Foreign Policy Blogs

Threats to Global Health: Politicking in the USA


Well, it’s a new week and the same old, same old is happening in Washington. The House Appropriations Committee has released the 2012 State and Foreign Operations Bill and, unsurprisingly but disappointingly, in its current form the bill proposes an 18% cut below last year’s appropriation.  The proposed total on for appropriations is $39.6 billion, which is a decrease of $8.6 billion from this year’s level.  The United States Agency for International Development (USAID) would lose $488 million from last year’s budget, which is $705 million less than President Obama requested, for a total of $1.04 billion for 2012.  In other words, a cut of over a third of fundingBilateral and multilateral assistance programs would also take big hits, as would the Department of State.  As the Chairwoman of the Committee, Representative Kay Granger (Republican of Texas) said on Wednesday during markup for the bill, many of the agencies and programs supported through the Appropriations Bill would see their funding rolled back to 2008 levels.  The global gag rule (or Mexico City Policy) would be reinstated, funding for the United Nations Population Fund (UNFPA) and UN Human Rights Council would be disallowed (along with further cuts to UN programs and participation), and funding for needle exchange programs would be prohibited. To put it simply, this is a terrible prospect for global health.

Let’s start with a specific issue.  Women’s reproductive health and maternal and infant morbidity and mortality programs are once again at the center of a political fight over abortion and family planning.  Take a country like Sierra Leone, which has an abysmal maternal and infant mortality record.  According to UNICEF, it has the world’s fifth-highest mortality rate for children under five, its maternal mortality ratio (number of annual maternal deaths per 100,000 live births) was 970 in 2008, and a woman has a one in twenty-one chance of dying in childbirth in her lifetime.  Only 25% of women give birth in a facility.  Sierra Leone has high rates of child and teen marriage and pregnancy and of pregnancies per woman and one of the least developed health care infrastructures.  Only 8% of women use contraceptives because most women do not have control over how and when they have sex with their partners or how many babies they will have.  It’s a country whose women and children would greatly benefit from comprehensive family planning programs that teach about and provide contraceptives, stress the importance of birth spacing, and support ante- and post-natal health.  Politics aside, family planning programs save lives and improve quality of life.  Sierra Leone, among many other countries (the US included), needs more of these programs.  See Mark Leon Goldberg’s post for The UN Dispatch for more about the need for family planning and the consequences of the proposed appropriations cuts to the UNFPA and others.

As Josh Rogin at Foreign Policy points out, due to the current debt ceiling crisis, there will not be much time to come up with a compromise plan with the Senate before the US government fiscal year starts on October 1.   Although the bill in its current form is very unlikely to pass the slim Democrat-majority Senate (and must first pass the House), it promises to create another on a long list of recent showdowns between parties, with global health and development programs and poor people around the globe playing pawns in another bout of political maneuvering.  There is no doubt that USAID and other government agencies need some reforming.  But the short-sighted budget cuts proposed in the Appropriations Bill will certainly harm disadvantaged populations that rely on US-financed programs and other assistance.  The United States’ foreign assistance programs, such as USAID, are vital to promoting equality, democracy, and good health and development around the world.  USAID has been integral to successful global health efforts.  Shame on the Appropriations Committee for once again putting these programs and agencies on the chopping block.


Original header photo here, from US Army Africa, CC BY.








Julia Robinson

Julia Robinson has worked in South Africa at an NGO that helps to prevent mother-to-child transmission of HIV and in Sierra Leone for an organization that provides surgeries, medical care, and support to women suffering from obstetric fistula. She is interested in human rights, global health, social justice, and innovative, unconventional solutions to global issues. Julia lives in San Francisco, where she works for a sustainability and corporate social responsibility non-profit. She has a BA in African History from Columbia University.