Earlier this year, President Trump used his fiscal year 2018 budget request to take aim at global priorities, outlining draconian, ideologically driven cuts with the potential to decimate US programs that promote women’s health and rights. Last night, the funding debate moved to Congress, where the Appropriations Committee of the House of Representatives voted to advance a bill with $10 billion in proposed cuts that would have devastating impacts on women and girls and US global leadership.
The House State and Foreign Operations Appropriations bill provides $47.4 billion in funding for the State Department and related agencies and programs; this represents a 17 percent cut from current funding levels and a 14 percent reduction of State Department funding. Within that, the legislation includes some $8.32 billion for global health spending, about $400 million below current funding levels.
While global leaders take action to secure effective family planning as a means towards women’s empowerment, this bill places a cap on family planning and reproductive health spending at $461 million—a $146.5 million reduction that would walk funding for these critical programs back to 2008 levels. While less harmful than the Trump Administration’s request to zero out this funding, these cuts would seriously undermine US efforts to promote sexual and reproductive health and rights and reduce maternal mortality around the world. During last night’s budget deliberations, Representative Barbara Lee (D-CA) introduced an amendment that would have restored current funding levels for family planning/reproductive health spending, but the amendment failed by six votes.
The House bill crowns these bilateral reproductive-health funding reductions with the elimination of all funding to the United Nations Population Fund (UNFPA), the largest international provider of contraception, family planning, and other reproductive health services. Although the Trump Administration already announced that it would withhold contributions to UNFPA over false allegations about the organization’s work in China, the House bill takes that a step further by legislatively prohibiting any US dollars from going to UNFPA. By cutting off funds to UNFPA, the United States is undermining its own interests as well as causing untold damage to the health and rights of women worldwide. With operations in more than 100 countries where the US Agency for International Development (USAID) does not run family planning programs and serving a large female refugee population fleeing conflict and sexual violence, UNFPA is a critical distributer of family planning services and reproductive health care. The elimination of US funding will seriously impair UNFPA’s global work, which in 2016 included preventing some 29,000 maternal deaths, enabling over 20 million people to access contraception, and averting more than 3.6 million unsafe abortions.
Furthering attacks on women’s health and rights, the House appropriations bill also includes numerous policy restrictions on abortion, including a version of the expanded Global Gag Rule announced by President Trump earlier this year. Echoing the Trump policy, the House bill legislatively blocks global health funding from going to any foreign nongovernmental organization that provides abortion services, referrals, or counseling, or that advocates for abortion. Trump and the House Appropriations Committee are playing politics with women’s lives and forcing healthcare providers to choose between offering a comprehensive set of services and receiving US government funding.
Amendments, offered by Representative Barbara Lee (D-CA) and Representative Nita Lowey (D-NY), sought to strike both the Global Gag Rule language and the ban on UNFPA funding. Unfortunately, the amendments failed by near party line votes; Representative Charlie Dent (R-PA) was the lone Republican to vote in favor of both.
In addition to attacking reproductive health, the House appropriations bill continues the Trump Administration’s targeting of multilateralism, particularly with respect to US contributions to the United Nations and UN agencies. The House reduces funding for contributions to international organizations—the account from which the United States pays its UN and World Health Organization dues—by about $200 million (a roughly 15 percent cut). Even worse, the bill zeroes out funding for UN agencies, including UN Women and the UN Development Program (UNDP), though it does maintain funding for UNICEF through a separate budget line. The elimination of US contributions would undermine the ability of these UN agencies to do their critical work.
On the positive side, the House Appropriations bill soundly rejects President Trump’s proposal to eliminate Development Assistance funding and to instead create an “Economic and Development Support Fund.” IWHC and others strongly opposed this Trump proposal, which would have moved dollars from a funding mechanism designed to improve the lives of men, women, and children around the world into one that is primarily intended to support the economic and strategic interests of the United States—a fundamental shift. The House Committee’s report states that “there is merit to consolidating certain accounts,” but, in the absence of review of Trump’s proposal by both the Administration and by Congress, it “deferred the decision.”
In some key areas, funding was maintained. Financing of HIV work remained roughly consistent with current levels, with the draft bill providing $6 billion for HIV programs, including $1.35 million for the United States’ contribution to the Global Fund to Fight HIV, AIDS, TB, and Malaria. Within that topline HIV funding number, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) programs received $4.4 billion, and another $330 million went to USAID’s HIV programs. This funding level, while still short of what is needed to truly end the HIV epidemic, would at least ensure that important prevention, care, treatment, and research can continue. It is critical that resources continue to flow into evidence-based programs at PEPFAR, including the DREAMS Initiative, which focuses on preventing HIV among young women in sub-Saharan Africa; girls and young women in this region account for 74% of all new HIV infections among young people.
With the bill now set to move to the full House of Representatives for consideration, and with Senate appropriators yet to finalize their own version of the legislation, IWHC urges Congress to remove harmful policy riders, restore funding for reproductive health, and fully fund the foreign affairs budget. Supporting reproductive health does more than improve women’s health: it helps to create the conditions that allow women and girls to make decisions about and have control over their lives. Cutting off access to contraceptives would hinder girls’ and women’s education and undermine their ability to earn sustainable incomes and participate actively in society.
Photo: Eric B. Walker