Population Institute Senior Fellow Dr. Joseph Speidel, along with six other former directors of the Office of Population and Reproductive Health at the U.S. Agency for International Development (USAID) – who served through Democratic and Republican administrations – joined together in the following letter to key members of the U.S. Congress in defense of USAID and its vital role in expanding access to family planning and reproductive health services.
We are the seven former Directors of USAID’s Office of Population and Reproductive Health, covering the period 1978-2022. We are proud of our service. We are even more proud of the role that USAID programs, including its family planning programs, play in alleviating poverty and improving health around the world.
Voluntary family planning programs have been part of that assistance since 1965. The family planning program has enjoyed bipartisan Congressional support through 11 successive administrations over the ensuing 60 years precisely because the program has been able to demonstrate results, adapt successfully to changing administration and congressional priorities, respond to changing needs on the ground, focus on building local capacity, seek out best practices and cost efficiencies, and work to transition countries away from donor assistance as their programs mature.
We know of no major instances of waste, fraud, and abuse – as currently being alleged against USAID. We also highlight that as civil servants and foreign service officers, we have dutifully carried out directives from the administration and Congress, including the Mexico City Policy. We are appalled at the recent, unfounded, and hurtful characterization of USAID staff as criminals, radical leftists, lunatics, and incompetents.
While the investment in family planning is a relatively small part of all foreign assistance, at about $600 million annually, it represents half of all donor assistance to family planning. The technical expertise that is found within USAID staff and its implementing partners has been key to the success of USAID’s family planning programs and is not found to the same degree elsewhere among the international community.
Enabling couples to determine the number and spacing of their children through voluntary family planning services is an essential part of maternal and child health programs, an essential part of humanitarian assistance, and an essential part of development. Since 1965, the number of contraceptive users in 84 USAID-assisted countries has grown from fewer than 20 million to more than over 400 million today. Investing in these programs has been shown to:
- protect women’s health by reducing unintended and high-risk pregnancies,
- reduce abortion which is often unavailable and/or unsafe,
- improve women’s opportunities for education, employment, and participation in society,
- improve child survival through improved birth-spacing,
- reduce HIV transmission, especially mother-to-child,
- reduce inter-generational poverty through smaller family size,
- enable greater investments in each child within a family, including lengthening school attendance,
- reduce pressures on natural resources: land, water, forests, wildlife, climate,
- spur economic growth by creating a “demographic dividend” through age structure changes, and
- increase prospects for government stability that accompany shifts in age structure.
Today, approximately 29 countries receive the majority of the $600 million appropriated annually by Congress for global family planning and reproductive health assistance, and almost as many countries have transitioned away from USAID assistance and now fund, implement, and evaluate their programs on their own. But international support for programs is still needed in many of the poorest countries of the world where access to these essential services has lagged, especially so in parts of Africa, south Asia, and the Middle East.
We are extremely troubled by the recent and abrupt steps taken by the Trump Administration to shut down USAID. While every new administration reviews US foreign assistance programs to ensure consistency and alignment with its foreign policy priorities, shutting down all programs during this review is unprecedented, dangerous, and illegal. The 90-day program pause and more recent stop-work order have already done immense harm around the world, worsening global health conditions, expanding humanitarian strife, and making host countries question the reliability of the US as a partner — and opening the door to China, Russia and others to step into the vacuum. Furthermore, they threaten our own national security, strength and prosperity here at home. These actions also upend the lives and livelihoods of thousands of hard-working Americans and negatively impact many US-based businesses and non-profit organizations.
Together with other USAID investments in health and humanitarian assistance, family planning makes the world a better place. And when the world is in a better place, America is in a better position to thrive.
It has been estimated that a 90-day pause in family planning funding alone will result in an estimated 11.7 million women denied services, 4.2 million unintended pregnancies, and over 8,000 maternal deaths. Of course, this represents only some of the impact on women’s health and welfare. The full impact would factor in the added impacts on child health, family well-being, and the broader economic, environment and security dividends.
We urge all our Congressional representatives to take action to end the pause as soon as possible and to resume USAID’s essential foreign assistance, including the international family planning programs that USAID has for decades supported so effectively.
Sincerely,
Joseph Speidel (1978-1983)
Steven W. Sinding (1983-1986)
Duff Gillespie (1986-1993)
Elizabeth Maguire (1993-1999)
Margaret Neuse (2000-2006)
Scott Radloff (2006-2013)
Ellen H. Starbird (2013-2022)*
* years serving as Office Director