Order Code IB96026
CRS Issue Brief for Congress
Received through the CRS Web
Population Assistance and Family Planning
Programs: Issues for Congress
Updated July 24, 2003
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, 2002-2003
Congressional Consideration of FY2003 and FY2004 Legislation
Foreign Operations Appropriations, FY2003
Foreign Relations Authorization, FY2004-2005
Foreign Operations Appropriations, FY2004
LEGISLATION

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Population Assistance and Family Planning Programs:
Issues for Congress
SUMMARY
Since 1965, United States policy has
UNFPA and reviewing the organization’s
supported international population planning
program in China, Secretary of State Powell
based on principles of voluntarism and
announced on July 22, 2002, that UNFPA was
informed choice that gives participants access
in violation of the “Kemp-Kasten” amend-
to information on all methods of birth control.
ment. This provision bans U.S. assistance to
This policy, however, has generated conten-
organizations that support or participate in the
tious debate for over two decades, resulting in
management of coercive family planning
frequent clarification and modification of U.S.
programs.
international family planning programs.
For FY2003, the President proposed no
In the mid-1980s, U.S. population aid
UNFPA funding, although there was a “re-
policy became especially controversial when
serve” of $25 million that could be used if the
the Reagan Administration introduced restric-
White House determines that UNFPA is
tions. Critics viewed this policy as a major
eligible for U.S. support. The Administration
and unwise departure from U.S. population
further requested $425 million for bilateral
efforts of the previous 20 years.
family planning programs, a reduction from
the $446.5 million provided in FY2002.
The “Mexico City policy” further denied
U.S. funds to foreign non-governmental orga-
H.J.Res. 2, the Consolidated Appropria-
nizations (NGOs) that perform or promote
tion for FY2003, passed Congress in February
abortion as a method of family planning,
2003, providing $446.5 million for bilateral
regardless of whether the money came from
population aid and $34 million to UNFPA.
the U.S. government. Presidents Reagan and
UNFPA funds are subject to several condi-
Bush also banned grants to the U.N. Popu-
tions, including a requirement that the Presi-
lation Fund (UNFPA) because of its program
dent certify that the organization is no longer
in China, where coercion has been used.
involved in the management of a coercive
family planning program.
President Clinton repealed Mexico City
policy restrictions and resumed UNFPA fund-
For FY2004 the Administration seeks
ing. On January 22, 2001, President Bush
$425 million in bilateral family planning
revoked the Clinton Administration popula-
funds and sets asides $25 million in a reserve
tion policy position and restored in full the
account for UNFPA if the organization be-
terms of the Mexico City restrictions that were
comes eligible for U.S. support.
in effect on January 19, 1993. Foreign NGOs
and international organizations, as a condition
The House deleted a committee amend-
for receipt of U.S. funds, now must agree not
ment to H.R. 1950 on July 15 that would have
to perform or actively promote abortions as a
authorized $50 million for UNFPA in FY2004
method of family planning in other countries.
and FY2005, and revised current law in a way
that may have made it more difficult to deny
After delaying the transfer of $34 million
U.S. contributions to UNFPA.
appropriated by Congress in FY2002 for
Congressional Research Service
˜ The Library of Congress

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MOST RECENT DEVELOPMENTS
On July 15, 2003, the House voted 216-211 to delete a UNFPA provision added by the
International Relations Committee to the FY2004/2005 State Department Authorization bill
(H.R. 1950). During committee markup, the House panel had added an amendment by
Congressman Crowley (23-22) authorizing a $50 million U.S. contribution for each of the
two years to UNFPA. UNFPA was denied American support in FY2002 when the Secretary
of State determined that the organization’s activities in China violated the Kemp-Kasten
amendment barring U.S. aid to groups that support or participate in the management of a
program of coercive abortion or involuntary sterilization. The executive branch has not made
a decision on FY2003 UNFPA funding; in order to transfer resources this year, President
Bush would need to determine that UNFPA no longer provides China with such support.
