Questions fiscal conservatives need to ask about funding for family planning

By Rebecca Oas, Ph.D. | August 4, 2016

Much of the controversy over funding for international family planning in the U.S. government is really about abortion. Pro-life members of Congress object to funding the family planning NGOs that promote and perform abortions overseas, even if U.S. funding does not pay for those specific things due to the Helms Amendment. And, when pro-life administrations block abortion-promoting groups from receiving any family planning funding by reinstating the Mexico City Policy, the resulting outcry only confirms what the pro-life community already knows: with very few exceptions, the family planning lobby and the abortion lobby are inextricably linked.

But for many pro-life lawmakers, there is a strong desire to fund family planning, if only it could be meaningfully separated from abortion. In fact, according to former head of USAID’s division on population and reproductive health, Duff Gillespie, Republicans have allocated more funding to international family planning than Democrats in recent administrations (clip below is excerpted from this 2015 event at the Wilson Center). And that was while the Mexico City Policy was in place.

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So, pro-life members of government don’t see family planning as a pro-life issue per se, provided they can put safeguards in place to prevent funds from going to abortion groups.

But there is another argument that needs to be heard in appropriations meetings, and that has to do with the arguments justifying increased international family planning spending. To illustrate, a recent Guardian article titled “Critical moment for family planning as funds come under pressure.”

Let’s examine some excerpts:

Countries with the lowest take-up of contraception will need to increase spending on family planning to meet international targets.

At the halfway point of Family Planning 2020 (FP2020), an ambitious initiative to increase access to modern contraception for 120 million more women and girls in 69 target countries, organisers said national governments need to allocate more money in their health budgets for contraceptives amid concerns that donor funding could begin to fall.”

These “international targets” are framed in terms of contraceptive access, but a look at the fine print on FP2020’s website reveals that the real target is adding 120 million additional users. The obvious, but erroneous, implication is that the only thing stopping these women from using contraceptives is lack of access.

So, the Guardian would have you believe that access is lacking, funding is needed to create supply, and demand will simply follow. If only it were so simple, as in the old days where there wasn’t so much emphasis on use being voluntary

Across the world, logistical challenges remain another stubborn barrier to family planning. Even with more money, a lack of trained healthcare workers to raise awareness of the types of contraception available and cultural taboos around sex make reaching targets difficult.

One thing that’s completely missing from this article, despite its talk of budget shortfalls, is any suggestion that existing provision of family planning services for current users will be in any way jeopardized. And, given that only about 5% of women with an “unmet need” for such services claim a lack of access to them, anyone would think we’ve about reached a saturation point.

The bottom line is this: “unmet need” does not equal lack of access, and provision of access is not a guarantee of use. As long as family planning groups use rhetoric about access in their justification for increased spending, government representatives entrusted with taxpayer money need to be asking some hard questions, like “demonstrate to me that these women actually want, cannot get, and intend to use contraceptives.”

And if the evidence isn’t there, the funding shouldn’t be there either. It’s a matter of fiscal responsibility, and something that all lawmakers should care about – whether they identify as pro-life or not.