In Nepal, former aid workers who lost their jobs after the United States slashed foreign assistance funding have resorted to sex work to survive. The cuts, implemented last year, have left an estimated 35,000 aid workers jobless in Nepal alone, according to the NGO Federation of Nepal. For many, particularly transgender individuals in a country with few legal employment options, this has meant turning to sex work, often in the same communities they once served.
Rubi Lama, a transgender woman who spent nine years conducting HIV outreach, now works as a sex worker on the side of a highway in central Nepal. She, along with approximately 100 other LGBTQ+ former aid workers, finds themselves in precarious situations, facing risks of violence and HIV transmission. Lama reported earning as little as $3 per client, an amount far below the $80 needed for rent and food each month.
The shutdown of U.S.-funded organizations, such as Friends Hetauda, has eliminated vital services, including HIV testing, counseling, and the distribution of prevention medication like PrEP. Manisha Dhakal, executive director of the Blue Diamond Society, stated that between 35% and 45% of her organization's former staffers have turned to sex work due to the lack of alternatives.
Public health experts warn of a potential spike in HIV prevalence as access to prevention medication and testing has been severely curtailed. Dr. Sarbesh Sharma, director of Nepal’s National Centre for AIDS and STD Control, cautioned that HIV does not respect borders, highlighting the interconnectedness of global health.
The impact extends beyond Nepal, with U.S. foreign aid cuts affecting over 280,000 aid workers globally. Sadie Healy, who tracks these job losses, noted that most affected were overseas workers. The U.S. State Department, in response, stated that the administration has focused on efficiency and effectiveness in its assistance programs, emphasizing that the U.S. remains the largest global donor of health and humanitarian aid and calls for increased contributions from other nations.
Many former aid workers have described enduring violence, including rape, and fear of contracting HIV and other sexually transmitted infections. The skills acquired during their aid work, such as persuasion and risk assessment, sometimes help them navigate dangerous encounters, but these are not always enough. The loss of funding has left these individuals with no viable options, forcing them to confront extreme personal risks to meet basic survival needs.