The Crowley amendment, which would have required the President to find that UNFPA
“directly” supports or participates in coercive or involuntary activities, would appear to have
made it more difficult to deny funding to UNFPA than under existing law. Not only did the
Crowley amendment add the word “directly,” but it also defined the circumstances under
which UNFPA would be found ineligible as “knowingly and intentionally working with a
purpose to continue, advance or expand the practice of coercive abortion or involuntary
sterilization, or playing a primary and essential role in a coercive or involuntary aspect of a
country’s family planning program.”
Subsequently, House and Senate Foreign Operations Appropriations bills (H.R. 2800
and S. 1426) have taken different positions on international family planning issues for
FY2004. The House measure, approved on July 23, provides $425 million, as requested, for
bilateral population programs, and $25 million for UNFPA, subject to conditions similar to
those that currently apply. The Senate bill appropriates $445 million for bilateral programs,
and includes language that would effectively reverse the President’s “Mexico City” abortion-
related restrictions. S. 1426 further provides $35 million for UNFPA, subject to current
restrictions. Although the FY2004 proposal does not include specific funding for UNFPA,
there is $25 million held in “reserve,” money that presumably would be available if the
President makes a determination to restore UNFPA’s eligibility. If such a determination
were made prior to September 30, 2003, UNFPA would receive up to $34 million from funds
already appropriated for FY2003.
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,
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
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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
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.
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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.
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
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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 January 13, 1987, Planned
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
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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.
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.
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
USAID or non-USAID funds from the date they signed an agreement to receive FY2000
USAID population funds through September 30, 2001:
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! 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.
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 said it increased USAID costs to manage family planning
programs because of the additional paperwork and delayed implementation of projects.
(USAID contracted with John Snow, Inc. to track the certification process.) They further
believed 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 believed 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.
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. 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,
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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.
New Mexico City Policy Guidelines. USAID released on February 15, 2001,
specific contract clauses necessary to implement the President’s directive. The 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.)
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.
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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
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.
Bush Administration freezes FY2002 UNFPA funding. 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
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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.)
State Department Team Assesses UNFPA Program in China. 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 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.
The State Department’s assessment team filed its report with Secretary Powell on May
29 (but not made public until late July), making a series of findings and recommendations.
See [http://www.state.gov/g/prm/rls/rpt/2002/12122.htm] for report’s full text.) The group
found that:
! There is no evidence that UNFPA “has knowingly supported or participated
in the management of a program of coercive abortion or involuntary
sterilization” in China;
! Despite some relaxation of government restrictions in counties where
UNFPA operates, China maintains coercive elements in its population
programs in law and practice;
! Chinese leaders view “population control as a high priority” and remain
concerned over implications for socioeconomic change.
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On the basis of these three findings, Ambassador Brown and his colleagues recommended
that:
! The United States should release not more than $34 million of previously
appropriated funds to UNFPA;
! Until China ends all forms of coercion in law and practice, no U.S.
government funds should be allocated to population programs in China;
! Appropriate resources, possibly from the United States, should be allocated
to monitor and evaluate Chinese population control programs.
Nevertheless, on July 22, Secretary of State Powell, to whom the President has
delegated the decision, announced that UNFPA was in violation of Kemp-Kasten and
ineligible for U.S. funding. The State Department’s analysis of the Secretary’s determination
(see [http://www.state.gov/g/prm/rls/other/12128.htm] for the full text) found that even
though UNFPA did not “knowingly” support or participate in a coercive practice, that alone
would not preclude the application of Kemp-Kasten. Instead, a finding that the recipient of
U.S. funds — in this case UNFPA — simply supports or participates in such a program,
whether knowingly or unknowingly, would trigger the restriction. The assessment team
found that the Chinese government imposes fines and penalties on families (“social
compensation fees”) that have children exceeding the number approved by the government.
