organisation to be in,” she told Swissinfo.
In the Dominican Republic, as was the case in Haiti, USAID’s withdrawal left partner clinics facing what Sridhar called “massive stockouts” of family-planning supplies. In Kenya, a partner supporting survivors of sexual and gender-based violence had to reduce staffing.
“The people I’m collaborating with are no longer able to fulfill the roles that they’re playing,” she explained.
Fós Feminista is pooling purchases of contraceptives and other reproductive health supplies through its INNOVA Health Supplies initiative, while exploring ways to deliver care with fewer resources.
Women and malnourished children wait their turn to be weighed by health personnel at La Paix University Hospital, in Port-au-Prince, Haiti, May 8, 2024.
Copyright 2024 The Associated Press. All Rights Reserved
The shifting politics of reproductive health
Sridhar warns of growing self-censorship as organisations compete for shrinking resources.
“All conversations on abortion are out,” she said. References to transgender inclusion and gender equality are also disappearing as proposals narrow toward maternal and child health or HIV.
The Trump administration has slashed US foreign aid, shifting remaining assistance towards its “America First” agenda.
She fears US bilateral health agreements, coupled with Washington’s support for the Geneva Consensus Declaration, which rejects an international right to abortion, could reinforce restrictive reproductive-health policies.
Meanwhile, in Geneva, the conversation is shifting to finding new ways to finance and deliver healthcare. Governments are exploring pooled finance, development impact bonds and unconventional sources of capital, including remittances and Islamic charitable funds, she said.
Sridhar called for making better use of existing resources and holding governments to commitments they have already made. She pointed to the 2001 Abuja Declaration, under which African Union countries pledged to allocate at least 15% of their annual budgets to improving healthcare.
At the UN General Assembly in September, governments and partners announced more than $715 million in commitments to reproductive healthcare, including nearly $300 million pledged by Burundi, Madagascar, Mozambique and Zimbabwe.
“Expecting countries at this moment to step up [to] bridge the gap that the US has left behind […] is unlikely to happen,” Sridhar said.
Edited by Virginie Mangin/gw
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