BackgroundOn 29th January 2025, the Trump Administration issued stop-work orders to its USAID-implementing partners. These resulting funding cuts and ideological attacks on global development and humanitarian assistance had immediate consequences on sexual and reproductive health and rights (SRHR). In February and July 2025, IPPF surveyed its Member Associations (MAs) and Collaborative Partners (CPs) to assess the impact of these funding cuts on their work and the clients they serve. By July 2025, $87.2 million in funding had been lost from 2025 through to 2029 due to cancelled contracts[1]. IPPF MAs / CPs in the Africa Region and the Arab World Region have been most affected, with an estimated loss of $26 million and $9.4 million in funding, respectively. Funding losses have forced the closure of nearly 1,400 clinics - 1,175 in Africa alone. In 2025, 9 million people were estimated to have lost access to SRH services including contraception, HIV testing, and care for survivors of gender-based violence (GBV) from a range of service delivery channels. MAs and CPs also reported declining stock levels of SRH commodities, especially contraceptive products, since January 2025.These case studies document the human cost of this retreat in funding, drawing on case studies from IPPF MAs / CPs in Bangladesh, Ethiopia, Mozambique, and Sudan. Global ContextGovernment donors are withdrawing support as right-wing populism and religious fundamentalism rises. This shift is led by the US but mirrored in Europe, where governments are diverting aid budgets toward defence and border control. Trump’s "America First" Strategy has rejected the traditional model of foreign aid. It has replaced it with an investment model that prioritizes US commercial interests and biodefense, signalling a move away from multilateralism and withdrawal from the World Health Organization (WHO).The Mexico City Policy (also known as the Global Gag Rule) was first introduced in 1984, prohibiting funding to any foreign non-governmental organisation (NGO) that provides comprehensive information on abortion and pregnancy options or performs abortion, thereby severing support for a vast network of SRH providers. The Trump Administration announced a sweeping expansion of the Mexico City Policy in late January 2026. The expanded policy is no longer limited to global health funding, and instead now weaponizes all non-military U.S. foreign assistance amounting to at least US $30 billion annually. This includes diversity, equity and inclusion (DEI) policies, and gender identity rights, recast as threats and condemned as “radical gender ideologies that prey on our children” by Vice-President JD Vance. These latest policies of the Trump Administration further institutionalise fear and paralysis in the global development sector and among the communities IPPF serves. In addition to targeting foreign non-government organisations, the scope has been widened in an attempt to block foreign assistance funding to any U.S. organizations, other governments, parastatals, and multilateral institutions who engage in upholding human rights.  This is yet another attack on national sovereignty through the curtailing of SRHR and LGBTQI+ rights.Historically, the reinstatement of the Mexico City Policy has reduced access to contraceptive services and increased abortion rates.[2] Latest measures go beyond historical precedents by:Framing standard contraception as "abortifacients" to broaden prohibited activities.Banning work on gender equality, gender-affirming care and DEI under the guise of preventing "divisive" conceptsFurthermore, the introduction of the America First Global Health Strategy has instigated discussions towards a series of bilateral agreements with a number of African governments. The recent $1.6 billion bilateral agreement with Kenya serves as the blueprint for this new era, imposing strict conditions such as significant co-financing requirements—raising fears of debt distress for partner nations—and mandatory health data sharing, which has already sparked legal challenges regarding patient privacy[3]. We are deeply concerned that this new aid modality will be used as an instrument to pressure governments to restrict sexual and reproductive rights. Compounding the volatility of US withdrawal is the retrenchment of European donors. Nine European donors have cut a combined €30 billion from their development budgets over the next four years[4]. The European Commission has stated it cannot fill the gap left by the US. Against this backdrop of unprecedented funding disruptions and strategic realignment, the experiences of IPPF MAs / CPs provide crucial ground-level evidence of how these macro-level policy shifts translate into real-world consequences for health systems and the people they serve.Explore the case studies in full: Sudan: Bracing for the full impact in the midst of civil warEthiopia: “The biggest challenge in our history”Mozambique: Navigating funding cuts and commodity securityBangladesh – Crisis on crisis for marginalised populations  

