The Foreign Service Journal, June 2007

J U N E 2 0 0 7 / F O R E I G N S E R V I C E J O U R N A L 47 ush administration policies are constrain- ing women’s access to family planning, HIV/AIDS and other public health pro- grams in the developing world and are undermining best practices, particularly in sub-Saharan Africa. Taken together, the Mexico City Policy, which applies to U.S. family planning funding; the President’s Emergency Plan for AIDS Relief, which governs U.S. funding to combat HIV/AIDS; and a series of USAID policy and funding directives have acted to restrict compre- hensive health programming in the developing world while expanding funding to Bush administration supporters and faith-based organizations, even those without experience in the health sector specifically or development generally. A barrier to women’s security and development, these policies are reversing the hard-won gains of recent decades. They have contributed to declines in maternal and child health and access to health care generally, and have led to increases in birth rates and maternal mortality rates. They have diverted vital funding away from implementation of effective HIV/AIDS prevention strategies and successful multilateral initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Further, the policies have deflected public attention, as well as taxpayers’ funds, from health programs benefiting women who rely on U.S.-financed public health programs for life-saving services. The Mexico City Policy On Jan. 22, 2001, his second full day in office, President George W. Bush reinstated the Mexico City Policy, created during the Reagan administration and named for the city that hosted the conference where it was first introduced. It prohibits USAID family planning funding from going to for- eign nongovernmental organizations that — with funding from any source, including their own — do any of the fol- lowing: provide counseling and referral for abortion; per- form abortions in cases not involving a threat to the life of the woman, rape or incest; or advocate making abortion legal or more available in their country. These prohibitions do not apply to U.S. organizations. However, their programs are still profoundly affected because they are required to enforce the restriction on for- eign NGOs receiving U.S. family planning assistance. This has resulted in the exclusion of many capable foreign NGOs from partnerships with U.S. implementers, fragmenting the local public health delivery infrastructure and wasting funds to duplicate public health delivery channels. The policy also W OMEN ’ S H EALTH U NDERCUT BY A DMINISTRATION P OLICIES C OMPREHENSIVE HEALTH PROGRAMMING IN DEVELOPING COUNTRIES IS BEING SCUTTLED , ALONG WITH THE C ONSTITUTION , UNDER THE B USH ADMINISTRATION ’ S IDEOLOGICAL AGENDA . S UB -S AHARAN WOMEN ARE AMONG THE IMMEDIATE CASUALTIES . B B Y T AMERA F ILLINGER Tamera Fillinger was an FSO legal adviser with USAID, serving in Nairobi, Jakarta and Washington, D.C., from 1992 to 2000. She now advises international development NGOs in private practice. She lives in Beijing with her fam- ily. This article was prepared for a University of Maryland law school symposium on the global advancement of women. A footnoted version of the article is available as “Enhancing Human Security: U.S. Policies and Their Health Impact on Women in Sub-Saharan Africa,” 6 U. Md. L.J. Race, Religion, Gender & Class 337-52 (2006).