When it comes to the health and lives of women and girls, the president’s proposed global health budget is a death warrant: Zero funding for family planning and reproductive health, 10 percent less funding for HIV prevention and treatment, and what appears to be the elimination of the Commodity Fund, which provides life-saving male and female condoms that prevent sexually transmitted infections like HIV and HPV, as well as unwanted pregnancies.
Yet, one week before the release of Trump’s proposed FY18 budget, the State Department included family planning and reproductive health as an international health program supported by U.S. global health assistance.
The State Department’s announcement was made in a special briefing to the press on Trump’s expansion of the global gag rule – the notorious policy restriction on U.S. global health assistance that prohibits medical providers from using non-U.S. funds to provide information or services related to abortion, and from advocating for changes in local abortion laws.
At that briefing, State Department officials listed the programs that would be impacted by Trump’s global gag rule. That the State Department would list family planning and reproductive health among health programs impacted by the policy when they knew such funding would be eliminated in Trump’s FY18 global health budget is deceptive.
The State Department maintained that Trump’s global gag rule would apply to $8.8 billion in global health assistance (FY17), and that the policy was not a cut in global health assistance since funding for non-compliant groups would be redirected to compliant groups. What they failed to say is that the President’s proposed budget for FY18—which would be released one week later—would account for only $6.5 billion in global health assistance, which would be 26 percent less funding (with no funding allocated for family planning and reproductive health) that could be redirected.
The State Department’s assurances that funding will simply be redirected to organizations that will comply with the global gag rule restrictions rings hollow. There has been no assessment of how many U.S. funded groups will be unable to comply with the new policy and if there even exists qualified organizations that could both comply with the policy and also carry out evidence-based programs on the ground.
A common narrative that is embedded with wishful thinking is that the president’s budget is “dead on arrival,” a statement made by Senator John Cornyn and that has been repeated by many in the global development community. Yes, there is a ways to go in the budget process and Congress will have its turn to remedy much of the damage in Trump’s budget. But that should not diminish cause for concern or silence outrage over how the Trump administration is treating the health and rights of women and girls and other marginalized populations through its policies and funding.
The twofold action of restricting all global health assistance and eliminating family planning and reproductive health funding reinforces what many global health advocates and experts know: Trump’s agenda has nothing to do with global health and everything to do with cutting off access to family planning and reproductive health services.
An estimated 225 million women globally have an unmet need for family planning, meaning that they do not desire to have a child at this time, yet are not using effective contraception. This lack of access to family planning methods is a contributor to the preventable deaths of 303,000 women annually due to complications during pregnancy and childbirth. Additionally, according to UNAIDS, adolescent girls and young women aged 15-24 are at an increasingly high risk of HIV acquisition, comprising 20 percent of new HIV incidences among adults globally in 2015, despite accounting for only 11 percent of the adult population.
This is not a time for advocates to scramble for crumbs from the table. It is the time to push Congress for a humane budget that shows the world that the U.S. cares about women and girls. They can start by fully funding a global health agenda that includes family planning and reproductive health and HIV prevention and treatment.