For the third year in a row, the Trump-Pence administration is proposing a dramatic cut for international family planning and reproductive health (FP/RH) programs as part of the President’s fiscal year (FY) 2020 budget request, released today after a five-week delay. The funding requested—$237 million—represents a whopping 61 percent cut from the amount that Congress just appropriated last month as part of the FY 2019 omnibus spending package. While better than the nothing—literally zero dollars—included in the first Trump budget request for FY 2018, it even represents a reduction from last year’s paltry request that roughly halved the prior year’s appropriated level.
The proposed cut to international FP/RH programs is but one part of an overall reduction of 24 percent to the international affairs programs that 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 observed, “Clearly, Congress is going to call ‘strike three’ when it comes to the Administration’s latest attempt to propose dangerous and disproportionate cuts to the International Affairs Budget, particularly after having rejected similar efforts over the last two years.”
As detailed in the State Department’s congressional budget justification (CBJ), $237 million is being requested within the Global Health Programs (GHP) account managed by the U.S. Agency for International Development (USAID). As it has in its two previous requests, the GHP request is targeted to address three objectives: “controlling the HIV/AIDS epidemic, preventing child and maternal deaths, and combating infectious disease threats.” FP/RH is included within the “preventing child and maternal deaths” thematic area (p. 68). But the rationale for investments in family planning has been revised in subtle but significant ways—deleting references to preventing unintended pregnancy and “enhanc[ing] the ability of couples to decide the number, timing, and spacing of births” and “reducing abortion,” while adding that FP/RH activities will be implemented “with attention to the traditions, values, and cultures of these countries.”
The $237 million requested by the Trump-Pence administration for FY 2020 is a $370.5 million—or 61 percent—cut from the FY 2019 appropriated level for bilateral and multilateral FP/RH programs and even a $93.5 million—or 28 percent cut from the President’s FY 2019 budget request.
President’s Budget Requests and Appropriated Levels for FP/RH—FY 2018-2020
(In Millions of Dollars)
The State Department document engages in some rather creative accounting to suggest that this year’s request level is really not less than last year’s proposed amount by asserting that “when combined with an expected $65 million from FY 2018 and FY 2019 funds reallocated from the United Nations Population Fund, the FY 2020 Budget provides a total of $302 million for family planning/reproductive health.”
The additional funds for bilateral FP/RH programs that the budget request proposes to reallocate from UNFPA are related to the State Department’s invocation of the Kemp-Kasten amendment to withhold the U.S. contribution to UNFPA the last two years (FY 2017 and FY 2018) because UNFPA “continues to partner with the [National Health and Family Planning Commission]” in China, where coercive abortion and involuntary sterilization have occurred. Interestingly, no Kemp-Kasten determination has been made yet on the fate of the FY 2019 contribution, which the budget request clearly has designs upon. Under the law, a decision on the FY 2019 contribution must be made by the State Department within six months of enactment of the appropriations bill. It would hardly be surprising that withholding the FY 2019 contribution from UNFPA is all but a foregone conclusion given the inclusion of the reprogramming gimmick in the CBJ.
Dating back to previous Republican administrations that cut off contributions to UNFPA under the Kemp-Kasten amendment, annual appropriations bills have included boilerplate language mandating that any funds withheld from UNFPA due to the “operation of any provision of law” are to be transferred to the USAID GHP account for bilateral “family planning, maternal, and reproductive health activities.” Throughout the years, FP/RH advocates have frequently questioned the adherence to congressional intent of some of the decisions on how withheld UNFPA funds were allocated. For example, $12 million of the withheld FY 2017 contribution has recently been allocated to create a two-year pilot project to prevent, diagnose and treat cervical cancer in two African countries. Certainly a laudable initiative, but one for which congressional appropriators made a conscious decision not to fund in either the FY 2017 or FY 2018 bill. (It is perhaps worth noting the CBJ proposes to allocate the entirety of the withheld funds to FP/RH activities with none going toward maternal health programs.) Advocates have also feared that withheld UNFPA funds might one day be used to backfill proposed cuts to the bilateral FP/RH budget. That day has apparently come.
To add insult to injury, no funds are requested for a U.S. contribution to the United Nations Population Fund (UNFPA) in FY 2020. But UNFPA is not alone. For most other UN agencies that receive annual voluntary contributions, the administration is again proposing the elimination of the International Organizations and Programs (IO&P) account, under which contributions are provided to them, and merging IO&P into an Economic Development and Support Fund, which may “support a limited number of international organizations and related multilateral activities important to U.S. strategic objectives.”
When the Trump-Pence administration zeroes out all funds for FP/RH as in its first request or slashes the congressionally enacted level as in its second and third request—and otherwise proposes politically untenable cuts to foreign assistance and State Department 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 nine 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. That is why 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 and resisted.