The Department further noted that UNFPA has funded computers and data-processing
equipment that helps strengthen the management of the Chinese State Family Planning
Commission. Beyond the legitimate uses of these and other items financed by UNFPA, such
equipment facilitates China’s ability to impose the social compensation fees and perform
abortions on those women coerced, because of the financial penalties, to have abortions they
would not otherwise undergo. The State Department analysis concluded that UNFPA’s
involvement in China’s family planning program “allows the Chinese government to
implement more effectively its program of coercive abortion.”
Critics of the Administration’s decision oppose it for a number of reasons, including the
loss of about $34 million, an amount that represented about 9% of UNFPA income in 2001.
They argue that access to voluntary family planning programs by persons in around 140
countries will be reduced, undermining the health of women and children, preventing
unwanted pregnancies, and increasing the likelihood of higher numbers of abortions. The
European Commission announced on July 24, 2002, a $32 million family planning program,
launched in partnership with UNFPA, that would in some degree cover the gap by the loss
of U.S. resources. The EU initiative, however, benefitted just 22 countries participating in
its African, Caribbean and Pacific program. Still other critics are concerned about the
possible application of the Administration’s interpretation of Kemp-Kasten for other
international organizations that operate in China and to which the U.S. contributes — for
example, UNICEF, the World Health Organization, and the U.N. Development Program.
(See below under the section on Legislation for a discussion of congressional debate on
this and other family planning aid issues in 2002 and 2003.)
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
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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
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 2001/2002 investigations noted above, remains a cloudy and controversial matter. The
State Department, in its 2002 report on human rights conditions (released March 2003),
concluded that although the Chinese government “formally prohibits the use of physical
coercion to compel persons to submit to abortion or sterilization,...intense pressure to meet
birth limitation targets set by government regulations has resulted in instances in which local
birth planning officials reportedly have used physical coercion to meet government goals.”
The report notes that the SFPC issues nationwide notices prohibiting officials from forcing
women to undergo abortions or sterilization against their will, but that the government does
regard social compensation fees and other administrative punishments to be coercive.
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Chinese officials, while acknowledging past occurrences of forced abortion and
involuntary sterilizations, say this is no longer the case and characterize the social
compensation fees as not coercive, but a “disincentive” or “necessary form of economic
restraint.” (State Department Assessment Team Report, May 29, 2002.)
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
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 $425
million for each of fiscal years FY2002 and FY2003, but Congress increased funding to
$446.5 million. The Administration is again requesting $425 million for FY2004.
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
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
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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.
Table 1. Population Assistance, FY1994-2004
(appropriations of millions of $s)
1994 1995
1996a
1997
1998 1999
2000b
2001b
2002
2003
2004d
Population
485.1 541.6
356.0
385.0
385.0 385.0
372.5
425.0
446.5
446.5
425.0
Aid
d
UNFPA
40.0
35.0
22.8
25.0
20.0
0.0
21.5
21.5
0.0c
34.0c
Total
525.1 576.6
378.8
410.0
405.0 385.0
394.0
446.5
480.5c
480.5
450.0d
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 FY1998 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. Congress appropriated “not more than” $34 million for UNFPA in FY2002 and directed for FY2003 the
same amount as in FY2002. The State Department, however, determined that UNFPA supported in
FY2002 coercive family planning programs in China, thereby making the organization ineligible for U.S.
contributions. The $34 million was re-directed to other population aid programs, keeping the total for
FY2002 at $480.5 million. For FY2003, the Administration has not yet issued a determination regarding
UNFPA’s eligibility status.
d. Request for FY2004. Although there is no specific request for UNFPA in the budget submission, $25 million
is placed in a reserve account that would presumably be available for UNFPA if it is eligible for U.S.
support. Otherwise, the $25 million would most likely be transferred to fund bilateral family planning
programs, bringing the total for the FY2004 request to $450 million.
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International Family Planning Issues and Legislation,
2002-2003
Although Congress continued to debate during the last year the three major population
aid issues — Mexico City policy, UNFPA eligibility, and total funding amount — most
attention has focused on UNFPA activities in China and whether the organization should
receive U.S. support.
