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.