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Population-fund cuts come at deadly price

by Cesar Chelala

NEW YORK — The Bush administration’s recent decision to cut back funds appropriated by Congress to the United Nations Population Fund, or UNFPA, will have serious repercussions in that agency’s support for reproductive health in developing countries. The U.S. decision is aggravated by reduced contributions from Japan and Denmark. UNFPA is accused of condoning forced abortions in China, and of making abortions a general part of its policy. This accusation was originally made by the Population Research Institute, an antiabortion group that has branches worldwide. Officials from the institute alleged that American funds were being used “illegally” by UNFPA to pay for forced abortions, forced contraception and forced sterilization in China.

UNFPA’s response to these accusations is that its work in China is conducted in areas where the one-child family policy is no longer enforced, and that American funds are not used for programs in China regardless.

Amy Cohen, the president of Population Action International, an organization active in voluntary population planning, said the funds cutback is motivated by domestic politics. She criticized the measure because she said it will have a negative impact on preventing unwanted pregnancies and the spread of HIV.

One of UNFPA’s activities that may be affected is supplying condoms to men in high-risk groups to prevent the spread of HIV. The cost of this activity this year is estimated to be close to $300 million.

According to UNFPA officials, the loss of U.S. funds would translate into 2 million unwanted pregnancies, 800,000 induced abortions, 4,700 maternal deaths and 77,000 infant and child deaths.

The decline in funding comes when the demand for contraceptives in developing countries is expected to rise by 40 percent over the next 15 years. It is estimated that 120 million women worldwide want either to space their births or to stop having children altogether, but they are unable to get contraceptives.

Since its creation, UNFPA has contributed improving women’s health, particularly in developing countries. Its policies have stressed the importance of adequate pre- and postnatal care as well as the need to space out births. That need is particularly pressing in developing countries, since it has been repeatedly shown that women in poor health who have many children without a proper interval between births experience further damage to their health.

Pregnancies, particularly when frequent and closely spaced, can lead to maternal exhaustion syndrome. When a woman conceives again before completely recovering from her last birth, she increases her chances of giving birth to a premature or low-birth-weight baby. This condition leads to a vicious cycle with a significant negative impact on the health and well-being of both the mother and her children.

Without proper assistance and education, as provided by organizations such as UNFPA, women who don’t want to have additional children end up having an abortion. In many countries, this procedure is illegal, forcing women to either perform the abortions themselves or have it performed by inexperienced people, in many cases without the appropriate techniques and care. In those conditions, illegal abortions become a significant cause of maternal death.

In health-related missions that I carried out in more than 40 countries, I was able to see the work carried out by local UNFPA offices, where the emphasis is on the quality of care for mothers and their children. That was also the most important aspect of missions that I carried out in the past on behalf of that agency in Egypt, Equatorial Guinea, and Sao Tome and Principe.

To ignore these achievements does nothing for the health of women worldwide. If anything, governments should increase, not decrease, their contributions to organizations such as UNFPA, which work in areas critical to women’s health.