Order Code IB96026
Issue Brief for Congress
Received through the CRS Web
Population Assistance and Family Planning
Programs: Issues for Congress
Updated June 7, 2002
Larry Nowels
Foreign Affairs, Defense, and Trade Division
Congressional Research Service ˜ The Library of Congress

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CONTENTS
SUMMARY
MOST RECENT DEVELOPMENTS
BACKGROUND AND ANALYSIS
Introduction to U.S. Population Assistance Issues:
Setting the Context
Abortion and Coercion
The “Mexico City” Policy
Funding for UNFPA
Family Planning Conditions in China
Funding Levels
International Family Planning Issues and Legislation
In the 107th Congress
Congressional Action
Foreign Relations Authorization and Other Authorizing Measures
Foreign Operations Appropriations, FY2002
Emergency Supplemental Appropriations, FY2002 (H.R. 4775)
LEGISLATION

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Population Assistance and Family Planning Programs: Issues for
Congress
SUMMARY
Since 1965, United States policy has
of the Mexico City restrictions that were in
supported international population planning
effect on Jan. 19, 1993. Foreign NGOs and
based on principles of voluntarism and
international organizations, as a condition for
informed choice that gives participants access
receipt of U.S. funds, now must agree not to
to information on all methods of birth control.
perform or actively promote abortions as a
This policy, however, has generated conten-
method of family planning in other countries.
tious debate for over two decades, resulting in
frequent clarification and modification of U.S.
For FY2002, President Bush sought $425
international family planning programs.
million for population assistance and a $25
million contribution to the U.N. Population
In the mid-1980s, U.S. population aid
Fund, the same amounts enacted for FY2001.
policy became especially controversial when
the Reagan Administration introduced restric-
The House rejected efforts during
tions. Critics viewed this policy as a major
consideration of the Foreign Operations ap-
and unwise departure from U.S. population
propriations bill (H.R. 2506) to alter the Mex-
efforts of the previous 20 years.
ico City policy. However, the Senate voted to
include text that would make the President’s
The “Mexico City policy” further denied
policy virtually inoperable. The Senate further
U.S. funds to foreign non-governmental orga-
increased funding levels to $450 million for
nizations (NGOs) that perform or promote
population aid and $40 million for UNFPA.
abortion as a method of family planning,
As cleared by Congress on Dec. 20, H.R. 2506
regardless of whether the source of money
provides $446.5 million for bilateral programs
was the U.S. Presidents Reagan and Bush
and not more than $34 million for UNFPA.
also banned grants to the U.N. Population
Congress further agreed to delete Senate
Fund (UNFPA) because of its program in
language that would have overturned the
China, where coercion has been used. During
President’s abortion restrictions on family
the Bush Administration, a slight majority in
planning funds.
Congress favored funding UNFPA and over-
turning the Mexico City policy but failed to
In January 2002, the White House placed
alter policy because of presidential vetoes or
a hold on the transfer of UNFPA funds pend-
the threat of a veto.
ing a review of the organization’s programs in
China. No decision has been made whether
President Clinton repealed Mexico City
or at what level to fund UNFPA this year. For
policy restrictions and resumed UNFPA fund-
FY2003, the President proposes no UNFPA
ing. Since 1995, debates have been conten-
funding, although there is a “reserve” of $25
tious regarding efforts to cut funding, codify
million that could be used if the White House
the Mexico City policy, and block UNFPA
determines UNFPA eligible for U.S. support.
funds if it continued work in China.
The Administration further requests $425

million for bilateral family planning programs
On Jan. 22, 2001, President Bush re-
in FY2003, less than amounts for this year,
voked the Clinton Administration population
but the same as proposed for FY2002.
policy position and restored in full the terms
Congressional Research Service ˜ The Library of Congress

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MOST RECENT DEVELOPMENTS
On June 6, the Senate passed its version of the FY2002 supplemental (H.R. 4775) with
language requiring the President to transfer $34 million to the U.N. Population Fund
(UNFPA) by July 10 if a State Department investigation commission concludes that UNFPA
is not involved in coercive family planning practices in China. The White House opposes
the Senate language. The House-reported version of the supplemental had included an
identical provision proposed by Representatives Kolbe and Lowey (approved 32-31). The
House Appropriations Committee also added an amendment by Representative Tiahrt
(approved 32-30) that essentially overrode the Kolbe/Lowey amendment, requiring the
President to determine by July 31 whether UNFPA participates in the management of
coercive family planning practices. The second rule (H.Res. 431) for House consideration
of H.R. 4775, however, struck both amendments from the bill.
The issue concerns UNFPA activities in China and allegations of coercive abortions
and involuntary sterilizations in that country. If the President determines that UNFPA is
engaged in the management of such practices, the organization will be ineligible for U.S.
contributions under the terms of the so-called “Kemp-Kasten” amendment that has been
annually included in Foreign Operations spending bills since the mid 1980s. Congress, in
the FY2002 Foreign Operations Appropriations bill (P.L. 107-115), provided “not more
than” $34 million for UNFPA. The White House froze the funds in January 2002 after new
allegations surfaced regarding coercive family planning activities in Chinese counties where
UNFPA maintains programs. A State Department investigation team spent two weeks in
China in May to assess the situation and is expected to complete a report by late June.
Under any of the amendments considered, a determination that UNFPA violated Kemp-
Kasten would result in the termination of U.S. support. Without such a determination,
however, the Senate amendment would require the President to transfer the full $34 million.
Under the Tiahrt amendment, however, the President could have found that UNFPA did not
violate Kemp-Kasten, but still reduced the U.S. contribution to something less than $34
million to express displeasure over alleged coercive family practices in China and UNFPA’s
involvement.
On February 4, the President proposed $425 million for the U.S. Agency for
International Development (USAID) bilateral family planning program in FY2003. The
amount is the same as proposed a year ago for FY2002 but $21.5 million less than Congress
approved. The request does not specify an amount for UNFPA, but includes a “reserve” of
$25 million that could be available for the U.N. organization.
