Order Code RL33250
International Population Assistance and Family
Planning Programs: Issues for Congress
Updated January 19, 2007
Luisa Blanchfield
Analyst in Foreign Affairs
Foreign Affairs, Defense, and Trade Division
Connie Veillette
Analyst in Foreign Affairs
Foreign Affairs, Defense, and Trade Division
International Population Assistance and Family
Planning Programs: Issues for Congress
Summary
Since 1965, U.S. policy has supported international population planning based
on principles of volunteerism and informed choice that gives participants access to
information on all methods of birth control. This policy, however, has generated
contentious debate for over two decades, resulting in frequent clarification and
modification of U.S. international family planning programs. Given the divisive
nature of this debate, U.S. funding of these programs will likely remain a point of
contention during the 110th Congress.
In 1984, controversy arose over U.S. population aid policy when the Reagan
Administration introduced restrictions, which became known as the “Mexico City
policy.” The Mexico City policy denied U.S. funds to foreign non-governmental
organizations (NGOs) that perform or promote abortion as a method of family
planning, regardless of whether the money came from the U.S. government.
Presidents Reagan and Bush also banned grants to the U.N. Population Fund
(UNFPA) due to evidence of coercive family planning practices in China.
President Clinton resumed UNFPA funding and repealed the Mexico City policy
in 1993. President George W. Bush, however, re-applied the Mexico City
restrictions. Following a State Department investigation of family planning programs
in China, the Administration suspended U.S. contributions to UNFPA in 2002, citing
violations of the “Kemp-Kasten” amendment. This amendment bans U.S. assistance
to organizations that support or participate in the management of coercive family
planning programs. The suspension of U.S. contributions to UNFPA has continued
through FY2006.
In his FY2006 Foreign Operations budget request, the President proposed $425
million for family planning programs, which included $25 million for UNFPA. The
final conference text (H.R. 3057/P.L. 109-102) adopted $440 million for bilateral
family planning programs. Conferees also approved a total of $34 million for
UNFPA, if the organization is found eligible, $11.5 million of which would be drawn
from the $440 million for bilateral programs.
The Bush Administration request for the FY2007 budget includes less funding
for family planning programs than the traditional $425 million request. The proposal
includes about $357 million for family planning health activities, an amount from
which any UNFPA transfer would be drawn if the organization is determined eligible
under Kemp-Kasten restrictions. The House Foreign Operations Appropriations
Subcommittee reported H.R. 5522, the FY2007 Foreign Operations Appropriations
bill, on May 15, 2006. The Committee recommended a total of $432 million for
reproductive family planning activities, including $34 million for UNFPA should it
be eligible under Kemp-Kasten provisions. Foreign Operations programs are
currently operating under the terms of a continuing resolution, which will expire on
February 15, 2007. This report, originally drafted by Larry Nowels, will be updated
as event warrant.
Contents
U.S. Population Assistance Issues: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Setting the Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
The Population Statistics Debate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Evolution of U.S. Policy (1974-1994) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Trends in Population Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Policy and Funding Issues in the U.S. Family Planning Debate . . . . . . . . . . . . . . 4
Abortion and Coercion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The Mexico City Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Restrictions on United Nations Population Fund (UNFPA) Funding . . 8
Family Planning Conditions in China . . . . . . . . . . . . . . . . . . . . . . . . . 11
Funding Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
International Family Planning Legislation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Foreign Operations Appropriations, FY2006 and FY2007 . . . . . . . . . . . . . 15
FY2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
FY2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Foreign Affairs Authorization Act, FY2006/2007 . . . . . . . . . . . . . . . . . . . . 17
Science, State, Justice, and Commerce Appropriations, FY2006 . . . . . . . . 17
Emergency Supplemental Appropriations, FY2005 . . . . . . . . . . . . . . . . . . 18
Other International Family Planning Legislation — 109th Congress . . . . . . 18
H.R. 1011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
H.R. 2811 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
H.R. 4188 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
H.R. 4465 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
List of Tables
Table 1. U.S. Population Assistance, FY1994-2007 . . . . . . . . . . . . . . . . . . . . . 14
International Population Assistance and
Family Planning Programs: Issues for
Congress
U.S. Population Assistance Issues:
Setting the Context
Overview
Population assistance became a global issue in the late 1950s and early 1960s
after several private foundations, among them the International Planned Parenthood
Federation (IPPF), 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. With the passage of the Foreign Assistance Act of
1961, Congress first authorized research on international family planning and
population issues, and in 1965, the U.S. Agency for International Development
(USAID) launched a series of population and reproductive health programs. In 1968,
Congress specifically funded family planning aid activities and USAID began to
purchase contraceptives for distribution through its programs in the developing
world.
