Population, Family Planning and Presidential Priorities

by Jeffrey Locke

Over the last week, the American people and financial markets around the world watched as Congress debated an eye-popping $700 billion dollar economic rescue for the American economy.  Lost amidst the media's coverage of the rescue plan was another Congressional decision - to punt to the next President and new Congress tough decisions on funding for most FY 2009 government programs, including foreign assistance. 

As World Watch Institute's latest magazine issue "Population Forum" illustrates, concerted foreign assistance that emphasizes international family planning programs is going to be required to address the nexus of population issues that have emerged - environmental degradation, climate change, as well as poverty, security and the health of women and children.  However, having worked in Togo, West Africa, an area of the world where hundreds of thousands of women already fail to have their family planning needs met, I'm left to wonder: if the next Administration turns away from our obligations overseas, will foreign assistance and developing world women be the first casualties of the economic downturn?

This past week I attended a presentation at the Woodrow Wilson Center for International Scholars that highlighted the launching of "Population Forum."  Featuring remarks by Robert Engelman, Vice President for Programs at World Watch Institute; Thomas Prugh, editor of World Watch Institute; Sean Peoples of the Woodrow Wilson Center; and PAI's own Vice President of Research, Karen Hardee; the event provided a forum to discuss the magazine's focus on population and why issues such as population growth, age structure and youth bulges have become increasingly relevant to environmental issues.

Already prominent in discussions within national security circles (as demonstrated by PAI's own Shape of Things to Come), demographic characteristics have now become salient for how environmental organizations approach environmental degradation, and efforts to mitigate global climate change.  World Watch magazine editor Thomas Prugh, in acknowledging that "the planet faces a range of grave and interlinked challenges" that harbor serious consequences for ignoring population issues, left this question to policymakers: "What should be the response by the developed world?"

Over the last four decades, one of the responses by the U.S. Congress has been to provide funding for voluntary family planning programs overseas - which have succeeded in reducing average fertility rates among developing world married women from about six children per woman to three children.  This success is despite a downward trend since 1995 in funding - nearly $100 million -- a 39 percent reduction (when adjusted for inflation) that coincides with President Bush withholding nearly $200 million in funding for the United Nations Population Fund and his Administration's implementation of the Global Gag Rule in 2001.

Fortunately, this past July the U.S. House and Senate Appropriations Committees proposed historic funding increases for these crucial programs, and acknowledged the role that high rate of population growth plays in contributing to "competition for limited resources, environmental degradation, malnutrition, poverty and conflict."  While Congress was unable to enact these funding increases in time for the new fiscal year on October 1, the continuing resolution passed ensures that Federal agencies and programs will continue to operate at current levels - possibly until the foreign assistance priorities of the next President are revealed - which, as my colleague Craig Lasher notes, "matters greatly." 

These priorities will have a direct bearing on over 200 million women in the developing world, who already want to space or limit their childbearing but live without modern contraception.  Having lived among some of these women who lack access to contraception in Togo, West Africa, a country that has lacked a steady USAID presence for years, I've seen what can happen to women in the developing world if either Presidential nominee decides to turn away from family planning programs. 

I've seen scores of women seeking contraception, with their babies strapped to their backs, waiting in my village's health clinic from 6 a.m. until nightfall, only to have to return the next day or the day after that, to procure elusive contraception.  I've seen girls left off the rolls of school enrollment, married off as children and twice pregnant by 15.  I've seen large numbers of young males lacking opportunity - lacking an adequate education to get a job, lacking sufficient land to farm, angry at their government for change - migrating from Togo to feed their young and growing families.

The situation for women and families in Togo and in much of the developing world represents the stark choice in foreign assistance priorities for the next President:  does the U.S. expand family planning programs into nations that have high rates of unmet contraceptive need, or does the U.S. scale back family planning assistance, as the U.S. has done with serious consequences in the Philippines and Kenya? 

For Republican Presidential nominee John McCain, his recent debate with Senator Barack Obama highlighted his belief to cut spending and institute a "spending freeze" on programs deemed not vital - leaving only entitlement, Veterans Affairs and defense programs unfrozen.  Prior to the debate however, Senator McCain stated that a McCain-Palin Administration would give priority to efforts to improve maternal and child health.  As family planning is recognized in public health as a crucial element (along with health clinic access and obstetric care) in improving the health of the mother and child - would international family planning programs be spared from Senator McCain's proposed spending freeze?

At the same debate with Senator McCain, Senator Obama stated that due to the financial crisis, as President he would have to prioritize and "eliminate programs that don't work and make sure programs we do have are more efficient and cost less." Senator Obama went on to acknowledge that "there are some programs that are very important that are underfunded." Will U.S. international family planning programs qualify as a program that an Obama-Biden Administration would find additional resources for?

Despite decades of success in creating healthier families and a healthier planet, we in the SR/RH and environmental communities are now left to wait and see whether international family planning programs meet the foreign assistance and funding priorities of the next President.  As my Togolese brethren would say, "On verra" - we will see.