Real Reform or More of the Same?
US Foreign Assistance and HIV
Prevention, Reproductive Health
and Human Rights
Serra Sippel
Executive Director
Center for Health and Gender Equity
November 6, 2008
Sexual and Reproductive Health of
Women
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80% of HIV infections are sexually
transmitted
More than 50 % of infections worldwide,
and 61 % of those infected in subSaharan Africa are women
200 million women need contraceptives
80 million unintended pregnancies occur
each year
500,000 women die each year from
pregnancy-related complications
Comprehensive Approaches to
Sexual and Reproductive
Health and Rights
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Evidence and support for policies and
programs that address SRHR and
HIV/AIDS intersections
SRH Services:
FP, MCH, HIV and other STIs,
reproductive tract infections, sexual
health, GBV, prevention of unsafe
abortion and post-abortion care
The US and SRHR
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For decades the U.S. has been a
global leader in support for
international family planning
U.S. joined consensus on SRHR in
1994 (Cairo) and 1995 (Beijing)
US Foreign Assistance:
Obstacles to SRHR
“Condoms for family planning are distributed
separate from condoms for HIV prevention.”
(US government official)
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Vertical programming
Vertical funding
Restrictions on funding
$ Millions
FY07 US Health Funding Trends
All Accounts plus OGAC Transfers
2000
1800
1600
1400
1200
1000
800
600
400
200
0
95
96
97
98
03
04
05
06
Fiscal Year
Population
HIV/AIDS w/OGAC
Child Survival
Infectious Diseases
HIV/AIDS
07
Restrictions on US Funding
“We have had to lower the age of
contraceptive needs from 15-49 to 10-49
years of age because we have found
10-15 year-olds need contraceptive
methods.”
(DR government official)
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US POLICY:
NO condom information
for 10-14 year-olds
De-funding UNFPA
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UNFPA, a leading global agency
supporting comprehensive
approaches to SRHR
Since 2001, the U.S. has denied
funding to UNFPA
Global Gag Rule
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Bars any foreign organization that
receives U.S. foreign assistance from
using its own funds or funds from other
donors to perform abortions; advocate
for the liberalization or decriminalization
of abortion in laws and policies; or
provide information, make referrals, or
counsel women on the procedure—even
in countries where abortion is legal.
Anti-Prostitution Loyalty Oath
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“No funds . . . May be used to
provide assistance to any group or
organization that does not have a
policy explicitly opposing prostitution
and sex trafficking.”
“No funds . . . may be used to
promote or advocate the legalization
or practice of prostitution or sex
trafficking.”
Foreign Assistance Reform
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2006 Bush introduces plan to
reorganize foreign aid
Overhaul of 1961 Foreign Assistance
Act?
Current recommendations from
development experts
SRHR and Development
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In 2000, the MDGs were affirmed by
the U.S. and 188 other countries
with the goal to eradicate poverty
SRHR central to Millennium
Development Goals (MDGS)
Sexual and Reproductive Health and Rights (SRHR)
Goal 3: Gender Equality and Empowerment
Goal 1: Eradicate extreme poverty.
Goal 2: Achieve universal primary education.
Goal 4: Reduce child mortality.
Goal 5: Improve maternal health.
Goal 6: Combat HIV/AIDS, malaria, and other diseases.
Goal 7: Ensure environmental sustainability.
Goal 8: Develop a global partnership for development.
Recommendations
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Collaborate with the international
community.
Create cabinet-level posts on global
development and women.
Ensure that U.S. funding gets in the
hands of women.
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Eliminate restrictions.
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Fund comprehensive programs.
Thank you!
Serra Sippel
ssippel@genderhealth.org