The first International Population Conference was held in 1974, followed by the
second in Mexico City in 1984, and the third in Cairo in 1994.1 The attention and
funding given to international family planning programs are credited with helping to
decrease population growth in developing countries from about a 1.7% per year
average between 1980 and 2002, to a projected annual average of 1.2% between 2002
and 2015. Fertility rates have fallen in developing nations from 4.1 children per
woman in 1980 to 3.0 in 2005 (if China is excluded from this calculation, however,
the decline in fertility rates is less dramatic at 3.5 children in 2005). Nevertheless,
while global population growth has slowed, the world’s population reached 6 billion
in 1999, 6.5 billion in 2005, and is expected to rise to 9.3 billion by 2050, with most
of the growth occurring in developing nations. In 1960, 70% of the world’s
1 The conferences were coordinated by the United Nations. More information is available
at [http://www.un.org/esa/devagenda/population.html].
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population lived in developing countries, and in 2005 the level had grown to 81%.
These countries now account for 99% of world-wide population growth.2
The Population Statistics Debate
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 active 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, and 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 active 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 added
productive capacity; therefore, they say, high population growth rates actually can
contribute to a country’s ability to increase its standard of living. Proponents of this
view argue that at the very least 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.
Evolution of U.S. Policy (1974-1994)
As the population debate evolved, many countries, including the United States,
changed their views. At the 1974 international population conference, the United
States and other donor countries asserted that high fertility rates were an impediment
to economic development — a point that was then rejected by developing countries.
In keeping with this view, in 1977 the Carter Administration 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 negative effect on
other development objectives.
A decade later, at the second International Conference on Population in Mexico
City in 1984, some participants reversed their positions. Many developing countries
had become convinced of the urgent need to manage 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.
2 Population Reference Bureau, Frequently Asked Questions About the PRB World
Population Data Sheet, (2005)
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Nearly another a decade later, the Clinton Administration changed the U.S.
position on family planning programs by lifting restrictive U.S. provisions announced
at the Mexico City Conference. At the 1994 International Conference on Population
and Development in Cairo, U.S. officials emphasized support for family planning and
reproductive health services, improving the status of women, and providing safe
access to abortion.
Trends in Population Research
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.
More 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.3 Some demographers conclude that global population projections for this
century may need to be reduced by as much as one billion people. A U.N. report
dated December 9, 2003 — “World Population 2300” — projects as a “medium
scenario” that world population will peak in 2075 at 9.2 billion and then, as fertility
in all countries reach below replacement levels, decline over the next 100 years to 8.3
billion. The report projects that if fertility rates return to replacement levels, world
population would begin to rise, reaching 9 billion by 2300; otherwise, the number of
people would remain at around 8.3 billion.
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.
3 See, for example, “Population Estimates Fall as Poor Women Assert Control,” New York
Times, March 10, 2002.
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Policy and Funding Issues in the
U.S. Family Planning Debate
Throughout the debate on family planning — at times the most contentious
foreign aid issue considered by Congress — the cornerstone of U.S. policy has
remained a commitment to international family planning programs based on
principles of volunteerism and informed choice that give participants access to
information on all major methods of birth control. At present, USAID maintains
family planning projects in more than 60 countries that include counseling and
services, training of health workers, contraceptive supplies and distribution, financial
management, public education and marketing, and biomedical and contraceptive
research and development. USAID applies a broad reproductive health approach to
its family planning programs, increasingly integrating it with other interventions
regarding maternal and child health, the enhancement of the status of women, and
HIV prevention and transmission.
In addition to differences of opinion over how population growth affects
economic development in developing countries, family planning assistance has
become a source of substantial controversy among U.S. policymakers on two other
issues: 1) 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 2) setting appropriate and effective funding levels for family
planning assistance.
Abortion and Coercion
The bitterest controversies in U.S. family planning policy have erupted over
abortion — in particular, the degree to which abortions and coercive 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. In
every Congress since 1973, abortion opponents have introduced constitutional
amendments or legislation that would prohibit abortions, but none have been enacted.
As an alternative, abortion critics have persuaded Congress to attach numerous
provisions to annual appropriation measures banning the use of federal funds for
performing abortions.
Much 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.
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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 provisions prohibiting indirect support for coercive family planning
(specifically in China) and abortion activities related to the work of international and
foreign non-governmental organizations. Two issues in particular which were
initiated in 1984 — the Mexico City policy involving funding for foreign
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.4 In 1984, the Reagan Administration announced
that it would further restrict U.S. population aid by terminating USAID support for
any foreign organizations (but not national 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.” During the George H.W. 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.
Critics charge, however, that the Mexico City policy is a violation of free speech
and the rights of women to choose. They contend that the policy undermines
maternal health care services offered in developing nations and may actually
contribute to the rise in the number of abortions performed, including some that are
unsafe and illegal. They further emphasize that family planning organizations may
cut back on services because they are unsure of the full implications of the
restrictions and do not want to risk losing eligibility for USAID funding. Opponents
also believe that the conditions of the Mexico City policy undermine relations
between the U.S. government and foreign NGOs and multilateral groups, creating a
situation in which the United States challenges their right to determine how to spend
their own money and imposes a so-called “gag” order on their ability to promote
changes to abortion laws and regulations in developing nations. The latter, these
critics note, would be unconstitutional if applied to American groups working in the
United States.
