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Although the final vote has yet to be tallied, funding for international family planning appears to have cleared a difficult hurdle in the U.S. Congress.
Voting on the issue, scheduled for Senate consideration Feb. 25, has been seen by many in the public health sector as a bellwether for congressional support of all family planning programs, both in the United States and abroad.
"It seems to me, for the readers of Contraceptive Technology Update, that this is now seen by many, including me, as a vote on family planning more generally, not simply internationally," states George F. Brown, MD, MPH, vice president of the programs division for the New York City-based Population Council. "Those who are opposed to international family planning are intentionally confounding the issue with abortion and seeking to attack family planning under the guise of attacking abortion. This has a very profound impact domestically as well as well as internationally."
This problematic mix of family planning and abortion issues can be seen in the dual approach taken by the House of Representatives to the international family planning issue. In a 220 to 209 vote on Feb. 13, representatives approved a bill backed by President Bill Clinton calling for the March 1 release of funding. At the same time, the House ratified an alternate bill proposed by Rep. Chris Smith, R-NJ, to restrict foreign funds to those programs that promote abortion.
The Senate will not consider the Smith bill at all, predicts Susan Cohen, senior public policy associate at the Alan Guttmacher Institute’s Washington, DC, office.
"Senate procedure requires unanimous consent’ for any legislation to go to Senate floor," Cohen explains. "Any single senator can object to unanimous consent, and many would object to taking up the Smith bill. That’s because No. 1, the majority of the Senate still opposes the Mexico City’ policy and so would defeat the Smith bill anyway; and No. 2, the President would veto the Smith bill, so to spend time considering it would be a waste."
The "Mexico City" policy, so named because it was first advanced at a 1984 international population conference there, was used during the Reagan and Bush presidential administrations to withhold U.S. foreign aid from those organizations who used private funding for any abortion-related information or services overseas.
This policy, reversed at the beginning of Clinton’s first term, is not needed, say family planners, since a 1973 law prevents family planning money from being spent on abortions. Those for reinstatement counter that abortion is indirectly subsidized, since U.S. money goes to groups that offer privately financed abortion counseling and procedures.
In its struggle over the troublesome issue, Congress cut its original 1995 fiscal year (FY) appropriation for international population assistance from $547 million to $385 million. It then subjected that amount to a complicated allocation system that kept the FY 1996 funds from becoming available until July 1996. To further exacerbate the matter, the money then was dispensed at a 7% monthly rate for the next 15 months. This same formula essentially was carried over to FY 1997, according to an Issues in Brief paper prepared by the New York-based Alan Guttmacher Institute.1
A Congressional agreement, however, also allowed President Clinton to request that the funds be released on March 1, 1997, instead of July 1, if he certified the delay was harming family planning programs. This finding was released in a Jan. 31 statement to Congress.
"It is my determination that a delay will cause serious, irreversible, and avoidable harm," reads the presidential statement. "In the balance are the lives and well-being of many thousands of women and children and American credibility as the leader in family planning programs around the world."2
Bear in mind that a vote for a March 1 release doesn’t mean an accelerated or even a full release of international family planning funds, says Cohen. The question before Congress is whether to disburse the money five months or nine months late.
"I think that’s an important point to stress because a lot of the media reports have been whether or not they would speed up the release of funds," Cohen points out. "And there’s nothing speeded up about five months late."
And even if the funds are released, programs receiving international family planning aid still won’t be "home free," notes Cohen — they still will be subject to a 7% per month metering allocation policy.
U.S. family planners should be thankful that they have not been subjected to the funding power plays surrounding their sister programs on foreign soil.
"We’ve lost an incredible amount of ground due to the increase in administration: the politics, the requests for information," asserts Amy Pollack, MD, MPH, president of the New York City-based AVSC International, the second-largest organization receiving U.S. international family planning funding. "It dries out the program while politicians continue to debate."
1. Cohen S. Issues in Brief: A Response to Concerns about Population Assistance. New York, NY: Alan Guttmacher Institute; 1997.
2. Office of the White House. Statement by the President on USAID Funds for International Planning. Washington, DC; Jan. 31, 1997.