This year, the Trump administration has banned federal employees and grant recipients from acknowledging World AIDS Day, celebrated on the 1st December 2025. The State Department’s directive told employees to “refrain from publicly promoting World AIDS Day through any communication channels, including social media, media engagements, speeches or other public-facing messaging”.This latest directive comes after US funding cuts this year put essential sexual and reproductive healthcare, which includes HIV prevention services, at risk for millions worldwide. A global survey of Member Associations  conducted by IPPF revealed the devastating impacts on our Member Associations who provide integrated sexual and reproductive healthcare services. Over half our Member Associations were affected, with an estimated loss of $85million. The Trump administration’s decision to enforce silence around World AIDS Day demonstrates a lack of respect for the lived experiences of those living with HIV, those who died of AIDS, and all affected by HIV. This directive impedes the ongoing efforts to reduce the transmission of HIV and to address stigma, discrimination, and inequality. These decisions are not isolated from broader state driven ideologies and anti-rights pushbacks that continue to suppress the acceptance and fair inclusion of all people in society. This enforced silence on World AIDS Day serves only to further embed stigma and injustice and is another reminder as to why we must confront these moments with equal strength and clarity. IPPF supports the rights of all people in society and works to provide sexual and reproductive health services to all, in particular those who are marginalised, such as gay men and other men who have sex with men, sex workers, trans people, people who inject drugs, and prisoners. IPPF works with our Member Associations doing vital work to support those living with HIV, to end stigma, and ‘overcome disruption’ to providing essential health services to communities, including HIV testing, prevention and treatment. In times of crisis and oppression, rights and dignity need champions. At IPPF we carry this moment with our Member Associations on the ground and stand behind them in their continued dignity and fight for the right to continue the vital work they do. At IPPF we will continue our work towards a vision of a world free from HIV where everyone is valued equally, has a healthy, pleasurable, and fulfilling life within a just and equal society. Key to an impactful HIV programme is understanding and addressing drivers of the HIV pandemic, including structural barriers; violence against women; discrimination; stigma; harmful social norms; inequalities related to sex, gender, sexual orientation, race, disability, and economic status; criminalisation of HIV transmission and certain populations; and restrictive laws and policies.Due to social and biological vulnerabilities, certain groups of people experience higher rates of HIV including women and girls; gay, bisexual, and other men who have sex with men; sex workers; people who inject drugs; trans people; and people in prisons. Working with those affected by and living with HIV to design, implement, and evaluate IPPF services and programmes is essential on our pathway to realise a society free of discrimination and stigma, and for all people living with HIV to live healthy and fulfilled lives. A community-led and inclusive response includes both tailoring services and programmes to address the needs of communities more severely affected by HIV, as well as addressing the needs of all people who would benefit from HIV‑related services such as youth, people with disabilities, pregnant women and infants, people in sexual relationships with individuals living with HIV, boys and men, and others who may not identify as a member of certain groups. Of key importance is creating programmes, services, and spaces that are inclusive, discrimination-free, and accessible to all, where each person feels welcomed and that their health and well‑being needs will be at the centre of the care that they receive.At IPPF our Member Association’s work demonstrates what we can achieve when we lead with community-led responses. For example, in Mozambique, the Associação Moçambicana para o Desenvolvimento da Família (AMODEFA), together with sex workers, are working to ensure that sex workers have access to comprehensive sexual and reproductive health services, with oral pre-exposure prophylaxis (PrEP*) for HIV prevention.In Zambia, the Planned Parenthood Association of Zambia (PPAZ), through a partnership between the Children’s Investment Fund Foundation (CIFF) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria—has secured 21,600 Dapivirine Vaginal Rings for HIV prevention for women. Adding the PrEP ring as an additional HIV prevention option gives women more choice about which HIV prevention method they can use, empowers them to make informed decisions about their health, and increases the chance that individuals can find a method that works for them.On Worlds AIDS day we are doubling down on our commitment and support to the communities we work with and our Member Associations who continue to provide innovative healthcare models to prevent HIV transmission, and provide vital care to those living with HIV. The work in Mozambique and Zambia are just two examples of the work that many Member Associations are implementing globally to provide essential health services to communities, including HIV testing, treatment and prevention. *Pre-Exposure Prophylaxis (PrEP) is used to reduce the risk of getting HIV.