Mexico City Policy Removed. President Clinton, in a January 22, 1993
memo to USAID, lifted restrictions imposed by the Reagan and Bush
Administrations on grants to family planning NGOs — in effect repealing the
4 For a more detailed discussion of the original Mexico City policy, its implementation, and
impact, see CRS Report RL30830, International Family Planning: The “Mexico City”
Policy, by Larry Nowels.
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Mexico City policy. The memo noted that the policy had extended beyond
restrictions in the Foreign Assistance Act and was not mandated by law. In his
remarks, President Clinton explained that this step would “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.”
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 the November 1999
passage 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, the President could waive the
certification requirement for up to $15 million in grants to groups that would
otherwise be ineligible. President Clinton exercised the waiver and further instructed
USAID to implement Section 599D in a way that would minimize the impact on U.S.
funded family planning programs. Nine organizations refused to certify under the
terms of P.L. 106-113, including two of the largest recipients of USAID population
aid grants — IPPF and the World Health Organization (WHO). These nine non-
certifying organizations received about $8.4 million in FY2000 grants, of which IPPF
accounted for $5 million and WHO roughly $2.5 million. These conditions, enacted
in an appropriation act, expired at the end of FY2000.
Bush Administration Restores the Mexico City Policy. On January 22,
2001, President George W. Bush revoked the Clinton Administration memorandum
and restored in full the terms of the Mexico City restrictions. In making the
announcement, the White House Press Secretary stated that the “President is
committed to maintaining the $425 million funding level provided in the FY2001
appropriation because he knows that one of the best ways to prevent abortion is by
providing quality voluntary family planning services.”5
As was the case during the 1980s and early 1990s when the Mexico City policy
was in place, foreign NGOs and international organizations, as a condition for receipt
of U.S. funds, would need to certify that they would not 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 not be used to pay for abortions or
to advocate or actively promote abortion. Supporters of the certification requirement
argue 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 use USAID resources for legal activities while
diverting money raised from other sources to perform abortions or lobby to change
5 The White House. Office of the Secretary. Restoration of the Mexico City Policy, January
22, 2001.
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abortion laws and regulations. The certification process, they contend, stops the
fungibility “loophole.”
Bush Administration Mexico City Policy Guidelines. On February 15,
2001, USAID released 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 that 1) perform or actively promote
abortion as a method of family planning in USAID-recipient countries; or 2) 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. The
implementing regulations contain several exceptions, including the following:
! Abortions may be performed if the life of the mother would be
endangered if the fetus were carried to term or 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 are 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 is 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.
The President issued a memorandum on August 29, 2003, for the Secretary of
State, directing that the Mexico City policy conditions be applied to State Department
programs in the same way they are applied to USAID activities. This directive
mostly impacts State Department-managed refugee programs, large portions of which
are implemented by international organizations and NGOs. The President’s
memorandum, however, stated that the policy would not apply to multilateral
organizations that are associations of governments, presumably referring to the U.N.
High Commissioner for Refugees, among others. The President further stated that
the Mexico City policy would not apply to foreign aid funds authorized under P.L.
108-25, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Act of 2003.
Related Mexico City Policy Issues. The Bush Administration policy to
prevent foreign assistance from supporting organizations performing or promoting
abortions has also shaped other U.S. policy positions at multilateral fora. In October
2004, international family planning activists sought to commemorate the 10 year
anniversary of the Cairo International Conference on Population and Development
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(ICPD) with a statement endorsing the 1994 recommendations. Although more than
250 global leaders, including 85 current and 22 former heads of state and government
from Europe, Asia, and Africa, signed the document, President Bush chose not to add
his signature. According to State Department officials, while the United States
supports the goals and objectives of the Cairo conference, the U.S. could not join
others in signing the “world leaders” statement because it included the concept of
“sexual rights.” This term, these officials said, does not have a consensus definition
and was not part of the ICPD platform. Critics, however, note that a year later at the
1995 Beijing women’s conference, “sexual rights” was included in the adopted action
plan and supported by United States.
Restrictions on United Nations Population Fund (UNFPA) Funding.6
At the 1984 Mexico City Conference, the Reagan Administration instituted a new
policy relating to the United Nations Population Fund (UNFPA).7 The
Administration required that UNFPA must provide “concrete assurances that [it] is
not engaged in, or does not provide funding for, abortion or coercive family planning
programs.” The Administration was particularly concerned with UNFPA’s activities
in China, where there is evidence of coercive family planning practices.
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 directed 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 the U.S. to
support them. 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.
