Undeniable Progress, But Also Shortcomings, Since ICPD

It’s been 30 years since United Nations member states and representatives from civil society met in Cairo at the International Conference on Population and Development (ICPD) and agreed to its groundbreaking Programme of Action. It’s a cornerstone document which recognizes that investments in family planning are central to sustainable development. It committed countries around the world to the goal of advancing reproductive health and rights worldwide. The Programme of Action centers on three key goals: the reduction of infant, child, and maternal mortality; the provision of universal access to education, particularly for girls; and the provision of universal access to a full range of reproductive health services, including family planning. Overall, it provides a comprehensive set of recommendations to guide governments in establishing policies that advance these goals.

On June 14, U.S. Secretary of Health and Human Services Xavier Becerra hosted an event to commemorate the 30-year anniversary of ICPD. He was joined by leaders from across the government and by representatives from non-governmental organizations. The Secretary noted the importance of the 1994 agreement and crucial advancements made since that day. Other speakers included Jennifer Klein, the Executive Director of the White House Gender Policy Council, and Dr. Natalia Kanem, the Executive Director of the United Nations Population Fund (UNFPA).

During this uncertain time for sexual and reproductive health and rights, the event reminded us of the tremendous progress that we have already achieved: Family planning access has improved, the maternal mortality rate has declined by over 40%, and there have been significant developments in HIV/AIDS prevention and treatment. The Biden-Harris administration has reaffirmed its commitment to implementing the ICPD agenda, and the United States remains the largest bilateral donor to reproductive health programs that provide family planning, reduce maternal mortality, and address early/forced marriage and female genital mutilation.

And while progress has been undeniable, it’s equally undeniable that the promise of Cairo has never been met. The agreement and the pledges were truly groundbreaking, but the promises have gone unfulfilled. And no country has fallen shorter than the United States. Not two months after ICPD concluded, Republicans, led by Rep. Newt Gingrich, won control of the U.S. House of Representatives and set about undermining U.S. support of family planning programs everywhere. George W. Bush’s inauguration in 2001 brought a swift imposition of the Global Gag Rule and the elimination of support to UNFPA. The early years of the Obama administration offered hope, as funding for these crucial programs hit its peak, but that hope was short-lived. Funding was slashed in 2017 by a Republican House majority even more conservative than the one led by Gingrich.

Had appropriations simply kept pace with inflation since funding peaked in 2010, today we’d be providing $1.03 billion — still shy of the $1.74 billion U.S. “fair share” needed to address the unmet need for family planning of 218 million women in developing regions. Instead, current investment is $607.5 million, a cut of nearly 40% in today’s dollars.

It gets worse. House Republicans have proposed capping international family planning funding at $461 million, a nearly 25% cut that would cause more than 8 million women and couples to lose access to the contraceptives they need. Their proposed funding bill would also reinstate the Trump-era Global Gag Rule and bar support to UNFPA. Finally, the bill also reiterates rather than repeals the harmful and archaic Helms Amendment.

These attacks undermine efforts to advance gender equality, promote the human rights of women and girls, and expand access to basic health care. If adopted, this bill will send a devastating message that the United States cannot serve as a trusted partner in international sexual and reproductive health and rights. United States funding extends lifesaving care to the global community. Without it, we cannot achieve global health targets and we will fail to promote gender equity. The success of the ICPD agenda and the prosperity of women and girls worldwide depends on U.S. support. It is crucial that we reject these harmful attacks and continue to work towards sexual and reproductive health and rights for all.