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. 

AIDS-free Generation? Not Without Women Image

AIDS-free Generation? Not Without Women

Women are now the majority of people living with HIV worldwide. The HIV pandemic has changed--our responses have to change with it, or we'll never create an AIDS-free generation.

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Urge your Senators to Support International Family Planning Funding

Tell your Senators that you support full funding for international family planning and a permanent repeal of the Global Gag Rule.

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Tell your Representative to Support the United Nations

Congress is now considering a bill (H.R. 2829) that would effectively end our relationship with the United Nations. Act now and tell your Representative to oppose this harmful piece of legislation.

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Take Action on the Global Gag Rule

Join your voice with others and urge your member of Congress to co-sponsor the Global Democracy Promotion Act of 2011, a bill that would create a legislative barrier to block attempts by a future administration to re-instate the Global Gag Rule.

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Raise your voice for the Global Sexual and Reproductive Health Act Image

Raise your voice for the Global Sexual and Reproductive Health Act

Ask your Representative to co-sponsor the Global Sexual and Reproductive Health Act (H.R. 1319), newly introduced legislation that promotes a truly comprehensive and integrated approach to U.S. international reproductive health programs.

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Tell your Representative to Oppose Elimination of International Family Planning Funding Image

Tell your Representative to Oppose Elimination of International Family Planning Funding

The House is currently debating a spending bill (H.R. 1) that, as it stands, would drastically decrease funding for international family planning and reproductive health, global HIV/AIDS, and maternal and child health programs and services. We need you to speak out for women's health and rights today!

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Help Make U.S. Global AIDS Programs Work for Women

Send a postcard to Ambassador Goosby, the U.S. Global AIDS Coordinator, and urge him to make U.S. global AIDS programs and policies work harder and better for women and girls worldwide.

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Urge your Representative to Co-Sponsor the ICPD Resolution Image

Urge your Representative to Co-Sponsor the ICPD Resolution

Urge your member of Congress to support sexual and reproductive health and rights and sustainable development globally by co-sponsoring Rep. Lee's ICPD resolution.

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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.

The New York Times: High Court Weighs Dispute Over AIDS Funding

The Supreme Court wrestled Monday with the First Amendment implications of a policy that forces private health organizations to denounce prostitution as a condition to get AIDS funding. The court appeared divided, and not along ideological lines, in an argument over whether the anti-prostitution pledge violates the health groups' constitutional rights.

Posted on April 22, 2013

Huffington Post: The Right to Fight AIDS

The Supreme Court today will hear a case that will decide the basic rights of groups fighting HIV. The case --Agency for International Development, Et. Al., v. Alliance for Open Society International, Inc., Et. Al.--centers on a policy that requires organizations to adopt the U.S. government's point of view as a condition of receiving U.S. global HIV/AIDS funds. Not surprisingly, it is being challenged on grounds that it violates the First Amendment.

Posted on April 22, 2013

U.S. spends N450bn on Nigeria’s health sector programmes in 10 yrs – Envoy

The United States Government said on Thursday that it had spent $3 billion on Nigeria’s health sector capacity building programmes in 10 years. The U.S. Ambassador to Nigeria, Terence McCulley, said this during a tour of the primary health centre in Masaka, Nasarawa State. “We’ve been partners of the Nigerian government in the HIV and AIDS campaign since 2004,” he said.

Posted on April 18, 2013

Alicia Keys campaigns for HIV education

Alicia Keys says she wants to spark a global conversation about HIV, the virus that causes AIDS. The Grammy Award-winning singer met with women who are part of an HIV program at United Medical Center in the nation’s capital Monday to discuss their experiences with the virus, including the fear and stigma associated with the disease.

Posted on April 16, 2013

United States Announces $10 Million in Support for G-8 Preventing Sexual Violence Initiative

Today at the G-8 Foreign Ministers meeting in London, the United States joined G-8 partners in support of the United Kingdom’s Preventing Sexual Violence Initiative, and reaffirmed its commitment to work with the international community to strengthen global coordination and individual countries’ capacity to prevent sexual violence; promote justice and accountability; and provide care for survivors of such violence.

Posted on April 11, 2013

Reuters: Prostitution policy splits NGOs in top court AIDS case

A Supreme Court case that challenges a law requiring anti-prostitution policies for HIV/AIDS programs seeking federal money has generated a split among nonprofit groups that counsel sex workers overseas. The case involves a 2003 law that bars funding for groups that work on HIV/AIDS prevention but do not have a policy opposing prostitution and sex trafficking.

Posted on April 10, 2013

Huffington Post: Why the Global Fund Is a Terrific Investment

The Global Fund to Fight AIDS, Tuberculosis and Malaria announced today that it will need $15 billion to continue its life-saving work. If the world comes together to meet this replenishment goal, it will build on one of its greatest achievements of the past decade by saving millions more lives. HIV, TB and malaria are three of the world's biggest killers, but thanks to the Global Fund we are starting to make significant progress in controlling them.

Posted on April 8, 2013

As anti-prostitution pledge heads to Supreme Court, public health leaders file brief against it

The case of the “anti-prostitution pledge” heading for the Supreme Court this month focuses on whether the requirement that groups funded by the President’s Emergency Plan For AIDS Relief create policies “explicitly” condemning prostitution is compatible with the First Amendment. A brief filed Wednesday in the case asks also if the requirement is compatible with the interests of public health.

Posted on April 4, 2013

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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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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Sexual and Reproductive Rights and the U.S. Global Health Initiative

The U.S. Global Health Initiative (GHI) is a comprehensive policy approach that seeks to strengthen and increase the efficiency of existing U.S. global health programs.

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What Does Family Planning Have to do With HIV? Everything.

Voluntary family planning is an indispensible component of HIV prevention and treatment.

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U.S. Foreign Policy & Funding Topics

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)