Desperation and Danger: The Impact of U.S. Aid Cuts in Nepal

In the pitch darkness along a central highway in Nepal, Rubi Lama waits. Her painted face momentarily illuminated by passing trucks. Each night brings danger, yet it’s the money she earns that keeps her alive. Lama once approached this highway not as a sex worker, but as someone striving to help sex workers.

Lama’s journey from aid worker to sex worker highlights a dire situation. As a transgender individual, she passionately spent years conducting HIV outreach within Nepal’s marginalized communities, particularly for LGBTQ+ workers waiting by the roadside every night. Lama now finds herself working among them after losing her job due to sweeping U.S. foreign aid cuts.

The impact of these cuts was widespread. In January 2025, when the U.S. withdrew funding for USAID, it led to massive job losses, impacting over 280,000 workers worldwide. In Nepal’s already struggling economy, the fallout was severe, particularly for those in LGBTQ+ and transgender communities where job options are scarce.

“One decision from one powerful country—services are cut,” said Manisha Dhakal, Blue Diamond Society’s executive director. This forced many former staffers into sex work to survive.

Life for those turned to sex work is fraught with danger. Lama and her colleagues face potential exposure not only to violence but a resurgence of HIV. Access to HIV prevention medication vanished with the funding cuts, prompting fears of increasing HIV rates. Lama’s account demonstrates these fears. Amid blaring horns and angry shouts, she moves quietly, knowing the violence lingering in the shadows.

Princy Tamang, another former outreach worker, experiences the same risks. Beaten by clients, forced into unprotected sex, Tamang fears contracting HIV.

The Friends Hetauda NGO, from which Lama worked, once contributed greatly, offering essential HIV services. All halted with the cuts. Of 350 staffers, 262 found themselves jobless. The few legal job opportunities for openly transgender persons make sex work the last resort for survival.

The health risks resulting from policy shifts are immense. Discontinued PrEP medication and inaccessible condoms leave former staffers vulnerable. Many halted antiretroviral treatments, fearing discrimination at hospitals, which heightens transmission risk.

“Viruses like HIV do not respect borders,” warned Dr. Sarbesh Sharma. With the HIV testing rates plummeting, a global concern grows.

Many workers, like Aashika Tamang, who recounts her extensive abuse, reminisce about better days spent aiding those vulnerable. This job shift creates a paradox—moving from vital outreach to standing beside those once helped.

Lama’s story epitomizes the grueling reality. Raised in poverty under hardships including assault, she overcame challenges, carving out a life channeling purpose through aid work. Her dismissal shattered these efforts, forcing her into sex work.

Night after night she confronts her fears along the streets. Each encounter reflects desperation interwoven with trauma, with persuasion skills sometimes the only defense against violence.

For Lama, facing abuse and exploitation are daily realities. She’s often confronted, sometimes threatened with a knife, yet her charisma built through former roles helps avert catastrophes. These experiences underline a cruel irony: knowledge meant to reduce harm is now her survival mechanism.

Sujata Chaudhary, sporting a tattoo in honor of her mother, relates similar trials. Often forced into unprotected encounters, avoiding clients’ homes helped her dodge previous violent incidents.

Magar and Thapa recount terrifying ordeals post-transition to sex work, including rape at gunpoint and gang violence. Such descriptions reveal a common theme—deprivation places lives at risk, vulnerable to more physical harm.

Every night Lama and her peers return to the streets, surviving on meager earnings. Although aware of right and wrong, without alternative funding, this path remains unchanged. The prospects for departing are bleak without intervention.

Dark highways hold brief glimpses of hope amid danger, as individuals struggle to reclaim dignity lost alongside the aid once promised.

With thorough reporting, organizations like the Associated Press continue exposing crises worldwide, partially relying on public support.