“Birthrates Help Keep Filipinos in Poverty” – that's the headline of an April 21, 2008 Washington Post article highlighting the plight of a growing number of poor women in the Philippines who lack access to one of the most basic forms of health care: family planning (FP) and reproductive health services. The article, which mentions that the U.S. is scaling down its FP program in the Philippines, should be a wake-up call for policymakers about the global impact of declining FP assistance on the lives of hundreds of millions of men and women in the Philippines and other developing nations. U.S. investments in international family planning have been one of the most successful and cost-effective ways to improve maternal and child health, ease population pressures on the environment, and help countries fight poverty. But despite the achievements of recent decades -- including an increase in use of contraceptives among married women in the developing world from 10 percent to 60 percent since 1960 and a decline in average fertility rates from about six children per woman to three children per woman -- significant needs remain. For example, only one-third of married Filipino women use modern contraceptives.

Last week, despite President Bush's veto threat, the Senate passed the FY 2008 State-Foreign Operations Appropriations bill (by a vote of 81-12) that includes significant provisions overturning destructive policies on family planning and HIV/AIDS.

It's extremely rare for an organization to refuse funding, let alone $45 million. But that is exactly what CARE, a leading international relief organization, did last month when they refused U.S. government funding for food aid. According to a recent General Accountability Office report, the U.S. food aid program is seriously flawed. CARE agreed, finding that it hindered the development work they were trying to accomplish in the developing world. By challenging a policy they viewed as detrimental to their mission, CARE has put a spotlight on potential flaws in this U.S. policy – a spotlight that may even generate a change in policy.

Last week, President Bush proposed a dramatic 25% reduction in funding for international family planning and reproductive health (FP/RH) programs in his federal 2008 budget request despite the fact that they are one of the most successful components of the U.S. foreign assistance program. These draconian cuts come at a time when U.S. funding for FP/RH programs is already 35% below (when adjusted for inflation) the levels of twelve years ago. In addition, the re-imposition of the Global Gag Rule in 2001 has made matters worse by forcing family planning providers in poor, developing nations to lay off staff and shut down their clinics. PAI implores the U.S. Congress to increase-rather than cripple-funding for international family planning and reproductive health as a key way to reduce global poverty and improve women's health worldwide.

As the 109th Congress adjourns, its inability to pass appropriations bills ranks among the top failures that have rightly earned it the moniker the “do-nothing Congress.” Among the 9 of 11 mandatory spending bills that will not get final approval is foreign assistance, which includes funding for international family planning.

In January of this year, Secretary of State Condoleezza Rice announced a major restructuring of the U.S. government's foreign assistance program under a new vision of “transformational democracy.” As details of the plan have emerged, it appears that the short-term national security and democracy promotion objectives favored by the State Department are trumping the traditional focus on development and poverty reduction. This shift could prove enormously detrimental to long-term development programs, including family planning and reproductive health. PAI urges Congress to address the potential dangers that lie in this restructuring now, before these programs-that help so many women and children in need-are irreversibly undermined.

On June 9, the House overwhelmingly adopted its version of the FY 2007 foreign operations bill, the annual legislation which funds U.S. development and humanitarian assistance programs including Family Planning and Reproductive Health (FP/RH) programs. The House-approved bill includes $432 million for FP/RH programs, as well as $34 million for a U.S. contribution to the United Nations Population Fund (UNFPA), subject to a Kemp-Kasten restriction ruling. The $432 million funding level is a significant accomplishment in light of the Bush administrationís desire to cut the FP/RH funding level nearly 20 percent to $357 million. PAI commends family planning champions on the Foreign Operations Subcommittee, in particular Ranking Member Nita Lowey (D-NY), for rejecting the steep cuts proposed by the President and for their efforts to restore funding to these critical programs.

In a significant rebuke to the Bush administration, the House Appropriations Subcommittee on Foreign Operations today approved a fiscal year 2007 appropriations bill that rejects the administration's steep proposed cuts in international family planning and reproductive health programs. If the cuts had been adopted, U.S. efforts to reduce maternal and infant mortality, unintended pregnancies, abortion, and sexually transmitted infections would have been greatly impeded.

PAI praises the U.K. Department for International Development (DFID) for pledging an initial 3 million pounds – the equivalent of over US$5 million – to a new fund supporting health organizations that have lost U.S. funding since the re-imposition of the Global Gag Rule. We also commend the International Planned Parenthood Federation (IPPF) for creating the fund, which will significantly reduce the number of unintended pregnancies and abortions worldwide.

A new directive from the Office of the U.S. Global AIDS Coordinator (OGAC) enforcing abstinence-until-marriage and be-faithful (AB) program funding will impose significant new restrictions on the use of U.S. HIV/AIDS prevention funds. The directive earmarks two-thirds of all prevention funding for the sexual transmission of HIV to AB programs, thus allocating less than 10 percent of all prevention funds to comprehensive, sound prevention programs. PAI calls on Congress to reject these new restrictions, which seem to contradict congressional intent that funding for comprehensive HIV prevention activities not be dwarfed by risky and unproven AB programs.