- Comprehensive Sexual and Reproductive Health
- Family Planning
- Women, Girls, and HIV
- Rights-Based Maternal Health
- U.S. Foreign Policy & Funding
- Watch: Making U.S. Foreign Assistance Work for Women and Girls in Ethiopia
- Female Condoms and U.S. Foreign Policy
- Family Planning Policy Restrictions and HIV
- U.S. Global Health Initiative
- Global Gag Rule
- Helms Amendment
- Foreign Assistance Budget
- Foreign Assistance Reform
- Kemp-Kasten Amendment
- Abstinence & Fidelity
- Anti-Prostitution Pledge
- Advocacy and Foreign Assistance
- Why Women and Girls?
U.S. Foreign Policy & Funding
In 1994, the U.S. joined 178 other countries in signing the International Conference on Population and Development (ICPD) Programme of Action. This agreement marked an historic reframing of family planning, refocusing efforts away from population reduction and toward a focus on women’s health and human rights. Women’s groups also succeeded in gaining international recognition of the fundamental rights of reproductive self-determination and reproductive health care.
In 2010, Secretary of State Hillary Rodham Clinton strongly reaffirmed the U.S. commitment to the ICPD framework. However, the U.S. government has not yet translated the principles and priorities of comprehensive sexual and reproductive health and rights into action through its international policies and foreign assistance.
For example, the U.S. response to global sexual and reproductive health issues is segregated. Instead of being addressed holistically, these issues are “siloed” by different offices, agencies, and funding mechanisms. They are governed by different policies and evaluated separately.
In practice, this means that global HIV programs have not typically supported family planning for HIV positive women who want to postpone or avoid childbearing. Women receiving U.S.-supported prenatal care may not receive counseling on effective family planning methods. U.S.-funded HIV testing centers are not required to integrate screening for gender-based violence.
Also, a comprehensive and collaborative approach to sexual and reproductive health has been further complicated by politically-motivated funding restrictions that run counter to the promotion of health and human rights.
How foreign assistance breaks down: The Foreign Assistance Dashboard provides a view of U.S. Government foreign assistance funds and enables users to examine, research, and track aid investments in a standard and easy-to-understand format. It was initiated by the Department of State and USAID under the policy guidance of the National Security Staff.
Source$15 billion - Launched in 2003 by President George W. Bush, PEPFAR pledged $15 billion over 5 years to combat global HIV/AIDS.
Source$48 billion - PEPFAR was reauthorized on July 30, 2008 and authorized $48 billion through fiscal year 2013.
Source0 - Emergency contraception (EC) is not distributed by USAID.
Source35 - In real terms, U.S. support for family planning is at the same level now as it was 35 years ago.
While it seems Americans will have to wait until next week to hear word about the fate of gay marriage rights, there was still a very important human rights decision handed down today: The Supreme Court has ruled that the federal government cannot require HIV outreach organizations to sign an anti-prostitution pledge in order to get government funding.
People have always bought and sold sex, sometimes risking shame or punishment. But these days, simply helping a sex worker can have costly legal and financial consequences.Under the U.S.’s flagship international aid program on HIV and AIDS, an organization that gives out free condoms at a brothel, for example, might be deemed in violation of the program’s anti-prostitution policy, and, as a result, risk losing public funding.
Global health has been absent from the debates so far. It needs to make an appearance in the third at final debate, because we're about to sacrifice the opportunity to make a difference for women in the name of politics.
When rape is used as a weapon of war in places like Congo or Bosnia, thousands of women and girls can become pregnant, but a piece of 39-year-old U.S. legislation means that few if any aid groups are allowed to provide or even discuss abortion services with them.
The New York Times, February 1, 2012 - Ten years ago, the heads of the G-8 countries met in Genoa, Italy, to back the establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria — a new funding mechanism that dramatically increased resources available to fight preventable, treatable diseases stalking the poor and depleting developing economies around the globe.
UNAIDS and PEPFAR welcome the launch of the Business Leadership Council to end new HIV infections am
UNAIDS, 27 January 2012 — UNAIDS and PEPFAR welcome the launch at the World Economic Forum in Davos, Switzerland of two new initiatives by business leaders—the Business Leadership Council for a “Generation Born HIV Free” and the Social Media Syndicate to end new HIV infections in children.