In Mozambique, in the continued fight against HIV, certain populations face a heightened risk of transmission, such as sex workers. With an HIV prevalence of 12.5% among adults, and a disproportionate burden on women, the need for targeted, effective interventions is critical. Among women, HIV prevalence can range from 4.5% in younger age groups to as high as 26.6% in those aged 35-39. This alarming reality underscores the urgency of comprehensive HIV prevention strategies tailored to vulnerable groups like sex workers.From April 2024, the Phamberi na Kudzirira (Forward with Prevention) project, which is funded by the Government of Japan, through the Japan Trust Fund (JTF) and implemented by IPPF’s Member Association in the country, Associação Moçambicana para o Desenvolvimento da Família (AMODEFA), has been addressing this challenge through innovative strategies that integrate Pre Exposure Prophylaxis (PrEP) and other biomedical HIV prevention methods such as the vaginal ring. Through mobile brigades, peer education, and targeted health services, the project has been making meaningful contributions in HIV transmission reduction efforts among sex workers in Mozambique’s Manica province.Manica province was strategically selected as the intervention site because one of its districts serves as a key transport corridor with interconnected roads leading to Maputo, other provinces in Mozambique, as well as the neighbouring country of Zimbabwe. This makes Manica a hotspot for heavy truck drivers and sex workers, thus an area of heightened HIV risk.The overarching goal of the Phamberi na Kudzirira project is to contribute to the reduction of HIV transmission by supporting the acceptance, distribution, and effective use of oral PrEP. The project seeks to ensure that sex workers have access to comprehensive sexual and reproductive health services, with PrEP as a cornerstone of HIV prevention.Peer Educators: Empowering Voices for ChangeThe Phamberi na Kudzirira project works with a dedicated team of 10 health workers who are all trained to provide high quality, inclusive PrEP services tailored to the specific needs of sex workers. It also works with 20 peer educators across three districts in Manica province: Gondola, Chimoio, and Manica. The peer educators, who also double up as sex workers, are trained to share accurate information, offer support, and guide their peers to access vital HIV prevention services.Not only does the project leverage the trust and influence that peer educators hold within the sex worker community, but it also empowers sex workers to become active agents of change in the HIV response. The credibility and relatability of the peer educators are further reinforced by the fact that all 20 of them are personally using PrEP, demonstrating their confidence in the program and serving as powerful role models for their peers.The successes of the ongoing training program are measured through pre- and post-tests for the peer educators, to ensure that quality information is consistently shared during outreaches.Barriers to accessing sexual reproductive health servicesThe Phamberi na Kudzirira project is however not without challenges. One of the significant challenges that sex workers face, and which the project continues to address, is the anxiety that comes with accessing SRHR services in health facilities.“The fear of being judged or mistreated often discourages sex workers from seeking medical help, even when necessary. To overcome this, I often accompany them to health facilities. AMODEFA works with partner health facilities who have been trained on non-discriminatory practices and are therefore able to satisfactorily attend to clients. Accompanying sex workers to these facilities helps to reassure them of the services and the service providers. Their interaction with the trained service providers encourages them to return for services when in need,” says Linda, a peer educator.Mobile brigades: enhancing access to SRHR services at hotspotsTo address the challenge of sex workers’ uptake of SRHR services in health facilities, the Phamberi na Kudzirira project has intensified efforts to create a more private and supportive environment through mobile brigades.Given the unique needs of sex workers, who often work at night in various hotspots, mobile brigades have played a crucial role in delivering services where they are needed most. These brigades bring HIV testing and PrEP services directly to the areas where sex workers operate, helping to reduce barriers such as stigma at health facilities.Since September 2024, AMODEFA has conducted 18 successful outreach missions, significantly increasing the accessibility of HIV prevention services.Sara*, a sex worker, is one of the beneficiaries of the mobile brigades.