In Sync with the World? A New US Approach to International Reproductive Health


People around the world are
confident that the Obama administration will mark a sweeping departure
from the Bush go-it-alone, with-us-or-against-us approach to foreign
policy.  But how far will it go?  A policy paper on U.S. foreign assistance reform,
just released by the Center for Health and Gender Equity (CHANGE), calls
for the U.S. to rejoin the world, especially in terms of its position on sexual and
reproductive health and rights.  With U.S. foreign assistance reform
on the agenda of Congress and the new administration, there is tremendous
opportunity for progress. 

For years the U.S. has been
stiff-arming the world when it comes to international development and
human rights.  Filled with the certitude endowed by their brand
of American exceptionalism, the Bush administration and its friends
in Congress have eschewed the consensus and commitments created by the
global community. 

As a result, U.S. policy on
foreign aid has been saturated with irony.  While never missing
an opportunity to espouse a commitment to global democracy, U.S. political
leaders seem to trust only themselves in determining what is best for
the world’s poor. Scoring political points with domestic audiences
also takes a high priority.   What people overseas want and
need, or what world leaders have agreed upon – these seem to come
at the bottom of the decision making barrel. 

But what if things were different? 
What if, as CHANGE’s policy paper recommends, U.S. foreign assistance
structures made an explicit commitment to women’s empowerment and
sexual and reproductive health and rights?   

Think of what a meaningful
change that would make in a world where over 500,000 women die each
year from pregnancy-related causes, and where the vast majority of these
deaths are preventable. Think of the life change for the millions of
women who suffer illness and injury due to gender violence, or sexual
and reproductive health complications. Consider the women of sub-Saharan
Africa who make up 61% of HIV infections, and the young women there
who make up 75% of these infections for the 15 to 24 age group.   

And think what it would mean
to their families – mothers, sisters, wives, daughters healthy, happier
and able-bodied.  And think of their communities and countries,
where an improvement in women’s health means bolstering the potential,
the spirit, the imagination of half their populations.

One great part about joining
the global consensus is the U.S. doesn’t have to reinvent the wheel
– the framework and targets already exist. 

In 2000, the eight Millennium Development
Goals
(MDGs) were
affirmed by the U.S. and 188 other governments with the ambitious yet
achievable aim of cutting poverty in half by 2015. In 1994, the International Conference
on Population and Development

(ICPD) in Cairo set basic guiding principles around sexual and reproductive
health and rights. 

And while you’d never know
it by looking at U.S. policies – global leaders have agreed that sexual
and reproductive health and rights are absolutely essential to achieving
the MDGs (a full exploration of the reasoning behind this can be found
in Public
Choices, Private Decisions: Sexual and Reproductive Health and the Millennium
Development Goals
).
In October 2007, the UN General Assembly affirmed a new target – to
achieve universal access to reproductive health by 2015.   

They based this decision on
the evidence: children with healthy mothers fare better than children
with unhealthy mothers; communities with healthy women are economically
better off; moms who can choose the spacing of their children are better
able to send them all to school, feed them, and keep them healthy.   

In short: Sexual and reproductive
health and rights are so important that we cannot defeat global
poverty without them. 

Fortunately, President-elect
Obama has already signaled a commitment to the Millennium Development
Goals and to changing some of the worst policies of the Bush administration,
including the Global Gag Rule.  The question is: will the U.S.
fully
get on board?  Will we commit to the collaborative leadership
necessary to confront these challenges?  Turn the page on the hodgepodge
of restrictive policies, disgracefully low funding levels, and disregard
for human rights that have plagued U.S. sexual and reproductive health
policy? 

Fortunately, we have an exciting
opportunity to do just that – to make sure that the U.S. government
aligns its foreign assistance objectives with the goals and agreements
that hold so much promise for the world’s poor.   We need
to let our political leaders know: it is time for human rights, public
health, and international consensus to finally become U.S. foreign policy’s
guiding star. 

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