The White House, December 6, 2011 - The struggle to end discrimination against lesbian, gay, bisexual, and transgender (LGBT) persons is a global challenge, and one that is central to the United States commitment to promoting human rights. I am deeply concerned by the violence and discrimination targeting LGBT persons around the world whether it is passing laws that criminalize LGBT status, beating citizens simply for joining peaceful LGBT pride celebrations, or killing men, women, and children for their perceived sexual orientation.
Miami Herald, November 22, 2011 - Secretary of State Hillary Clinton gave a speech recently that most will never hear. But she said something we all should know: “Creating an AIDS-free generation has never been a policy priority for the United States government — until today.” Or in other words, we can end AIDS.
USAID Youth in Development Policy and Sexual and Reproductive Health and Rights
USAID released its Youth in Development Policy in October 2012 and implementation guide in September 2013. Recognizing that more than half of the world’s population today is under the age of 30 and living in developing countries, the policy emphasizes that investments in sexual and reproductive health and rights are critical to protect the well-being of young people and improve health, education, and economic outcomes.Download this PDF
File Under: Fact Sheets
The Legal Landscape for Abortion Provision In U.S. Foreign Assistance
This brief is a comprehensive analysis of three distinct but overlapping legal systems that inform prohibition or provision of funding for abortion services through United States foreign assistance programs.Download this PDF
File Under: Policy Briefs
US Strategy to Prevent and Respond to Gender-Based Violence Globally: What Does it Mean for SRH?
The 2012 United States Strategy to Prevent and Respond to Gender-Based Violence Globally is the country’s first comprehensive, multi-sector approach to gender-based violence. What does it mean for sexual and reproductive health?Download this PDF
File Under: Fact Sheets
Fact Sheet: U.S. National Action Plan on Women, Peace, and Security
The United States National Action Plan on Women, Peace, and Security (NAP) was issued by executive order by President Barack Obama in 2011. What does it say about sexual and reproductive health and rights?Download this PDF
File Under: Fact Sheets
U.S. Global HIV Policy: Combination Prevention
This paper outlines why the U.S. must support a true combination prevention strategy, one that scales up proven biomedical tools, integrates sexual and reproductive health services into HIV prevention, and addresses social barriers to HIV prevention.Download this PDF
File Under: Policy Briefs
GHI Implementation and Sexual and Reproductive Health in Guatemala: A Progress Report
A preliminary analysis of the U.S. Global Health Initiative in Guatemala finds that resource and policy constraints are a barrier to progress.Download this PDF
File Under: Research Documents
U.S. Foreign Policy & Funding Topics
This video documents CHANGE's 2010 study tour to Ethiopia and makes policy recommendations for improving the effectiveness of U.S. foreign assistance to advance the sexual and reproductive health and rights of women and girls in Ethiopia.
The female condom is currently the only available dual protection tool that prevents both HIV/STIs and unintended pregnancy.
Attacks on international family planning funding and policy hinder the progress of U.S. efforts to provide effective HIV prevention, care, and treatment.
The GHI, introduced in 2009, is the first U.S. international development effort that promotes a woman-centered approach to integrated health services.
Documentation and analysis of the Global Gag Rule shows that the policy restricts a basic right to speech and the right to make informed health decisions.
The Helms amendment prohibits U.S. funds from being used to provide abortion services or information.
Foreign assistance accounts for about one percent of the total U.S. budget.
To increase the effectiveness of U.S. foreign assistance spending, policy makers are currently working to reorganize foreign assistance and bring greater coherence to the country's aid structure.
The Kemp-Kasten Amendment prohibits foreign aid to any organization that the administration determines is involved in coercive abortion or involuntary sterilization.
When Congress reauthorized the President’s Emergency Plan for AIDS Relief in 2008, it loosened, yet maintained, a funding preference for programs that focus on abstinence and faithfulness to the exclusion of condom education.
The anti-prostitution pledge requires organizations receiving U.S. funds to explicitly oppose prostitution, which compromises health services for sex workers--one of the groups at highest risk for HIV infection.
Listen to CHANGE President Serra Sippel discuss why advocacy is critical to developing effective U.S. global health policy (podcasts)