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 80% of HIV infections are sexually transmitted 80% of HIV infections are sexually transmitted More than 50 % of infections worldwide, and 61 % of those infected in sub- Saharan Africa are women More than 50 % of infections worldwide, and 61 % of those infected in sub- Saharan Africa are women 200 million women need contraceptives 200 million women need contraceptives 80 million unintended pregnancies occur each year 80 million unintended pregnancies occur each year 500,000 women die each year from pregnancy-related complications 500,000 women die each year from pregnancy-related complications

Comprehensive Approaches to Sexual and Reproductive Health and Rights Evidence and support for policies and programs that address SRHR and HIV/AIDS intersections Evidence and support for policies and programs that address SRHR and HIV/AIDS intersections SRH Services: 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 For decades the U.S. has been a global leader in support for international family planning 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) 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) Vertical programming Vertical programming Vertical funding Vertical funding Restrictions on funding Restrictions on funding

FY07 US Health Funding Trends All Accounts plus OGAC Transfers

Restrictions on US Funding “We have had to lower the age of contraceptive needs from to years of age because we have found year-olds need contraceptive methods.” (DR government official) US POLICY: US POLICY: NO condom information for year-olds

De-funding UNFPA UNFPA, a leading global agency supporting comprehensive approaches to SRHR UNFPA, a leading global agency supporting comprehensive approaches to SRHR Since 2001, the U.S. has denied funding to UNFPA Since 2001, the U.S. has denied funding to UNFPA

Global Gag Rule 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. 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 “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 2006 Bush introduces plan to reorganize foreign aid 2006 Bush introduces plan to reorganize foreign aid Overhaul of 1961 Foreign Assistance Act? Overhaul of 1961 Foreign Assistance Act? Current recommendations from development experts Current recommendations from development experts

SRHR and Development In 2000, the MDGs were affirmed by the U.S. and 188 other countries with the goal to eradicate poverty 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) 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 Collaborate with the international community. Collaborate with the international community. Create cabinet-level posts on global development and women. Create cabinet-level posts on global development and women. Ensure that U.S. funding gets in the hands of women. Ensure that U.S. funding gets in the hands of women. Eliminate restrictions. Eliminate restrictions. Fund comprehensive programs. Fund comprehensive programs.

Thank you! Serra Sippel