American policies on international health were condemned last week for being based on ideology rather than science; for rolling back progress achieved in protecting sexual and reproductive health and rights; for increasing the risk of unwanted pregnancies, HIV infection, and unsafe abortions; and for “condemning millions of women to die.”
Seven hundred participants from 109 countries gathered in London to review progress on the Cairo Consensus, a programme of action ratified by 179 nation states at the 1994 International Conference on Population and Development (ICPD). The programme, which was designed to achieve sexual and reproductive rights for all by 2015, is now at the halfway point of its 20 year task. It is credited with introducing a human rights framework to population control.
Delegates at the conference heard that although once the United States was a champion of the programme and an important funder of family planning initiatives through its Agency for International Development (USAID), under George W Bush's leadership the country had reversed its position and now actively campaigned to undermine progress.
Timothy Wirth, the former senator of Colorado who led the US delegation to Cairo, said the Bush administration had become “obstructionist” and “regressive,” refusing to fund its share of UN family planning services and insisting upon “naive and dangerous” abstinence only approaches which denied young people information about safe sex and condom use.
On President Bush's first day in office he reinstated the “global gag rule,” which withholds USAID funds from any foreign organisation that, even with non-US money, performs, refers, or counsels on abortion, regardless of whether abortion is legal in their country.
Medical societies such as the American College of Obstetricians and Gynecologists have denounced these restrictions, saying they “violate basic medical ethics by jeopardising a health care provider's ability to recommend appropriate medical care.”
The global gag rule has resulted in funds being withdrawn from the two key global organisations working to prevent unwanted pregnancy and unsafe abortions&;the International Planned Parenthood Federation (IPPF) and the United Nations Population Fund (UNFPA).
According to Steven Sinding, the IPPF's director general, the organisation immediately lost $8m (£4.5m; €7m), in addition to an anticipated $75m that it had been due to receive over the next five years. Dr Sinding said that the losses amounted to 25% of the organisation's budget and were “devastating.”
Bush's policies have “on issue after issue placed ideology above evidence and bias above science,” said Mr Wirth. Speaking to the BMJ , Mr Wirth, now the president of the United Nations Foundation, described how last month the Bush administration withheld $34m that congress had appropriated for UNFPA for 2004, because of baseless allegations that the fund is complicit in forced abortions in China.
“The secretary of state sent three review teams to China which [found] the claims weren't true, and Congress held hearings on it, found no evidence for the charge, and appropriated the money. Despite this, the Bush administration, for its own ideological reasons, went along with this narrow right to life position and withdrew all funding from UNFPA,” Mr Wirth said.
UNFPA has said that the lost funds could have helped prevent up to two million unwanted pregnancies and nearly 800 000 abortions, 4700 maternal deaths, and more than 77 000 infant and child deaths.
“Isn't it shameful,” Mr Wirth said, “that so many of the men talking about the sanctity of life are by their actions, ignorance, and prejudice, effectively condemning women to die?” (See p....Janice's article).
The full report card on progress on health and reproductive rights since the International Conference on Population and Development can be found at www.countdown2015.org