6 For more detailed information regarding UNFPA, see CRS Report RL32703, The U.N.
Population Fund: Background and the U.S. Funding Debate, by Luisa Blanchfield, Connie
Veillette, and Larry Nowels.
7 UNFPA is a U.N. specialized agency that “supports countries in using population data for
policies and programs” to improve reproductive health, prevent HIV/AIDS, promote gender
equality, and make motherhood safer. UNFPA was the lead U.N. agency for the 1994
International Conference on Population and Development in Cairo. For further information
on UNFPA’s mandate and activities, visit [http://www.unfpa.org/].
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The Clinton Administration lifted the ban on UNFPA contributions, making
available $14.5 million in FY1993 but stipulating that funds could not be used in
China. Again, congressional critics of Chinese family planning practices attempted
unsuccessfully to attach provisions 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. While the United
States continued to support UNFPA during the next eight years (except for FY1999),
Congress attached restrictions in appropriation measures that in most cases reduced
the U.S. contribution by the proportionate share of UNFPA funds spent on China.
Bush Administration and UNFPA. For FY2002, Congress provided “not
more than” $34 million for UNFPA. But in mid-January 2002, the Bush
Administration placed a hold on U.S. contributions to UNFPA, pending a review of
the organization’s program in China. The White House said it initiated the review
because of new evidence that coercive practices continued in counties where UNFPA
concentrated its programs.8
Since the July 2002 determination, the Administration has transferred $34
million from each of FY2002, FY2004, and FY2005 appropriations, and $25 million
from FY2003 funds that would have otherwise been provided to UNFPA to support
bilateral family planning programs and activities combating human trafficking and
prostitution. Approximately $22.5 million in unused UNFPA funds from FY2006
will be transferred to the International Organizations and Program account.
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, a State Department investigative
team visited China in May 2002 and reported a series of findings and
recommendations. Among them, the team found no evidence that UNFPA “has
knowingly supported or participated in the management of a program of coercive
abortion or involuntary sterilization” in China, and recommended the United States
release not more than $34 million of previously appropriated funds to UNFPA.9
Nevertheless, on July 22, 2002, Secretary of State Powell, to whom the
President had 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 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.10 Instead, a finding that the recipient of U.S. funds —
in this case UNFPA — simply supports or participates in such a program, whether
8 See House International Relations Committee hearing, Coercive Population Control in
China: New Evidence of Forced Abortion and Forced Sterilization, October 17, 2001, and
a Senate Foreign Relations Committee hearing, U.S. Funding for the U.N. Population Fund:
The Effect on Women’s Lives, February 27, 2002.
9 See [http://www.state.gov/g/prm/rls/rpt/2002/12122.htm] for report’s full text.
10 See [http://www.state.gov/g/prm/rls/other/12128.htm] for the full text.
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knowingly or unknowingly, would trigger the restriction. The assessment team found
that the Chinese government imposed fines and penalties on families (“social
compensation fees”) that have children exceeding the number approved by the
government. The Department further noted that UNFPA had funded computers and
data-processing equipment that had helped strengthen the management of the
Chinese State Family Planning Commission. Beyond the legitimate uses of these and
other items financed by UNFPA, such equipment facilitated, in the view of the State
Department, China’s ability to impose social compensation fees or perform abortions
on those women coerced 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.”
On September 17, 2005, the State Department stated that the United States had
been urging UNFPA and China to modify the organization’s program in a manner
that would permit U.S. support to resume, but that no key changes had occurred that
would allow a resumption of U.S. funding under the conditions of the Kemp-Kasten
provision. Subsequently, on October 18, USAID notified Congress that the
reprogrammed UNFPA set-aside would be made available to expand family planning
and reproductive health programs in 14 countries.11
U.S. Response to the New UNFPA China Program. The September 17
announcement followed a June 22, 2005 UNFPA Executive Board meeting to
consider UNFPA’s new five-year, $27 million program for China. At the meeting,
Kelly Ryan, Deputy Assistant Secretary of State for the Bureau of Population,
Refugees and Migration, argued that UNFPA should end its operations in China
because of the coercive nature of China’s family planning programs. Two days later,
State Department spokesman, Sean McCormick, issued a statement saying the United
States was “disappointed” that UNFPA had decided to continue financial and
technical support to the Chinese birth limitation program. His statement noted that
U.S. opposition was not aimed at UNFPA but was a “matter of principle, based on
strong American opposition to “human rights abuses associated with coercive birth
limitation regimes.” He acknowledged that UNFPA does not approve of coercive
policies but that the organization’s continued presence in China offered a “seal of
approval” for Chinese policies.
Opposition to the State Department Determination. Critics of the
Administration’s decision opposed it for a number of reasons, including the loss of
$34 million, an amount that represented about 9% of UNFPA income in 2001. They
argued that access to voluntary family planning programs by persons in around 140
countries would be reduced, undermining the health of women and children,
increasing unwanted pregnancies, and increasing the likelihood of higher numbers
of abortions. Still other critics were 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,
WHO, and the U.N. Development Program.
