UNFPA, the United Nations Population Fund: A Review of the Role of UNFPA in Promoting Reproductive Health Worldwide Issue Brief

Summary

UNFPA¹, the United Nations Population Fund, provides international leadership on reproductive health and population programs for the world's poorest countries and areas hit hardest by natural disasters and war. With funding from about 166 countries, UNFPA supports services to help people plan their families or avoid pregnancy, give birth safely, prevent transmission of HIV/AIDS, and combat discrimination against women (UNFPA, 2005a). The United States has withdrawn critical support for the agency in response to domestic conservative politics making it the only country to ever withdraw funding from UNFPA for political reasons. The lost funds directly affect the most impoverished and vulnerable women in the world and could prevent the deaths of approximately 4,700 women each year (U.S. Committee for UNFPA, 2005). This Planned Parenthood^® Federation of America Issue Brief provides background on UNFPA, its work, and the implications of U.S. politics for reproductive health services to women in the poorest parts of the world.

What is UNFPA?

Founded in 1969 with support from the United States, UNFPA provides funding and technical assistance to governments and non-governmental organizations (NGOs) in 126 countries in sub-Saharan Africa, Latin America and the Caribbean, Asia and the Pacific, the Arab states, Eastern Europe and the former Soviet states (UNFPA, 2005b; UNFPA, 2005c).

UNFPA is the only multilateral agency — a politically neutral agency that receives funds from a number of countries — primarily dedicated to addressing the unmet need for family planning and reproductive health care services worldwide (Cohen, 1999; PAI, 2003). UNFPA provides contraceptives and information, health care for mothers and children, and services to prevent sexually transmitted infections (STIs), including HIV/AIDS. UNFPA's humanitarian response is at the front lines of global disaster, human-made and natural, to provide assistance to people in crisis situations. The fund's rapid response includes the immediate shipment of equipment and supplies to enable pregnant women to deliver safely. For many women living in some of the poorest, most remote regions of the world, or those areas most devastated by war or natural disaster, UNFPA is the primary source of funding for family planning and reproductive health information and services (PAI, 2003). Since its founding, UNFPA has provided nearly $6 billion in assistance for voluntary family planning and reproductive health care programs in developing countries (U.S. Committee for UNFPA, 2005).

UNFPA's Mission

UNFPA's work is based on the internationally accepted human right of all couples and individuals to decide freely and responsibly the number and spacing of their children, as originally declared at the 1968 UN International Conference on Human Rights (Office of the United Nations High Commissioner for Human Rights, 1968). Its strategies are guided by the Programme of Action adopted by 179 nations at the 1994 International Conference on Population and Development (ICPD). The Programme of Action is a blueprint for achieving universal access to family planning, reproductive and sexual health care by 2015; universal access to primary education by 2015; and reductions in infant, child, and maternal mortality (UNFPA, 2005b; UNFPA, 2005d). UNFPA's mission is to assist countries in achieving the goals laid out in the Programme of Action, particularly those aimed at decreasing maternal mortality, improving the health status of young women, improving access to family planning education and services, and addressing unsafe abortion as a serious public health threat (UNFPA, 2005e).

Making it real... Examples of UNFPA's work In China, UNFPA is working with governments in 32 counties to shift family planning policies from a population control focus to a rights-based approach. Government population targets and birth quotas in the counties were lifted, and replaced with comprehensive family planning services, information, and education programs aimed at enabling individuals and couples to choose the number and spacing of their children (Maloney, 2004; U.S. Committee for UNFPA, 2005).

The financial and technical assistance UNFPA provides reflects its commitment to reproductive rights, gender equality, and male responsibility, and to the autonomy and empowerment of women everywhere. The Fund safeguards and promotes these priorities as important building blocks for healthy individuals, communities, and the planet (UNFPA, 2001). Furthermore, UNFPA explicitly condemns coercion in any form.

UNFPA addresses unsafe abortion as a serious public health threat, and works with countries to build programs aimed at reducing the need for abortion through expanded and improved family planning and reproductive health care services (UNFPA, 2005f). As a matter of policy and in accordance with the ICPD Programme of Action, UNFPA does not support abortion as a method of family planning and builds programs aimed at reducing the need for abortion. (UNFPA, 1999).

UNFPA's Work with Countries

Any country that is a member of the United Nations may request assistance from UNFPA for population and family planning-related activities (Scruggs, 2002). In turn, UNFPA provides this assistance in keeping with its human rights and ICPD framework as described above. UNFPA is obliged to provide support, regardless of a country's political orientation, so long as the program is consistent with UNFPA's mission (Cohen, 1999).

In 2000, Cambodia launched its first census in 36 years, with UNFPA support, to help plan for the future needs of its citizens. (UNFPA, 2005f)

UNFPA works with host governments and local nongovernmental partners to develop country-specific approaches. The fund typically maintains a small number of staff in each country. Programs and projects are supported by UNFPA technical advisors who coordinate the projects with a variety of local, national, and international partners and the host government. Working with in-country partners gives local health care providers an opportunity to expand their skills and builds capacity within each country to deliver high quality, voluntary family planning and reproductive health services. As UNFPA is politically neutral and draws on support and expertise from dozens of countries, it can provide assistance in nations where, for political or resource reasons, the international development agencies of individual countries cannot (PAI, 2003). Some nations may feel more inclined to ask for family planning and reproductive health assistance from UNFPA rather than getting tied up in political strings — such as the U.S. global gag rule — or changes in programmatic direction with bilateral (government-to-government) donors. Therefore, UNFPA is able to reach a larger number of countries and their citizens than bilateral programs (Maloney, 2002).

UNFPA also works at the national and international levels to support policy changes that are in line with international agreements, such as the ICPD, which contribute to the long-term commitment of national governments to meeting the reproductive health needs of its citizens.