Congressional Consideration of FY2003 and FY2004 Legislation
Foreign Operations Appropriations, FY2003. On July 24, 2002, the Senate
Appropriations Committee reported its FY2003 spending measure (S. 2779), including two
earmarks of $450 million for bilateral family planning programs and $50 million for the U.N.
Population Fund (UNFPA). The Administration had requested $425 million for family
planning activities but no contribution to the UNFPA. In addition, the legislation modified
the Kemp-Kasten language so that in the future the Secretary of State would have to find that
an organization “directly participates in the practice of coercive abortion or involuntary
sterilizations” before declaring the group ineligible for U.S. support. Instead of the current,
more implicit standard under which Kemp-Kasten has been interpreted, this new language
would appear to have set a more rigorous and specific test for determining whether UNFPA
or any other organization fell under the Kemp-Kasten conditions. The Senate bill further
included a general provision (section 581) that would appear to have partially reversed the
Mexico City policy. The language required the President to apply the same conditions to
foreign private organizations in the use of non-U.S. funds for advocacy and lobbying
activities that are applied to American private organizations. It is presumed that such
restrictions on how U.S. private groups apply their own funds would be unconstitutional.
The requirement banning foreign organizations that perform abortions with non-U.S. funds
would have remained unchanged.
The House-reported measure (H.R. 5410) provided $425 million for bilateral family
planning aid and a “hard” earmark of $25 million for UNFPA. The House bill further
conditioned the UNFPA contribution, including a restriction that UNFPA provides no
funding for the State Planned-Birth Commission or its regional affiliates in China, and
required the U.S. to reduce its grant to UNFPA by whatever amount the organization spends
in China. The legislation did not address the Mexico City policy.
Both House and Senate Foreign Operations bills, as reported, expired with the end of
the 107th Congress. The Senate adopted a revised FY2003 Foreign Operations measure as
part of H.J.Res 2, making several significant changes to what the Senate Appropriations
Committee had recommended in 2002 regarding international family planning funding and
policy issues. H.J.Res. 2 provided $435 million for population assistance, $15 million less
than what was proposed by the Senate panel in July 2002. The legislation also did not
include language in S. 2779 that would have effectively reversed the Mexico City policy.
During Senate debate, lawmakers adopted an amendment by Senator Leahy earmarking $35
million for the UNFPA. Funds could be provided to UNFPA, however, only if the President
determined that the organization no longer supported or participated in the management of
a program of coercive abortion or involuntary sterilization. The Leahy amendment altered
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the determination requirement shifting the responsibility from the Secretary of State to the
President. The Senate legislation did not include the change to Kemp-Kasten language
proposed by the Committee in July 2002 that would have narrowed the circumstances under
which the restriction could be imposed.
On February 12, House and Senate conferees agreed to an FY2003 Foreign Operations
measure as part of H.J.Res. 2, an omnibus appropriation bill. The measure provides $446.5
million for family planning activities, compared with $425 million recommended by the
House in H.R. 5410 and $435 million passed by the Senate. Conferees agreed to allocate $34
million to UNFPA, the same as in FY2002, but made the contribution subject to several
conditions, including a requirement that the President certifies that the organization is no
longer involved in the management of a coercive family planning program.
The
Administration has not yet issued a determination regarding UNFPA’s eligibility status for
FY2003.
Foreign Relations Authorization, FY2004-2005. During debate on an omnibus
bill authorizing State Department and public diplomacy programs, the House International
Relations voted 23-22 to authorize $50 million for UNFPA in FY2004 and FY2005, and to
amend existing eligibility requirements that would appear to have made it more difficult for
the President to deny funding to UNFPA. The vote came on an amendment offered by
Congressman Crowley to H.R. 1950, legislation reported by the Committee on May 8, 2003.
The Crowley amendment would have made the money available only if the President
determined that UNFPA “directly” supports or participates in coercive or involuntary
activities.