11 The most significant increases come in programs for Georgia, Madagascar, Romania,
Russia, Rwanda, and Ukraine.
CRS-11
Other Related State Department Determinations. There have been
several other State Department determinations related to the July 2002 decision
regarding UNFPA. On August 6, 2003, for example, the State Department decided
that it would fund a $1 million HIV/AIDS program supporting African and Asian
refugees only if the implementing NGO group — Reproductive Health for Refugees
Consortium — did not include Marie Stopes International among its members.
Marie Stopes International is a British-based reproductive health organization that
at the time was a major implementing partner of UNFPA in China. The State
Department, while not making a legal determination under the Kemp-Kasten
amendment, felt that an action not to fund Marie Stopes International would be an
“approach most consistent with U.S. policy.” On August 11, however, the
Consortium declined to accept the $1 million grant due to the exclusion of Marie
Stopes International.
In another related decision, the Administration notified the Global Health
Council in April 2004 that the U.S. government would not provide funding for the
Council’s 31st annual meeting in June 2004 because UNFPA would be a participant.
Reportedly, U.S. officials told representatives of international organizations and
NGOs that UNICEF, WHO, and other organizations that continued involvement in
joint programs with UNFPA might jeopardize their funding support from the United
States.12
Family Planning Conditions in China. As noted, much of this debate has
focused on UNFPA’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.)
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 became 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. Chinese 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.
12 Christopher Marquis, “U.S. is Accused of Trying to Isolate U.N. Population Unit,” New
York Times, June 21, 2004.
CRS-12
Other 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
a new $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.
On September 1, 2002, China adopted the Population and Family Planning Law,
the country’s first formal law on this subject. The law, which requires couples who
have an unapproved child to pay a “social compensation fee” and extends preferential
treatment to couples who abide by the birth limits, is intended to standardize the
implementation of the Government’s birth limitation policies. The State Department
Country Reports on Human Rights Practices for 2004 (dated February 2005),
however, found that enforcement of the law varied by location. While the law says
that officials should not violate citizens’ rights, it does not define those rights or the
penalties for violating them.
The broad question concerning the degree of coercive family planning practices
in China remains a controversial matter. The State Department’s human rights report
concluded that “Central Government policy formally prohibits the use of physical
coercion to compel persons to submit to abortion or sterilization. Because it is
illegal, the use of physical coercion was difficult to document. A few cases were
reported during the year [2004]... However, the Government does not consider social
compensation fees and other administrative punishments to be coercive.” Chinese
officials acknowledge past instances of forced abortion and involuntary sterilizations,
but 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.”13
Recent attention has focused on reports documenting a campaign by local family
planning officials around the city of Linyi in Shandong Province to force couples
with two children to undergo sterilizations or to demand women pregnant with a third
child have an abortion. Local activists are pursuing a class-action lawsuit against the
government. The group’s leader, Chen Guangcheng, has been under house arrest
since filing the case in September 2005. In mid-September, China’s National
Population and Family Planning Commission acknowledged that illegal coercive
practices had occurred, and that responsible officials had been dismissed and that
some had been detained.14
13 U.S. Department of State, Assessment Team Report, May 29, 2002.
14 Benjamin Kang Lim, “Blind China Activist Under House Arrest Since September,”
Reuters, January 6, 2006; Philip Pan, “Who Controls the Family? Blind Activist Leads
Peasants in Legal Challenge to Abuses of China’s Population Growth Policy,” Washington
Post, August 27, 2005; and “China Terse About Action on Abuses of One-Child Policy,”
Washington Post, September 20, 2005.
CRS-13
Following the May 2002 State Department investigation of Chinese policies,
senior Department officials began a series of discussions with China regarding its
birth planning law. Arthur Dewey, Assistant Secretary of State for Population,
Refugees, and Migration, told the House International Committee on December 14,
2004, that in six rounds of talks with Chinese officials, there had been “encouraging
movement” in China’s approach to population policy and the reduction of coercive
practices.15 Nevertheless, Assistant Secretary Dewey said that the social
compensation fee policy set out in China’s national law on Population and Birth
Planning is a “harsh and effective enforcement tool” that is used to force women to
have an abortion, and is therefore regarded as a coercive policy. While negotiations
have resulted in some progress, he concluded that China’s policies have not been
altered enough to allow the Bush Administration to resume UNFPA funding.
As noted previously, U.S. officials continued to voice their opposition at a
UNFPA executive board meeting on June 22, 2005, where members met to consider
a new, five-year (2006-2010), $27 million UNFPA program in China. A State
Department press release on June 24 again acknowledged that China had made some
progress in its approach to population issues, but argued that Beijing’s birth
limitation policy continues to contain several coercive elements, including the social
maintenance fee for unplanned births, and regulations that limit choices by women
other than to undergo an abortion. At the June 22 meeting, China’s deputy U.N.
ambassador Zhang Yishan argued that due to the size of China’s population, it had
to maintain a strong family planning program, and that without the policies of the last
30 years, China’s population would have grown by 300 million additional people.