“The mobile brigades have enabled my friends and I to access testing and PrEP without the fear of the stigma that we often experience in health facilities. We feel more comfortable accessing services at the mobile brigades as they come right to where we are and the clinicians understand our needs very well,” she says.In areas where mobile brigades are not present, peer educators step in to guide sex workers to health units, ensuring they still receive testing and treatment despite concerns about stigma.Adherence to PrEP challengesAdherence to PrEP has also been identified as a challenge by the sex workers, as Rosa*, a sex worker explains.“Taking medication every day often feels tiring. However, the peer educators have emphasized the need for me to ensure that I take my medication as recommended. The peer educators encouraged me to prioritize my PrEP drugs in the same way I prioritize my meals. This helped me to understand the importance of the drugs,” she says.The engagement of sex workers as peer educators has been instrumental in promoting sustainability and ensuring that knowledge is passed on from one hotspot such as bars and roadside stops to the next. The mobile brigades have further strengthened this effort by making HIV testing and prevention services more accessible and less stigmatized, thus empowering sex workers to take charge of their health.Not only does the Phamberi na Kudzirira project leverage the trust and influence that peer educators hold within the sex worker community, but it also empowers sex workers to become active agents of change in the HIV response. The peer education model has proven to be one of the project’s greatest strengths.So far, 712 sex workers have been enrolled on oral PrEP courtesy of the Phamberi na Kudzirira project, demonstrating the reach and the impact of the program.Looking ahead, the project aims to continue expanding its reach and impact. The introduction of the vaginal ring as a new HIV prevention option in Mozambique holds significant promise, and AMODEFA hopes to integrate this method into its services as soon as it becomes widely available.“We are looking forward to this option, since adherence will be easier for us,” says Carla*, a sex worker and who is also a peer educator. Carla* notes that the vaginal ring will help in reducing reliance on a single method and improve overall adherence among sex workers.Sergio Mpilele, the Phamberi na Kudzirira Project Manager says that building on the current achievements, the project is paving the way for a more inclusive and effective HIV prevention response in Manica Province.“AMODEFA's innovative approach to HIV prevention in Manica province is setting a powerful example for how community led, inclusive health initiatives can make a real difference in the lives of those most at risk. Through the empowerment of peer educators, the accessibility of mobile brigades, and the continued education of sex workers about PrEP,” he says.*Names have been changed to protect the privacy of the individuals involved.Evelyn Nduati is the JTF Project Lead at the IPPF Africa Regional Office. 

On 16 August 2023, Japanese House of Representatives member Dr Toshiko Abe visited head office and the Adolescent and Youth Friendly Services Centre of IPPF’s Member Association in Mozambique, the Associação Moçambicana para Desenvolvimento da Família (AMODEFA). Dr Abe visited one of AMODEFA’s eight youth centres in a particularly marginalised and high poverty density area, where youth friendly health services is difficult to reach for the local youth who need them most. Their youth centre functions as the hub of youth target activities such as provision of a range of services from HIV testing and treatment to SRHR counselling and other information and services around sexual health and rights. In 2022 23.57 % of AMODEFA’s family planning services were provided to clients under 20 years. AMODEFA was established in 1989 and has been IPPF’s Full Member Association since 2010. It is an independent, non-profit, and non-governmental association working in 10 provinces in Mozambique. As the leading service provider in Mozambique, AMODEFA provides comprehensive and diverse sexual and reproductive health, including that related to SGBV. Their focus is on vulnerable people such as women, girls, people with disabilities.