BACKGROUND AND ANALYSIS
Introduction to U.S. Population Assistance Issues:
Setting the Context
Population assistance became a global issue in the late 1950s and early 1960s after
several private foundations, among them the International Planned Parenthood Federation,
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began providing money to developing countries to control high population growth rates. In
1966, when global population growth rates were reaching an historic annual high of 2.1%,
the United Nations began to include population technical assistance in its international
development aid programs. Population assistance grew rapidly over the next half-dozen
years, with the United States, other developed countries, and international organizations such
as the World Bank, all beginning to contribute funds.
The first International Population Conference was held in 1974, followed by the second
in Mexico City in 1984, and the third in Cairo in 1994. The attention and funding given to
international family planning programs are credited with helping to bring a decrease in
population growth in developing countries from about 2.4% per year in the 1960s to about
a 1.6% annual average during the 1990s. Fertility rates have fallen in the developing world
from 6.2 children per woman in 1950 to just below 3 in 1998. Nevertheless, while global
population growth has slowed, it reached 6 billion in 1999 and is expected to rise to 8.9
billion by 2050, with most all of the growth occurring in developing nations. In 1960, 70%
of the world’s population lived in developing countries; today the level is 80%, and these
countries now account for 95% of world-wide population growth.
But population statistics alone are only part of a larger story. For the past thirty years
and more, countries have heatedly debated what the statistics mean. Proponents of
aggressive family planning programs have held that high fertility rates and rapid population
growth are serious impediments to a country’s development. According to this school of
thought, people are consumers: no poor country can increase its standard of living and raise
its per capita income while wrestling with the problems of trying to feed and care for a
rapidly expanding population. Thus, poor and developing countries should invest in family
planning programs as part of their economic development process.
On the opposing side, critics of aggressive population planning programs hold that there
is little or no correlation between rapid population growth and a country’s economic
development. Some argue that increased numbers of people provide increased productive
capacity; therefore, they say, high population growth rates actually can contribute to a
country’s ability to increase its standard of living. At the very least, proponents of this view
say, current economies of scale and global trading patterns have too many empirical variables
and uncertainties to establish a direct correlation between population growth and economic
development.
As this population debate evolved, many countries, including the United States,
changed their views. In the 1974 international population conference, the United States and
other donor countries asserted that high fertility rates were an impediment to economic
development — an assertion that was then rejected by developing countries. In keeping with
this view, the Carter Administration in 1977 proposed legislative language, later enacted in
Sec. 104(d) of the Foreign Assistance Act of 1961, which sought to link population growth
and traditional development assistance programs on the grounds that a high population
growth rate could have a serious negative effect on other development objectives.
A decade later, at the second conference in Mexico City in 1984, a reversal of positions
occurred. Developing countries had become convinced of the urgent need to control
population growth, while U.S. officials asserted that population growth was not necessarily
a negative force in economic development, but was instead a “neutral phenomenon.” At
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Mexico City, Reagan Administration officials emphasized the need for developing countries
to adopt sound economic policies that stressed open markets and an active private sector.
Again nearly a decade later, the Clinton Administration changed the U.S. position on
family planning programs by lifting restrictive provisions adopted at the Mexico City
Conference. At the 1994 Cairo Conference, U.S. officials emphasized support for family
planning and reproductive health services, improving the status of women, and providing
access to safe abortion. Eight years later, President Bush revoked the Clinton Administration
position on family planning issues and abortion, reimposing in full the Mexico City
restrictions in force during the 1980s and early 1990s. Throughout this debate, which at
times has been the most contentious foreign aid policy issue considered by Congress, the
cornerstone of U.S. policy has remained to be a commitment to international family planning
programs based on principles of voluntarism and informed choice that give participants
access to information on all major methods of birth control.
Since the 1994 Cairo conference, groups supporting strategies to limit rapid population
growth have supported a broader agenda of initiatives that include the promotion of gender
equality, increasing adolescent education on sexuality and reproductive health, and ensuring
the universal right of health care, including reproductive health. Although endorsed at the
July 1999 U.N. meeting of 179 nations to assess progress of the Cairo population conference
recommendations, the issues of child education and government responsibilities for ensuring
access to safe abortions in countries where the practice is legal were particularly
controversial. Some governments opposed the broadening of the Cairo mandate and some,
including Argentina, Nicaragua, and the Vatican, filed reservations to the recommendations
reached by consensus.
Most recently, new research suggests that there has been a significant decline in
birthrates in several of the largest developing nations, including India, Brazil, and Egypt.
(See, for example, “Population Estimates Fall as Poor Women Assert Control,” New York
Times, March 10, 2002, p. 3.) Some demographers conclude that global population
projections for this century may need to be reduced by as much as one billion people.
Although there are differences of opinion as to why fertility rates are falling – and whether
the trend is universal throughout the developing world – a few demographers argue that the
change has less to do with government family planning policies and foreign aid and more to
do with expanded women’s rights in these countries. Women are choosing to have fewer
children, they argue. Others also cite the fact that with improved health conditions and
lowered infant mortality rates, parents are deciding to have fewer babies because they are
more confident that their children will survive.
In addition to differences of opinion over how population growth affects economic
development in developing countries, population planning assistance has become an issue
of substantial controversy among U.S. policymakers for two other reasons: the use of federal
funds to perform or promote abortions abroad and how to deal with evidence of coercion in
some foreign national family planning programs, especially in China; and setting the
appropriate, effective, and affordable funding levels for family planning assistance.
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Abortion and Coercion
The bitterest controversies in U.S. population planning assistance have erupted over
abortion — in particular, the degree to which abortions and coercive population programs
occur in other countries’ family planning programs, the extent to which U.S. funds should
be granted to or withheld from such countries and organizations that administer these
programs, and the effect that withholding U.S. funds will have on global population growth
and family planning services in developing nations. These issues essentially stem from the
contentious domestic debate over U.S. abortion policy that has continued since the Supreme
Court’s 1973 Roe v. Wade decision holding that the Constitution protects a woman’s decision
whether to terminate her pregnancy. Abortion opponents have introduced in every Congress
since 1973 constitutional amendments or legislation that would prohibit abortions, but none
have been enacted. As an alternative, abortion critics have successfully persuaded Congress
to attach numerous provisions to annual appropriation measures banning the use of federal
funds for performing abortions.