He countered that, by law, family planning workers are not permitted to utilize
coercive measures in their work.
The UNFPA Executive Board approved the new five-year program for China
on January 30, 2006. Prior to the signing, U.S. Deputy Representative to the United
Nations, Ambassador Alejandro Wolff, expressed disappointment that no substantive
changes had been made to the draft plan that had been reviewed in mid-2005. He
argued that UNFPA assistance provided a “de facto United Nations ‘seal of
approval’” to Chinese “abhorrent” practices. He further asserted that the new
Country Program Document for China was incorrect in its claim that China was
committed to implementing the Cairo Population Conference action plan, a program
that excluded coercive practices in family planning activities.16 A group of ten
European nations disagreed, however, issuing a statement saying that China did
conform to the program of 1994 International Conference on Population and
Development.17
15 Dewey cited, for example, the elimination of a requirement for married couples to obtain
government permission prior to pregnancy in 25 of China’s 31 provinces, municipalities,
and autonomous regions. He also noted the government’s launch of a public information
project highlighting the status of the girl child. This he regarded as a positive step towards
ending discrimination in China against girls and women.
16 U.S. Mission to the United Nations. Ambassador Wolff: Remarks on Proposed UNFPA
Sixth Country Program for China, January 26, 2006.
17 UN Population Fund Endorses 27-million-dollar China Program. Agence France Presse,
(continued...)
CRS-14
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. Until FY1996, Congress generally supported higher
funding levels for population aid than proposed by the President, especially during
the Reagan and Bush Administrations. Appropriations peaked in FY1995 at $577
million.
During the balance of the Clinton Administration, however, Congress cut and
placed restrictions on bilateral funding. Amounts for bilateral programs fell to $356
million in FY1996, but grew steadily to $425 million by FY2001. When President
Bush took office in January 2001, the White House said that it would maintain the
$425 million funding level of the previous Administration. While budgets submitted
by President Bush adhered to the $425 million target through FY2006, in every year
Congress increased funding levels, as shown in Table 1. Bilateral funds reached
their highest totals since the mid-1990s in FY2002 and FY2003 at $446.5 million,
but fell back somewhat more recently. In some years beginning in FY2002, bilateral
family planning levels have received additional resources when UNFPA-earmarked
funds were reprogrammed for bilateral activities after UNFPA was determined to be
ineligible for U.S. support.
Table 1. U.S. Population Assistance, FY1994-2007
(appropriations of millions of $)
1994
1995
1996
1997
1998
1999
2000
2001
2002c
2003c
2004c
2005c
2006c
2007
Bilateral
485.1 541.6 356.0 385.0 385.0 385.0
372.5a 425.0 465.5
443.5
429.5 448.1
440.0d 357.0
Aid
f
UNFPA
40.0
35.0
22.8
25.0
20.0
0.0
21.5b
21.5b
0.0
0.0
0.0
0.0 0.0
f
Total
525.1 576.6 378.8 410.0 405.0 385.0
394.0 446.5 465.5
443.5
429.5 448.1
440.0d
Source: USAID/Office of Population and CRS calculations. Amounts are adjusted for rescissions in selected years.
a. The bilateral FY2000 aid level reflects a transfer of $12.5 million from population assistance to child survival activities.
b. UNFPA amounts for FY2000 and FY2001 reflect a $3.5 million deduction due to legislative restrictions.
c. In each of FY2002-FY2006, the Administration determined that UNFPA was ineligible for U.S. funding because of programs
in China, and withheld appropriated funds. The withheld funds were reallocated for USAID bilateral family planning, vulnerable
children, and counter-trafficking in persons programs.
d. $440 million is the amount appropriated for bilateral aid per P.L. 109-102. Figure does not include 1% rescission required by
P.L. 109-148.
f. Any UNFPA contribution for FY2007 is included in the Administration’s bilateral family planning request of $357 million.
Foreign Operations programs are currently operating under a continuing resolution, and the final bilateral aid for FY2007 has not
yet been determined.
17 (...continued)
January 30, 2006.
CRS-15
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. A more recent analysis
suggests a different trend, noting that donor nations contributed $2.3 billion in 2002,
the largest amount ever. It cautioned, however, that donor allocations still fall far
below the targets set at Cairo.18 Similarly, the UNFPA announced in January 2007
that the number of donors to its program had increased from 166 in 2004 to 180 in
2006. The amount promised from donors reached a record of $360 million in 2006.19
International Family Planning Legislation
Foreign Operations Appropriations, FY2006 and FY2007
FY2007. The President’s FY2007 request of $357 million marks the first time
during the Bush Administration that the President has sought less than $425 million
for international family planning activities. If the U.N. Population Fund becomes
eligible for U.S. support, presumably a U.S. contribution of $25 million would be
drawn from the $357 million request. This would be the second year that the
Administration has proposed that $25 million for UNFPA be drawn from its total
request rather than in addition to amounts requested for bilateral programs.
