Kevin Duffy, independent health consultant, comments on news that the government has decided to cut funding for overseas abortions.
MSI Reproductive Choices, International Planned Parenthood Federation, and UNFPA have each lost significant levels of funding from the UK taxpayer. The Government has decided to withhold £131 million of previously agreed funds from UNFPA and has informed MSI and IPPF that £70m expected in June 2021 for its flagship Women’s Integrated Sexual Health programme (WISH) will not be paid. We welcome these funding cuts.
On 21 April 2021, the Foreign, Commonwealth & Development Office (FCDO) announced in a written statement that this year it is cutting £4.5 billion from the UK’s foreign aid budget, reducing the total spend by about 30% to £10b. This follows an in November last year by Chancellor Rishi Sunak, that given the unprecedented level of government debt resulting from our COVID-19 response, it was necessary to temporarily move away from the legally enshrined aid spending target of 0.7% of national income to 0.5%.
Foreign aid has always been, and remains, a contested matter with strong feelings held and expressed from many different perspectives. There are those who think it is right, perhaps even a moral obligation, for us as a rich nation to help others who are less fortunate. Some think that charity must begin at home and that we have plenty of need here in our own country without sending our taxes overseas. Some note the nuance between development aid and humanitarian relief.
Regardless of your overall position on the use of aid, most of us agree that it is not right for our taxes to be used to promote and to provide abortion on-demand in other countries, particularly when some national governments have chosen to restrict legal access; our taxes should not be used in ways which undermine national sovereignty.
Abortion is not a form of contraception
The provision of effective contraception methods is a well-intentioned public health intervention. Delaying first pregnancy and spacing between births are important aspects of women’s healthcare, which we think is best delivered by local midwives as part of a fully integrated range of maternal, newborn, and child health services.
The problem with funding UNFPA or international NGOs such as Marie Stopes International is that these organisations consider abortion on-demand as an essential method of family planning. You cannot provide funding to MSI with the sole purpose of supporting contraception without these monies also in some way being used by it to support the provision of abortion on-demand. It is for this reason, the provision of abortion as a method of family planning, that both IPPF and MSI were not able to sign the U.S. Protecting Life in Global Health Assistance (PLGHA) and thus were subsequently defunded. We wrote about this here.
Responding to the recent FCDO cuts, Simon Cooke, CEO at MSI Reproductive Choices, tweeted that providing schoolgirls with access to both contraception and abortion is a ‘smart investment’ and ‘helps keep girls in education’.
This is worth examining further.
MSI has overseas programmes providing reproductive health services to adolescents, in this context let us read that as schoolgirls. Cooke and his colleagues think it is right and proper to provide these girls with contraception even though many will be below the local age of consent, reasoning that this will help to prevent pregnancy and keep them in school. When the contraception fails or has not been used correctly, then Cooke thinks his staff should perform an abortion, just to keep her in school. There is little or no consideration that in many cases these vulnerable girls are having transactional sex to gather up enough money to pay their school fees, or that the sugar daddies are in many cases committing statutory rape or in the case of older adolescents who have reached the age of consent, are acting in a coercive and abusive manner. We are not aware of any cases in which MSI has reported the abuser to the local police; many of these girls are treated by MSI without parental involvement and are rarely referred to local support groups.
The safeguarding norms which we expect here, are all too often neglected in overseas programmes. Why would we want our taxes used to support such unacceptable behaviour?
Abortion is not an essential public health intervention
It is often argued that providing contraception is an essential public health intervention, one which is necessary to reduce the numbers of unintended pregnancies and subsequent harmful abortions. This is a key rationale used to elicit the billions of taxpayer funding for sexual and reproductive healthcare (SRH) provider organisations. The opening line on the government’s website for its Women’s Integrated Sexual Health programme describes the aim of the programme: “To increase the use of family planning methods to reduce maternal deaths and prevent the use and access to unsafe abortion”.
That rationale is contested, the evidence used to support claims that contraception reduces the number of abortions is unconvincing. We need look no further than what we can learn from the UK, a country in which family planning is promoted from the age of adolescence and effective contraception is widely available free-of-charge. That said, we do acknowledge recent concerns that COVID-19 has in some cases made it more difficult for women to easily access their contraceptive method of choice in a timely and affordable manner.
There is a growing concern that provision of contraception might be leading to increasing numbers of unintended pregnancies and the subsequent choice to have an abortion.
BPAS sees abortion as part of ‘birth control’
On 07 July 2017, The Daily Mail published an interview with Ann Furedi, then CEO of BPAS, in which she said: “When you encourage women to use contraception, you give them the sense that they can control their fertility – but if you do not provide safe abortion services when that contraception fails you are doing them a great disservice. Our data shows women cannot control their fertility through contraception alone, even when they are using some of the most effective methods. Family planning is contraception and abortion. Abortion is birth control that women need when their regular method lets them down.”
On the same day, BPAS released a report showing that in 2016, 51% of women choosing to have an abortion were using at least one method of contraception at the time of becoming pregnant.
To be clear then, contraception fails, much more often than is commonly thought, resulting in women having unintended pregnancies, and a large proportion of these women then seeking abortion.
Ann Furedi has always been open and honest about this, as can be seen in this Twitter chat in June 2020. She and Cooke both consider abortion as acceptable birth control and a necessary service to make available when providing contraception.
Furedi and Cooke argue that it is not possible to decouple the provision of contraception from the provision of abortion services. It is not possible to provide an international NGO such as Marie Stopes with funding just to provide contraception and to be certain that none of these monies will end up supporting the provision of abortion; by which we do not imply the inappropriate direct use of restricted funds but simply an acknowledgement that funding always defrays shared operational costs across all the services departments of such an organisation.
All government funding for abortion overseas should stop
Our taxes should not be used to provide abortions overseas and so we welcome the cuts announced by Dominic Raab and we will continue our campaigning for the permanent defunding of MSI Reproductive Choices, International Planned Parenthood Federation and UNFPA.