It will soon be two years since the United Nations adopted a new 15-year development policy encapsulated in the 17 Sustainable Development Goals. This sprawling, ambitious agenda was designed partly to address the shortcomings of the Millennium Goals, the most disheartening of which for women was the failure to meet promises of improved maternal health care.
Now a financial shortfall faces the agency at the center of all aspects of reproductive health work for women and girls: the United Nations Population Fund, or UNFPA. The shortfall was triggered earlier this year when the Trump administration in Washington, bowing to right-wing pressures, cut off all payments to the Fund by a non-negotiable executive order. The latest data suggest that other nations are not filling the void, and the Fund is being forced to make cuts in crucial programs once supported by the United States.
To make matters worse, the Trump administration has imposed bans on US assistance to virtually any humanitarian organization that will not certify its opposition and rejection of abortion at all levels, from campaigning or counseling on safe abortion — millions of girls and women die when it is illegal and dangerous — to ending legal abortion services everywhere within Washington’s reach.
In the last year of the administration of President Barack Obama, who had lifted the prohibitions of the “global gag rule,” as the policy is known worldwide, the US had made contributions totaling $69 million to the UN Population Fund to basic operating funds and noncore contributions ($5.88 million from Obama carried over to 2017 before Trump became president).
Since January, not a dollar has gone to the Fund since Trump negated the $32.5 million in the 2017 budget that he inherited.
“After the decision to defund UNFPA, five key donors have, as of now, committed $9.6 million in increased core contributions,” said Abubakar Dungus, the media and communications chief for the Fund, in an email. “But as of August 1, UNFPA’s core contributions stood at $331 million, showing a $19 million gap from the $350 million target for 2017.” Those are just the operating expenses. (The five countries are Belgium, Luxembourg, Norway, Sweden and Spain.)
“In 2016,” he added, “the US was the third-largest donor to UNFPA’s humanitarian responses, representing almost 20 percent of overall humanitarian funding received. US contributions enabled UNFPA to provide gender-based violence and sexual and reproductive health services for girls and women, in particular in Iraq and Syria.”
By the end of this year, data from the Fund show, programs in Iraq for psychosocial support for victims of gender-based violence and surviving Yazidi women, who also need medical care, would have to be cut. Training programs are also threatened for 260 providers of emergency obstetric care, 54 in family planning and counseling and 78 who would deliver a minimal initial service package to survivors. Assistance to community health services could run out of money. Similar programs for Syrian women are also on the endangered list, including fielding mobile health units and safe-delivery spaces for pregnant women.
Ironically, Nikki Haley, the US ambassador to the UN, has defended her opposition to refugee resettlement in the US by saying that most of those people would rather stay where they or return to their homes and that the best course for outsiders was to provide safety and services to the civilians in need, so that they would not have to flee.
European nations are often called to help the UN in many areas when an unreliable US administration changes policies, as it has with the Population Fund since 1985, so they may be in line to rescue the agency again this year. They may also be asked to do so in the years to come, under a Republican government in Washington.
A recent report from Devex, a media platform covering international development issues, said that the European Commission’s Directorate for International Cooperation and Development, which designs European international development policy, was preparing to announce a 500 million euro ($570 million) program with the UN on women’s rights. The plan is to be unveiled at the UN General Assembly opening in September, according to a senior European Union aid official quoted by Devex.
The European program was described as having women’s rights as its main focus, including legislative and legal issues and programs to combat violence. But since the Trump administration’s war on family planning and women’s reproductive health was launched early this year, there may be efforts to broaden the European mission to also address the health setbacks. At the UN Population Fund, violence against women is viewed as a health-related problem, especially when force, sometimes lethal, is used to prevent a woman from obtaining contraceptives.
In its search for more resources, the Population Fund also has sources outside international institutions, in foundations and a variety of nongovernmental organizations. These could contribute significantly to mitigating the estimated $600 million loss in global family planning and reproductive health assistance that will be caused globally by the widening effects of the global gag rule.
In 2012, the Bill and Melinda Gates Foundation and the British government — with other participants, notably including UNFPA and USAID — convened a family planning “summit” in London to establish a campaign to provide contraception on a mass scale to 120 million women in the developing world by 2020. In July 2017, the program marked its fifth anniversary with another large gathering in London. That meeting recorded $2.5 billion in new commitments, with more than half of the total pledged by Asian and African countries.
The Guttmacher Institute, a research and policy organization based in New York and Washington specializing in research and policy on women’s reproductive health and rights, reports that of the estimated 206 million pregnancies in 2017 in developing regions, 43 percent will be unintended. Women with an unmet need for modern contraception account for 84 percent of all unintended pregnancies in developing regions, with women using no method of contraception accounting for 74 percent of unintended pregnancies. Women using a traditional method account for another 10 percent, the Institute found.
In pregnancy, Guttmacher researchers say, of the 127 million women who give birth each year in developing regions, many do not receive essential maternal and newborn health care. And there are wide disparities across regions.
While debates continue over institutional versus home births (attended by trained midwives), medical authorities and doctors in countries where home care is unsatisfactory and distances to health centers are long and conditions arduous if not life-threatening, often argue for clinic or hospital births. Guttmacher found that 56 percent of women in Africa deliver in a health center, compared with 91 percent in Latin America and the Caribbean, where fertility rates have fallen and poverty has declined in many places.
Goal 5 of the Sustainable Development Goals (also known as Agenda 2030) measures gender equality. Among its targets for determining success is the question of how much access women and girls age 15 to 49 have to sexual and reproductive health and rights. Crucially, one target asks countries to examine whether their laws and regulations guarantee this access to sexual and reproductive health care, information and education. This guarantee is what would make the word “access” mean something.
The Development Knowledge Platform, which supports and tracks the goals within the UN’s Department of Economic and Social Affairs, reckons that there may still be a long way to go, based on findings from a May 2017 report of the UN secretary-general, “Progress Towards the Sustainable Development Goals.”
“Just over half (52 percent) of women between 15 and 49 years of age who are married or in union make their own decisions about consensual sexual relations and use of contraceptives and health services,” the platform found, based on available data dating to 2012 from 45 countries, 43 of which are in developing regions.
The Population Fund, with other UN agencies and programs, is at the forefront of the battle to improve the lives of women by giving them more control over their bodies and reproductive rights. Yet now a distracting chill has been cast over this mission by inhumane and antiwomen directives in Washington, setting back this important work.
This article was updated.