Most of this debate has focused on domestic spending bills, especially restrictions on
abortions under the Medicaid program in the Labor/Health and Human Services
appropriation legislation. Nevertheless, the controversy spilled over into U.S. foreign aid
policy almost immediately when Congress approved in late 1973 an amendment to the
Foreign Assistance Act of 1961 (Section 104(f)) prohibiting the use of foreign development
assistance to pay for the performance of abortions or involuntary sterilizations, to motivate
or coerce any person to practice abortions, or to coerce or provide persons with any financial
incentive to undergo sterilizations. Since 1981, Congress has enacted nearly identical
restrictions in annual Foreign Operations appropriation bills.
For the past 25 years, both congressional actions and administrative directives have
restricted U.S. population assistance in various ways, including those set out in the Foreign
Assistance Act of 1961, and more recent executive regulations and appropriation riders
prohibiting indirect support for coercive family planning (specifically in China) and abortion
activities related to the work of international and foreign nongovernmental organizations.
Two issues in particular which were initiated in 1984 — the “Mexico City” policy involving
funding for non-governmental-organizations (NGOs), and restrictions on funding for the
U.N. Population Fund (UNFPA) because of its activities in China — have remained
controversial and continue as prominent features in the population assistance debate.
The “Mexico City” Policy. (For more detailed discussion of the original “Mexico
City” policy, its implementation, and impact, see CRS Report RL30830, International
Family Planning: The “Mexico City” Policy.) With direct funding of abortions and
involuntary sterilizations banned by Congress since the 1970s, the Reagan Administration
in 1984 announced that it would further restrict U.S. population aid by terminating U.S.
Agency for International Development (USAID) support for any organizations (but not
governments) that were involved in voluntary abortion activities, even if such activities were
undertaken with non-U.S. funds. U.S. officials presented the revised policy at the 2nd U.N.
International Conference on Population in Mexico City in 1984. Thereafter, it become
known as the “Mexico City” policy. USAID announced in late 1984 that it would not
provide funds for the International Planned Parenthood Federation/London (IPPF) in FY1985
because the IPPF/London, which had operations in 132 countries, refused to renounce
abortion-related activities it carried out with non-U.S. funds. On Jan. 13, 1987, Planned
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Parenthood Federation of America (PPFA) filed a lawsuit against USAID challenging the
“Mexico City” policy. In 1990, the U.S. District Court and Court of Appeals ruled against
PPFA, and in 1991, the Supreme Court refused to review the lower court’s decision. The
President’s discretionary foreign policy powers to establish different standards for NGOs and
foreign governments were thereby upheld.
During the Bush Administration, efforts were made in Congress to overturn the Mexico
City policy and rely on existing congressional restrictions in the Foreign Assistance Act of
1961 banning direct U.S. funding of abortions and coerced sterilizations. Provisions adopted
by the House and/or Senate that would have reversed the policy, however, were removed
from legislation under threat of a presidential veto.
Mexico City Policy Removed. In its first days in office, the Clinton Administration
changed U.S. family planning assistance policies, covering not only the Mexico City
restrictions but also funding for UNFPA population assistance in general. In a January 22,
1993 memo to USAID, President Clinton lifted restrictions imposed by the Reagan and Bush
Administrations on USAID grants to family planning NGOs — in effect repealing the
Mexico City policy. The memo noted that the policy had extended beyond restrictions in the
FAAct and was not mandated by law. In his remarks, President Clinton explained that this
step “will reverse a policy that has seriously undermined much needed efforts to promote
safe and effective family planning programs abroad, and will allow us to once again provide
leadership in helping to stabilize world population.” On August 26 and 30, 1993,
respectively, USAID provided $2.5 million to the World Health Organization’s Human
Reproduction Program (HRP) and $13.2 million to IPPF.
Efforts to Legislate the Mexico City Policy. Beginning in 1993, abortion
opponents in Congress attempted to legislate modified terms of the Mexico City policy.
Under the threat of a Presidential veto and resistence from the Senate, Mexico City
restrictions had not been enacted into law until passage in November 1999 of the
Consolidated Appropriations Act for FY2000 (P.L. 106-113). The White House accepted
the family planning conditions in exchange for congressional support of the payment of
nearly $1 billion owed by the United States to the United Nations. The restrictions expired
at the end of FY2000, although they applied to all FY2000 appropriated funds that could be
obligated through September 30, 2001.
Under the terms of Section 599D of P.L. 106-113, private foreign non-governmental
and multilateral organizations had to certify that they neither performed abortions nor lobbied
to change abortion laws in foreign countries in order to receive USAID population aid grants
in FY2000. Section 599D allowed the President to waive the certification requirement for
up to $15 million in grants to groups that would otherwise be ineligible, but with the penalty
of a $12.5 million transfer out of the $385 million population aid appropriation to child
health programs. The restrictions applied only to FY2000 funds that were available for
obligation until September 30, 2001.
One day after signing the legislation, the President exercised his waiver authority
(November 30, 1999), thereby reducing FY2000 population aid funds to $372.5 million. He
further instructed USAID to implement Section 599D in a way that would minimize the
impact on U.S. funded family planning programs. In USAID-issued certification forms,
organizations had to state that they would not engage in three types of activities with either
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USAID or non-USAID funds from the date they signed an agreement to receive FY2000
USAID population funds through September 30, 2001:
! perform abortions in a foreign country, except where the life of the mother
would be endangered, or in cases of forcible rape or incest;
! violate the laws of a foreign country concerning the circumstances under
which abortion is permitted, regulated, or restricted; or
! attempt to alter the laws or governmental policies concerning circumstances
under which abortion is permitted, regulated, or restricted.
If an organization declined to certify or did not return the certification form, it was ineligible
to receive FY2000 USAID population funds unless it was granted a waiver under the $15
million exemption cap.
