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WORLD POLICY JOURNAL
Barbara Crossette * Obscured by the debate over the Bush administration’s occupation of Iraq and the tactics of antiterrorism warriors at home, there is another Bush legacy, one that threatens to undercut development in the poorest, most vulnerable nations, with more loss of goodwill for the United States. Four years of ideologically driven, unrealistic, and outdated social policies have turned American foreign aid into a vehicle for the most intractable, irrational, and uninformed elements of the conservative right. The Bush administration, bucking nearly all current expert thinking on how to tackle world poverty, persistent hunger and the HIV/AIDS epidemic, has entrenched itself behind global policies that draw their inspiration from the most illiberal of American anti-abortion, anti-choice, anti-gay lobbies. These policies have opposed women’s rights, especially the freedom of choice in reproductive health services; denied women abortion for any reason; railed against increased sex education for the school-aged young—urging abstinence on a disbelieving world in-stead—and fought to block all global efforts to distribute emergency contraception, even to devastated women in refugee camps or combat zones, where rape is a significant fact of life and a war crime that complicates the rebuilding of torn societies. All this has been happening as United Nations agencies, the World Bank, and independent aid groups have come to conclude, some even reluctantly, that with enough of the right help, ordinary women may be more important than governments in cutting high poverty rates, alleviating food shortages, and reducing widespread transmission of the virus that causes AIDS. This is the new reality: development has to work from the bottom up. Those who oppose advances in international family planning, often with a McCarthyite zeal, have made condoms iconic to their moral arguments. In the developing world, condoms are lifesavers against not only AIDS but also unwanted teen pregnancies, the largest killer of girls in a number of poor countries. The world is tens of millions of condoms short, international experts say. But their wider distribution, especially to the young, is strenuously opposed by the conservative lobby and limited by U.S. aid to only those organizations willing to sign on to an administration policy against abortion. In that chilling climate, nongovernment organizations also feel they must tread carefully in reaching out to sex workers and gay groups, hugely important targets, especially in Asian and African countries where governments try to deny their existence. Ideologues of the right seize projections of a “birth dearth” to justify downplaying the overwhelming need for more contraception of all kinds, conveniently ignoring the brutal reality that 98 percent of the world’s population growth this century will take place not in the low-growth countries of Europe or Japan but in the most desperately poor, disease-wracked nations. A billion young people worldwide are about to enter their reproductive years; they form the largest reproductive generation in human history. Go to the woefully under-equipped clinics in rural Latin America, in the cities of Africa, or in the villages of Asia and family planners will shake their heads in bewilderment at how irrelevant, if not fatal, the current American message of abstinence can be when girls as young as ten may be forced into sex or drawn to a sugar daddy for just enough money to eat the next meal or go to school, and women of all ages have no power to refuse the advances of violent partners or demand the use of condoms, though they risk being infected with the AIDS virus. To them, American ideologues, fortified by plain ignorance about much of the world, become weapons of mass destruction. On an extended study trip that I made to Latin America, Africa, and Southeast Asia in 2004, I heard scant criticism of the war in Iraq but many expressions of anger or sadness about restrictions on American aid for health and social programs, and the example this is setting. Fred Sai, the father of family planning in Ghana, spoke for many when he said bitterly that governments have no business mixing morality with public health. In June 2004, on the eve of an international conference in Washington on the needs of young people worldwide, the United States abruptly withdrew its support from the sponsoring organization, the Global Health Council. When the conference opened, the council’s president, Nils Daulaire, told the assembled participants that “the people who have driven a wedge between U.S. public health officials and their colleagues at this conference are not concerned with solving worldwide health threats.” For 30 years, the U.S. had been active in the Global Health Council, which began as an American nonprofit organization in 1972 and is now the largest such health-care alliance in the world. Last June, it suddenly became the focus of right-wing wrath because “blackballed” organizations such as the International Planned Parenthood Federation and the U.N. Population Fund were taking part in the conference on youth. Daulaire, a physician who had been a senior health official at the United States Agency for International Development (USAID) from 1993 to 1998, called the enemies of the council and other organizations a “clique” exploiting public health issues for domestic political purposes. “Not