PESHAWAR, Pakistan: Pakistani authorities have asked the Doctors Without Borders (MSF) aid group to close its medical facilities in a militancy-wracked tribal district, the organization said, as officials tighten controls on foreign NGOs working in the country.
MSF said the government has refused to renew the permit required to continue its health care projects in Kurram district in the Federally Administered Tribal Areas (FATA) located in the restive northwest along the Afghan border.
“MSF is saddened by the decision from the authorities responsible for NGOs working in Kurram Agency,” Catherine Moody, the group’s country representative, said in a statement released late Wednesday.
The tribal districts are among the poorest areas in Pakistan, and are governed under a draconian legal system introduced by British colonial rulers more than a century ago.
A senior government official in Kurram confirmed that MSF has been asked to stop working in the district after its permit expired.
“They have been asked to stop working until their (permit) is renewed,” the official told AFP Thursday, adding that authorities have been paying closer attention to foreign NGOs across the country, especially in tribal areas.
The organization said officials have not explained why their permit was refused in an area where its has been providing health care for 14 years.
Although violence in Pakistan and its tribal districts has declined in recent years following a series of military offensives against insurgents, Kurram has remained a top target for militant groups.
Parachinar, the capital of the mainly Shiite Kurram tribal district became a scene of carnage in June when twin blasts ripped through a crowded market days ahead of Eid celebrations marking the end of Ramadan, killing 69 people and wounding more than 200.
The attack was the third major bombing to strike the area since January, with 115 people killed in total — the highest in Pakistan.
Inhabitants in the tribal belt have long complained its development and security has been neglected by Islamabad, which also appoints administrators with sweeping powers including the prerogative to collectively punish entire clans for the crime of an individual.
MSF has been working in Kurram since 2004 where it was responsible for an outpatient department for children under five years and an inpatient department for severely ill children up to 12 years of age.
“We will, as much as possible continue to provide obstetric and newborn services to the women of FATA through the MSF women’s hospital located in Peshawar,” the statement said.
The group has a long history in Pakistan, working with communities affected by natural disasters, conflicts and insufficient health care facilities for over 30 years.
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Pakistan ejects MSF from militancy-hit tribal district
Pakistan ejects MSF from militancy-hit tribal district
Malawi suffers as US aid cuts cripple health care
LILONGWE: A catastrophic collapse of health care services in Malawi a year after US funding cuts is undoing a decade of progress against HIV/AIDS, providers warn, leaving some of the most vulnerable feeling like “living dead.”
In the impoverished southern Africa country, the US government’s decision to slash foreign aid in January 2025 has led to significant cuts in HIV treatments, a spike in pregnancies and a return to discrimination.
Chisomo Nkwanga, an HIV-positive man who lives in the northern town of Mzuzu, told AFP that the end of US-funded specialized care was like a death sentence.
After his normal provider of life-saving antiretroviral therapy (ART) vanished due to budget cuts, he turned to a public hospital.
“The health care worker shouted at me in front of others,” Nkwanga recalled. “They said, ‘You gay, you are now starting to patronize our hospitals because the whites who supported your evil behavior have stopped?’“
“I gave up,” he said, trembling. “I am a living dead.”
More than one million of aid-dependent Malawi’s roughly 22 million people live with HIV and the United States previously provided 60 percent of its HIV treatment budget.
Globally, researchers estimate that hundreds of thousands of preventable deaths have been caused by the Trump administration’s dismantling of US foreign aid, which has upended humanitarian efforts to fight HIV, malaria and tuberculosis in some of the world’s poorest regions.
- Lay offs, panic -
In Malawi, the drying up of support from USAID and the flagship US anti-HIV program, PEPFAR, has left a “system in panic,” said Gift Trapence, executive director of the Center for the Development of People (CEDEP).
“The funding cut came on such short notice that we couldn’t prepare or engage existing service providers,” Trapence told AFP.
“We had to lay off staff... we closed two drop-in centers and maintained two on skeleton staff,” he said.
“We did this because we knew that if we closed completely, we would be closing everything for the LGBTI community.”