In the first external review of USAID’s management of the new restrictions, an October
5, 2000 General Accounting Office report found that USAID had complied with FY2000
legislative family planning conditions regarding abortion activities (GAO Report GAO-01-3,
found at [http://www.gao.gov/]). The GAO, however, also reported that the International
Planned Parenthood Federation (IPPF) had inadvertently transferred $700,000 in USAID
funds to two affiliates the Federation and USAID had earlier agreed would not be supported
with U.S. funds because the two organizations engaged in abortion-related activities.
Although the error was corrected prior to the GAO audit, Senator Helms, who commissioned
the GAO study, raised concerns over IPPF’s initial violation of its agreement with USAID.
A key issue regarding an evaluation of the impact of the FY2000 restrictions was
whether the $15 million in total grants allowed under the waiver authority were sufficient to
cover all foreign organizations that declined to certify regarding their involvement in
abortion-related activities. In total, nine organizations refused to certify, including two of
the largest recipients of USAID population aid grants – IPPF and the World Health
Organization (WHO). (During the Reagan and Bush Administrations, IPPF was one of the
few family planning organizations that declined to sign “Mexico City” policy conditions and
received no USAID funding during that period.) These nine non-certifying organizations
were awarded about $8.4 million in FY2000 grants, of which IPPF accounted for $5 million
and WHO roughly $2.5 million.
Critics of the certification requirement opposed it on several grounds. From an
administrative standpoint, they say it increased USAID costs to manage family planning
programs because of the additional paperwork and delay implementation of projects.
(USAID contracted with John Snow, Inc. to track the certification process.) They further
believe that family planning organizations would cut back on services because they would
be unsure of the full implications of the restrictions and would not want to risk losing
eligibility for USAID funding. Opponents also believe the conditions would undermine
relations between the U.S. government and foreign NGOs and multilateral groups, creating
a situation in which the United States challenged their sovereignty on how to spend their own
money and imposed a so-called “gag” order on their ability to promote changes to abortion
laws and regulations in developing nations. The latter, these critics noted, would be
unconstitutional if applied to American groups working in the United States.
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Supporters of the certification requirement argued that even though permanent law bans
USAID funds from being used to perform or promote abortions, money is fungible; that
organizations receiving American-taxpayer funding can simply use USAID resources for
legal activities while diverting money raised from other sources to perform abortions or
lobby to change abortion laws and regulations. The certification process, they contended,
stops the fungibility “loophole.”
Bush Administration Restores the Mexico City Policy. Like his predecessor,
President George W. Bush, as one of his first official actions in office, issued a memorandum
revoking the Clinton Administration memorandum and restoring in full the terms of the
Mexico City restrictions that were in effect on January 19, 1993. As was the case during the
1980s and early 1990s, in the future foreign NGOs and international organizations, as a
condition for receipt of U.S. federal funds, must agree not to perform or actively promote
abortions as a method of family planning in other countries. President Bush noted in his
order that American taxpayer funds should be not used to pay for abortions or advocate or
actively promote abortion. Critics charge, however, that the policy is a violation of free
speech and the rights of women to choose; and that the policy will undermine maternal health
care services offered in developing nations and may actually contribute to the rise in the
number of abortions performed, some that are unsafe and illegal. (See Congressional Debate
in the 107th Congress, below, for congressional consideration of amendments supporting and
opposing the Mexico City policy in 2001 and 2002.)
New Mexico City Policy Guidelines. Following several weeks of inter-agency
consultations, USAID released on February 15, 2001, specific contract clauses necessary to
implement the President’s directive. (President Bush re-issued on March 28 his
Memorandum to USAID, including contract guidelines identical to those in the agency’s
February 15 notice. He did so in an effort to avoid a vote in Congress to overturn his policy
under provisions of the Congressional Review Act (CRA) (P.L. 104-121). The CRA,
enacted in 1996, established a mechanism by which Congress can review and disapprove,
using expedited procedures, federal agency rules. S.J.Res. 9, introduced by Senator Boxer
and others on March 20, states congressional disapproval of the February 15 USAID rule
regarding the Mexico City Policy. By re-issuing the Memorandum to USAID, complete with
policy guidelines, the White House hoped that the Mexico City Policy would not fall within
the parameters of the CRA.)
The new guidelines state that U.S. NGOs receiving USAID grants cannot furnish
assistance to foreign NGOs which perform or actively promote abortion as a method of
family planning in USAID-recipient countries, or that furnish assistance to other foreign
NGOs that conduct such activities. When USAID provides assistance directly to a foreign
NGO, the organization must certify that it does not now or will not during the term of the
grant perform or actively promote abortion as a method of family planning in USAID-
recipient countries or provide financial support to other foreign NGOs that carry out such
activities. Abortion is defined as a “method of family planning when it is for the purpose of
spacing births,” including (but not limited to) abortions performed for the physical or mental
health of the mother. To perform abortions is defined as the operation of a “facility where
abortions are performed as a method of family planning.” (USAID memorandum to all
contracting officers and negotiators, titled Voluntary Population Activities – Restoration of
the Mexico City Policy, dated February 15, 2001.)
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Promoting abortion is defined as an organization committing resources “in a substantial
or continuing effort to increase the availability or use of abortion as a method of family
planning.” Examples of what constitutes the promotion of abortion include: operating a
family planning counseling service that includes information regarding the benefits and
availability of abortion; providing advice that abortion is an available option or encouraging
women to consider abortion; lobbying a foreign government to legalize or to continue the
legality of abortion as a method of family planning; and conducting a public information
campaign in a USAID-recipient country regarding the benefits and/or availability of abortion
as a method of family planning.
The regulations also contain exceptions:
! abortions may be performed if the life of the mother would be endangered
if the fetus were carried to term or abortions performed following rape or
incest; health care facilities may treat injuries or illnesses caused by legal or
illegal abortions (post-abortion care).
! “passive” responses by family planning counselors to questions about
abortion from pregnant women who have already decided to have a legal
abortion is not considered an act of promoting abortion; referrals for
abortion as a result of rape, incest, or where the mother’s life would be
endangered, or for post-abortion care are permitted.
USAID will further be able to continue support, either directly or through a grantee, to
foreign governments, even in cases where the government includes abortion in its family
planning program. Money provided to such governments, however, must be placed in a
segregated account and none of the funds may be drawn to finance abortion activities.