Five years ago, when Arnilda Simango was 13, she started dating a boy from her community, outside Xai-Xai City, in Gaza Province in southern Mozambique. A year later she got pregnant, at his insistence, and he left her shortly after the baby was born. AMODEFA’s youth services offered her counselling and advice throughout her pregnancy and became the network through which she made new friends.  Today, at the age of 18, she is raising her son, with help from her mother and plans to return to school. “When I started dating, I thought I wanted a partner who could take care of me and that could maybe fill the void I felt for not having a father. When I started the relationship with my boyfriend, he insisted that he needed a son because all his friends already had one. I had little space to say no because he threatened to date someone else and I was convinced he was the right person for me. When I got pregnant in 2016, he started behaving strangely. He stopped being affectionate and gave indications that he did not want to be with me anymore. That's when a friend of mine told me that there was a youth center where I could get advice on how to proceed in this situation". The Adolescent and Youth Friendly Services (SAAJ) center, based at the Patrice Lumumba Urban Health Center, on the outskirts of Xai-Xai, is run by AMODEFA and provides HIV testing and treatment, prenatal and postpartum consultations, and other information and services around sexual health and rights. The center is supported by the Women’s Integrated Sexual Health (WISH2ACTION) programme, led by IPPF.   "One day I walked there and received a lot of advice. As I was already 4 to 5 months pregnant, I was advised to open a prenatal form. They did all the follow-up until I gave birth to my son.” "Believe me, being a single mother at 14 was a suffocating experience and it could have been worse if I had not been accompanied by [the SAAJ]. I do not know how to thank them. I practically felt alone without knowing what to do, but I had a lot of advice here and made friends with other girls". Planning for the future  Arnilda dropped out of 7th grade once she became pregnant and helped her mother selling basic goods from a stall in her home. It is from this small business that her mother supports her two children who are still living at home, as well as five grandchildren. Arnilda plans to return to school next year to continue her studies now her son is old enough to stay with his grandmother. Her dream is to be a professional model. Until then she does not want to have another child, so she goes to the SAAJ for family planning purposes. Arnilda says she walks 50 minutes to the center every three months for the contraceptive injection.  "I wanted the implant, but it doesn't settle well with me, so I renew the injection every three months.  I do this because I need to continue studying to have a decent job that allows me to support my son. Next year I will go back to school. "A second child is not in the plans. I still consider myself a minor. Even the first child I only had because at the time I had no one to give me advice and show me the best way. I believed in my ex-boyfriend and today I have this lesson. Today I can say that I have come to my senses, not only from the experience of being a mother, but from everything I learn here [at the SAAJ]. There is no friend of mine who does not know SAAJ. I always advise them to approach here because I know they will have all kinds of counselling and accompaniment.”

On the evening of 14 March 2019, Cyclone Idai made landfall in the city of Beira in central Mozambique. With wind speeds of 185 kilometers per hour, it was the largest cyclone on record to hit the Southern Hemisphere and Africa. The impact was devastating, leading to the loss of life and extensive damage to infrastructure – not only in Mozambique, but in Malawi, Madagascar and Zimbabwe. In Mozambique alone, more than 130,000 people had to seek shelter in the 136 accommodation centers (emergency tented camps) that were set up across the county. The situation was dire, and the Mozambican government had to call for assistance to rebuild crucial infrastructure like health, transport and communications. The Associação Moçambicana para Desenvolvimento da Família (AMODEFA), IPPF’s Member Association in Mozambique, responded in the most affected areas of Mozambique, including Beira, Tete, Chiomoio and Zambezia. AMODEFA is still there providing sexual and reproductive awareness and services.  