WASHINGTON - Under beleaguered President Paul D. Wolfowitz, the World Bank may be scaling back its long-standing support for family planning, which many countries consider essential to women's health and the fight against AIDS.In an internal e-mail, the bank's team leader for Madagascar indicated that one of two managing directors appointed by Wolfowitz ordered the removal of all references to family planning from a document laying out strategy for the African nation. And a draft of the bank's long-term health program strategy overseen by the same official makes almost no mention of family planning, suggesting a wider rollback may be underway.
The World Bank has traditionally championed birth control and other methods of family planning as a key strategy to improve women's health and economic status.
The controversy has raised worries among some bank officials and health advocates that the Bush administration's conservative stance on family planning issues may be seeping into the institution.
The managing director, Juan Jose Daboub, denied he was making substantial changes to the bank's policy or that he demanded deletions to the Madagascar report. Daboub, a Roman Catholic with ties to a conservative Salvadoran political party, questioned staff outrage directed at him.
"To me this sounds like a storm in a glass of water," he said in a recent interview. "There is no reason understandable for this."
Bank staff members dispute Daboub's claim that he made no changes to the Madagascar report. "It's a blatant lie," said one staffer who has seen the document. Like other internal critics, the employee requested anonymity because he said he feared for his job.
A copy of the report obtained by the Los Angeles Times shows repeated deletions of references to family planning and contraception.
Women's health advocates said the situation was worrisome. "There's mismanagement there," said Carmen Barroso, a regional director for the International Planned Parenthood Federation. "Wolfowitz appointed a guy in a very high position who felt free to censor in line with his personal beliefs. I think that's good grounds for sacking."
The controversy has added fuel to anger at the bank over Wolfowitz's management style and his involvement in two unusual and large pay raises given to his girlfriend, Shaha Ali Riza, a bank employee on loan to the State Department.
Wolfowitz's problems have been compounded by revelations that Defense Department officials told one of their contractors to hire Riza for a short-term contract while Wolfowitz was the deputy Defense secretary. The Pentagon announced Wednesday that it was looking into the matter.
These issues will be on the table as the bank's board of directors meets today to debate Wolfowitz's future.
The board reportedly met Tuesday to discuss changes made to a draft document that lays out a long-term "Strategy for Health, Nutrition and Population Results." These papers, periodically revised, set bank policy and shape funding.
Overseen by Daboub's office, a draft version raised alarms among some staff members because it contained only one reference to family planning, and that was to a past project.
The current policy paper refers to family planning at least 23 times, repeatedly identifying it as a fundamental tool for tackling poverty and disease.
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Scaling back family planning funding "would have a tremendous impact because the World Bank is a major lender in the health sector, particularly in the poorest countries," said Bea Edwards, international director at the nonprofit Government Accountability Project.
The bank lends to private organizations such as the Gates Foundation as well as the United Nations Capital Development Fund.
The Bush administration has imposed its beliefs about family planning and abortion on other international organizations.
It has cut funding for U.N. agencies that promote family planning, forbidden any group it funds to discuss abortion and pushed abstinence programs.
Bank staff members say the Madagascar plan has been finalized and worry that other country plans may be altered as well.
Daboub said he would send at least 11 country reports, including Benin, Chad and Cameroon, to the board before December. "I respect the freedom of our partner countries to decide" on family planning, he wrote in an e-mail to colleagues meant to quell their anger.
Daboub said he did not ask that family planning be struck from the Madagascar report. "It is not true," he said.
Yet internal e-mails obtained by the Government Accountability Project appear to indicate otherwise. Referring to Daboub as the "MD," an acronym for his title as managing director, Madagascar country program coordinator Lilia Burunciuc wrote to colleagues on March 8, 2007: "One of the requests received from the MD was to take out all references to family planning. We did that."
Burunciuc added that this is "a potential problem for us" because Madagascar had made a "strong request for help" on family planning in the document, which serves as a three- to four-year plan for the goals a country wants to achieve with the bank's help.
Madagascar identified improved family planning as one of its national commitments.
Yet a copy of the report includes edits and deletions, which a bank staffer said were made by Daboub's office, showing that specific targets to boost contraceptive use were cut and broader aims were rewritten.
In one graphic, the words "improved quality of health services to ensure easy access, affordability and reliability" were inserted in place of "improved access and provision of contraceptives."
Copyright 2007 Los Angeles Times