Funding for UNFPA. Also at the 1984 Mexico City Conference, the Reagan
Administration established the requirement that the United Nations Population Fund
(UNFPA) provide “concrete assurances that [it] is not engaged in, or does not provide
funding for, abortion or coercive family planning programs.” Concern was highest over
UNFPA’s activities in China’s coercive family planning practices. At the time, the
Administration reportedly held up $19 million (of $38 million allocated for UNFPA for
FY1984) until the organization could provide the necessary assurances.
Subsequently, Congress legislated a more restrictive UNFPA policy — aimed at
coercive Chinese family planning programs and UNFPA’s continuing operations in the
country — by enacting the “Kemp-Kasten amendment” in the FY1985 Supplemental
Appropriations Act (P.L. 99-88). This language prohibited the use of appropriated funds for
any organization or program, determined by the President, to be supporting or participating
“in the management” of a program of coercive abortion or involuntary sterilization.
Following enactment of P.L. 99-88, USAID announced that $10 million of $46 million that
had been earmarked for UNFPA during FY1985 would be redirected to other programs, and
later said that the United States would not contribute to UNFPA at all in 1986. Most of the
$25 million that was originally allocated for UNFPA was spent for other international family
planning activities. Even though this pattern to redirect UNFPA transfers to other population
assistance programs continued, critics of the Kemp-Kasten amendment and the President’s
determination to suspend contributions asserted that UNFPA was the world’s most effective
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family planning organization and that the quality of services provided in developing nations
outside of China suffered due to the unwillingness of U.S. support. At the time of
suspension, U.S. payments represented nearly one-third of UNFPA’s annual budget. From
1986 through 1993, no U.S. contributions went to UNFPA.
Like the Mexico City policy, the Clinton Administration moved quickly to lift the ban
of UNFPA contributions, making available $14.5 million in FY1993 but stipulating that none
of the funds could be used in China. Again, congressional critics of Chinese family planning
practices attempted unsuccessfully to attach riders to various foreign aid bills banning U.S.
contributions unless UNFPA withdrew from China or the President could certify that China
no longer maintained a coercive family planning program. Nevertheless, while the United
States continued to support UNFPA during the next five years, Congress attached restrictions
in appropriation measures that in most cases reduced the U.S. contribution by the amount
UNFPA spent in China. UNFPA ended a 5-year program in China in 1997. But when the
organization negotiated in early 1998 a new multi-year Chinese program, Congress, over the
Administration’s objections, prohibited American support for FY1999. Congress resumed
UNFPA funding in FY2000 and 2001 but under the condition that the $25 million earmark
would be reduced by whatever amount UNFPA’s program cost for China.
For FY2002, Congress provided “not more than” $34 million for UNFPA. But in mid-
January 2002, the White House placed a hold on U.S. contributions to UNFPA, pending a
review of the organization’s program in China. According to February 27 testimony by
Arthur Dewey, Assistant Secretary of State for Population, Refugees, and Migration before
the Senate Foreign Relations Committee, the White House initiated the review because of
new evidence that coercive practices continue in counties where UNFPA concentrates its
programs. In September 2001, Josephine Guy led an investigative team sponsored by the
Population Research Institute, spending four days interviewing women in one of the Chinese
counties where UNFPA maintains active programs. The team concluded that a consistent
pattern of coercion continues in this “model” UNFPA county, including forced abortions and
involuntary sterilizations. (See House International Relations Committee hearing, Coercive
Population Control in China: New Evidence of Forced Abortion and Forced Sterilization,
October 17, 2001. See also testimony of Josephine Guy before the Senate Foreign Relations
Committee, February 27, 2002.)
UNFPA commissioned what it characterized as an independent international review
team, led by Dr. Nicholaas Biegman, a Dutch diplomat and former head of the Netherlands
International Cooperation Agency. Following a five day visit in October 2001, the team
found “absolutely no evidence that the UN Population Fund supports coercive family
planning practices in China or violates the human rights of Chinese people in any way.” The
Biegman group acknowledged that voluntary family planning services are not the “norm”
throughout China, but concluded that UNFPA’s work served as a model for demonstrating
to Chinese officials that voluntary programs are the most effective way to reduce population
growth. (See testimony of Nicholaas Biegman before the Senate Committee on Foreign
Relations, February 27, 2002.)
While most observers agree that coercive family planning practices continue in China,
differences remain over the extent to which, if any, UNFPA is involved in involuntary
activities and whether UNFPA should operate at all in a country where such conditions exist.
Given the conflicting reports, the State Department sent its own investigation team to China
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for a two-week review of UNFPA programs on May 13. The team was led by former
Ambassador William Brown, and included Bonnie Glick, a former State Department official,
and Dr. Theodore Tong, a public health professor at the University of Arizona. A final report
on its findings is expected by late June.
Presumably, the team will assess whether UNFPA “supports or participates in the
management of a program of coercive abortion or involuntary sterilization.” If
Administration officials conclude that this is the case, UNFPA would be in violation of the
Kemp-Kasten amendment and be ineligible for U.S. grants. Alternatively, the President
could find that the UNFPA did not violate Kemp-Kasten, but reduce the U.S. contribution
to something less than $34 million to express displeasure over alleged coercive family
practices in China and UNFPA’s involvement.
Although the appropriation language does not require the U.S. to provide $34 million
to UNFPA, some House and Senate Appropriation Committee leaders say that was their
intent, and strongly urge the White House to release the full amount appropriated. On May
9, 2002, the House Appropriations Committee approved (32-31) an amendment to the
FY2002 Supplemental Appropriation (H.R. 4775) by Representatives Lowey and Kolbe that
would have required the President to transfer the full $34 million to UNFPA by July 10 if the
State Department commission concludes that UNFPA is not involved in coercive family
planning practices in China. Meeting on May 15, however, the Committee added a provision
sponsored by Representative Tiahrt that overrode the Lowey/Kolbe amendment, requiring
the President to determine by July 31, 2002, whether UNFPA participates in the management
of coercive family planning practices, but leaving open the question on how much to
contribute. During floor debate on H.R. 4775, the House adopted a second rule (H.Res. 431)
governing debate on the bill that deleted both the Lowey/Kolbe and Tiahrt amendments. As
a result, the House-passed measure contains no language concerning UNFPA. Nevertheless,
the Senate attached a provision that is nearly identical to the Lowey/Kolbe language to its
version of the Supplemental Appropriation, legislation that cleared the Senate on June 6.