one person in that clique has ever spent a day in a clinic in a developing country,” he said in his speech. Gert Rosenthal, until recently Guatemala’s ambassador to the United Nations and a diplomat who has been a strong advocate of expanding women’s rights and liberalizing social policies in the developing world, has been among those who have watched the United States, allied with the most conservative Muslim nations and the Roman Catholic Church, wage repeated campaigns to strip international agreements of any hint of social liberalism and to roll back significant gains in policies worldwide made in the last decade. These reversals cannot easily be undone. Rosenthal says that by 2004 the American delegation was outdoing the Vatican in its behavior in international forums. “The most conservative—I would say, retrograde—positions on population are coming out of the U.S. delegation,” Rosenthal said. “Unbelievable!” Some Europeans squeamish about sexual health were beginning to echo the Americans, Rosenthal said, fearing a snowball effect. George Bush’s Right-Wing Agenda It is significant that the control of population policy had by 2001 settled firmly in the White House, prodded by a conservative bloc in Congress. Professional experts drawn from diplomatic, health, intelligence, and aid offices have been effectively cut out of the policymaking process. When President Bush decided to end all U.S. contributions to the United Nations Population Fund in 2002, based on a spurious charge by a marginal right-wing research group that the agency was funding abortion in China, he brushed aside a report to the contrary made by a State Department team that visited China to examine the charges. A British parliamentary group fact finding in China around the same time also found the claims made against the United Nations to be false. After the loss of American contributions, now totaling over $60 million and growing yearly, the U.N. Population Fund extrapolated what this could mean in human terms. In a year, the agency said, the lack of American money could translate into 2 million unwanted pregnancies, up to 800,000 illegal abortions, 4,700 maternal deaths and 77,000 infant and child deaths. Even a future abrupt change in American policy cannot bring back those who have died, nor restore overnight the programs that have been slashed. The fund has in the meantime given up on the United States and is relying on Europe and Japan as major donors. The United States is out of U.N. family planning. There are both personal and political ironies in this Bush legacy. George W. Bush’s father, George Herbert Walker Bush, was a leading proponent of expanded American aid to address social problems abroad when he was a member of Congress in the 1960s, said Steven W. Sinding, a former director of population and health policies at USAID and later professor of population and family health at the Mailman School of Public Health at Columbia University. “It was W’s father who was one of the early champions of international family planning,” said Sinding, who is now director general of the London-based International Planned Parenthood Federation, which has been cut off from all American aid because it supports abortion rights. Sinding added in an interview that in the 1960s it was the political left in the United States and Europe that was often more opposed to population policies, which were being portrayed by anti-colonial fire-brands as tantamount to genocide in the Third World. Mostly right-wing, or at least conservative, philanthropists, promoted and financed international population programs, encouraged by Gen. William Draper, whom President Eisenhower had assigned to survey the issue. Draper concluded that rapid population growth and attendant poverty in the Third World should be considered a security threat to the United States. When Eisenhower disagreed, Draper struck out on his own, founded the Population Crisis Committee and raised money from independent sources. The Ford and Rockefeller foundations were also moving on a parallel track, Sinding said. In the light of recent history, and accumulating intelligence reports dating back into the 1990s, Draper was right. How often are we told about the breeding grounds for terrorism among poor, frustrated, unemployed (or underemployed) young men? Today, in many of the world’s most desperate places, young people account for up to half the population. In 2004, the International Labor Organization reported than more than a quarter of young people between the ages of 15 and 24 around the world were unemployed, with the highest rates in the Middle East and southern Africa. Globally, 85 percent of the young live in developing countries. Nevertheless, since 2001 the United States has been doing some tough arm-twisting to institutionalize the social agenda of the conservative right internationally. Ambassador Rosenthal of Guatemala, describing how Latin American and Caribbean nations have tried with some success to hold the line against Washington in hemispheric meetings over the last year or two, said that there has been extraordinary, outrageous pressure on small nations such as those in Central America to agree to eliminate references in regional documents to women’s reproductive rights. Not only would the international institutionalization of one notion of morality undermine and complicate the task of social activists in developing countries, who rely on United Nations agreements as