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We're Back: United States Reclaims A Leadership Role In International Reproductive Health and Rights

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On Friday, April 3, at the conclusion of the annual meeting of the United Nations Commission on Population and Development, the international community pledged to ramp up efforts to improve women's health and reduce poverty in the developing world. And for the first time in eight years, the United States was front and center in advocating an increased global commitment to reproductive health and rights.

Add this new U.S. stance to the recently resumed American support for the United Nations Population Fund (UNFPA), the repeal of the infamous "global gag rule" that barred overseas organizations that so much as provided abortion information from receiving U.S. family planning assistance, and Secretary of State Hilary Clinton's unequivocal endorsement of women's rights as human rights, and it is safe to say: The U.S. is back!

Or, more precisely, back on track--the policies of the past eight years have left a lot of catching up to do. Current U.S. international family planning assistance, at $545 million a year, is significantly higher than previous years, but falls far short of the $1 billion that represents the minimum U.S. share of the global commitment.

While the United States contributes more funds than any other country toward voluntary family planning services worldwide, European nations far outspend the United States in terms of the proportion of the gross domestic product allocated to foreign assistance. There is, understandably, a sense that Bush administration policies have left Europe to pick up the slack in international family planning funding and other aspects of promoting sexual and reproductive health.

The renewed U.S. commitment to international sexual and reproductive health is a timely development. The meeting also marked the 15th anniversary of the Cairo Program for Action, a 20-year plan to stabilize population growth and reduce poverty, in part by investing in women's health.

Though the vast majority of United Nations (UN) member states signed onto the Cairo Program of Action, 15 years later, most countries have fallen behind in their commitments. UNFPA estimates that, in 2008, there was a nearly $4 billion gap between actual and needed support for family planning from donor nations.

To focus attention on these gaps, the Guttmacher Institute and UNFPA convened an expert panel at last week's UN population meeting to discuss global funding priorities, especially given a more supportive U.S. administration.

Stan Bernstein, senior policy adviser at UNFPA, chaired the panel. Barbara Hendrie, counselor of development and human rights for the United Kingdom Department for International Development, heralded the change in the U.S. administration as a "major opportunity" for the European donor community and the United States to work together on reaching development goals.

Scott Radloff, director of the department of population and reproductive health at the U.S. Agency for International Development, shared new initiatives under the Obama administration, while Susan Cohen, director of government affairs at the Guttmacher Institute, represented the nongovernmental perspective.

The result was a lively debate of European versus American approaches to investing in developing countries. For example, the United Kingdom prefers to provide "basket funding" or core support, investing in developing country health systems overall and pooling funds with other European countries where there are overlaps in programs.

In contrast, U.S. funding focuses on specific programs, partly due to Congressional oversight that requires greater accountability and meeting assigned targets. Despite these differing donor philosophies, the panelists agreed that their funding initiatives could be complementary.

Both Hendrie and Radloff also spoke of the need for their countries to make programs more efficient by integrating family planning and HIV/AIDS services. And all involved expressed real optimism that with support of the current U.S. administration, these kinds of changes might finally be possible.

The social and financial return on these investments is great, added Cohen, citing Guttmacher and UNFPA evidence. Meeting targets set in the Cairo Programme for Action and in UN Millennium Development Goals will require strong commitment and increased cooperation. For this to work, the United States must maintain a clear leadership role and European donors cannot back away now just because the United States has returned to the scene.