The White House opposes the Senate language.
Under any of these amendments a finding that UNFPA was in violation of Kemp-
Kasten would result in the termination of U.S. support. Without such a conclusion, however,
the Senate and Lowey/Kolbe amendments would require the President to provide the full $34
million contribution. The Tiahrt amendment would leave open the possibility for the
President to allocate something less than $34 million for UNFPA.
Family Planning Conditions in China. As noted, much of the UNFPA debate has
focused on that organization’s programs in China, both because of China’s well-known
population growth problem and because of widespread publicity given to reports of coercion
in its family planning programs. China’s population increased from 500 million in 1950 to
1.008 billion according to the 1982 census — an average annual growth rate of 2%, or a
doubling of the population every 36 years. (Although the 2% rate is not particularly large
by developing country standards, many consider a lower rate crucial to China’s economic
development prospects given the country’s already huge population size.)
Given population growth rates, Beijing authorities came to view control of population
growth not simply as an important priority, but as a necessity for the nation’s survival. In an
attempt to reach a 1% annual population growth rate, Chinese authorities in 1979 instituted
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a policy of allowing only one child per couple, providing monetary bonuses and other
benefits as incentives. Women with one living child who become pregnant a second time
were said to be subjected to rigorous pressure to end the pregnancy and undergo sterilization;
couples who actually had a second child faced heavy fines, employment demotions, and other
penalties. PRC leaders have admitted that coerced abortions and involuntary sterilizations
occur, but insist that those involved are acting outside the law and are punished, particularly
through the Administrative Procedure Law enacted in October 1990. Chinese authorities
have termed female infanticide an “intolerable crime” that must be punished by law.
After 1983, thought to be the peak year of coercion in Chinese family planning in the
1980s, the PRC relaxed its “one-child” policy in rural areas. The original target for the
PRC’s population in the year 2000 had been 1.2 billion, but that goal was relaxed in 1984
to 1.25 billion, and the Chinese minister of family planning indicated in 1991 that the target
population size for 2000 was now 1.294 billion. (UNFPA reports that China’s population
in 1999 was 1.267 billion, with an annual growth rate of 0.9%.) In addition, the policy has
been loosely applied for Tibetan, Muslim, and other ethnic minorities. China has also
reported regional differences in the so-called “one-child” policy. Economic reforms helped
weaken policy enforcement in more prosperous areas, with rising incomes absorbing fines.
More recent press reports suggest that the Chinese State Family Planning Commission
(SFPC) has softened some of its previous harsh tactics to limit population growth. A number
of counties have ended the system of permits for pregnancy and quotas for the number of
children that can be born annually. When it launched in January 1998 its latest $20 million,
five-year program in China, UNFPA announced that SFPC officials had agreed to drop birth
targets in the 32 counties where U.N. activities would be focused. And in May 1999, the city
of Beijing ended an eight-year policy that women had to be at least 24 years old to bear a
child and lifted the requirement for couples to obtain a certificate before having their child.
Nevertheless, the degree of coercive family planning practices in China, as evidenced
in the two conflicting recent investigations noted above, remains a cloudy and controversial
matter. The State Department, in its 2001 report on human rights conditions (released March
2002), concluded that the Chinese government “continued to implement comprehensive and
sometimes coercive family planning policies.” The State Department further notes that the
UNFPA program in 32 Chinese countries has led local governments to inform the public of
UNFPA efforts to address family planning and reproductive health matters strictly on a
voluntary basis. According to the State Department, local government officials have
eliminated countywide birth and population targets that often lead to coercive enforcement
practices. Nevertheless, the Department cautions that, “economic fines assessed on
individual families for over-quota children” continue.
Funding Levels
Since 1965, USAID has obligated over $6.6 billion in assistance for international
population planning. In many years, and especially over the past decade, the appropriate level
of funding for population assistance has been controversial, and at times linked directly with
differences concerning Mexico City restrictions and abortion. During the 1980s and 1990s,
Congress and the executive branch frequently clashed over the amount of foreign aid that
should be allocated to family planning programs. Until FY1996, Congress generally
supported higher funding levels for population aid than proposed by the President, especially
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during the Reagan and Bush Administrations. Family planning appropriations – including
bilateral population aid and UNFPA contributions – averaged about $280 million annually
during the late 1980s, but grew rapidly in the 1990s, peaking in FY1995 at $577 million.
With the change in party control of Congress during the FY1996 budget cycle, family
planning policy and budget issues became, and have continued to be, the most contentious
foreign aid matter considered by Congress. Population appropriation levels fell abruptly to
$356 million in FY1996. But because of the four-month delay in enacting the Foreign
Operations spending measure (largely because of the family planning dispute), coupled with
a new requirement to “meter” population funds – that is, making them available on a monthly
schedule in increments of $23 million over a 15-month period – USAID had only $151.5
million available for supporting bilateral family planing programs in FY1996. Most of the
FY1996 population aid appropriation was “pushed” into the next year because of the
metering mechanism. Population aid appropriations grew slightly to $385 million during
each of the next four years, but fell far short of White House requests. Due to restrictions
enacted for FY2000 noted above, $12.5 million of those appropriations were transferred from
population assistance to child health programs. President Clinton proposed a $541.6 million
budget for bilateral population aid in FY2001, a level that would have returned to the amount
provided in FY1995. Congress approved $425 million. President Bush proposed the same
level for FY2002, but Congress increased funding to $446.5 million. The Bush
Administration proposes $425 million for FY2003.