ammunition in dealing with their governments and religious institutions, but it would also mean that years of hard international negotiating could be lost. With the euphoria of the post–Cold War 1990s behind us, it is unlikely that the remarkable gains of social agreements, particularly on the rights of women and children—now seen as the keystone to national development—can be restored. The United States has, for example, formally distanced itself from the groundbreaking international consensus reached in Cairo in 1994 at the International Conference on Population and Development, which redefined population control by putting it in the hands of people—women and men—not statisticians or governments. Study after study by expert organizations— governmental, intergovernmental, or voluntary—has shown that given the opportunity and the contraceptives, women want to and will reduce the size of their families, even when they have to do so at the risk of violence from husbands or other partners. Now in the age of AIDS, a woman’s right to say no, or to demand safe sex has become a matter of life or death. If you are poor and female in, say, Nigeria or India, this is neither a feminist idea nor a moral issue. Paradoxically, it gives true meaning to the phrase “right to life.” In October 2004, more than 250 present and former world leaders and other eminent figures, affirming the Cairo agreement in a statement, left no doubt that this is not a mere “women’s” issue. The leaders’ document reiterates that basic education, expanded human rights, and the protection of the environment were also part of the Cairo consensus, which may be the most pro-family document ever to emerge from the United Nations. That 1994 document said, in essence, that the well-being of the family was the key to national development and progress; economic growth and political maturity grew from these roots. For conservatives, the problem with Cairo appears to be that the 179 nations represented there had also signed on in support of a central—at least equal—decision-making role for women in the family and society. This is now attacked as a “feminist agenda.” What many population experts in particular find most tragic in this American turnaround is the precipitous fall from the heights where the United States once stood in the world in promoting social development. “The U.S. went from leader to antagonist,” said Stirling Scruggs, an American who recently retired as head of information and external relations at the U.N. Population Fund after serving the agency in the Philippines, North Korea, and China. Before joining the United Nations, he had been a Peace Corps volunteer in the Philippines and executive director of Planned Parenthood of Memphis, Tennessee. “Both in the U.N. and when I was overseas, I was proud to be an American in my early years because I knew my government was leading the way,” he said. That pride has vanished. “What had been in many people’s eyes the most benevolent government, the government that championed human rights and women, has reversed itself and has the opposite effect now,” he said. “Women are dying because of that.” From Activism to Obstructionism In London, Steven Sinding of the International Planned Parenthood Federation— which in recent years has led a trend toward shifting focus from traditional family planning to programs for youth—outlined how the American activism of the 1960s has become the obstructionism of today. By 1966, with President Lyndon Johnson’s first budget request for population programs, a bipartisan consensus was growing rapidly in Congress, and provoking a reaction among conservatives. But it was not until 1979–80 that Republicans began to turn the issue of international family planning aid into an ideological battleground in Congress and in public life generally. “What we had was a bipartisan coalition in Congress in the mid-to-late 60s coalescing around [the issue of] population growth,” Sinding said. “The congressional budget rose from an initial $25 million to $50 million to $75 million to $100 million year by year in rapid succession, ramping up to what became a stable figure in the $100 million to $150 million range by the early 1970s—which was a lot of money in those days.” By then the United States was the largest and most influential donor to international population programs and the motivating force behind the founding of the United Nations Population Fund, first called the U.N. Fund for Population Activities or UNFPA, the initials by which it is still known. Unfortunately the official in charge of population programs for USAID, R. T. Ravenholt, was a controversial figure who took a very aggressive approach, including the promotion of abortion as a method of family planning. “Ravenholt’s pushing abortion as part of the response to the demographic crisis really woke up the right wing in the United States and made USAID and U.S. funding for international population[work] a target of anti-abortion activists,” Sinding said. “Between 1973 and the Reagan election [in 1980] they really organized themselves and decided they were going to take on this issue in a major way. It became part of the Republican Party platform in 1980 to de-fund international family planning, and specifically to eliminate the advocacy of abortion. It’s been in the Republican platform every since. “It’s been a very conscious strategic alliance between the religious conservatives, who never had been particularly partisan