We’re Back! US Reclaims Leadership Role in International Reproductive Health


On Friday, April 3, at the
conclusion of the annual meeting of the United Nations Commission on
Population and Development, the international community pledged to ramp
up efforts to improve women’s health and reduce poverty in the developing
world. And for the first time in eight years, the United States was
front and center in advocating an increased global commitment to reproductive
health and rights.

Add this new U.S. stance to
the recently resumed American support for the United Nations Population
Fund (UNFPA), the repeal
of the infamous "global gag rule"

that barred overseas organizations that so much as provided abortion
information from receiving U.S. family planning assistance, and Secretary of State
Hilary Clinton’s unequivocal endorsement of women’s rights as human
rights
, and it
is safe to say: The U.S. is back!

Or, more precisely, back on
track–the policies of the past eight years have left a lot of catching
up to do. Current U.S. international family planning assistance, at
$545 million a year, is significantly higher than previous years, but
falls far short of the $1 billion that represents the minimum U.S. share
of the global commitment.

While the United States contributes
more funds than any other country toward voluntary family planning services
worldwide, European nations far outspend the United States in terms
of the proportion of the gross domestic product allocated to foreign
assistance. There is, understandably, a sense that Bush administration
policies have left Europe to pick up the slack in international family
planning funding and other aspects of promoting sexual and reproductive
health.

The renewed U.S. commitment
to international sexual and reproductive health is a timely development.
The meeting also marked the 15th anniversary of the Cairo Program for
Action, a 20-year plan to stabilize population growth and reduce poverty,
in part by investing in women’s health.

Though the vast majority of
United Nations (UN) member states signed onto the Cairo Program of Action,
15 years later, most countries have fallen behind in their commitments.
UNFPA estimates that, in 2008, there was a nearly $4 billion gap between
actual and needed support for family planning from donor nations.

To focus attention on these
gaps, the Guttmacher Institute and UNFPA convened an expert panel at
last week’s UN population meeting to discuss global funding priorities,
especially given a more supportive U.S. administration.

Stan Bernstein, senior policy
adviser at UNFPA, chaired the panel. Barbara Hendrie, counselor of development
and human rights for the United Kingdom Department for International
Development, heralded the change in the U.S. administration as a "major
opportunity" for the European donor community and the United States
to work together on reaching development goals.

Scott Radloff, director of
the department of population and reproductive health at the U.S. Agency
for International Development, shared new initiatives under the Obama
administration, while Susan Cohen, director of government affairs at
the Guttmacher Institute, represented the nongovernmental perspective.

The result was a lively debate
of European versus American approaches to investing in developing countries.
For example, the United Kingdom prefers to provide "basket funding"
or core support, investing in developing country health systems overall
and pooling funds with other European countries where there are overlaps
in programs.

In contrast, U.S. funding focuses
on specific programs, partly due to Congressional oversight that requires
greater accountability and meeting assigned targets. Despite these differing
donor philosophies, the panelists agreed that their funding initiatives
could be complementary.

Both Hendrie and Radloff also
spoke of the need for their countries to make programs more efficient
by integrating family planning and HIV/AIDS services. And all involved
expressed real optimism that with support of the current U.S. administration,
these kinds of changes might finally be possible.

The social and financial return
on these investments is great, added Cohen, citing Guttmacher and UNFPA
evidence
. Meeting
targets set in the Cairo Programme for Action and in UN Millennium Development
Goals will require strong commitment and increased cooperation. For
this to work, the United States must maintain a clear leadership role
and European donors cannot back away now just because the United States
has returned to the scene.

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