Couples in developing nations want smaller families. US family planning assistance responds to the growing desire of couples worldwide to make their own decisions about how many children to have and when to have them. Today, family size averages fewer than three children, down from six children 30 years ago—in large part reflecting the improved availability of family planning. Yet in many countries, women still have more children than they would like.

Contraceptive use is growing rapidly. From Bangladesh to Botswana to Brazil, increasing numbers of women are using modern contraception, contributing to declining birth rates around the world. Roughly half of all married women in developing countries now use family planning, compared to 10 percent in the 1960s. In many countries, however, contraceptive services are still difficult to obtain, unaffordable, or of poor quality.

Most developing country governments now support family planning, recognizing its many benefits. Family planning saves the lives of mothers and children by helping women to avoid high risk pregnancies and increase the time between births. Smaller family size also improves the economic situation of families. Moreover, slower population growth makes it easier for countries to provide education, health care and jobs, and to protect natural resources from further degradation.

Needs are Growing

The number of couples in need of family planning is increasing. Although world population growth is slowing, about 78 million people were added in 1999 for a total of 6 billion people. It took until the early nineteenth century to reach the first billion people; it took only 12 years to add the sixth billion. Moreover, because of past population growth, the number of women in their childbearing years in developing countries is growing by about 24 million a year, faster than ever before. Family planning services have to expand rapidly to keep up with both population growth and rising demand.

A Foreign Aid Success Story

US population assistance is highly effective. US-funded programs have had a practical focus on expanding and improving family planning services. US foreign aid has supported contraceptive services provided by both governments and the private sector; supplied contraceptives; helped train health workers and managers; and introduced creative new approaches to educating people about family planning and reaching them with services. Tens of millions of couples use family planning as a direct result of US assistance. Many millions more have benefited indirectly from improvements in services resulting from American advice and innovations.

Countries receiving US assistance have experienced remarkable increases in contraceptive use and declines in birth rates. In the 28 most populous countries receiving US funds, the average number of children per family has dropped from 6.1 in the 1960s to 4.2 today. In Colombia, Indonesia and Mexico— all countries which have received extensive US assistance—average family size is now three children. Taiwan and Thailand, which were early recipients of US assistance, now have an average family size of two children and no longer require US assistance.

US-assisted programs are voluntary and do not support abortion. U.S. assistance is based on the free and informed choice and consent of individuals. US-funded programs seek to empower couples to make their own decisions, for example, by working to expand the number of contraceptive methods available and training staff in proper counseling techniques. By law, US funds cannot support programs that use coercion or incentives to encourage use of family planning and cannot be used to perform abortions. Improving access to contraception is also the best way to reduce reliance on abortion.

US Funds Crucial, Cost per Citizen Small

The cost of US population assistance to each American is negligible. In 1995, before the 30% budget cut imposed by Congress, US family planning aid of $577 million amounted to little more than $2 for each American. Americans contribute less per person than the Danes, Dutch, Germans and Norwegians. (Danes and Norwegians contribute the most, about $10 each.)

US funds are vital to global family planning efforts. As the industrialized nation with the largest population and economy, the United States remains the biggest donor in the field. The US contribution currently represents more than a third of all grant aid for family planning, but with US encouragement, other donors are taking up more of the financial burden. Moreover, governments and consumers in developing countries continue to pay most of the costs—about 80 percent of current global spending on family planning. Total donor assistance from all sources is currently only about one-third of total estimated need.

A Defining Moment

The decisions we make now will make a difference to the future of our planet and to our children and grandchildren. In an interconnected world, Americans stand to benefit directly from efforts to slow population growth with its negative impacts on the global economy and environment. The prospects for peace and economic development in the twenty-first century will depend, among other things, on slowing population growth and meeting human needs. Without continued commitment, there is no guarantee that population trends will continue to move rapidly in their current positive direction.