A committed volunteer  None of this would have been possible without the help of volunteers like Emerson Chaves, a clinical psychologist. Emerson is stationed in Chimoio, Manica Province. He is a passionate 29-year-old with a desire to offer psychosocial support to his community. Emerson performs his work with dedication as part of AMODEFA’s emergency response team to Cyclone Idai.  “The people of Chimoio were unable to seek for help after the disaster,” Emerson said. “Trying to survive had become a priority as opposed to seeking health services. Most people will not come for services unless we talk to them first.” Emerson’s work is not without its challenges. He works within a community that has deep-rooted cultural traditions that make talking about sex difficult. Yet his work involves sensitizing people about sexual and reproductive health and rights (SRHR), both at the health facility and within the community. This work is especially targeted at women and girls, who are disproportionately affected by issues of displacement. Emergency situations leave girls and young women vulnerable and at a higher risk of sexual exploitation and forced marriage, and they lack basic health services including sexual and reproductive healthcare. These circumstances increase the need for accurate information and quality services on family planning and reproductive health. “Due to the cultural background, I have to approach the topic in a special way and sensitize my community about sexual and reproductive health and rights,” Emerson points out.  Tackling gender-based violence  He shared his experience dealing with cases of gender-based violence; Emerson said the norm in many communities is that the family of a girl that is sexually assaulted receives a ‘bride price’ from the perpetrator’s family. This is usually done as a negotiation between the families. Once this takes place, the case does not get reported to the authorities – if one reports the case the ‘bride price’ is taken away. Many cases of gender-based violence are not reported because of these types of cultural barriers. Fortunately, the IPPF Humanitarian response was able to utilize the Minimum Initial Service Package (MISP), a set of life-saving activities to be implemented at the onset of every humanitarian crisis. MISP focuses on areas such as preventing sexual violence and maternal and infant mortality, and reducing the transmission of HIV, Through AMODEFA, IPPF rolled out the MISP in the affected areas where more than 130,000 people had been displaced, reaching 9,983 people in total, and 3,350 people with sexual and reproductive health (SRH) services. For IPPF, protecting the SRHR of communities and delivering the necessary SRH services in these humanitarian settings is the main objective.  A day with Emerson Emerson beings his day with a plan at the health facility. He has a choice to visit either of six facilities in his area: Motocoma, Chipinda Umue, Inchope, Zembe, Marera or Macate. At these facilities, Emerson receives clients who have been referred from community mobilizers to seek psychosocial support. On Saturdays, he is out with the community mobilizers to sensitize the community on SRHR. He begins with the group sessions then conducts door-to-door visits. The psychosocial care that people need in humanitarian settings is unique – especially when SRHR are concerned. “People in the community are not aware that the facility is offering services,” he said. “They still think that it is closed after the disaster. It is my duty to give correct and updated information on the situation about health services. The community needs to be aware that we are offering services, especially the community members who need SRH services at this time.” 

Updated 29 April   Cyclone Idai tore through Malawi, Mozambique and Zimbabwe on 14 March, leaving hundreds dead, thousands of homes destroyed and almost 2 million impacted. Among those affected by the cyclone are close to 75,000 pregnant women, of whom 43,000 are expected to give birth during the next six months.  IPPF, along with Member Associations (MAs) and partners, are on the ground in Malawi and Mozambique to assess the needs and to deliver healthcare services to those in dire need.   The impact of so far   Malawi The Government of Malawi confirmed the current death toll at 59 with close to 867,000 people impacted by the cyclone. More than 87,000 are currently displaced. Mozambique In Mozambique, the city of Beira – home to over 500,000 people – was hit the hardest by Cyclone Idai, with the government declaring a cholera outbreak in the city on 27 March. The cyclone has damaged and destroyed close to 100,000 homes and has claimed the lives of over 500 people, the number still rising. The Global Gag Rule Though the Global Gag Rule did not directly deny funding for humanitarian work, the ripple effect has had a devasting impact on the capacity at our MAs like AMODEFA, when responding to humanitarian crises.  