Depending upon your perspective, 2012 was either a promising year for family planning and reproductive health, or one of the worst in recent memory. If you take a broad, global perspective, it’s clearly the former, but if you are focused on the U.S., it’s clearly the latter.
First the really good news: on July 11, World Population Day, foundations, organizations, and leaders from several countries gathered this summer in London for a groundbreaking summit that produced major new pledges of support for international family planning assistance. Convened by the Bill & Melinda Gates Foundation and the United Kingdom’s Department for International Development (DFID), the conference brought together representatives from developing and donor nations alike. The commitments would expand family planning services to another 120 million women in the developing world by 2020. Reflecting this new wave of support for family planning, a growing number of leaders in the developing world pledged to step up their support for voluntary family planning. Nigeria, Kenya, and Ethiopia, in particular, are redoubling their efforts.
Now the really bad news: Social conservatives this year set their political sights on birth control. Attacking contraception as morally “dangerous” and a social evil, they sought to slash funding and restrict health insurance coverage of contraceptives. The war on contraception failed to put Planned Parenthood out of business, as some legislators vowed to do, but state budget cuts and new regulatory restrictions have taken a toll on family planning clinics serving low-income households. In Texas alone this year more than 50 family planning clinics closed their doors after the legislature cut funding by two-thirds and barred funding for all clinics run by Planned Parenthood.
So what about 2013? What does it portend for family planning and reproductive health? On balance, I think 2013 will be a better year. If the major commitments that were made at the London Family Planning Summit start to be fulfilled—and there is every reason to think that they will—than we could see a gradual ramping up of family planning services in the developing world. Much depends, however, on which direction the U.S. Congress goes with respect to funding. At present, Congress is at a standstill over the level of support for international family planning assistance. The House Appropriations Committee has been pushing for a 25 percent cutback, while the Senate Appropriations Committee has supported a roughly comparable increase in funding. For the moment, funding is frozen at last year’s level ($610 million), but that could change, depending on what happens with the fiscal cliff and how the new Congress views international family planning.
Congress is also deadlocked over Title X, the federal program that supports family planning clinics here at home. The House has sought to eliminate funding, while the Senate has fought, successfully so far, to preserve current funding levels. I suspect, however, that the new House of Representatives will be less amenable to wiping out funding for Title X, while the new Senate will be an even stronger supporter of the program. With any luck the Congressional war on contraception, which has never enjoyed popular support, will come to an end in 2013. Nothing, however, is certain, particularly as Congressional caps on discretionary spending could force cutbacks in domestic and international family planning.
So while we can look to the New Year with renewed confidence, we cannot take anything for granted. At the Population Institute, we never do. To anyone who has really studied the issue, family planning may be the closest thing there is to a ‘no-brainer’, but with a volatile electorate and 80 new legislators in Congress, we have to be ever vigilant.
With 2012 winding down, I want to express my deep appreciation to all those who have supported our work over the past year. For 43 years the Population Institute has been making a difference in Washington and around the world, but nothing that we have accomplished would have been possible without the generous support of individuals and foundations who believe in our work.
Thanks for your support, and best wishes for a happy and healthy New Year.
Posted by Robert J. Walker, President