Contraceptive Shortfall

OPERATOR: Yes, our next question comes from Becca Rothschild of Detroit Free Press.

BECCA ROTHSCHILD, DETROIT FREE PRESS: Hi. I had a couple questions and you may have covered it a little bit at the beginning of the last answer, which I missed. But let's talk specifically about the United States. What are the solutions, policy, aid-wise, NGO-wise? What can average people do to help? What does the US government need to do to help? I need to communicate to my readers in Michigan why they should care and what they can do about it, not just how bad the problem is and that more money needs to be there. So how would I explain that to them? What needs to happen here?

WIRTH: First the global health epidemic is one – everybody in the world is connected. The people of Detroit are no further away from a healthcare disaster than an airplane potentially coming in with an infected person from India or Africa or wherever. The world is much more closely connected all the time. We've seen that with the growth of AIDS. We're seeing that with the increased presence of Tuberculosis. We're seeing that with Malaria creeping up into the southern part of the United States. All situations in which Americans thought that they were immunento, that these were problem that existed someplace else, well, they're not. They are problems that are increasingly right at home.

Second, if we are looking around the world at the long-term stability of the United States, thinking very clearly about the new national security issues, we must think about the global health situation, we must thing about the global environment. We are not an island unto ourselves. The global environment is related to significant issues of pollution that affect all Americans. The world is getting smaller and the problems of the world are coming home to us much more rapidly than we imagined. Third, in the area of population I would let Amy speak to that in particular. Amy?
COEN: I originated in your area. So I would love to. And Thoraya went to school there, so we both feel very strongly about our Detroit connection.

The other thing I would love -- my family and those I've left in Detroit and Michigan -- to know is that they need to hold their elected officials accountable. That international family planning funds are incredibly, incredibly important and that the elected officials from Michigan in Congress have to support – and need to support – the very small amount of money that our country sends abroad. We have not lived up to our fair share dues, and Michigan needs to take much more of the leadership in saving women's lives around the world. We know Detroit has a community resulting from immigration, and care deeply about the world and we are simply not doing our part.

ROTHSCHILD: OK. We're not keeping our commitment to this small amount of money. How much is that? What else can people here do? I mean, I can say call your elected officials, but specifically, they need to tell their elected officials what they want. What do they need to tell them? How much money are we talking about?

COEN: Well, we're talking about hopefully this year $425 million, which is a shortfall of what in 1995 was $530 million. So we can ask them to make sure they support the International Family Planning Fund that comes out of this country and goes to fund the poorest women in the world.

ROTHSCHILD: So we...

COEN: And that's the best thing.

ROTHSCHILD: We committed to $530 million in '94 and...

COEN: Well...

ROTHSCHILD: ...wouldn't be -- would be happy...

COEN: Right. We...

ROTHSCHILD: ...but content with $425?

COEN: Well, no. They should know that our Congress in 1995 supported $540 million. We have dropped -- we this year -- I won't give you the whole story but this year it's $425 million. It needs to be more that. We are falling far short of our commitment and our promises. So what we need to say is that we've got -- I mean, I think that's what -- that's what we need to specifically ask elected officials for is more money, at least $540 million. And they should talk to their elected officials that this is important to them.

WIRTH: Just one -- a final point if I can on this. It's very important for the United States to lead. If the United States begins to pick up the fair share of our responsibilities around the world, others will follow. If the United States backs off, there's follow up as well and the world is poorer as a consequence -- poorer in every way. I think that this administration's Secretary Powell, Secretary O'Neil, you know, are clearly lining up and understanding the international security implications of developing a healthcare system that is focused on AIDS, that is focused on the needs of women, that is focused on the infectious diseases around the world.

ROTHSCHILD: There's also policy issues involved here, most notably the global gag rule. Given the current climate in DC, especially coming out of the White House, do you expect this commitment to increase?

WIRTH: I think that the global gag rule has to do with abortion. It does not have to do with the availability of commodities. And we are given to understand that the White House and the administration will make an increased commitment to the availability of condoms and commodities, and that's a terribly important first step as we think about both HIV/AIDS and reproductive healthcare issues.

ROTHSCHILD: But if...

WIRTH: Condoms and commodities are not...

COEN: And the -- and we have increased -- and the numbers have increased. Last year it was 390 and this year it's 430. And so this is the time actually to push for an increase in Congress, believe it or not. I mean, that Congress is giving some more and if we get more constituency support I think we can up it again next year.

ROTHSCHILD: But the gag rule is going to -- I mean the gag rule is specifically targeted toward abortions but it's going to end up hurting family planning agencies, right?

COEN: Well, it's not good news but it is clearly -- this conference is clearly about international family planning, and this is a Congress and a White House that sees these issues separately. In international family planning it's a great political strategy to get it increased right now. There's groups working on overturning the gag rule but they're separate issues, they're separate votes. And they're going to be kept separate in Congress. So what we want the message to be is that -- what happens is the global gag rule's important but that's where the focus is. And if we could get focus also now intensely on increasing funds, I think actually we could make a difference. I think we could increase this funding.

ROTHSCHILD: Thank you.

OPERATOR: Thank you.

WIRTH: Conference coordinator...

OPERATOR: At this time it appears there are no further questions. I would like to express my deepest apologies for the problems that have occurred during this conference.* And if you have any further questions you can dial 914-833-7093. Ladies and gentlemen, thank you for participating in today's conference. This concludes the program. You may now disconnect. Have a great day.

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* Due to technical difficulties, lapses in transmission occurred. When appropriate, text substitutions were made for greater clarity.