Due to the loss of funding from the GGR, AMODEFA had to close eight clinics and end programs including the sex worker outreach program in Beira – one of the worst affected areas from the cyclone. This has meant that instead of having a functioning program and staff, and volunteers to mobilize and on which to base the emergency response, AMODEFA only had one remaining staff member in Beira.  Recruiting and training new volunteers for the humanitarian response then requires spending extra money and time, resources that are already scarce. On top of this, there are reports of an increase in sex worker activity along the main truck corridor, an area with an existing HIV prevalence of around 15%. It is not uncommon for women to turn to sex work in the wake of an emergency in order to provide for their families.  Even if the GGR does not have a direct impact on humanitarian SRH funding, it certainly has an impact on the response capacity and lives of the affected population through reduced access to SRH services.     Our response    Malawi Update:  The conditions in the camps are very dire, there is no food, so some people are returning to their homes or to family members houses. Most of the camps are closing off due to this. Our MA has been providing outreach for over two weeks, through two teams, who have reached a total of 16 camps. FPAM is the only organization that is on the ground providing both SRH information and services right in the camps. Clients are accessing our services in large numbers. There is high demand for family planning, HIV testing, and cervical cancer screening in all the camps we have visited. Additionally, there have been anecdotal reports to our team members that some girls and young women said that men with authority at the camp were coaxing girls to exchange food with sex. The risk of STI transmissions and teenage unwanted pregnancies is high as most sites have no access to SRHR services due to long distances from to health facilities, coupled with low levels of knowledge on SRHR issues. This has been exemplified by people`s inability to understand basic SRH issues. There is a strong need for long term, sustainable, access to SRH care and long acting contraceptive supplies. IPPF’s MAs in Malawi and Mozambique are on the ground working with partners to help deliver life-saving healthcare. During times of crisis and humanitarian situations, vulnerable populations such as people living with HIV, children and pregnant women are at a greater risk due to disruptions in healthcare services and systems. IPPF’s response in Malawi is being led by our MA – Family Planning Association of Malawi (FPAM) – who are working with partners like UNFPA to help deliver hygiene kits to affected areas. They are also co-ordinating efforts with the Malawi Association of Midwives on identifying and delivering essential maternal healthcare services. Carlos Sitoe of Family Planning Association of Malawi said: “Cyclone Idai has devastated Malawi. Some health centres have been submerged, and we are hearing reports that women are having to give birth at evacuation centres without skilled attendants.  It is imperative that we are able to reach people affected by this disaster with sexual and reproductive healthcare. Our teams have started providing outreach services but will require many more resources to be able to sustain the response for months to come.”  We continue to operate throughout 16 camps, there has been 1,828 family planning services, 1,059 STIs services, total clients of 21,365 thus far. Mozambique  The Associação Moçambicana para Desenvolvimento da Família (AMODEFA), IPPF’s MA in Mozambique, are currently on the ground assessing needs with local partners and delivering hygiene kits in a coordinated effort with UNFPA. Santos Simione, Executive Director, AMODEFA: “Mozambique has been severely affected by Tropical Cyclone Idai in the last few weeks. Our organisation is on the ground doing assessments and providing training to staff and volunteers in order to be able to reach the thousands of people that are in dire need of sexual and reproductive healthcare. In the coming weeks and months we will be providing life saving care including contraception, prenatal care and safe deliveries. Our commitment is to saving lives, minimizing suffering and restoring people's dignity.”

