U.S. Funding for the United Nations Population Fund (UNFPA)

Dear Senator/Representative,

My name is Scott Church, and my wife’s name is Audrey Church. I am an engineer and landscape photographer, and Audrey is a psychiatric nurse practitioner and a clinical preceptor at the University of Washington Graduate School of Nursing. We live in Seattle, WA and have been active in working with girls at risk for female genital mutilation (FGM) in Uganda. In this capacity, we represent the US-Uganda Godparent’s Association. The Godparent’s association has been running a high school for such girls in Kampala for some time. We have also been active in public awareness and education about FGM in the Pacific Northwest region. In our efforts we have worked with the United Nations Population Fund’s REACH program in Africa and have greatly appreciated their worldwide efforts on FGM education. In our capacity as public reproductive health educators and field workers, we are greatly disturbed by the Bush Administration’s decision to cut off funding for the United Nations Population Fund (UNFPA). As Christians, we are disturbed by the worldwide prevalence of abortion, especially its frequent use by some for either birth control or convenience. However, based on an extensive review of the Congressional testimony behind this decision and the support given for it by its advocates, we feel that the allegations against UNFPA have no merit. If we may, we would like to briefly review what we know about UNFPA and the issues they are addressing in the world. Then we will comment on what we’ve found regarding the allegations against them and outline why we are convinced that they do not justify a termination of U.S. dollars.

The Problem

As you know, world population has risen significantly since the early nineteenth century. Between 1800 and 1900 the world’s population grew from 1 billion to 1.6 billion. It reached 2.5 billion by 1950, and in just the last 52 years, has increased to 6.2 billion (U.S. Census Bureau, 2002). The population growth rate peaked during the 60’s and has since been declining. However, according to some estimates, this decline will not reverse real growth until the middle of this century by which time world population will have reached 7.9 to 10.9 billion (National Academy of Sciences, 2000; United Nations, 2001). This population is projected to be primarily urban, tropical and of older average age than at present. The overwhelming majority of the increase in the last 100 years has been due to improved global access to public health, nutrition, sanitation, immunization and antibiotics. The decline in growth rate since the 60’s has been due mainly to the advent of modern contraceptives. When these became globally available, women began having fewer pregnancies as infant mortality declined. Some countries, such as Italy and Ukraine, are actually shrinking (National Academy of Sciences, 2001).

Even so, this decline in fertility is not happening uniformly around the world. Average fertility rates are at replacement level or higher in over two thirds of the world’s nations. The world’s poorest nations in particular are expected to increase their populations dramatically in coming decades. The population of Africa alone is expected to increase from 800 million to 1.7 to 2.3 billion by mid century (National Academy of Sciences, 2001; United Nations, 2001). During the 60’s, the average birth rate was 5 children per woman in developed countries, and 6 per woman in undeveloped countries. By the end of the 20th century, this had fallen to 3 per woman worldwide as the use of contraceptives increased approximately 600 percent (Khanna et al., 1992; PRB, 2001). But most of this decrease happened in the developed world (Khanna et al, 1992). It has long been known that poverty is the single best predictor of high birth rates. There are a variety of reasons for this, but lack of access to education and reproductive health care, and the lack of say women have in many cultures regarding the timing and frequency of their pregnancies, are widely recognized as the greatest factors. For instance, nearly two thirds of the world’s illiterate are women (over 600 million). In sub-Saharan Africa and South Asia only 2 to 7 women per 1000 ever get to attend college (UNFPA, 2001). In many nations, such as Botswana, Chile and Namibia, women are under the legal guardianship of their husbands and have literally no right to manage property or divorce (Dollar & Gatti, 1999). Though accurate data are difficult to come by, some sources estimate that nearly 125 million poor women worldwide do not have access to contraception or reproductive health education, and nearly 350 million have no access to reproductive health care of any kind (Ross & Winfrey, 2001, UNFPA, 1999). Girls that have had at least 6 or 7 years of schooling (in which among other things, they receive basic health and sexuality education and at least some training for economic opportunities), almost always tend to have smaller families. In Egypt for instance, only 5 percent of women who remained in school past the primary level became pregnant as teenagers. The corresponding figure for those who did not is over 50 percent (Riley, 1997; United Nations, 1995). This has taken a terrible toll on women and poor communities worldwide.

The evidence is clear - access to education and reproductive health care for women, and the ability to choose the timing and frequency of their pregnancies, leads to lower birth rates and a higher quality of life. Educated women who have a say in their own reproductive futures almost always choose fewer children. These children then receive a higher quality of care and are typically raised in homes that provide a more stable economic environment than would otherwise be available. This in turn leads to slower population growth, better economies and less ecological impact on poor regions. The global denial of access to such benefits is a clear violation of human rights.

UNFPA was started precisely to bring these human rights violations to light and rectify them. Their Program of Action Charter, as adopted at the International Conference on Population and Development in Cairo in 1994, states, “Everyone has the right to the enjoyment of the highest attainable standard of physical and mental health. States should take all appropriate measures to ensure, on a basis of equality of men and women, universal access to health-care services, including those related to reproductive health care, which includes family planning and sexual health”, and that “all couples and individuals have the right to decide freely and responsibly the number and spacing of their children, as well as the right to information and means to do so” (ICPD, 1994). UNFPA’s work in bringing these basic rights to developing world women has not only alleviated great suffering and injustice, it has also brought the world closer to a truly sustainable future. This has been made possible through the demonstrated success of many programs, including the following.

Contraception and Counseling

Not only is a woman’s ability to plan her pregnancies critical to her quality of life, in many cases it is critical to her health and may even save her life. Without quality pre natal and emergency obstetric care, every pregnancy increases a woman’s chance of death from complications. Likewise, a developing world child’s chances of death at birth are significantly increased if it has been less than two years since the mother’s previous annual pregnancy (PAI, 2001). In addition, by some estimates nearly a quarter of the world’s pregnancies (over 52 million) end in abortion, and most abortions in the developing world are performed in unsafe conditions (UNFPA, 2000). Such abortions are seldom the end result of planned pregnancies where contraception was accessible. In fact, some studies have shown that lack of reproductive health care actually increases the prevalence of abortion (Rahman et al., 2001; Scientific American, April 4, 2001). Factors like these have been a strong motivator for women to seek contraceptives, and wherever women have been given access to them birthrates have declined. However, lack of education, health care and relational and civic freedom frequently prevents this from happening. The most commonly cited reasons for lack of contraceptive use are lack of access, lack of knowledge, and the opposition of spouses and family members (Bulatao, 1998). UNFPA funding provides extensive reproductive health care, access to a wide range of contraceptives, facilities for maternal and infant care, and facilities for the prevention and treatment of sexually transmitted diseases. These services translate directly into improved quality of life for women, infants and communities.