Where Does the Money Come From?

UNFPA is funded from voluntary contributions, primarily from national governments, and not from the UN's budget. In 2004 UNFPA spent $221.9 million to support family planning, reproductive health, and population projects around the world (UNFPA, 2004). Most of these funds were from 166 national governments, representing a diverse range of ethnicity, religion, region, size, and wealth (U.S. Committee for UNFPA, 2005).

UNFPA responded to the December 26, 2004 tsunami with an $8 million program for the reestablishment of reproductive health services demolished by the disaster. The funds are being used in places like Indonesia to restore day-to-day operations of health care clinics and to provide a supply of contraceptives to allow easy access to reproductive health services for people made homeless by the disaster. (UNPFA, 2005h)

While the number of countries supporting UNFPA has grown, the majority of the funds come from a small group of the world's wealthiest countries. The Netherlands and the United Kingdom are UNFPA's largest donors (UNFPA, 2004). Until 1985 the United States provided nearly one-third of the total annual funding for UNFPA and was the single largest donor to UNFPA (PAI, 2003). As such, when one major donor, such as the United States, decreases or eliminates funding, the impact is significant.

Who Decides Where the Money Goes?

All of UNFPA's work must be approved by its executive board, which is made up of representatives from 36 UN member states. Seats on the executive board are distributed among all regions of the world (UNFPA, 2005h). The United States, despite its lack of financial support to UNFPA in recent years, is an active participant in the executive board. Because UNFPA's budget comes from mostly governmental sources, it cannot promote the views of any one country — only its own program and philosophy (Cohen, 1999).

The U.S. government has made a dramatic reversal when it comes to UNFPA. In 1969 it identified the need for a UN entity to address global population issues and helped create UNFPA to meet that need, and continued as a lead donor of the agency until 1985 (PAI, 2003). Since then, the United States has routinely withdrawn and reinstated support in reaction to swings in the domestic political mood.

UNFPA's work has been complementary to the international reproductive health assistance provided by the United States to other countries through the U.S. Agency for International Development (USAID), since 1965 (USAID, 2005). UNFPA's reach, for example, is much broader; in 2002 UNFPA worked in at least 60 countries where USAID does not have a program (USAID, 2005b; UNFPA, 2005j). The two agencies also collaborate on projects, such as a national survey of health facilities and resources in Afghanistan (UNFPA, 2002).

Despite this history and the broad support of other countries for UNFPA's work, the U.S. contribution to the fund has been attacked by family planning opponents in Congress and the White House. Since 1985, when the Reagan and George H.W. Bush administrations first withheld funding based on politically motivated claims that UNFPA supported coercive family planning practices in China (Cohen, 1999), U.S. support for UNFPA has been inconsistent. Funding was restored by President Clinton when he entered office in 1993, however, family planning opponents succeeded in cutting off funds again in 1999 (Cohen, 1999). Funds were resumed at a lower rate in 2000 and 2001. Since 2001 the United States has once again withheld its annual support for UNFPA (PAI, 2004).

(Data source: PAI, 2004)

UNFPA and the George W. Bush Administration

After taking office in 2001, President George W. Bush continued U.S. support for UNFPA by requesting that Congress include a $25 million contribution to UNFPA in the annual budget. Congress approved even more, $34 million. In an additional endorsement of UNFPA's work, in October the U.S. Department of State requested congressional approval for $600,000 to support UNFPA's work on behalf of pregnant women in Afghanistan and surrounding refugee camps (planetWire.org, 2005).

The 2002 budget process saw a complete reversal of Bush administration support: early in the budget process the Bush White House asked Congress to include a $25 million contribution to UNFPA and Congress approved $34 million in funding. Then, in July the White House reversed its position, announcing that it was cutting off support for the fund.

The July announcement cited the "Kemp-Kasten" amendment, which conditions funding to UNFPA on annual certification by the president that UNFPA does not "support or participate in the management of a program of coercive abortion or involuntary sterilization." In May 2002 a White House team was dispatched to China to look for violations of the Kemp-Kasten amendment in the UNFPA program there. The team found no violations, and issued a report recommending release of the $34 million approved by Congress and withheld by the White House. This report was kept secret from the public for two months (Cohen, 2002).

Despite these findings, which were verified by another investigative team from the United Kingdom, the Bush administration refused to release the funds (All Party Parliamentary Group on Population, Development and Reproductive Health, 2002; U.S. Department of State, 2002a, 2002b).

Why U.S. Funding Matters

The loss of U.S. funding creates severe impacts on UNFPA's programs and the people in the developing countries it serves. UNFPA estimates that the $34 million loss will lead to 2 million unwanted pregnancies, 800,000 induced abortions, 4,700 maternal deaths and 77,000 infant and child deaths (U.S. Committee for UNFPA, 2005). Through support for UNFPA, the United States has an opportunity to save lives and promote healthier societies around the world.

¹ Formerly the United Nations Fund for Population Activities, the organization's official name is now UNFPA, the United Nations Population Fund.

Cited References

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Cohen, Susan A. (2002). "Bush Bars UNFPA Funding, Bucking Recommendation of Its Own Investigators." The Guttmacher Report on Public Policy, 5(4), 13.

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Office of the United Nations High Commissioner for Human Rights. (1968, accessed July 27, 2005). Proclamation of Teheran. [Online] http://www.unhcr.ch/html/menu3/b/b_tehern.htm.

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Lead Author — Rhonda Schlangen, International Division, Planned Parenthood^® Federation of America

Published: 06.01.03 | Updated: 09.29.06

Published by International Division, Planned Parenthood^® Federation of America

©2005 Planned Parenthood^® Federation of America, Inc.
All rights reserved.


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