NEW YORK - The Trump administration will withhold funds from the United Nations agency focused on reproductive and maternal health care for a third consecutive year, though critics and lawmakers say the decision will hurt vulnerable women and children, undermine US interests and is not based on evidence.
Secretary of State Michael Pompeo authorized the move to cut $32.5 million in funding to the agency for its core operations addressing maternal death, female genital mutilation, child marriage and gender-based violence and meeting family planning needs.
Pompeo's decision also denies the UN Population Fund, known as UNFPA, any US funding for emergency humanitarian operations in places such as Venezuela and Syria -- support that has amounted to as much as $36 million in previous administrations.
A State Department spokesman said Pompeo made the decision because he had determined the UN agency "supports or participates in the management or a program of coercive abortion or involuntary sterilization" in China.
The UNFPA, lawmakers and advocates say that simply isn't true.
The agency doesn't run or fund any programs in China and works only on policy guidance -- with a view to changing Chinese practices such as sex-selective abortion, UNFPA officials say. They add that since the US signed off on their program for China in 2015, no Trump administration official has come to visit or inspect it, raising questions about the basis for Pompeo's decision.
"The Trump administration shouldn't fabricate excuses to withdraw funding from the UNFPA, especially when vital, life-saving work is at risk," said Sen. Jeanne Shaheen, a New Hampshire Democrat who sits on the foreign relations committee.
The UNFPA cuts are part of a broader Trump administration pushback against reproductive health, Shaheen and other senators noted in a letter to congressional appropriators. The administration has also drastically expanded a policy meant to deprive international aid groups of funding if they discuss or provide abortions -- cutting aid for all their health programs, from nutrition to tuberculosis, if they do.
In their April letter, the senators pushed appropriators to reconsider President Donald Trump's budget proposal for fiscal year 2020, which included a 61% reduction in international family planning and reproductive health programs. Urging support for UNFPA, they argued that cutting US funding to the agency "is unfounded, short-sighted and will have a harmful impact on some of the world's most vulnerable communities."
Pompeo is going ahead with the cuts by using an amendment to appropriations law called the Kemp-Kasten Amendment, first enacted in 1985, which requires that no US funds be given to an organization or program that "supports or participates in the management of a program of coercive abortion or involuntary sterilization."
A State Department spokesperson, who wouldn't be named, said Pompeo's decision was shaped by wording in public UNFPA documents.
The UNFPA "continues to indicate in its public country program documents that it partners on family planning with the Chinese government agency responsible for these coercive policies. The Secretary has determined that UNFPA therefore 'supports or participates in the management of a program of coercive abortion or involuntary sterilization,' " the spokesperson said.
"The issue is the word 'partner' " said Sarah Craven, chief of UNFPA's Washington office.
"When we partner with the government of China, we're trying to end their sex selective abortion and coercive birth limits," she said, referring to the Chinese practice of forcing women to have abortions. "That doesn't mean we help the government do those things," Craven said, "it's literally the opposite."
She noted that UNFPA "partners" with Bangladesh to end the practice of child marriage there and similarly works with Egypt to end female genital mutilation. "Any country we work in, we support human rights," Craven said. "We absolutely do not support coercion in any country in which we work."
"I would hope and believe that is something the United States would want to support and partner with us on," Craven said.
UNFPA would welcome a visit from a Trump administration to see the China program, she said. She added that the funding decision, and the charge that UNFPA supports coercive practices, was conveyed in a phone call from the US mission to the UN and not in a formal letter.
The US cuts come at a time when needs are enormous. Natalia Kanem, UNFPA's executive director, estimates that in 2018 "a staggering 136 million people needed aid, an estimated 34 million of whom were women of reproductive age."
The State Department spokesperson said that the funding for UNFPA would be transferred to the US Agency for International Development "to support family planning, maternal, and reproductive health activities."
But the senators' letter noted that shift in funding doesn't simply replace UNFPA programs. The UN agency works in 150 countries worldwide, "often where the US Agency for International Development does not operate family planning/reproductive health programs," they said.
Seema Jalan, executive director of the Universal Access Project, said that UNFPA has been "a critical provider of health care services for women and girls in some of the most challenging places in the world right now, including Venezuela and Syria." The funding rollback "stands in stark contrast to our values as Americans and turns our backs on the world's most marginalized girls and women," she said.
The US had been the second largest donor for UNFPA's emergency responses in places such as Yemen or Venezuela. The funding is used to help mothers access health care, support survivors of gender-based violence and provide supplies such as "dignity kits," which provide women fleeing violence or natural disasters with staples such as soap, toothbrushes, combs, sanitary napkins, a bucket for water and other items.
Ann Erb-Leoncavallo, a senior adviser for UNFPA's Global Humanitarian Division said that the internal fund she puts aside every year for countries that are affected by emergencies had run out by the beginning of June. Trump administration reproductive health policies mean other aid groups are running out of money more quickly than usual and are turning to UNFPA for extra support.
"At the moment until the end of the year, I don't have any additional funding internally, for any type of unexpected emergencies," Erb-Leoncavallo said. Pointing to situations such as the escalating need along Venezuela's border with Colombia, she said, "this is where we will be really at a loss."
Craven said the loss of the US support for UNFPA "is dramatic, it's also the loss of a chance to work together in the field in places where [the US was] leading," she said.
USAID does not work in the Za'atari refugee camp in Jordan, the world's largest for Syrian refugees displaced by violence there. Since it opened in 2012, the maternity clinic there has now delivered 10,000 babies without a single maternal or newborn death. Before the Trump administration decision to pull funding for UNFPA, newborn children were put in a bassinet decorated with a US flag.
That doesn't happen anymore. Other countries have stepped in to fill the shortfall as US funding disappeared. "That's a loss in terms of US partnership and coordination," Craven said.
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