Fight Against HIV/AIDS Depends on Both PEPFAR and US-Supported Family Planning

Washington, DC - May 14, 2007

As the HIV/AIDS epidemic increasingly affects women, it is more important than ever that HIV/AIDS programs coordinate with and complement family planning and reproductive health programs.  The question is: How can this be done most effectively?

In the United States, both the President’s Emergency Plan for AIDS Relief (PEPFAR) and international family planning funds are subject to severe and hampering restrictions further limiting the flexibility of these funds to address women in need.  The Global Gag Rule denies foreign organizations receiving U.S. family planning assistance the right to use their own non-U.S. funds to provide legal abortion, counsel or refer for abortion, or lobby for the legalization of abortion in their country.  The Prostitution Pledge requires all groups receiving PEPFAR funds sign a pledge opposing prostitution.  The abstinence-until-marriage earmark in PEPFAR requires one third of all prevention funding to go toward abstinence-until-marriage programs.  The myriad of rules and regulations on both PEPFAR and family planning funding hurt the very people that these programs are supposed to be helping.

Until these harmful restrictions are repealed, it is important to understand and work within the existing policy framework in order to provide the most efficient and effective reproductive health services possible.  Since in the US policies follow the provision of services, PAI urges that  programs funded by the US  formally coordinate their services so that woman benefit while we work to remove the harmful restrictions that hamper these programs. In addition, we urge country governments and other funding sources to continue to work to make prevention programs as strong as possible.  It is crucial that these programs do not adopt the restrictions that hamper U.S. funding.

Coordination of PEPFAR and family planning requires funding for both.  However, as we discussed here last week, despite international family planning’s successful track record, there has been a 41% drop in assistance since 1995 (adjusted for inflation).  In fact, the U.S. no longer funds any family planning at all in five PEPFAR focus countries: Botswana, Cote D’Ivoire, Guyana, Namibia, and Vietnam.  This devastating oversight prevents women around the world from accessing high quality, U.S.-supported reproductive health programs and services, hindering PEPFAR’s fight against the spread of HIV.

As Ambassador Mark Dybul, U.S. Global AIDS Coordinator, stated to the House Committee on Foreign Affairs last month, “HIV/AIDS does not exist in a vacuum. It is inextricably tied to other threats to public health, and it has ramifications for a wide range of development-related issues.”  By working together, international family planning and PEPFAR can improve the lives of women and families around the world.  But, without U.S. resources for family planning, PEPFAR is losing the fight against the spread of HIV—and women are the ones who pay the ultimate price.

Population Action International (PAI) works to improve individual well-being and preserve global resources by mobilizing political and financial support for population, family planning and reproductive health policies and programs.