|Frank E. Loy, Under Secretary of State for Global Affairs|
Duff Gillespie, USAID Deputy Assistant Administrator for Population, Health, and Nutrition
On-the-Record Briefing, Office of the Spokesman
U.S. Department of State, Washington, DC, April 6, 2000
04/06/00: View the video archive of the White House World Day event.|
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International Family Planning
MR. REEKER: Welcome to the State Department. This afternoon, we're very pleased to have Under Secretary of State Loy, Frank Loy, and USAID Deputy Assistant Administrator for Population, Health and Nutrition Duff Gillespie for this special briefing to discuss the importance of U.S. international family planning assistance.
This is, of course, a background -- it's an on-the-record briefing but providing you background for tomorrow's events at the White House in honor of World Health Day, the ceremony tomorrow at the White House in the East Room at 1:30 p.m. The Secretary will, of course, be speaking then.
So let me turn it directly over to Under Secretary Loy. Both gentlemen will deliver some remarks and then we can go to any questions that you have.
UNDER SECRETARY LOY: Thank you. Good afternoon. As was just mentioned, tomorrow the President will host an event, World Health Day, and it's designed to highlight an issue that is critical both to our foreign policy but, much more important, is critical to the lives and the well-being of particularly women and children around the world.
A part of health and a hugely important part of health is family planning, and we want to talk today about U.S. assistance for family planning internationally. And Duff Gillespie and I are here to talk about that.
A few months ago, Secretary Albright stood before you right here and spoke -- as I recall spoke very passionately in fact -- about international family planning and the need for U.S. leadership in this area. She explained at that time why the President requested a restoration of U.S. funds for international family planning, back to 1995 levels, a substantial bump from current levels, and why we needed to eliminate the harmful restrictions on that family planning funds that were imposed by Congress last year.
This Administration remains absolutely committed to restoration of this funding and to obtain that funding without those restrictions. I want to explain just a little bit why we feel so strongly about this and why we bring it up particularly at the time of World Health Day. Family planning saves lives, and it protects the health of women and men and children.
The statistics are grim: 600,000 women, roughly, die each year of complications related to pregnancy and childbirth. That's one woman every minute. In fact, complications of pregnancy and childbirth are the leading cause of death and disability for women of reproductive age in developing countries.
There are about 12 million children under 5 years of age of that die every year. In addition, by the end of last year, there were nearly 34 million people infected with HIV. More than 2.5 million persons die of AIDS every year. Nearly half of all the new HIV infections are among women, and nearly half of those are among young people -- sometimes very young people, young people under the age of 25.
Now, we know that family planning can address these grim statistics in each of those categories. It can save the lives of many of the women that die of complications from pregnancy or childbirth by making sure that the children are spaced in such a way that the mothers can become healthy again before they have their next child, and also by permitting them to avoid abortion, and particularly botched or back-alley abortions which cost many, many thousands and thousands of lives a year.
We know that we can save the lives of many of these 12 million children if they are permitted to grow up in an atmosphere where they are spaced in such a way that they can grow before the next one arrives and where their parents can take care of them. And we know that there is an intimate relation between family planning and the prevention of HIV/AIDS.
So we know we can address these statistics, and we want to do that.
The United States has provided family planning assistance to developing countries for over 30 years, both through USAID and through the United Nations Population Fund, which is present in over 150 countries. That assistance is critical for those countries. It is desired by those countries. It is a lifesaving assistance. Yet we know that despite these facts and this compelling case, a small minority in Congress has managed to draw our family planning assistance down to record low levels and to increasingly place unnecessary and quite harmful restrictions on the assistance that we do provide. Restoring those funds and eliminating those restrictions will save lives, hundreds and thousands of lives, and that is why we are here today. And that is why the President is devoting time and attention tomorrow to this issue.
We can talk more about all of these details when we get into the question period, but let me turn the mike over to Duff Gillespie, the Deputy Assistant Administrator for Population, Health and Nutrition of the U.S. Agency for International Development. Duff's office is responsible for providing and overseeing our assistance to the reproductive health of women and men, including family planning, in over 50 developing countries.
So, Duff, if you would please provide some additional information.
MR. GILLESPIE: Thank you, Frank. Well, not only is my program responsible for implementing family planning and other types of health nutrition programs, we're also responsible for implementing this legislation that we're here about. So I thought I would spend a little time giving you an update on what the possible consequences might be of these restrictions that Frank alluded to.
We have sent out a certification package to foreign non-governmental organizations and multilateral organizations, such as the World Health Organization, and they have two choices, basically. One choice is to certify that they will not provide family planning, not provide abortion services or advocate for changes in abortion policies and laws from now until the year 2001, September 31, 2001. Or they can do nothing, or refuse to sign, and can continue to do activities that they would otherwise do.
