U.S. Foreign Aid for Reproductive Health and Family Planning Delivers More than the Sum of its Parts
By Dilly Severin, Executive Director, Universal Access Project
It’s no secret that the United States has an outsized influence on the world. Our futures are, and have always been, connected to the futures of communities overseas.
The U.S. has historically been the single largest provider of foreign assistance – we have long invested in the health, rights, and stability of communities outside our own borders as a reflection of our values as Americans and because we know that creating a safer, healthier and more secure world pays dividends for us all, for just one percent of our overall federal budget.
Within this one percent, a small slice of the U.S. foreign aid "pie" is dedicated to international reproductive health and voluntary family planning. This relatively small investment delivers returns beyond its measure: putting people in the driver’s seat of their own bodies, lives, and futures fulfills essential human rights and sparks a ripple effect of more stable and prosperous families, communities, and countries. The U.S. Fiscal Year 2023 investment in international family planning assistance served 24.2 million women and couples, helping avoid more than 8 million unintended pregnancies, 3.2 million unplanned births, 2.6 million unsafe abortions, and 14,000 maternal deaths.
As some of its earliest actions in office, the Trump-Vance Administration froze foreign assistance and issued a stop-work order on all current foreign assistance projects. In the months since, the Administration has effectively dismantled the U.S. Agency for International Development (USAID) and eliminated more than 5,000 contracts – totaling 86% of USAID’s contracts and amounting to more than $75 billion. Most recently, it has moved to formally abolish the agency, restructuring some semblance of foreign aid under the State Department.
A portion of the eliminated U.S. foreign aid contracts – 48, totaling approximately $377 million – were awarded to the United Nations Population Fund (UNFPA), the UN agency dedicated to sexual and reproductive health. This marks a significant blow to UNFPA, which has counted on U.S. support over the last four years to prevent more than 17,000 maternal deaths, 9 million unintended pregnancies, and nearly 3 million unsafe abortions; reaching more than 13 million women and young people with essential health services.
The numbers are staggering, but behind the statistics are real people who have long relied on U.S. foreign aid and who now have the rug pulled out from under them.
These are expectant mothers in crisis zones who deserve a safe childbirth; domestic violence victims who deserve shelter and counseling; people who deserve information and access to voluntary family planning; young girls who deserve to grow up free of violence and harmful practices like child marriage or genital mutilation. Pregnancy, periods, and essential sexual and reproductive health needs do not stop when a donor halts its funding.
The question of using American taxpayer dollars effectively and efficiently through foreign aid is not the wrong question; but eliminating virtually all assistance is the wrong answer.
In fact, recent polling shows overall broad public support for investing in global health and humanitarian aid, recognizing that doing so also protects the health and well-being of Americans. At the same time, most adults – 86 percent – in the polling vastly overestimated the share of the U.S. federal budget allocated to foreign aid, estimating that foreign aid amounts to about a quarter of the federal budget when, in fact, it’s closer to one percent. The data also show that most of the American public thinks the latest actions to slash U.S. foreign aid will increase global health and humanitarian crises without alleviating fiscal issues at home. The fact is that we cannot balance the federal budget on one percent – so the argument against foreign aid is an ideological one, rather than a fiscal one.
The actions to dismantle USAID and almost entirely eliminate U.S. foreign aid will leave the world’s most vulnerable people with no recourse, halt hard-fought progress on global health, peace and security; and forfeit the United States’ role as a leader in global health, including sexual and reproductive health, rights and justice. This is not delivering for the American people. It is dismantling foreign assistance as we know it. In the midst of the chaos, we must remember: real human health, rights and dignity are under attack when they should not ever be up for debate.
