In 1994, the world convened at the International Conference on Population and Development (ICPD) in Cairo to recognize that reproductive rights are human rights and that women's health is essential to global prosperity and opportunity for all. As we celebrate the thirtieth anniversary of this historic gathering, the Biden-Harris Administration is announcing additional efforts to recommit to the landmark consensus achieved through the ICPD Programme of Action.
Advancing and protecting sexual and reproductive health and rights is fundamental to achieving gender equity and equality and promoting the human rights of women, girls, and LGBTQI+ persons, particularly those who face multiple and intersecting forms of discrimination. The United States remains the largest bilateral donor to global family planning assistance - a commitment spanning more than five decades - and we are committed to supporting sexual and reproductive health services that improve the lives and wellbeing of everyone, advance dignity and human rights, promote gender equality, and ensure that women can control their own futures.
Since the earliest days of the Administration, President Biden and Vice President Harris have resolutely supported sexual and reproductive health and rights. The January 2021 Presidential Memorandum on Protecting Women's Health at Home and Abroad revoked the expanded global gag rule, restored life-saving funding to the United Nations Population Fund (UNFPA), and required that adequate funds be directed to support women's health needs globally, including for sexual and reproductive health services. With Fiscal Year 2023 funds, the United States provided $620 million to support global maternal and child health programs and $607.5 million to support global family planning and reproductive health programs, including $32.5 million in core funding to support UNFPA.
Today, we are announcing the following initiatives to help accelerate access to family planning, prevent maternal mortality, and address gender-based violence:
Improve Access to Family Planning and Reproductive Health
As the largest bilateral donor to family planning, the United States will continue its efforts to meet sexual and reproductive health needs and make pregnancy and childbirth safer by strengthening health systems and integrated health services, including access to family planning. Key initiatives to support this commitment include:
- Increase Access to Family Planning: In alignment with ICPD+30 priorities on youth and the UN Sustainable Development Goals focus on "No One Left Behind," USAID commits to supporting family planning progress in West Africa through an expected $86.5 million in Fiscal Year 2023 family planning and reproductive health (FP/RH) funds programmed in the nine Francophone West African countries that form the Ouagadougou Partnership and report some of the lowest contraceptive use rates and highest maternal mortality ratios in the world. This funding level represents an increase of $15.5 million over prior year commitments for these countries and will accelerate improvements in sexual and reproductive health care in the region by increasing access to voluntary family planning information and services.
- Address Barriers to Reproductive Health: To advance ICPD+30 priorities, USAID will announce the Accelerating Choice, Equity, and Sustainability for Services (ACCESS) program, providing $1.2 million to address persistent barriers to access, equity, and quality of family planning and reproductive health care, particularly with and for adolescents and youth, persons with disabilities, indigenous persons, migrants, and members of other underserved and underrepresented groups, such as LGBTQI+ persons.
- Improve Population Data: USAID will amplify its multi-decade commitment to advance population data availability and accessibility, including key data about women, girls, and underserved communities, through two initiatives: first, a new Demographic and Health Surveys Program, which will include an increased focus on data collection, analysis, and use to better identify inequities and respond to the needs of marginalized or vulnerable populations; and second, the U.S. Census Bureau Inter-Agency Agreement, which includes a sharpened focus on reaching marginalized groups.
Prevent Maternal Mortality and Morbidity
Although the global maternal mortality rate has fallen, approximately 300,000 women and girls die every year from largely preventable conditions related to pregnancy and childbirth. The United States is committed to supporting safe, respectful, and client-centered maternal and reproductive health services that address the major causes of maternal mortality and morbidity, with a focus on 25 countries that account for 70 percent of maternal and child deaths worldwide, including in conflict- and crisis-affected settings. These efforts are bolstered by the 2024 World Health Assembly 77 resolution co-sponsored by the United States to "Accelerate progress towards reducing maternal, newborn, and child mortality in order to achieve SDG targets 3.1 and 3.2." Key initiatives to support this commitment include:
- Enhance Availability of Maternal Healthcare: USAID, in partnership with the UK Foreign, Commonwealth and Development Office, will enhance access, availability, and affordability of quality family planning, reproductive health, and maternal health commodities. USAID's $1.6 million investment will strengthen supply chains and health care systems and help low- and middle-income countries bolster their pharmaceutical infrastructure and regulatory quality assurance systems for medical products. Adequate access to maternal health commodities, including medications for prenatal care, safe delivery, and postpartum support, is critical for preventing complications during pregnancy and childbirth, ultimately reducing maternal mortality rates. This builds on longstanding USAID investments to strengthen the supply chain in the health sector.
- Pioneer Solutions to Prevent Postpartum Hemorrhage: USAID, in collaboration with the Gates Foundation, is introducing an innovative approach to detect and treat postpartum hemorrhage in three countries, partnering directly with their governments to address the leading cause of maternal mortality globally. This approach harnesses new research findings that demonstrate how directly measuring blood and bundling several existing interventions can enhance the early detection and timely treatment of postpartum hemorrhage, which has the potential to decrease severe bleeding by 60 percent and thereby save maternal lives.
Address Child, Early, and Forced Marriage and Female Genital Mutilation and Cutting
The United States supports key UN partners, including UNFPA and the United Nations Children's Fund (UNICEF), through contributions to core funding as well as dedicated support to address female genital mutilation and cutting (FGM/C) and child, early, and forced marriage (CEFM), two forms of gender-based violence that disproportionately affect girls and have lifelong consequences on the health and wellbeing of women, their families, and communities. Globally, one in five girls is married before the age of 18, and pregnancy and childbirth-related complications remain a leading cause of death for girls aged 15 to 19 globally. CEFM is a violation of girls' bodily autonomy that can leads to increased risk of pregnancy-related morbidity and mortality and negatively affect infant health. Key initiatives to support this commitment include:
- Prevent Child, Early, and Forced Marriage: USAID invested $38.2 million in FY 2021 and FY 2022 to address child, early, and forced marriage around the world. These programs focus on equipping girls and young women with education and workforce readiness skills; mitigating harmful effects of child marriage through education, health, legal, and economic support; and raising awareness of the risks and harms associated with child marriage.
- Help End Female Genital Mutilation/Cutting: The United States is a long-standing donor to the UNICEF-UNFPA Joint Programme on the Elimination of Female Genital Mutilation, providing a contribution of $5 million in Fiscal Year 2023 funds. Since Fiscal Year 2017, the United States has invested this annual funding in the Joint Programme, which has succeeded in advocating for legal and policy frameworks banning FGM/C in 14 of 17 countries and supporting more than 6.3 million women and girls with FGM/C-related protection and care services.
- Partnership to End Child, Early, and Forced Marriage: For the first time, the United States provided a direct contribution of $500,000 in Fiscal Year 2022 funds to the UN Global Programme to End Child Marriage, which supports the health and rights of adolescent girls in 12 countries in Africa and South Asia with high prevalence of CEFM. Since 2016, the Global Programme has reached 21 million girls and supported the proposal or adoption of 94 policies and legal instruments addressing child marriage in line with international human rights law.