Now, when I say they can't advocate or provide abortion services, I don't mean with USAID money, United States taxpayers' money. They are prohibited from doing that already. This is with other money from other donors, from money that they might have raised in their country. So when you hear the term "gag rule," that's what's being referred to.
Thus far, we've gotten 450 of these foreign NGOs certification package and I'd like to spend a little time -- we expect many more, but this is what we have so far -- spend a little time on how confusing that must be to these organizations. Certainly, everybody here in this room knows how dynamic and how sometimes strident the debate is about abortion in the United States. It is one of the issues that dominates the press and the political process and elections, and is a very viable way that the United States comes to conclusions about this very sensitive topic.
What this says is that countries that receive -- NGOs that receive funds can not participate in such debates in their own countries. Let me read for you a letter that we received from one of the NGOs. This happens to be the International Planned Parenthood Federation, which refused to sign -- to agree to the certification. This particular organization has 130 affiliate agencies, associations, throughout the world.
It says that it's difficult "to understand how it can be that while the United States works hard through its foreign policy and assistance programs to encourage democratic participation of all citizens, the development of a functioning civil society and improved opportunities and health conditions for all; at the same time, this legislation undermines those very objectives and effectively denies access to desperately needed information, support to millions of women worldwide."
So there is this dissonance between the promotion of democracy and an open society and open markets, and this legislation.
Frank also mentioned that the President is seeking an increase in our budget up to the 1995 levels, a $169 million increase. That would bring us up to the $541 million that we had in 1995. Just to translate that $169 million into what it might mean programmatically, we estimate based on past experience that that would translate into the prevention of 3.5 million unintended pregnancies. And unintended pregnancies, of course, are the cause of abortion. By definition, a person seeking to have an abortion does not want that pregnancy. And we estimate that that 3.5 million unintended pregnancies would translate into roughly 1.4 million abortions that would be avoided with these additional funds.
Those are the two points I wish to make, and I would be happy, along with Frank, to entertain any questions or clarifications. There will be a folder available for you which has a lot of briefing information in it.
QUESTION: You said you had received responses from 450 organizations; is that what you said?
MR. GILLESPIE: That's correct.
QUESTION: How many organizations had you sent these letters to?
MR. GILLESPIE: Well, by the end of the year we expect that we'll have responses or refusals from about 1,200 or so organizations. These were just sent out about a month and a half ago.
QUESTION: So that was the total number that was sent out worldwide; do you know?
MR. GILLESPIE: Well, I don't want to get tied up in too much of the mechanics. I'd be happy to talk to you afterwards. But we send them to other organizations who then contact their subgrantees. So we actually didn't send out that number of certifications. The organizations would seek to get those certifications from them.
QUESTION: So that means that the 450 that have returned have agreed to the gag rule?
MR. GILLESPIE: Those 450 have. There is an unknown number who have decided not to.
QUESTION:Or haven't responded at all yet.
MR. GILLESPIE: Haven't responded, and we don't know.
QUESTION:I just want to make -- these restrictions that you're talking about are, in fact, the very same ones that this Administration acquiesced to in order to pay off the UN debt, right? I mean, this was the cause of all of the rancor with the family planning groups, right? I mean, you guys agreed to these restrictions and now you're trying to eliminate them?
UNDER SECRETARY LOY: At the very moment that we agreed to them, the President made it -- in his statement -- made it very clear that he was doing so because he was caught in a cruel dilemma and it was, as you note, tied to our ability to begin the payment of our past due UN debts.
And so you're absolutely right. We signed that bill. But we said at the time in the most clear terms that this was wrong. This was wrong for the reasons that Duff suggested; that it actually chills the debate and the discussion and the public participation in countries where we preach that that ought to happen. And it was wrong because we in the United States would not stand for it and we couldn't constitutionally impose that kind of a gag on our NGOs, and it seemed quite wrong to impose it on foreign ones.
And in the aggregate, it does not at all do what some of the proponents wanted it to do, and that is to reduce the reliance on abortion. As Duff said, it does the opposite.
So for all those reasons, the President made it clear that this was something we opposed. And we still oppose it and we oppose it actively and we do not want to see it again.
QUESTION:I didn't mean to bring up the whole justification for doing it, but don't you think that there's going to -- if you immediately come in after having agreed to this, if you immediately come in and try and remove the very same restrictions that you agreed to -- for whatever reason -- that there's going to be a backlash among this small minority of lawmakers on the Hill?
UNDER SECRETARY LOY: Well, I can't predict --
QUESTION:-- who have little enough faith in the integrity of this -- for better or worse -- the Administration, then this is just going to put them over the edge, isn't it?