Table 1. Population Assistance, FY1993-2002
(appropriations of millions of $s)
1994
1995
1996a
1997
1998
1999
2000b
2001b
2002
2003c
Population
485.1
541.6
356.0
385.0
385.0
385.0
372.5
425.0
446.5
425.0
Aid
d
UNFPA
40.0
35.0
22.8
25.0
20.0
0.0
21.5
21.5
34.0d
Total
525.1
576.6
378.8
410.0
405.0
385.0
394.0
446.5
480.5
425.0
Source: AID/Office of Population.
a Because of the FY1996 “metering” requirement for population aid that delayed the availability of funds, the
actual amount available for obligation in that year was $151.5 million. Since large amounts appropriated
in FY1996 and FY1997 were “metered” into the next fiscal year, levels available for obligation in
FY1997 and FY19998 were $495 million and $554 million, respectively. In years when “metering” was
not required – before FY1996 and since FY1998 – amounts available for obligation were nearly the same
as or identical to the appropriated level shown in Table 1.
b FY2000 levels reflect a transfer of $12.5 million from population aid. FY2000 and FY2001 reflect a $3.5
million deduction from UNFPA due to legislative restrictions.
c Request for FY2003.
d On hold, pending a review of UNFPA’s program in China.
Financing family planning and basic reproductive health care programs in developing
countries became a major issue at the 1994 Cairo population conference. Participating
nations agreed that foreign aid donors would provide one-third, or $5.7 billion, of the annual
costs of such services that were estimated to grow to about $17 billion in 2000. A July 1999
conference assessing implementation of the 1994 Cairo strategy, however, found that
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industrialized countries had fallen far short of the financing goal, providing only about $1.9
billion per year.
Supporters of increasing population aid, many of whom believe strongly that population
growth must be curtailed before meaningful development can occur, contend that family
planning should be among the highest priorities of U.S. development strategy. Population
growth, they argue, has long-term consequences, affecting diverse U.S. interests in
environmental protection, resource conservation, global economic growth, immigration
management, and international stability. They maintain that attention to family planning
assistance now could obviate future allocations in other development and health-related
accounts. Some proponents of population assistance programs see a particular irony, for
instance, in limiting funds for population stabilization programs while increasing the budget
claims of child survival and infectious disease programs. Population aid proponents also cite
recent studies that suggest that the prevalence of abortion declines in countries that have
wider availability and use of effective contraceptives. This relationship, they say, further
reduces the risk of unsafe abortions that are the leading cause of maternal deaths in
developing nations.
Opponents of increasing population aid argue that even without added funding levels,
the United States continues to be the largest bilateral donor in population assistance
programs. Some also claim that there is little or no correlation between rapid population
growth and a country’s economic development. At the very least, some opponents say,
current economies of scale and global trading patterns have too many empirical variables and
uncertainties to establish a direct correlation between population growth and economic
development.
International Family Planning Issues and Legislation
In the 107th Congress
For FY2002, the Administration requested $425 million for population assistance, the
same level as for FY2001, and a $25 million UNFPA contribution. The primary focus of
congressional attention in the 107th Congress, however, has been on the reimposition of the
Mexico City Policy and the current hold placed by the Administration on the U.S.
contribution to UNFPA. Several bills have been introduced that would effectively overturn
the President’s Mexico City policy. One – S. 367, the Global Democracy Promotion Act of
2001 – was favorably reported on August 1 by the Senate Foreign Relations Committee.
Similar text was added to the Senate version of the Foreign Operations Appropriations bill
(H.R. 2506). The House also debated legislation that would overturn the President’s Mexico
City policy, but no pending House bills currently include such language. Regarding UNFPA,
the “Saving Women’s Lives Act of 2002" (H.R. 3916), would re-appropriate and make
mandatory a $34 million FY2002 UNFPA contribution and authorize $50 million for
FY2003. H.R. 3916 would further provide U.S. funding only if UNFPA maintains a separate
account for U.S. transfers and does not co-mingle such funds with other sums, and does not
fund abortions as a method of family planning. The bill would not, however, deduct U.S.
contributions by the amount UNFPA spent in China, a condition added to most enacted
legislation in the late 1990s.
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Congressional Action
Foreign Relations Authorization and Other Authorizing Measures. In the
first legislative vote of the 107th Congress on international family planning issues, the House
International Relations Committee on May 2 adopted (26-22) an amendment by
Representative Lee that would overturn the Mexico City policy. The Lee amendment was
attached to H.R. 1646, an omnibus foreign policy authorization bill. The amendment, which
incorporated the text of H.R. 755, would have not subjected foreign groups to different
restrictions imposed on U.S. NGOs concerning the use of non-USAID funding for advocacy
and lobbying activities. It further directed that foreign NGOs would not be ineligible for
U.S. grants solely on the basis of health or medical services provided with non-USAID
funding so long as these activities were not in violation of the laws of the country in which
the groups operated and would not violate U.S. law if provided here. On May 16, however,
the full House voted (218-210) to delete the Lee amendment from H.R. 1646. The
Administration had said the President would veto H.R. 1646 if the Committee language on
Mexico City policy remained in the bill. The Senate Foreign Relations Committee, meeting
on August 1, favorably reported S. 367, legislation nearly identical H.R. 755 and to
provisions initially added to H.R. 1646 by the House International Relations Committee.
Foreign Operations Appropriations, FY2002. House critics of the Mexico City
policy made a second effort to overturn the restrictions during House Foreign Operations
Subcommittee markup of its draft FY2002 spending bill on June 27 (H.R. 2506). An
amendment by Representative Lowey, however, failed on a voice vote. The amendment was
similar to provisions adopted by the House International Relations and Senate Foreign
Relations Committees. The family planning issue was not raised during subsequent House
consideration. H.R. 2506 passed the House on July 24.
On July 26, the Senate Appropriations Committee approved its version of H.R. 2506
that included a provision effectively overturning President Bush’s decision to place abortion
restrictions on U.S. international family planning funds. The Senate adopted H.R. 2506 on
October 24 without altering the Committee’s family planning provision. The Senate text was
very similar to language adopted in the previous Congress by the Senate in S. 2522 and
supported by the Senate Foreign Relations Committee in 2001 (S. 367). As approved, the
FY2002 funding bill would have blocked the White House from barring foreign
nongovernmental organizations (NGOs) eligibility for USAID funding solely on the basis
of health or medical services they offer with their own, non-U.S. government provided funds
so long as they did not violate U.S. laws or the laws of the countries in which they operate.
