The United States Agency for International Development (USAID) instructed its staff this month to pressure at least six African governments to withhold U.S.-funded contraceptives from London-based Marie Stopes International (MSI), one of the world’s leading providers of family planning services in developing countries. This is the latest move by the Bush administration in a progression of increasingly restrictive family planning policy decisions that put politics first and women’s needs last.
This directive from the Bush administration takes a broader reading of the Kemp-Kasten amendment—which prohibits foreign aid for any organization that "supports or participates in the management of a program of coercive abortion or involuntary sterilization"—than has ever before been applied. The administration alleges that MSI’s work in China with UNFPA violates Kemp-Kasten, basing its decision to deny even indirect support of MSI’s programs on the same unfounded rationale it has used to defund UNFPA since 2002.
Though the stated purpose of this action is to reduce abortion, the effect will likely be the opposite. The impact of African ministries of health refusing to provide condoms, intrauterine devices and other contraceptives (including those donated to the ministries from other governments, as has been reported) to MSI clinics will leave some countries unable to meet the national demand for contraceptives. For instance, MSI provides a quarter of contraceptive services in Malawi. In Sierra Leone, where MSI is a major provider of contraceptives, supplies are expected to run out as soon as November, leaving 10,000 women who typically rely on MSI clinics with no access to birth control.
"These supplies, donated by the U.S. government in the name of the American people, will likely expire on the shelves of national storage centers before countries are able to put in place alternative distribution systems," said Dr. Sharon Camp, president of the Guttmacher Institute. "In the meantime, the people of Ghana, Malawi, Sierra Leone, Tanzania, Uganda and Zimbabwe will be left at increased risk of unintended pregnancy and HIV/AIDS."
More than 100 million married women living in developing countries have an unmet need for contraceptives, according to a recent study conducted by the Guttmacher Institute. Unmet need is greatest, and has declined the least, in Sub-Saharan Africa, where high rates of unintended pregnancy lead to high rates of unsafe abortion. A recent Guttmacher-WHO study confirms that broad access to contraceptives is linked to a reduced need for abortion. The lowest abortion rate in the world in 2003 was in Western Europe (12 abortions per 1,000 women aged 15–44), where contraceptive services and use are widespread and abortion is legal under broad grounds, safe and easily accessible.
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The unmet need for contraception in developing countries
The facts on abortion worldwide
The broad benefits of investing in international family planning assistance