The House Foreign Operations Appropriations Subcommittee reported H.R.
5522, the FY2007 Foreign Operations Appropriations bill, on May 15, 2006. The
Committee recommended a total of $432 million for reproductive health and family
planning activities, an increase of some $75 million over the Administration request.
Of the total, $350 million would come from the Child Survival and Health
appropriation account. If the UNFPA becomes eligible for U.S. support, $34 million
would be available, of which $22.3 million would be drawn from the International
Organizations and Programs (IOP) account, and $11.7 million from Child Survival
and Health. If UNFPA is deemed ineligible for U.S. funding under the Kemp-Kasten
amendment, then the unused IOP funds may be transferred to other family planning
programs.
Currently, Foreign Operations programs are being funded under the terms of a
continuing resolution (H.R. 5631/P.L. 109-289, as amended) which provides funding
at the FY2006 level or the House-passed FY2007 level, whichever is less. The
continuing appropriations resolution expires on February 15, 2007.
18 Population Action International, Progress and Promises: Trends in International
Assistance for Reproductive Health and Population, 2004.
19 “Record Number of Countries Contributed Record Amount to UNFPA in 2006,” UNFPA
Press Release, January 15, 2007.
CRS-16
FY2006. The President signed the FY2006 Foreign Operations Appropriations
Act (H.R. 3057/P.L. 109-102) on November 14, 2005. The spending measure
included $440 million for bilateral population assistance activities. The enacted
measure further designated $34 million as a U.S. contribution to UNFPA, $11.5
million of which would be drawn from the $440 million total for bilateral programs,
and $22.5 million would come from the International Organizations and Programs
account. The Administration had requested $425 million for total bilateral and
UNFPA funding,20 while the Senate recommended $450 million for bilateral
programs and a $35 million UNFPA contribution.21 Conferees deleted text approved
by the Senate that would have modified the Kemp-Kasten provision and would have
effectively overturned the Mexico City policy related to abortion.22 The White House
indicated the President would veto H.R. 3057 if the final bill included the Senate-
proposed policy changes, which were dropped in the conference agreement passed
by the House and Senate.
In September 2006, the State Department announced that UNFPA was
ineligible for U.S. funding for FY2006 under the provisions of the Kemp-Kasten
amendment. In a letter to Congress, the Administration stated that UNFPA’s
financial and technical support for China’s sixth program cycle is evidence of the
organization’s “support of the Chinese government’s program of coercive abortion
and involuntary sterilization.”23 The Administration stressed that it would remain
“engaged” with the Chinese government on this issue in the future, and noted that
since 2002 it has participated in numerous discussions with the Chinese government
regarding its coercive family planning practices. As a result of UNFPA ineligibility
under Kemp-Kasten, $22.5 million in UNFPA funding that would have been drawn
20 The President’s FY2006 Foreign Operations request for bilateral family planning
assistance totaled $425 million, a reduction of $16 million, or 3.6%, from the FY2005
enacted level. But unlike recent years, the budget proposal did not set aside a “reserve” for
UNFPA if the organization is determined to be eligible for U.S. support under the terms of
the Kemp-Kasten conditions.
21 The Senate bill also added a provision similar to what the Senate had passed during
debate on S. 600, the FY2006/2007 Foreign Affairs Authorization Act, that would
effectively overturn the Mexico City policy restrictions. The text in H.R. 3057, as passed
by the Senate, stated that foreign NGOs shall not be ineligible for U.S. funds solely on the
basis of health or medical services they provide with non-U.S. government funds. This
exemption would apply so long as the services did not violate the laws of the country in
which they are performed and that they would not violate U.S. laws if provided in the United
States.
22 H.R. 3057, as passed the Senate, included modified Kemp-Kasten language that appeared
to narrow the terms under which UNFPA could be declared ineligible for U.S. funding. The
Senate language stated that an organization could not receive funds if it “directly” supported
coercive abortion or involuntary sterilization. The term “directly” is not part of the Kemp-
Kasten restriction. The Senate measure further stated that an organization could not be
found in violation of this condition only because the government of a country in which the
organization operates conducted coercive practices. This would have represented a new
exception to past applications of the Kemp-Kasten language.
23 A copy of the State Department letter is available at [http://maloney.house.gov/
documents/women/unfpa/20060913UNFPAdetermination.pdf].
CRS-17
from the International Organizations and Programs account will be transferred to the
Child Survival and Health Programs Fund (per section 560 of P.L. 109-102).
