The First Debate: Will Candidates Discuss Women's Welfare Along with the World's and Wall Street's?

Personal Health

In the upcoming presidential debate on foreign policy issues, will candidates be asked to address sexual and reproductive health and human rights of women as a critical component to our nation's foreign policy? I submit that if we truly want to regain international credibility and legitimacy, the U.S. must become a collaborator with our global neighbors on a variety of issues. Why not start with the global crises women face throughout the world regarding fundamental sexual and reproductive health and rights? 

In this Friday's debate, the candidates should be pressured to talk about stands they would take involving women and sexual and reproductive health. Let moderator Jim Lehrer ask for responses to the facts:

  • 80% of HIV infections are sexually transmitted and women account for more than half of those infected worldwide
  • Women are 61% of those infected with HIV and AIDS in sub-Saharan Africa, the region most heavily hit by the HIV/AIDS pandemic
  • 200 million women experience yearly an unmet need for contraceptive services
  • 80 million unintended pregnancies occur each year, 60% of which end in abortion
  • 500,000 women die each year from pregnancy-related complications
  • 68,000 women die each year from unsafe abortions

The U.S. led the world for decades in supporting voluntary family planning programs. Prior to 2000, the U.S. joined other governments in signing international agreements that recognized the rights of individuals -- including adolescents -- to have access to accurate information and services to prevent unintended pregnancies and HIV infections. Yet for the past eight years, a very different U.S. government waged a narrow, moralistic crusade against sex and reproduction -- at times alone, and sometimes in the eclectic company of the Vatican. 

Will the candidates continue the U.S.'s so-called "balanced" approach to global HIV prevention that promotes abstinence and fidelity within marriage as the best ways to prevent HIV infection, even where marital sex represents the greatest risk for women? Or would candidates commit to promoting HIV prevention interventions that are based on evidence and are proven effective? Ask whether as president they will ensure that U.S. foreign policy advances the right to obtain information and to assure that individuals have access to comprehensive information, tools and skills so that they can decide freely what prevention method makes sense for their realities, whether they are young, old, man, woman, married, single, gay, straight, rich, poor.  

Will the candidates be asked to commit to funding the United Nations Population Fund (UNFPA), the UN agency effectively supporting a range of critical sexual and reproductive health programs and services? Are they aware that the U.S. has withheld funding from UNFPA based on a falsehood that UNFPA supports coercive family planning in China? Do the candidates understand the facts, which were delineated to the current Administration by assessment teams -- including delegations from the State Department and faith-based leaders -- which found that UNFPA does not support or participate in managing coercive family planning programs in China, and in fact has been a catalyst for change in China? 

Will the candidates address the crisis of maternal deaths due to unsafe abortions by supporting public health best practices to ensuring that abortions are safe? I would like to hear the candidates commit respect for all people to exercise free speech and assembly and standard ethical practices. Where groups are honest and open with patients about abortion or decide to legalize abortion in their countries because women and girls are dying, they should not be punished with denial of U.S. foreign assistance (read: rescind the Global Gag Rule).  And I'd like to see candidates decide that it is time that federal funds be used to provide safe, legal and voluntary abortions to those who cannot afford the procedure-overseas and at home (read: ask Congress to repeal the Helms and Hyde Amendments).   

And what about sex workers?  Would the candidates declare that sex workers deserve dignity and respect and have rights to U.S. assistance and HIV prevention? This question should be posed because these Senators both supported legislation to reauthorize PEPFAR with the condition that organizations have a policy explicitly opposing prostitution, and further requiring that funds cannot be used to promote or advocate legalization of prostitution. Such puritanical policies undermine public health and human rights, while exacerbating stigma and isolation of marginalized persons, and putting at risk the lives of sex workers, their clients and partners. 

There is much talk these days about U.S. foreign assistance reform.  Much of this talk concerns global humanitarian organizations -- many who are recipients of U.S. assistance.  But not much is being said about sexual and reproductive health and rights. And I doubt the presidential candidates will volunteer answers and therefore must be rigorously asked.

In a recent article for the ABA Human Rights magazine, I make recommendations for U.S. foreign assistance reforms that advance sexual and reproductive health and rights, which is expanded here:

  1. Institute greater transparency for foreign policy goals related to sexual and reproductive health and rights, delineating what the United States is trying to accomplish through its funding.
  2. Align U.S. foreign assistance with the ICPD Programme of Action and the Millenium Development Goals. Build on the successes of European donor nations, and pool resources where creative partnerships are happening.
  3. Create two new cabinet-level posts: one for global development and the other for women, making women's equality and sexual and reproductive health and rights a priority of U.S. foreign policy.
  4. Adopt modalities to ensure that U.S. funding goes directly to innovative, smaller grassroots organizations that promote sexual and reproductive health and rights and gender equality, and make sure U.S. money gets in the hands of women.
  5. Eliminate restrictions and unnecessary reporting requirements, and fund comprehensive sexual and reproductive health programs that integrate HIV prevention based on public health best practices and human rights standards.

The U.S. must abandon its self-absorbed role as Decider-in-Chief of morality and personal decisions on sex and reproduction. The U.S. must become a collaborator in the global arena, leading by example-leading by serving those who suffer most from ideological restrictions on sexual and reproductive health assistance. 

I look forward to watching the Friday debate to see if any candidate has chosen his path -- Decider or Collaborator for women and sexual and reproductive health and rights. 

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