Connect Four—Trump’s Four Years of Inadequate Budget Requests for Global Family Planning Programs

For the fourth year in a row, in what sexual and reproductive health and rights advocates hope will be its last budget request, the Trump-Pence administration proposed today another dramatic cut to international family planning and reproductive health (FP/RH) programs for fiscal year (FY) 2021. The funding requested for FY 2021—$237 million—represents a massive 61% cut from the congressionally-appropriated level for bilateral and multilateral programs for the current fiscal year. It is identical to the cut the president requested last year that Congress subsequently ignored.

The proposed cut to international FP/RH programs is but part of a 22% reduction to international affairs programs. These programs support U.S. global engagement and leadership through diplomacy and development activities and help protect America’s security and economic interests. As the U.S. Global Leadership Coalition declared: “As Congress now takes the reins on spending decisions, we urge lawmakers to follow their bipartisan playbook from the past three years—rejecting these dangerous cuts—and support $60 billion to ensure critical resources for the State Department, U.S. Agency for International Development (USAID) and other development agencies to keep our nation safe and promote America’s interests around the world.”

The FY 2020 omnibus spending bill, enacted at the end of December, continued the ten-year streak of Congress appropriating just over $600 million for bilateral and multilateral FP/RH assistance since FY 2011. Family planning funding has been stuck at basically the same level now for a full decade.

The president’s FY 2021 budget request proposes only bilateral FP/RH assistance within the Global Health Programs (GHP) account administered by USAID’s Office of Population and Reproductive Health. No funds are requested for a U.S. contribution to the United Nations Population Fund (UNFPA), nor are voluntary contributions requested for other important UN agencies.

The International Organizations and Programs (IO&P) account that historically has funded the voluntary contribution to UN agencies such as UNFPA and UNICEF is proposed for absorption into a new “Economic Support and Development Fund” (ESDF) along with the Economic Support Fund (ESF), Development Assistance (DA) and other existing regional (i.e., Assistance for Europe, Asia and Central Asia) and sector accounts—a proposal made previously by the administration and summarily ignored by Congress. The ESDF will only support a “limited number of [multilateral organizations] important to U.S. strategic objectives.” UNFPA will not be among those on the short list.

Not included in the main volume of the congressional budget justification (CBJ) document for the Department of State and foreign operations is any information on how much of ESF may be allocated to support FP/RH activities in the countries of America’s strategic allies. Typically, about $20 to $30 million is targeted to two or three countries. Last year, for example, an additional $22 million was requested for FP/RH in Egypt and Afghanistan, but the allocations were not revealed in the initial budget rollout and only became known later when detailed budget tables and appendices were released. Such detail for FY 2021 is not expected to be available for several weeks.

As detailed in the CBJ, FP/RH is included in the “preventing maternal and child deaths” thematic area (p. 69), one of the three objectives of the GHP account along with “controlling the HIV/AIDS epidemic” and “combatting infectious disease threats.” In last year’s CBJ, the rationale for investments in FP/RH was edited in some troubling ways. The description in this year’s CBJ is largely identical to last year’s but with one subtle but perhaps significant revision. Last year’s problematic language favoring recipient countries’ cultural and religious sensibilities over the rights of women has been modified to acknowledge the importance of a country’s “context” in U.S.-funded programs.

This modest revision looks like a particularly promising development at time when Trump-Pence administration political appointees are working feverishly to assemble a multinational coalition to restrict access to abortion and to promote traditional family values and inject this ideology into international fora. In contrast to the international section of the CBJ on family planning, one of the key aims of the domestic programs of the Department of Health and Human Services according to the main budget document is to prioritize the “value of human life” and to “continue to ensure robust protection of conscience rights and religious liberty (p. 51).”

As family planning advocates have pointed out in the past, when the Trump-Pence administration zeroes out all funds for FP/RH as in its first request or slashes the prior year congressionally-enacted level as their requests have for the last three years—and otherwise proposes politically untenable cuts to foreign assistance and Department of State operations—it creates needless chaos and inefficiency. Even though every Washington policymaker involved knows that Congress is likely to appropriate an amount of FP/RH funds comparable to that approved for the last ten fiscal years, the low budget request sows confusion in the field and paralyzes internal planning, programming and budgeting within USAID and interferes with timely and cost-effective expenditure of taxpayer dollars. Such pointless and malicious proposals to cut international affairs programs in general and bilateral and multilateral FP/RH programs in particular must be called out for what they are—political gamesmanship with no chance of success but with the potential to cause great harm to U.S. investments in improving global health and the quality of life of women, families, communities and nations around the world.