How international aid cuts have hit social programmes in Tajikistan
Back to the past? How international aid cuts have hit social programmes in Tajikistan
10.07.2025
Article published on the rus.azattyq.org website
After years of depending on donors, Tajikistan is suddenly facing a dramatic collapse in support for critical social programmes due to external funding being withdrawn, particularly by the United States. Projects to prevent HIV, tuberculosis and for the protection of women, are now under threat. Without continuing support, work in these areas will be put back twenty years.
HIV: Twenty years of progress at risk
Last year, the global fight against HIV achieved historic results: mortality rates had halved compared to 2010 levels, with the number of infections falling by 40%. Tajikistan has made great strides, halving deaths, reducing mother-to-child HIV transmissions and making antiretroviral treatment widely available.
All this was discussed in a new UNAIDS report AIDS. Crisis and the Power to Transform, which was published on 10 July. But now, claim the authors, the world risks losing these gains.
“Sudden and massive cuts in international funding from the vital US President’s Emergency Plan for AIDS Relief programme (PEPFAR) are already affecting dozens of countries. Unless the situation changes, there will be another six million new infections and four million AIDS-related deaths in the next four years”, says this new report.
What has happened to international aid to Tajikistan?
Shortly after taking office earlier this year, the new White House Administration set about cutting international aid. The US President, Donald Trump, decided to suspend more than 90% of foreign aid programmes supported by the US Agency for International Development (USAID). USAID has been the main channel of US support to Tajikistan for decades. Last year alone, the agency provided $58.5 million to the country, more than any other Central Asian state.
In total, Tajikistan has received more than $2 billion from USAID since gaining its independence. These funds have been channelled into health development, education, support for food security and combating infectious diseases. The withdrawal of aid for the health sector could be significant, with USAID having provided $38 million to fight HIV/AIDS alone from 2003 to 2021.
In total, more than 60% of all HIV programmes in Tajikistan are funded by international donors. “Even a cut of 10% to 20% could undo years of work”, said Aziza Khamidova, UNAIDS Country Director for Tajikistan.
Khamidova says that prevention programmes have already been suspended, community monitoring and access to PrEP (an HIV prevention measure in which a person at high risk of infection takes antiretroviral drugs on a regular basis) curtailed, with testing for key sections of the population drastically reduced.
Khamidova stated that women, young people and migrant workers are those who are most vulnerable. According to the National AIDS Centre, one in three new diagnoses has been linked to the return of migrant workers, particularly from Russia, since 2023. As a result, the risk of contracting the disease has increased among women, especially in rural areas, who end up being infected by their husbands.
Crisis centres and shelters under threat of closure
The CSO Ghamkori, based in the southern Tajikistan city of Bokhtar, runs one of the country’s few shelters for female domestic violence victims, as well as a crisis centre. In December the organisation agreed a $40,000 project with USAID, with the money to be used for accommodation, legal and psychological support for its residents and training for women wanting to live independent lives. In January, everything stopped, including the funding.
“Now, for the first time in 30 years, we are in a situation that might force us to close both the shelter and the crisis centre”, said Madina Nizomova, head of the CSO. Until recently, the shelter in Bokhtar housed up to 25 women with children every month.
“Women call and come to us seeking help but we’re unable to provide any because there’s no money to maintain the shelter or pay the staff”, said Nizomova.
Legal aid for the women is now provided just once a week by a lawyer from a partner organisation. “We are grateful but realise this is not enough as a victim cannot come at a pre-arranged hour or day because her problem needs to be resolved there and then”, she added.
Other crisis centres and shelters are in a similar position. According to local activists, in some regions support is almost entirely reliant on donor funds.
Funding cuts to tuberculosis (TB) programmes are already affecting detection rates
With USAID suspending its activities, the fight against TB in Tajikistan, recognised by the WHO as a high-risk country, has been left without critical support. Akmal Khudojberdiyev works for Partnership to Stop TB in Tajikistan, a group of people who have themselves overcome the disease and are now helping others. Having previously operated as part of the USAID-funded My TB-Free Community project, he and his team have been working with medical staff at TB centres to carry out field work.
“We visited the homes of residents, particularly in remote areas, administering Mantoux tests using a mobile X-ray machine with artificial intelligence where necessary. This helped us to diagnose new patients at an early stage”, Khudojberdiyev recalled.
Much has changed as a result of the cuts in external funding. “Remote treatment programmes, psychosocial support, which is especially important for patients undergoing long-term and difficult therapy, have been suspended. This could lead to their treatment being interrupted, as well as the development of disease-resistant variants”, he explains.
Asliddin Rajabzoda, Deputy Head of the Republican TB Protection Centre, told Azattyq Asia that the country’s remaining donors are now limited to supplying drugs for patients with resistant forms of the disease and providing reagents for laboratories.
“Since the beginning of the year, numbers of newly recorded TB cases have fallen by 200, simply because the work of mobile teams, which used to test residents in hard-to-reach mountainous regions with X-ray machines, has stopped”, said Rajabzoda.
Of the ten CSOs that are working to prevent TB only one is still functioning, albeit with a drastically reduced budget. “We have written to the WHO and the Global Fund, hoping for additional support. In order to maintain present levels, Tajikistan will need around $20 million over three years”, he said. Last year, more than 4,500 TB cases were recorded in the country, including 422 with resistant forms of the disease.
“It is becoming increasingly difficult to operate without international support”
The Gender and Development CSO has been running HIV and TB programmes for nearly 15 years and is now unable to run three major projects due to cuts in funding, said its Director, Nargis Saidova. “These were aimed at supporting refugee Afghan women, stateless people and providing legal access for women from socially vulnerable groups.
Saidova is convinced there is a desire in the country to fight socially significant diseases but resources, for a number of reasons, are lacking. “We believe in the potential of the State and its commitment to tackle these challenges. But to be frank, funds are limited and there is still not enough flexibility in funding instruments that could be used by civil society organisations. We are continuing to look for ways to be sustainable but this will become more and more difficult without continuing international support”.
Tajikistan has never intended to remain dependent on external funding indefinitely, said Aziza Khamidova. For example, the country has developed a multi-year sustainability plan to combat the spread of HIV.
“The country’s aim is to achieve full independence from donors by 2030. Extra funds have been set aside for 2026, but this is wholly insufficient to fill the giant hole that has been created”, Khamidova added.
“This is a crisis. Unsurprisingly, neither the State nor CSOs are able to take on the full weight of responsibility”, said an expert, who preferred to remain anonymous and has been involved in donor projects for more than ten years. In order to prevent the worst from happening, Tajikistan needs to undertake an urgent assessment of its national priorities, put a temporary focus on using the remaining international funds in critical areas such as HIV and TB, as well as securing more involvement from other donors. “Without this, our work will be set back twenty years”, he said.
