Foreign aid for sexual health sparks hot budget debate
Conservatives opposed to using EU development aid to finance family planning services in poor nations have succeeded in recent years in reducing support for reproductive health services in poor nations, say health advocates who are now bracing for further cuts.
Development aid is likely to be one of the losers at the 7-8 February EU budget summit, but the relatively small sum for sexual and reproductive health fuels an outsized debate over how European money is spent.
Last year, Brussels provided €150 million for family planning and counselling, or less than 2% of the European Commission’s overall foreign aid spending.
One outspoken critic of EU-funded family planning in needy nations is Nirj Deva, a British Conservative who is vice chairman of the European Parliament’s development committee. He contends that money has been used to enable women to abort female foetuses in countries where males are preferred.
“I will not allow, and tolerate, the idea that you can improve development parameters by killing children to keep the population under control as a development tool,” Deva said in an interview.
“It then becomes an imperialistic, Western idea of whether poor children in developing countries should be born or not. I thought we had stopped imperialism,” he said, arguing that the EU is supporting “gendercide” in some South Asian and African countries where boys are preferred over girls for cultural or labour reasons.
Support for family planning
The MEP's views are far from universal, with advocates saying reproductive health services - often provided by NGOs with EU financing - save lives, reduce poverty and give women a voice in family planning.
Portuguese MEP Ana Gomes, a Socialist who has campaigned for years to support human and women’s rights in the EU’s overseas policies, pledged to fight cuts.
“We are very much against any, first of all, reductions in development assistance, second, any reduction in the budget for reproductive health,” said Gomes, a former diplomat and member of the European Parliament’s committee on foreign affairs.
The EU is collectively the largest aid donor, providing $86 billion (€66 billion) from national governments and EU institutions – or 55% of the world total, according to the Organisation for Economic Co-operation and Development (OECD).
The European Commission's financing for family planning, reproductive health and AIDS has declined from $318 million (€234 million) in 2007 to $203 million (€150 million) last year, according to a Europmapping 2012 report on development aid and population assistance. At the same time, however, OECD figures show that support for population-related health programmes from EU national governments has held steady.
Austerity measures could reduce the EU’s total aid budget 11% for the seven-year period running from 2014 to 2020 under the proposals discussed by EU leaders at their November summit in Brussels. Sources familiar with the budget talks told EurActiv there is unlikely to be any big change at this week’s summit.
The EU’s role in supporting reproductive health and birth control and financing the UN Population Fund (UNFPA) escalated a decade ago when George W. Bush set out to revamp American aid priorities, shifting money away from ideologically divisive reproductive and women’s health programmes to the more popular fight against malaria and AIDS.
Barack Obama reversed some of his predecessor's polices. But the International Women’s Health Coalition has repeatedly accused Republicans who control the US House of short-changing family-planning aid for poor countries, and the New York-based advocacy group has fought Republican's efforts to cut funding for the UNFPA.
Pressure has grown in Europe to take a similar path as the US Republicans, especially among member states with large, religiously conservative constituencies, like Poland, Malta, Italy and Ireland.
“There’s a lot of misinformation out there in countries that still have strong religious views that Europe is paying for abortions or advising indigent women to have abortions, or pre-selecting children based on gender,” one UN health official who works closely with the EU in developing countries told EurActiv on conditional of anonymity.
“This couldn’t be further from the truth, but politicians are under pressure and under more scrutiny how and where they spend money, and that doesn’t always lead to the right decisions.”
The issue has gained populist momentum. In January, anti-abortion campaigners began collecting signatures for a European Citizens’ Initiative to ban the use of EU money for abortions at home or abroad. The One of Us campaign, backed by the Italian pro-life organisation Fondazione Vita Nova, says more than 34,000 people have signed so far, out of the one million needed for the initiative to be considered.
A Brussels NGO, European Dignity Watch, last year accused the European Commission of violating its own rules by funding abortions without the approval of all member states.
In a report, the group said “one is tempted to wonder whether in the current situation the EU’s development policy is not ‘fighting the poor’ rather than ‘fighting poverty’, or whether development aid should not be directed at providing food, drinking water, health, and education, to children in need, rather than reducing their numbers through abortion.”
Representatives at European Dignity Watch did not respond to EurActiv’s requests for comment.
But Nadine Krysostan, senior advocacy officer European Parliamentary Forum on Population and Development, sees many of the arguments against EU support for sexual and reproductive health services as “simplistic.”
The health counselling services are voluntary, she says, and the EU is barred under international agreements – including the programme of action agreed at the UN’s 1994 Cairo Conference on Population and Development – from promoting abortion as a birth-control option.
“Access to sexual and reproductive health and rights and voluntary family planning programmes and services save lives because they help women to better plan and space their pregnancies," Krysostan said in an interview. "This means that couples can have the number of children they want and that they are able to care well for. Also, it reduces the number of abortions who often occur because of unwanted pregnancies.”
As it is, there are millions of unsafe abortions every year - 22 million in 2008, according to the latest UN figures available. The Guttmacher Institute, a reproductive rights research group in the United States, estimates that of the more than 6 million abortions in Africa, 3% were carried out under safe conditions.
Despite the risks, “Women who do want an abortion do find the possibility to have one,” Krysostan said. “And in most cases these abortions are unsafe, which means that millions of women either die or are maimed or suffer serious health problems.”
If reproductive health is contentious, there is broader agreement on support for development aid – including less controversial areas as childhood vaccinations, malaria prevention, and pre- and post-natal care.
“There is a concerted attempt to cut the development budget over a longer period of time and I’m really, really appalled by that,” said Deva, the development committee’s vice president.
“The EU budget has done great stuff and who’s telling us that? People like Bill Gates and Bono and other people come and tell us that. We don’t tell ourselves these things.”
The EU’s main donor nations have committed to providing 0.7% of gross national income to development assistance by 2015. The Organisation for Economic Co-operation and Development, which compiles aid figures, says four – Sweden, Luxembourg, Denmark and the Netherlands - have exceeded the target.
Europe's overseas aid commissioner, Andris Piebalgs, recently urged rich nations not to renege on their commitments to help the world's poor people, even as EU capitals grapple with their own financing problems.
Plan, an international development organisation, last week urged EU national leaders to reverse plans to cut development aid, warning that “life-saving aid is under silent attack.”
“With nobody at the negotiating table defending the rights and interests of the world’s most vulnerable citizens, it’s easy for EU leaders to simply slash the proposed aid budget,” Karen Schroh, who head’s the group’s EU office, said in a statement.
“We saw at the last summit that development and humanitarian aid is being disproportionately targeted for cuts because nobody seems to be willing to act as the voice of the voiceless. In times of austerity leaders might looking to make savings, but these must not cost lives.”
Asked about criticism in cuts to overseas reproductive health aid, Nirj Deva, a British Conservative who is vice chairman of the European Parliament’s development committee, said: “The debate is about these small sums of money, and not about all the people starving or getting ill, who are having TB, malaria, AIDS – they are not talking about those people. They are talking this nonsense. And this nonsense is also killing women.”
- 7-8 Feb.: EU leadership summit on the 2014-2020 budget