Foreign Affairs Authorization Act, FY2006/2007
On April 5, 2005, the Senate adopted an amendment by Senator Boxer to S. 600,
the FY2006 and FY2007 Foreign Affairs Authorization Act, that appeared to
effectively reject the Mexico City policy. (See footnote 19 under the Senate-reported
version of H.R. 3057 for a discussion on the terms of the amendment). The Senate
suspended consideration of S. 600 and it was not enacted during the 109th Congress.
The House companion bill, H.R. 2601, included a provision creating 12 centers for
the treatment and prevention of obstetric fistula in developing nations.24 The
provision specified that each center would perform certain services, including
surgical repair and post-surgery support, educational activities to prevent incidents
of fistula, and expanded access to contraceptive services for fistula prevention.
During floor debate, Representative Christopher Smith (NJ) proposed an amendment
that deleted the requirement for each center to expand contraceptive services for
high-risk women, and added a new activity requiring centers to broaden abstinence
education and activities to expand access to family planning services. As revised in
the amendment, prevention activities would be provided at the discretion of the
centers.25 The House adopted the Smith amendment, but H.R. 2601 was not enacted
during the 109th Congress.
Science, State, Justice, and Commerce Appropriations,
FY2006
Although the Science, State, Justice, Commerce (SSJC) appropriation measure
does not contain funds for international family planning programs or UNFPA
contributions, State Department offices that oversee broad U.S. population policy and
manage U.S. voluntary contributions to international organizations, including
UNFPA, are funded in the SSJC bill. During House debate on the FY2006 SSJC
spending measure (H.R. 2862), Representatives Maloney, Shays, Crowley, and Israel
proposed an amendment that would block the State Department from using funds
provided in H.R. 2862 to enforce any provision of law that restricts or prohibits
funding for UNFPA. The affect of the amendment would be to bar the enforcement
24 Obstetric fistula is especially common in girls aged 15-19 whose bodies are not fully
developed for child birth and in girls and women suffering from malnutrition. For more
information, see CRS Report RS21773, Reproductive Health Problems in the World:
Obstetric Fistula: Background Information and Responses, by Tiaji Salaam-Blyther.
25 In support of his amendment, Congressman Smith argued that the changes would allow
faith-based hospitals to perform the required activities, something that would not have
occurred under the committee-reported language because of opposition of faith-based
facilities to providing contraceptive services. He further stated that the amendment’s
reference to “family planning services” would include contraception. Opponents of the
amendment, however, charged that the revised text “gutted” the prevention aspect of the
obstetric fistula centers by making these activities discretionary rather than mandatory as
in the original text. They contend that the most effective method to reduce the incidents of
obstetric fistula is to ensure that young girls and high-risk women do not get pregnant.
CRS-18
of the Kemp-Kasten restriction that is part of the Foreign Operations appropriation
measure. The House defeated the Maloney amendment, however, on June 16 by a
vote of 192-233.
Emergency Supplemental Appropriations, FY2005
During debate on H.R. 1268, an $81.9 billion request for supplemental spending
mainly for military operations in Iraq and Afghanistan, the House adopted by voice
vote an amendment offered by Representative Maloney that increased funding for
humanitarian assistance to tsunami victims by $3 million. Although not directly
stated in the text of the amendment, supporters of the amendment said it was their
intent to provide $3 million for a UNFPA’s work in tsunami-affected countries.
Other Members noted, however, that the text of the amendment did not direct the
Administration to use the $3 million as a UNFPA contribution, but only to
supplement the Tsunami Recovery and Reconstruction Fund. For this reason, the
amendment was not opposed by some lawmakers who do not support U.S.
contributions for UNFPA. The enacted measure (P.L. 108-13) reduced tsunami relief
aid by $3 million below the House-passed level and did not direct the Administration
to provide any funds to UNFPA.
Other International Family Planning Legislation — 109th
Congress
H.R. 1011. H.R. 1011 (Maloney). Women, Children, and Infant Tsunami
Victim Relief Act of 2005. Authorizes $3 million be made available to UNFPA to
assist tsunami victims. Introduced on March 1, 2005, and referred to the House
Committee on International Relations.
H.R. 2811. H.R. 2811 (Maloney). Repairing Young Women’s Lives Around
the World Act. Authorizes, “notwithstanding” any provision of law, $34 million in
FY2006 and each subsequent fiscal year as a U.S. contribution to UNFPA only for
prevention and repair of obstetric fistula. Introduced on June 8, 2005; referred to the
House International Relations Committee.
H.R. 4188. H.R. 4188 (McCollum). Focus on Family Health Worldwide Act
of 2005. Authorizes a series of activities aimed at improving voluntary family
planning programs in developing countries, and to increase funding authorizations
from $600 million in FY2007 to $1 billion by FY2011. Introduced on November 1,
2005, and referred to the House International Relations Committee
H.R. 4465. H.R. 4465 (Lowey). Global Democracy Promotion Act. Prohibits
the application of restrictive eligibility requirements on foreign non-governmental
organizations that provide development and humanitarian assistance.