before, and the Republican Party,” he said. “What had been a bipartisan commitment on the part of the United States—and a very stable political consensus dealing with global population growth—suddenly became an intensely political issue around the U.S. abortion debate, and it completely changed the optic.” Once entrenched in partisan politics, the issue moved, at least in part, away from Congress and the experts in a range of government departments and agencies to the White House, where it remains. Symbolic of this shift is the Mexico City policy, under which the Reagan White House overstepped an interagency coordinating group preparing for a 1984 United Nations population conference in Mexico and declared that no American money would henceforth go to any nation or organization that provided or promoted abortion as a means of family planning. That blanket ban has come to include even those private charities that advocate making abortion legal and safer in many countries where women die of botched or routinely dangerous back-street procedures. In the field, the U.S. regulation is called the “global gag rule” because its goal is perceived to be ending all counseling and discussion on the issue. In two decades, the Mexico City policy has become a political football. As one of his first acts in office in 1993, President Bill Clinton rescinded it; George W. Bush put it back in force immediately after his inauguration in 2001. Currently, as USAID correctly points out, the policy does not prohibit funds going to organizations that help women recover from abortions. USAID continues to be a major donor to family planning projects worldwide, and is still the leading contributor worldwide to programs to combat the spread of AIDS. The United States also has extensive programs to promote women’s political participation and expanded educational opportunities everywhere. But recent history is proving that political visibility and more education alone are not the solution because the poorest women burdened with perpetual pregnancy, ill health, and often an early death rarely benefit. It may be politically incorrect to say so, but in the villages of India’s states of Uttar Pradesh or Bihar, and in exurban shantytowns in Africa or Latin America there are just too many children without hopes of a better life, and women know that. As a community worker in Rajasthan once said to me, “They know there are not enough seats on the bus or enough places at the table.” From families like these in India, Nepal, Bangladesh, and many other places, boys are driven into urban slums to look for work and girls are often sold into the sex trade. In their pathetic brothel cubicles, AIDS awaits them. In the face of this, the two largest players in the world in population activities, the United Nations Population Fund and the International Planned Parenthood Federation, can no longer receive U.S. money, even for AIDS work. And USAID can no longer rely on objective experts in making policy decisions. It is bound by presidential directives influenced by political considerations, paradoxically now among Democrats as much as Republicans. Women’s Rights: A Red Flag To be fair, it should not be forgotten that the move away from liberal international social policies began in the waning years of President Clinton’s tenure. In 2000, the U.N. General Assembly adopted what have become known as the Millennium Development Goals, a set of benchmarks to be achieved internationally by 2015. Nowhere in those goals or indicators accompanying them for measuring progress, was reproductive health or the right of women to take charge of their lives explicitly stated. The goals were written in Secretary General Kofi Annan’s office, apparently to avoid controversy, and circulated among national delegations. The Clinton administration did not force the inclusion of women’s rights, despite all the efforts of strong advocates for Third World women on Hillary Clinton’s staff. The speculation is that Al Gore, heading into an election, was not keen on pushing the issue, a red flag to Republicans. Nafis Sadik, a Pakistani physician and the outspoken former head of the U.N. Population Fund who now serves as Kofi Annan’s special envoy on HIV/AIDS in Asia, has gone public in speeches critical of the United Nations hierarchy for failing to stand up to pressures from the lobby that now groups the United States with the most conservative Roman Catholic and Muslim nations. Sadik, who deftly ran the 1994 Cairo conference on population and development, is hopeful that a majority of nations will stick by their commitment to the decisions made there. But she is concerned that a skittish U.N. Secretariat—unlike the organization’s quasi-independent, bolder agencies such as the Population Fund, UNICEF, UNIFEM, and the United Nations Development Program—wants to avoid any more damage from Washington, where Congress is capable of cutting off more funding, threatening the very viability of the organization. Sadik also has come to believe that men in power see the population issue, and most of all women’s rights, as marginal. “I used to say in the U.N. that our colleagues, especially our senior colleagues, were as much an obstacle as the pope,” she said in an interview. “That’s a slight exaggeration. But ask them about reproductive rights, and their response is: ‘What’s that got to do with us?’ I say it has got everything to do with everyone.”
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