U.S. Foreign Policy & Funding

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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.

See CHANGE's report Reproductive Justice for All: Toward a U.S. Foreign Policy on Comprehensive Sexual and Reproductive Health and 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. 

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Tell President Obama: Stand with women and girls raped in conflict or crisis. Ensure that U.S. funds can be used to provide safe, voluntary abortion care overseas in cases of rape, incest, and life-endangerment.

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Source$15 billionLaunched in 2003 by President George W. Bush, PEPFAR pledged $15 billion over 5 years to combat global HIV/AIDS.

Source$48 billionPEPFAR was reauthorized on July 30, 2008 and authorized $48 billion through fiscal year 2013.

Source0Emergency contraception (EC) is not distributed by USAID.

Source35In real terms, U.S. support for family planning is at the same level now as it was 35 years ago.

Guardian: Cario+20: what progress has been made on women’s rights?

Twenty years ago, 179 governments signed a landmark agreement that put women’s rights, empowerment and well-being at the centre of discussions about population growth and development. The outcome of the International Conference on Population and Development, held in Cairo in 1994, moved away from the prevailing view that population could be controlled solely through family planning, and instead emphasised the importance of women’s social and economic empowerment to bring about change. Leaders are now meeting in New York to discuss progress since the Cairo agreement. But what do women’s rights campaigners think? They share their thoughts

Posted on September 22, 2014

Supreme Court Strikes Down Bush-Era Anti-Prostitution Pledge

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.

Posted on June 20, 2013

American Prospect: Promoting Human Rights versus Promoting Prostitution

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.

Posted on May 24, 2013

Is the GHI Dead, or Is This a Wake up Call?

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.

Posted on October 22, 2012

Foreign Policy, Akin-Style: How the U.S. Denies Abortions to Women Raped in War

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.

Posted on August 21, 2012

Why the Global Fund Matters

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.

Posted on February 1, 2012

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.

Posted on January 27, 2012

International Initiatives to Advance the Human Rights of LGBT Persons

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.

Posted on December 7, 2011

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.

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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.

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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?

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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?

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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.

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Infographic: AIDS-free Generation? Not Without Women

We can't create an AIDS-free generation without women: Visualize the numbers.

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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.

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File Under: Research Documents

GHI Implementation and Sexual and Reproductive Health in Ethiopia: A Progress Report

A preliminary analysis of the implementation of the U.S. Global Health Initiative in Ethiopia finds that a focus on women and girls is already making a difference.

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U.S. Foreign Policy & Funding Topics

Fact Sheets: US Strategies, Policies, and SRHR

The U.S. government has developed policies and strategies to make gender equality a foreign policy priority and to expand the reach and impact of those priorities. Knowing what each of these strategies and policies say about sexual and reproductive health and rights (SRHR) is important for turning plans into programs that meet the SRHR needs of women and girls throughout the world.

Watch: Making U.S. Foreign Assistance Work for Women and Girls in Ethiopia

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.

Female Condoms and U.S. Foreign Policy

The female condom is currently the only available dual protection tool that prevents both HIV/STIs and unintended pregnancy.

Family Planning Policy Restrictions and HIV

Attacks on international family planning funding and policy hinder the progress of U.S. efforts to provide effective HIV prevention, care, and treatment.

U.S. Global Health Initiative

The GHI, introduced in 2009, is the first U.S. international development effort that promotes a woman-centered approach to integrated health services.

Global Gag Rule

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.

Helms Amendment

The Helms amendment prohibits U.S. funds from being used to provide abortion services or information.

Foreign Assistance Budget

Foreign assistance accounts for about one percent of the total U.S. budget.

Foreign Assistance Reform

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.

Kemp-Kasten Amendment

The Kemp-Kasten Amendment prohibits foreign aid to any organization that the administration determines is involved in coercive abortion or involuntary sterilization.

Abstinence & Fidelity

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.

Anti-Prostitution Pledge

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.

Advocacy and Foreign Assistance

Listen to CHANGE President Serra Sippel discuss why advocacy is critical to developing effective U.S. global health policy (podcasts)