Foreign NGOs would also not face limitations on advocacy or lobbying activities using their
own, non-U.S. government funds that were more restrictive than those that apply to U.S.
NGOs which receive U.S. foreign aid grants. As noted above, it is generally held that under
the Constitution, U.S. NGOs cannot be restricted from using their own funds to advocate
policy positions they support. These proposed conditions would essentially extend that
protection to foreign NGOs and multilateral organizations.
On funding issues, H.R. 2506, as passed the House, assumed $425 million for FY2002
population aid, as requested, while the Senate increased spending to $450 million. The
Senate measure would have further increased the U.S. contribution to the U.N. Population
Fund from $25 million to $40 million.
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On December 20, Congress cleared the FY2002 Foreign Operations Appropriations bill
(H.R. 2506), resolving House-Senate disputes over three international family planning aid
issues that had stalled final passage for over a month. Conferees agreed to delete Senate
language that would have overturned the Administration’s Mexico City policy. The enacted
bill further provides a U.S. contribution the U.N. Population Fund (UNFPA) of “not more
than” $34 million so long as UNFPA does not fund abortions and the U.S. funds are
segregated and not co-mingled with other UNFPA money, are not used for UNFPA programs
in China. Conferees also dropped a House restriction that would have reduced the
contribution by whatever UNFPA spent in China. As noted above, however, these funds are
on hold by the White House, pending a review of UNFPA’s program in China. Finally, H.R.
2506 appropriates $446.5 million for U.S. bilateral family planning/reproductive health
programs in FY2002. The legislation allocates the $20.5 million overall increase from the
FY2002 request in such as way that will add $10.5 million in family planning amounts from
Child Survival account and $10 million from other economic aid accounts.
Emergency Supplemental Appropriations, FY2002 (H.R. 4775). As noted
above in the section on the U.N. Population Fund, the House Appropriations Committee on
May 9 approved (32-31) an amendment to H.R. 4775 by Representatives Lowey and Kolbe
that would have required the President to transfer $34 million to UNFPA by July 10 if a State
Department investigation team concludes that UNFPA is not involved in coercive family
planning practices in China. The money has been on hold by the White House since January.
Meeting on May 15, however, the Committee added a second UNFPA provision, sponsored
by Representative Tiahrt, requiring the President to determine by July 31, 2002, whether
UNFPA participates in the management of coercive family planning practices. Before final
passage, however, pursuant to H.Res. 431, the second rule for consideration of H.R. 4775,
both the Lowey/Kolbe and the Tiahrt amendments were deleted from the bill.
The Senate-passed Supplemental Appropriation includes a provision nearly identical
to the Lowey/Kolbe text. Under any of these amendments a finding that UNFPA was in
violation of Kemp-Kasten would result in the termination of U.S. support. Without such a
conclusion, however, the Senate and Lowey/Kolbe amendments would require the full $34
million contribution to go forward. The Tiahrt amendment would leave open the possibility
for the President to allocate something less than $34 million for UNFPA.
LEGISLATION
P.L. 107-115 (H.R. 2506)
Foreign Operations Appropriations for FY2002. Includes $446.5 million for population
assistance, $20.4 million higher than the request, and not more than $34 million for the U.N.
Population Fund, $9 million more than proposed. The bill does not include Senate-passed
language that would have overturned Bush Administration abortion restrictions. H.R. 2506
marked-up by the House Foreign Operations Subcommittee on June 27; reported by the
House Appropriations Committee on July 17 (H.Rept. 107-142). Passed the House on July
24. Reported by the Senate Appropriations Committee on Sept. 4 (S.Rept. 107-58). Passed
the Senate on October 24 (96-2). Conference report filed on December 19 (H.Rept.
107-345); passed the House on December 19 (356-66); passed the Senate on December 20.
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H.R. 755 (Lowey)
Global Democracy Promotion Act of 2001. Prohibits certain restrictive eligibility
requirements to foreign NGOs with respect to family planning programs. Introduced on
February 27, 2001; referred to the House International Relations Committee. See H.R. 1646
below.
H.R. 1646 (Hyde)
Foreign Relations Authorization Act, FYs 2002 and 2003. Authorizes appropriations
for the Department of State. Introduced on April 27, 2001; during markup on May 2, the
House International Relations Committee approved (26-22) an amendment by Representative
Lee that would overturn the Mexico City policy. The amendment was a modified version
of H.R. 755. The Committee reported H.R. 1646 on May 4 (H.Rept. 107-57). The House
voted (218-210) to delete the Lee amendment on May 16, and passed H.R. 1646 (352-73).
H.R. 1646 passed the Senate, amended, on May 1, 2002, without reference to the Mexico
City policy issue.
H.R. 3916 (Maloney)
Saving Women’s Lives Act of 2002. States that out of the funds appropriated in P.L.
107-115 (Foreign Operations Appropriations, FY2002), $34 million “shall be made available
only for United States voluntary contributions to the United Nations Population Fund.” The
bill further authorizes a $50 million contribution for FY2003. Introduced on March 7, 2002;
referred to the House Committee on International Relations.
H.R. 4775 (Young)
Supplemental Appropriations for Further Recovery from and Response to Terrorist
Attacks on the United States, FY2002. The Senate version includes language concerning the
release of the FY2002 U.S. contribution to UNFPA (see above for details). H.R. 4775
reported on May 20, 2002 (H.Rept. 107-480) with two provisions concerning UNFPA;
passed the House on May 23 after the House adopted a second rule (H.Res. 431) that deleted
all UNFPA provisions from the bill. S. 2551 reported by the Senate Appropriations
Committee on May 29 (S.Rept. 107-156); the Senate inserted the text of S. 2551 into H.R.
4775, and passed H.R. 4775 on June 6 (71-22).
S. 367 (Boxer)
Global Democracy Promotion Act of 2001. Prohibits certain restrictive eligibility
requirements from applying to foreign NGOs with respect to family planning programs.
Introduced February 15, 2001; reported by the Senate Foreign Relations Committee on
August 1.
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