The Family Planning Association of Malawi (FPAM) non-government organization, a cornerstone of rural health care, has been forced to ground the mobile clinics that served as the only medical link for remote villages.
“We had two big grants that were supporting our work, particularly in areas where there were no other service providers,” said executive director Donald Makwakwa.
“We are likely to lose out on all the successes that we have registered over the years,” he said.
A resident of a village once served by FPAM told AFP there had been an explosion in unplanned pregnancies when the family planning provider stopped work.
“I know of nearly 25 girls in my village who got pregnant when FPAM suspended its services here last year,” said Maureen Maseko at a clinic on the brink of collapse.
- Progress undone -
For over a decade, Malawi’s fight against AIDS relied on “peer navigators” and drop-in centers that supported people with HIV and ensured they followed treatment.
With the funding for these services gone, the default rate for people taking the HIV preventative drug PrEP hit 80 percent in districts like Blantyre, according to a report by the CEDEP.
“This is a crisis waiting to happen,” the report quoted former district health care coordinator Fyness Jere as saying.
“When people stop taking PrEP, we increase the chances of new HIV infections... we are undoing a decade of progress in months,” she said.
Trapence noted that without specialized support, thousands of patients had simply disappeared from the medical grid.
“We lost everything, including the structures that were supporting access... treatment and care,” he said.
In the impoverished southern Africa country, the US government’s decision to slash foreign aid in January 2025 has led to significant cuts in HIV treatments, a spike in pregnancies and a return to discrimination.
Chisomo Nkwanga, an HIV-positive man who lives in the northern town of Mzuzu, told AFP that the end of US-funded specialized care was like a death sentence.
After his normal provider of life-saving antiretroviral therapy (ART) vanished due to budget cuts, he turned to a public hospital.
“The health care worker shouted at me in front of others,” Nkwanga recalled. “They said, ‘You gay, you are now starting to patronize our hospitals because the whites who supported your evil behavior have stopped?’“
“I gave up,” he said, trembling. “I am a living dead.”
More than one million of aid-dependent Malawi’s roughly 22 million people live with HIV and the United States previously provided 60 percent of its HIV treatment budget.
Globally, researchers estimate that hundreds of thousands of preventable deaths have been caused by the Trump administration’s dismantling of US foreign aid, which has upended humanitarian efforts to fight HIV, malaria and tuberculosis in some of the world’s poorest regions.
- Lay offs, panic -
In Malawi, the drying up of support from USAID and the flagship US anti-HIV program, PEPFAR, has left a “system in panic,” said Gift Trapence, executive director of the Center for the Development of People (CEDEP).
“The funding cut came on such short notice that we couldn’t prepare or engage existing service providers,” Trapence told AFP.
“We had to lay off staff... we closed two drop-in centers and maintained two on skeleton staff,” he said.
“We did this because we knew that if we closed completely, we would be closing everything for the LGBTI community.”
The Family Planning Association of Malawi (FPAM) non-government organization, a cornerstone of rural health care, has been forced to ground the mobile clinics that served as the only medical link for remote villages.
“We had two big grants that were supporting our work, particularly in areas where there were no other service providers,” said executive director Donald Makwakwa.
“We are likely to lose out on all the successes that we have registered over the years,” he said.
A resident of a village once served by FPAM told AFP there had been an explosion in unplanned pregnancies when the family planning provider stopped work.
“I know of nearly 25 girls in my village who got pregnant when FPAM suspended its services here last year,” said Maureen Maseko at a clinic on the brink of collapse.
- Progress undone -
For over a decade, Malawi’s fight against AIDS relied on “peer navigators” and drop-in centers that supported people with HIV and ensured they followed treatment.
With the funding for these services gone, the default rate for people taking the HIV preventative drug PrEP hit 80 percent in districts like Blantyre, according to a report by the CEDEP.
“This is a crisis waiting to happen,” the report quoted former district health care coordinator Fyness Jere as saying.
“When people stop taking PrEP, we increase the chances of new HIV infections... we are undoing a decade of progress in months,” she said.
Trapence noted that without specialized support, thousands of patients had simply disappeared from the medical grid.
“We lost everything, including the structures that were supporting access... treatment and care,” he said.
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