UNDER SECRETARY LOY: We committed ourselves at the time to scrupulous enforcement of this law and these restrictions, and we're doing that. But I don't see any reason why we can't make clear once again, as we did at the outset, that this is a mistake and that we would be better off as a country and we would be better off in terms of our family planning agenda and we would be better off in terms of our make-abortions-rare agenda if we didn't have that.
QUESTION:Can I just ask, you said that they had two choices: they could either accept the gag rule or ignore it. What is the implications of either of those options?
MR. GILLESPIE: If you accept it, that is, you sign the certification, you in effect are -- the organization, the foreign NGO, is basically saying we will not provide abortion services -- and there are some NGOs which are in countries where abortions are legal -- or do anything that would promote a change of policy or law concerning abortion. That could be making abortion more restrictive or making it more available. The law doesn't specify that.
If you don't -- and there's a certain irony in this -- if you don't certify, and let's say that you are in a country and you are keenly desirous of changing an abortion law, whichever way, you can still do that. By not signing it, you're not making any agreement, any conditionality, of receiving funds. It does mean that the amount of money available to you is somewhat vulnerable, and that's because the legislation required a $12.5 million reduction in the appropriation, which was at $385 million but, in addition to that, has a $15 million cap on the amount of money that can go to organizations that choose not to fund.
So I mentioned International Planned Parenthood Federation. As long as they are under the $15 million cap, they will receive their funds and will not have to in any way restrict their behavior and what they do with other people's money that they receive.
UNDER SECRETARY LOY: Just to elaborate on that a bit, let's put it in context. We have an original appropriation of $385 million. This restriction says you cannot give more than $15 million to organizations that don't sign the certificate. So you can see that if you have a lot of organizations that don't sign the certificate, you would have to start cutting off very substantial organizations and cut them off from their funding. As long as we're under the $15 million, the effect is limited but it puts all the others on the test that if they act according to what some of them believe is their right, they run the risk that the $15 million cap is broken and there will be reductions in what is available to them.
QUESTION:How many organizations does the United States fund in this field?
MR. GILLESPIE: The number of organizations varies, but there are a number of categories of organizations. U.S. organizations that receive funds, as Frank alluded to, are not affected by this legislation because of, among other things, constitutional issues. So not counting those, that's roughly, say, about 130 U.S. organizations.
UNDER SECRETARY LOY: U.S. organizations working overseas, of course.
MR. GILLESPIE: Well, some of them actually work here in research capacities, too.
Now, of those, a number of the U.S. organizations enter into relationships with foreign NGOs. In addition, our U.S. missions throughout the world give money directly to foreign NGOs. Those foreign NGOs and the multilaterals are what this legislation applies to, and those we estimate will be around 1,2000, based on past experience. Now, that number will grow as the year continues.
In addition to that, there is the World Health Organization and the International Planned Parenthood Federation located in London. This does not affect our contribution to UNFPA, which is underneath a different appropriation and thus is not affected by it.
QUESTION:Okay, so I'm now just going to ask, are there actually any organizations that are near that $15 million cap now or is this something you're looking at five or ten years down the road as a problem? If there's 1,200 organizations, there can only be one or two that are anywhere near $15 million. Or am I wrong?
UNDER SECRETARY LOY: It's $15 million in the aggregate, not per organization. So we add up all of the ones that are recipients but that do not sign the certificate.
QUESTION:Do you know what the actual practical effect on the ground of these 450 that have agreed to the gag rule is? I mean, do you know how many of them are actually involved in -- with these abortion services that are now banned, out of the small number that have agreed so far?
UNDER SECRETARY LOY: I'm going to ask -- I don't know if we do know that, but I want to tell you a story that I just heard a short while ago from a person who was working in Nepal. And in Nepal, she told me, abortion is illegal and the person that's punished is the woman seeking the abortion, not the person providing the abortion.
A 13-year-old girl was convicted of violating that law because she had an abortion after a rape. She was sentenced to a long prison term. She was actually let out of prison at the age of 19, so she served 6 years.
A number of organizations in Nepal had been for the past years advocating her release and trying to make this case a significant case in their country indicating the unfairness of the procedure. They said that they would have to terminate that if they were to sign that certificate, and otherwise, as we said a moment ago, risk receipt of their additional funding. That would be an example. That's not a statistical number. I don't know whether we have any statistics.
QUESTION:So, basically, what you're saying is that even in countries where abortion is illegal, this is -- was already illegal for an organization to have to sign this gag order in order to continue getting funding, it still may adversely affect family planning because they won't be able to advocate for the change of law either pro- or anti-abortion, right?
