Defunding the UNFPA: sign of the times

The Lancet
Apr 15, 2017 Volume 389 Number 10078 p1491-1580
Defunding the UNFPA: sign of the times
The Lancet
Published: 15 April 2017
It was expected but still devastating. The US State Department on April 3 announced a defunding of the UN organisation for family planning and reproductive health, the UNFPA. The USA claimed the agency “supports, or participates in the management of, a programme of coercive abortion or involuntary sterilisation in China”, invoking the Kemp-Kasten Amendment prohibiting US funding of organisations involved in such activities. The UNFPA strenuously denies this allegation.

The removal of support, a loss of US$75 million for UNFPA, is a blow to an agency that ensures access to contraception and maternal and child health services, and fights against gender violence, child marriage, and female genital mutilation in more than 150 countries worldwide. In 2015, the USA was among the largest donors to UNFPA, which is currently facing a $140 million shortfall. Previous Republican presidencies withheld funding from UNFPA for similar antiabortion reasons. But the current US Administration’s invocation of Kemp-Kasten and its broadening of the related Global Gag rule appear to be a more direct attack on women’s lives and rights.

Extra chilling is that the White House rationalised UNFPA’s defunding despite their own memo stating no evidence of direct UN engagement in forced abortions or sterilisation in China. This clear play of politics over evidence shows them comfortable aligning health policy with an ideological agenda, but also shamelessly nonchalant with a lack of facts. This apparent disregard for truth in policy making is a worrying sign of things to come for other UN agencies and indeed women’s health.

In fact, the dismay over the UNFPA defunding masks the depressing reality of the low-level and priority of health funding for women. With the USA’s annual foreign assistance budget of about $40 billion, its $75 million for UNFPA is a tiny drop in the bucket. Republican representative John Shimkus absurdly asked during a recent US health-care debate why men should have to pay for prenatal care. To follow the US lead would send a message that the world does not care for women. Other countries should stridently reject this misogyny and harken support for UNFPA to continue its essential work.