The impacts of US funding cuts were severe in Ethiopia, resulting in huge budget cuts and staff losses for IPPF’s MA.
Background: FGAE and USAID funding
The Family Guidance Association of Ethiopia (FGAE) was established in 1966 and has since grown to become one of the largest providers of family planning and other SRHR services in Ethiopia. They host a network of 46 integrated SRH service delivery facilities, youth centres, and outreach sites, as well as 478 public and private franchised service delivery partners. Working closely with the Federal Government of Ethiopia, the organisation has over 700 employees and more than 8,000 programme and policy volunteers.
Before the USAID funding cuts, FGAE reached approximately 2.7 million clients in 2024, of which 1.4 million were for family planning services. The organization had four major project agreements in place with USAID, intended to maintain services and reach underserved communities until 2028. These USAID project agreements represented nearly half of the organization’s operating budget.
In early 2025, FGAE was confronted with what staff have described as the “biggest challenge in the association’s history.” The reinstatement of the Mexico City Policy and the expansion of restrictions on U.S. overseas development assistance did not merely reduce FGAE’s budget; they dismantled FGAE’s long-term strategic vision. The termination of all four major project agreements plunged the organisation into immediate crisis, creating uncertainty for both healthcare providers and the millions of vulnerable clients FGAE serves.
Impacts: the scale of the crisis
The financial and operational shock was immediate and severe. The funding cuts stripped FGAE of approximately $2.2 million from its 2025 annual budget—a loss representing 46% of the organisation’s total income. This abrupt deficit forced the association to make dramatic structural adjustments, including the termination of 162 staff members, or one-quarter of its entire workforce.
The ripple effect of these cuts extended far beyond internal operations, dismantling the broader health ecosystem FGAE had built. The organisation was forced to suspend partnerships with 366 health facilities, including 79 government health centres, effectively severing their reach of critical care in the public sector.
The human cost: leaving the vulnerable behind
The cuts hit the most marginalised communities hardest. By eliminating the funding that subsidised care, FGAE lost its ability to serve many with SRH care who could not pay—specifically rural populations and sex workers.
Perhaps the most alarming disruption occurred in HIV services, where the inability to cover staff costs for testing and treatment created a life-or-death crisis. Staff reported the anguish of patients fearing the loss of life-saving antiretroviral medications.
Resilience and a temporary lifeline of support
Amidst this collapse, emergency support played a pivotal role in helping FGAE keep their doors open. The emergency grant through IPPF’s Harm Mitigation Fund was described by staff as a “lifeline,” covering 22.5% of the financial deficit that FGAE faced. This critical funding allowed FGAE to keep its clinic franchise network open and meet essential obligations, effectively stabilising the organisation when it was on the brink of shutdown.
While IPPF’s Harm Mitigation Fund support did not restore the organisation to its pre-crisis funding level, it provided the necessary breathing room to identify and explore new funding strategies, including a renewed focus on domestic financing and drawing on fee-for-service clinic models to subsidize care for vulnerable populations.