This was similar to language recommended in July 2002 by the Senate
Appropriations Committee in the FY2003 Foreign Operations bill, but later dropped. By
adding the word “directly,” many presume that the determination issued last year by the
Secretary of State that denied FY2002 transfers to UNFPA would not be sufficient to cut off
contributions authorized in H.R. 1950. In addition, the Crowley amendment went beyond
the Senate Committee language from last year by defining the circumstances under which
UNFPA would be found ineligible. The provision in H.R. 1950 stated that the President
would need to find that UNFPA is “knowingly and intentionally working with a purpose to
continue, advance or expand the practice of coercive abortion or involuntary sterilization, or
playing a primary and essential role in a coercive or involuntary aspect of a country’s family
planning program.” Many believe that the justification for terminating UNFPA funds for
FY2002 would not meet this more specific test. During House debate on H.R. 1950,
however, lawmakers voted 216-211 on July 15 to delete the Crowley amendment.
Foreign Operations Appropriations, FY2004. On July 23, the House approved
$425 million for bilateral family planning programs, as requested.
For UNFPA
contributions, the House bill provides $25 million, available only under certain conditions:
! none of the funds can be used in China;
! funds must be maintained by UNFPA in a separate account and may not
comingle amounts;
! UNFPA does not perform abortions;
! UNFPA does not provide any resources for the Chinese State Planned-Birth
Commission or its regional affiliates; and
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! U.S. contributions will be reduced by whatever amount, if any, UNFPA
spends in China.
In addition, the provisions of the Kemp-Kasten amendment continue to apply, the terms of
which resulted in a cut-off of U.S. contributions in FY2002.
On July 17, the Senate Appropriations Committee approved its FY2004 Foreign
Operations (S. 1426), including several significant changes regarding international family
planning funding and policy. The Administration is likely to oppose, as it has in the past,
provisions in the Senate measure. For bilateral family planning activities, the Senate bill
provides $445 million, $20 million above the President’s request. In Section 691, the bill
effectively reverses the Administration’s Mexico City policy. Specifically, the provision
states that foreign NGOs shall not be declared ineligible for U.S. funds solely on the basis
of health or medical services they provide (including counseling and referral services) with
non-U.S. government funds. This exemption would apply so long as the services do not
violate the law of the country in which they are performed and that they would not violate
U.S. laws if provided in the United States. Section 691 further provides that non-U.S.
government funds used by foreign NGOs for advocacy and lobbying activities shall be
subject to conditions that also apply to U.S. NGOs. Since it is largely held that American
NGOs would not be subject to these restrictions under the Constitutional protection of free
speech, it is possible that this latter exemption would lift current prohibitions that apply to
overseas NGOs.
Although the White House has not yet issued its “Statement of Administration Policy”
for S. 1426, in its assessment of the House companion measure, H.R. 2800, the executive
said that it would “oppose any legislation that would infringe upon the President’s ability to
enforce current Administration policy regarding international family planning.” Addition of
such a provision to the House bill, the Statement said, would result in a Presidential veto.
For UNFPA, S. 1426 provides $35 million in FY2004, but makes these funds, together
with those appropriated for FY2002 and FY2003, subject to Kemp-Kasten limitations and
current restrictions that apply in FY2003.
LEGISLATION
H.R. 2800 (Kolbe)
Foreign Operations Appropriations, FY2004. Reported by the House Appropriations
Committee July 21 (H.Rept. 108-222); passed the House on July 23 (370-50). Provides $425
million in bilateral family planning programs and $25 million for UNFPA, subject to certain
conditions.
S. 1426 (McConnell)
Foreign Operations Appropriations, FY2004. Reported by the Senate Appropriations
Committee July 17 (S.Rept. 108-106). Provides $445 million in bilateral family planning
programs, and includes language that effectively reverses the President’s “Mexico City”
policy. Also provides $35 million for UNFPA, subject to current restrictions.
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