This hearing was a long-overdue opportunity for Congress to better understand the real-life, destructive consequences of the Gag Rule on women and children. Members of the committee heard first-hand how a decline in family planning services - due to the Gag Rule -- is increasing unwanted pregnancies, abortions and maternal mortality. Witnesses testifying at the heavily attended hearing included Duff Gillespie, PhD,former Senior Deputy Assistant Administrator for the Global Health Bureau at USAID and current PAI Board member; Ejike Oji, MD, Country Director for Ipas-Nigeria; and Joana Nerquaye-Tetteh, PhD,former Executive Director, Planned Parenthood Association of Ghana.
"The Global Gag Rule exacerbates the situation in Nigeria whereby women have no choice about how to manage their own lives. That is what makes me so angry, because at the end of the day it is our women-our wives, daughters, and sisters-who are dying," Dr. Oji testified. The Global Gag Rule prevents USAID from working with organizations that can most effectively increase use of family planning-largely through rural distribution. This is an incredibly dangerous gamble in Nigeria where nearly one-third of women say they have had an unwanted pregnancy and half of those have attempted an abortion.
I had the privilege of spending a few days with the Committee's witness from Ghana, Joana Nerquaye-Tetteh. She speaks with the authority needed to command the attention of policy makers and set the record straight when challenged, as she often was, by the Minority. According to Dr. Nerquaye-Tetteh, as a result of this U.S. policy access to family planning was significantly reduced and the number of unintended pregnancies and new sexually transmitted infections both increased. Immediately following the imposition of the Gag Rule, and PPAG's refusal to sign the policy, they saw a 50% increase in the number of women seeking post-abortion services.
While some supporters of the policy tried to make the case that family planning is not harmed by the Global Gag Rule, this is simply false. As Chairman Lantos stated in his opening remarks, "While the Global Gag Rule is being promoted as anti-abortion, it remains at its core anti-family planning." By preventing funding from going to the organizations where they can be most effective on the ground, the Gag Rule is the roadblock keeping life-saving reproductive health care and supplies from women in need.
Our longtime champion of international family planning and Chair of the House Appropriations Subcommittee on State- Foreign Operations, Nita Lowey, made a special appearance at the hearing testifying the Global Gag Rule "is unconstitutional, immoral, unsubstantiated and dangerous."
The hearing was especially well-timed as President Bush threatens to make good on his promise to veto the entire Fiscal Year 2008 foreign assistance spending bill over a provision that exempts contraceptives from the Gag Rule's restrictions. I know I join many of you in asking the President to stop playing politics with women's lives and repeal the Gag Rule.
]]>Katie Porter is a Legislative Policy Analyst at Population Action International.
As new discoveries in HIV prevention are made, including the use of circumcision and microbicides, the U.S. must have maximum flexibility to spend limited resources in the areas of HIV prevention that are most relevant to country demands. Maximum flexibility? You can almost feel the collective shudder on Capitol Hill. Congress cannot afford to let recipients do as they wish with tax payer dollars; can you blame them? But the alternative—dedicated funding for specific activities—can be dangerous, especially when funding is limited and lives literally lie in the balance.
]]>Katie Porter is a Legislative Policy Analyst at Population Action International.
As new discoveries in HIV prevention are made, including the use of circumcision and microbicides, the U.S. must have maximum flexibility to spend limited resources in the areas of HIV prevention that are most relevant to country demands. Maximum flexibility? You can almost feel the collective shudder on Capitol Hill. Congress cannot afford to let recipients do as they wish with tax payer dollars; can you blame them? But the alternative—dedicated funding for specific activities—can be dangerous, especially when funding is limited and lives literally lie in the balance.
The President's Emergency Plan for AIDS Relief (PEPFAR) states that 20% of PEPFAR's funding is spent on prevention activities, and the majority of the remainder for treatment. Of the prevention funding, one-third must be spent on abstinence-until-marriage programs. The message is clear: Regardless of how the epidemic is spreading or the number of people that need treatment, countries must address the disease by spending along arbitrary funding quotas as determined by U.S. law.
Promising new research in the area of male circumcision for HIV prevention has demonstrated again how dangerous this rationale is for the millions at risk of HIV infection. As reported late last year, male circumcision has been shown to reduce HIV infection rates in males by roughly 50%. If it is determined that male circumcision should be included in HIV prevention programs—to be used in addition to other evidence-based prevention efforts—it has the potential to make a huge impact in places like sub-Saharan Africa where there is both high HIV prevalence and low male circumcision rates. However, PEPFAR support for this new prevention method would compete with limited prevention funding due to required spending for abstinence-until-marriage programs. Again, countries must spend their U.S. funds according to the needs of the U.S. Congress, not the epidemic.
New discoveries are made in vain—and at considerable cost—if they cannot be funded and utilized in the countries where they can make the greatest impact. Congress can take full advantage of scientific discoveries that offer the most potential to save lives by stripping unnecessary and arbitrary earmarks from PEPFAR and exercising appropriate oversight of its programs instead. Let's see some flexibility.
]]>Katie Porter is a Legislative Policy Analyst at Population Action International.
The goal of achieving reproductive health equity for women around the world gained currency last week with the release of a World Health Organization-sponsored report citing unprotected sex as the second leading cause of disability and death in the developing world. What was refreshing for many of us in this field was the bold way in which the WHO called it like it is: "declining financial support, increased political interference and an overall reluctance to tackle threats to sexual and reproductive health" are threatening the very existence of strong family planning programs. That trend must end.
During a recent trip to Ethiopia, I heard time and time again just how difficult integration of family planning and HIV services is in light of funding cuts to family planning programs in many African countries. While U.S. support for HIV/AIDS is at an unprecedented level, our decades-long support for family planning is dangerously low and the repercussions for women, men, and their families are deadly. How much have we truly accomplished in a country where HIV infection is coming down if maternal and infant mortality rates are still high and on the rise?
]]>Katie Porter is a Legislative Policy Analyst at Population Action International.
The goal of achieving reproductive health equity for women around the world gained currency last week with the release of a World Health Organization-sponsored report citing unprotected sex as the second leading cause of disability and death in the developing world. What was refreshing for many of us in this field was the bold way in which the WHO called it like it is: "declining financial support, increased political interference and an overall reluctance to tackle threats to sexual and reproductive health" are threatening the very existence of strong family planning programs. That trend must end.
During a recent trip to Ethiopia, I heard time and time again just how difficult integration of family planning and HIV services is in light of funding cuts to family planning programs in many African countries. While U.S. support for HIV/AIDS is at an unprecedented level, our decades-long support for family planning is dangerously low and the repercussions for women, men, and their families are deadly. How much have we truly accomplished in a country where HIV infection is coming down if maternal and infant mortality rates are still high and on the rise?
As someone who spent five years working in a congressional office, I know how easy it is for Congress to throw its weight behind issues most interesting to the public and most talked about in the news. International family planning isn't one of them. And yet this report illuminates the scope of the problem in a way that should shame the world for allowing a decline in support for family planning. The report states: "Rapid population growth poses a bigger threat to poverty reduction in most poor countries than does HIV/AIDS." The new Congress gives us an important opportunity to educate new members and reeducate the old about the value of international family planning. The facts are on our side, now we have to sell it.
Without political and financial support, population will continue to grow at an unsustainable rate. Women and children will continue to die needlessly, and history will judge us for failing to support proven health interventions. Only through increased funding and a renewed commitment to family planning and sexual and reproductive health programs can we have the most profound effect on the health and well being of people around the world.
]]>Editor's note: For more on the Lancet series on sexual and reproductive health, read Tyler's post.