MR. GILLESPIE: That's correct. There are two things that I'd like to say about the impact. We don't know yet, quite frankly -- I mean, we just implemented this. It's only been in effect less than 2 months so the long-term effect will be hard to determine.
Under the Mexico City policy, which was a policy, not a law, we did -- I've been in this business a long time -- we did an assessment of the impact and whether or not organizations were complying with the Mexico City policy. The Mexico City policy was similar to this. There were some differences, but it was basically the same types of restrictions.
What we found, or what the people that were doing the study found, is that organizations wouldn't do things that, in fact, they were still allowed to do. There is a chilling effect that takes place. We don't know if that will happen with this policy and this legislation, but it is one thing that could happen.
The second thing that makes it difficult to answer that question, which is a good question, is that it was the Administration's policy after President Clinton overturned Mexico City not to ask organizations what they did with funds other than USAID funds, that that was considered to be something that was beyond the interest and the mandate of the program. And the President so stated that when he terminated or repealed -- not repealed, but terminated the Mexico City policy.
QUESTION:Well, what is exactly the President going to do tomorrow? He's going to get up and propose that just this restriction, these restrictions, be removed from the law? Or something else as well?
UNDER SECRETARY LOY: Tomorrow is World Health Day so it is a broader agenda than this. The fact is, I'm not exactly sure what he is going to say tomorrow. We do know his position on this issue, as I've stated it, that is these restrictions are a mistake and they should not be repeated.
QUESTION:So then, in other words, he isn't going to get up and say it's time -- announce some kind of a move in Congress to get these restrictions taken away?
UNDER SECRETARY LOY: He hasn't asked me what he ought to say, and I haven't --
QUESTION:No, I'm just kind of curious as to why we're here. I mean, yeah, we know that there was -- you know, that the Administration was opposed to this stuff, even though it agreed to it.
UNDER SECRETARY LOY: There is, of course, a piece of legislation introduced -- several piece of legislation that are relevant to this, one introduced by Representative Lowey, one by Representative Maloney. The former particularly deals with the restrictions and we think it is -- we totally support that approach. And we applaud the effort to introduce that bill and to, I hope, have it passed, which would actually upset or overturn the restriction.
But that is not -- the World Health Day, as I said, is not tied to that particularly. It is a broader theme. But there is no question that we want to stress -- and that he will want to stress the family planning element in health because, quite aside from all the other things we've talked about, it is a matter of lives and is a matter of health and women's health and children's health.
MR. GILLESPIE: Just to maybe expand a little bit and maybe not be quite as cautious as Frank, the $169 million increase is in the President's budget that has been submitted to Congress. And based on -- he hasn't consulted me yet either, amazing as that may seem. But his statement when he signed the waiver -- and you have asked why did he do it -- he's in a very difficult situation. But his displeasure about having to be put in that position and having to do it and his distaste for this legislation was made extremely clear, and that statement is on the White House web page. So I think there would be a lot of us very surprised if he didn't make some statement again saying that this legislation is bad and he wants it to not be in this year's appropriation. And it is appropriations; it's not an authorization so it has to be renewed each year.
QUESTION:(Inaudible) try and frame this thing because I write for an international audience who find the abortion debate here a little hard to understand. What motivates, in your opinion, the people in Congress who back this to do what they did? Were they trying to embarrass the Administration or were they just so extreme in their views that they don't mind risking these lives that you're talking about? Why did they do this?
UNDER SECRETARY LOY: Well, I can only speak to some public statements that were made at that time, and I think the feeling was that abortions generally were wrong and organizations that we supported ought not to either perform them or advocate in their favor and that it, in their mind, it didn't matter whether that was with money that came from us, which has been -- that hasn't been legal for many, many years so that was not the issue but, in their mind, we ought to simply not have anything to do with organizations that advocated for abortion reform or any change in the law or policy in that regard. And that is a deeply felt view, and I think it does have the strange results that Duff and I have talked about; that is, it actually is going to increase the number of people that have to rely on abortions. But the principle is what I think was in the minds of some of those legislators.
QUESTION:Very quick -- just a yes or no. My understanding, though, that the Administration was the one that proposed this language to mollify Chris Smith and others, right? It was not -- I mean, they wanted something even harsher, right, and the Administration came back with this compromise, as bad as it was, if that's what you're going to say? Right? I mean, you guys were the ones that came up with this language that does this?
UNDER SECRETARY LOY: I actually wasn't -- this was in the omnibus appropriation resolution of the very last day, and I don't exactly know which piece of paper came first. What I do know is that nobody on the Administration side wanted this. In the end -- and when you try to make a compromise, and this was a compromise -- you end up accepting things that you don't like.
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