Our Member Associations around the globe help bring happiness to people every day, by allowing them to access the sexual and reproductive rights they are entitled to. This International Day of Happiness, we’re sharing just a few of the stories of those who told us they were glad to be the recipient of IPPF services. "I’m so happy I now don’t have to worry about contraception for another 5 years" – Muna, Nepal Muna, now 21, got married when she was a teenager and soon had two children, a girl and a boy. She was keen to know more about her contraception options, particularly after flash flooding hit her country. IPPF Humanitarian, through the Family Planning Association of Nepal, were able to step in to help her. Read more about Muna "I am happy about life here" – Antonio, Mozambique 12-year-old Antonio moved in with his aunt after both his parents died from HIV-related illnesses. Antonio is also HIV positive, and with the help of IPPF Member Association AMODEFA, his aunt was able to tell him about it in an appropriate way, and to seek medication that best suited him. Read more about Antonio  "I was very happy when my daughter was born" – Sineang, Cambodia After three years of marriage, garment worker Sineang had started to wonder why she hadn’t yet become pregnant. After noticing some vaginal discharge, she visited a Reproductive Health Association of Cambodia clinic to seek treatment, and for support on her journey to become a mother. Read more about Sineang

Marinho, 30, works as an activista for Amodefa’s Challenge TB programme, bringing treatment to remote villages in the Ribaué district of Nampula. Since August last year he has identified 84 cases of TB in the eight communities in which we works; “75 patients are in treatment at the moment, the rest are recovered,” he says. Before Amodefa started work in Nampula, Marinho says, “people were dying because they couldn’t reach the hospital, but with this programme it is becoming easier because we bring the medication to the patients.” However, lack of transport means it is a challenge for him to keep on top of all his cases. “The distances are far and the few bikes we have are breaking,” Marinho says. Yesterday he travelled 40 km to visit his patients. Some of the communities he visits are up to 50 km away. In the first quarter of this year 1,318 people were tested for TB in the eight districts where Amodefa operates; in the second quarter, 2,106 were tested; and in the third quarter, the number reached 3,154. More than half of these people were diagnosed to have TB. The surge in the number of people going for tests is in a large part due to Amodefa’s ‘Day of the Cough’.  On the 27th of each month teams of activistas and volunteers go into communities, schools and jails to educate people about TB.   Before volunteers had to go from house to house to identify patients, “but now, with the lectures, it’s easy to find people who are TB positive because they are identifying themselves,” says Marinho. Children are particularly receptive to Amodefa’s message, Marinho says. He remembers one woman who had been sick for a long time and her daughter, knowing he was an activist, sought him out. The patient’s initial test for TB came back negative, so she was given alternative medication.  “She took the tablets but she was still sick - she was unable to walk or to eat,” Marinho says.  “We brought her here to the clinic, examined her and she immediately started TB treatment. Now she has started her recovery and is able to sit.” Lessons taught during the ‘Day of the Cough’ means communities are also now taking greater precautions against the disease, he says. Steps such as opening windows, cleaning the house, not eating from one communal bowl, and practising ‘coughing etiquette’ have all helped limit the spread of TB.  “People understand now and are taking serious measures to prevent it,” Marinho says. However, the US decision to withdraw funding from Amodefa following the introduction of the Global Gag Rule , could halt the Challenge TB programme just as it is gaining momentum. “If the programme stops the people will suffer,” says Marinho. “For people who live too far from the hospital to receive treatment, this programme saves their lives. Knowing Amodefa has come to eliminate TB, it can’t stop. If they stop now the TB will get resistant, so we’ve got to keep going, we’ve got to get stronger.”   SUPPORT OUR WORK WITH A DONATION

In the latest People and Power documentary, the team travel round Mozambique with AMODEFA, to look first-hand at the human impact the Gag rule has had in the country. The Global Gag Rule denies U.S. funding to organisations like IPPF if they use money from other donors to provide abortion services, counselling or referrals—even if abortion is legal in a country. It blocks critical funding for health services like contraception, maternal health, and HIV prevention and treatment for any organisation that refuses to sign it. The documentary talks to AMODEFA clients and staff who have been involved and helped by the US funded health programmes covering young people, HIV and Tuberculosis. AMODEFA faces significant losses to their programming budget of $2 million. Work that has built trust and provided support and treatment for many people who would have been left behind. The documentary spans several provinces, with the team visiting specialised outreach services that go out to the most rural populations. ‘We will have generations that are sick without knowing what they have. They will run the risk of transmitting HIV to other people because they do not know their HIV status,’ says project leader, Dr Marcel Kant. ‘We are condemning our society to live with this illness and there will be a large number of deaths.’ IPPF is working with AMODEFA to find alternative sources of funding. Executive Director Santos Simione, is working tirelessly with his team to ensure AMODEFA’s works continues, “We must be resilient! This also means being resilient to ensure that the progress made in sexual and reproductive health and rights continues and the provision of services minimizes the suffering of our population, particularly adolescents and young people, women and children”. The team Read more about AMODEFA's tireless work in Mozambique