[Senate Hearing 107-165]
[From the U.S. Government Publishing Office]
S. Hrg. 107-165
MEXICO CITY POLICY: EFFECTS OF RESTRICTIONS ON INTERNATIONAL FAMILY
PLANNING FUNDING
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON FOREIGN RELATIONS
UNITED STATES SENATE
ONE HUNDRED SEVENTH CONGRESS
FIRST SESSION
__________
JULY 19, 2001
__________
Printed for the use of the Committee on Foreign Relations
Available via the World Wide Web: http://www.access.gpo.gov/congress/
senate
_______
U.S. GOVERNMENT PRINTING OFFICE
75-604 WASHINGTON : 2002
____________________________________________________________________________
For Sale by the Superintendent of Documents, U.S. Government Printing Office
Internet: bookstore.gpr.gov Phone: toll free (866) 512-1800; (202) 512�091800
Fax: (202) 512�092250 Mail: Stop SSOP, Washington, DC 20402�090001
COMMITTEE ON FOREIGN RELATIONS
JOSEPH R. BIDEN, Jr., Delaware, Chairman
PAUL S. SARBANES, Maryland JESSE HELMS, North Carolina
CHRISTOPHER J. DODD, Connecticut RICHARD G. LUGAR, Indiana
JOHN F. KERRY, Massachusetts CHUCK HAGEL, Nebraska
RUSSELL D. FEINGOLD, Wisconsin GORDON H. SMITH, Oregon
PAUL D. WELLSTONE, Minnesota BILL FRIST, Tennessee
BARBARA BOXER, California LINCOLN D. CHAFEE, Rhode Island
ROBERT G. TORRICELLI, New Jersey GEORGE ALLEN, Virginia
BILL NELSON, Florida SAM BROWNBACK, Kansas
JOHN D. ROCKEFELLER IV, West MICHAEL B. ENZI, Wyoming
Virginia
Edwin K. Hall, Staff Director
Patricia A. McNerney, Republican Staff Director
(ii)
C O N T E N T S
----------
Page
Aguirre, Dr. Maria Sophia, associate professor, Department of
Economics and Business, Catholic University of America,
Washington, DC................................................. 41
Prepared statement........................................... 45
Bista, Dr. Nirmal K., director general, Family Planning
Association of Nepal, Kathmandu, Nepal......................... 36
Prepared statement........................................... 39
Boxer, Hon. Barbara, U.S. Senator from California, submissions
for the record:
``Women in Prison in Nepal for Abortion''.................... 56
Sec. 2151b. Population Planning and Health Programs.......... 59
Cleaver, Kathy, director of Planning and Information for the
Secretariat for Pro-Life Activities, U.S. Conference of
Catholic Bishops, Washington, DC............................... 56
Prepared statement........................................... 58
Eberstadt, Dr. Nicholas N., scholar, American Enterprise
Institute, Washington, DC...................................... 33
Galdos, Susana Silva, president, Movimiento Maneula Ramos, Lima,
Peru........................................................... 28
Prepared statement........................................... 31
Hutchinson, Hon. Tim, U.S. Senator fron Arkansas................. 5
Kreczko, Alan J., Acting Assistant Secretary, Bureau of
Population, Refugees and Migration, Department of State;
accompanied by: Barbara Turner, Acting Assistant Administrator
for Global Programs, USAID, Washington, DC..................... 13
Prepared statement........................................... 15
Lowey, Hon. Nita, U.S. Representative from New York.............. 10
Neier, Aryeh, president, Open Society Institute, New York, NY.... 60
Prepared statement........................................... 61
Pellegrom, Dr. Daniel E., president, Pathfinder International,
Watertown, MA.................................................. 51
Prepared statement........................................... 53
Reid, Hon. Harry, U.S. Senator from Nevada....................... 3
Smith, Hon. Chris, U.S. Representative from New Jersey........... 6
Snowe, Hon. Olympia J., U.S. Senator from Maine, prepared
statement...................................................... 9
(iii)
MEXICO CITY POLICY: EFFECTS OF RESTRICTIONS ON INTERNATIONAL FAMILY
PLANNING FUNDING
----------
THURSDAY, JULY 19, 2001
U.S. Senate,
Committee on Foreign Relations,
Washington, DC.
The committee met, pursuant to notice, at 10 a.m. in room
SD-419, Dirksen Senate Office Building, Hon. Barbara Boxer,
presiding.
Present: Senators Boxer, Feingold, Chafee, and Allen.
Senator Boxer. This meeting of the Foreign Relations
Committee will come to order. And as we await the arrival of
the first panel, which consists of several Senators and
Representative Nita Lowey and Representative Chris Smith, we
want to welcome Senator Hutchinson. And what I want to do,
Senator, is give a brief opening statement and then call on
you, and perhaps by that time we will be joined by our other
colleagues.
I want to welcome you all to this important hearing. Today
the Senate Foreign Relations Committee meets to discuss the
effects of the Mexico City Policy on international family
planning. I want to thank Chairman Biden for supporting this
hearing and for allowing me to chair it.
Mexico City Policy is known as the global gag rule. It
restricts foreign, non-governmental organizations that receive
USAID family planning funds in three ways, and I'm going to
identify the three ways that these restrictions play out.
First, these non-governmental foreign organizations may not
use their own money to provide legal abortion services. Second,
they may not use their own money to advocate for changing the
abortion laws in their own country. And third, they may not use
their own money to provide full and accurate medical
information about legal abortion services to their patients.
As a result, many foreign, non-governmental organizations
are being forced to either limit their services or simply to
close their doors to women across the world, and we will hear
witnesses who will so testify.
I believe, and I know, that this will cause women and
families increased misery and death. Among the witnesses who
will testify before the committee this morning are the
presidents of two foreign, non-governmental organizations who
provide family planning services abroad. Ms. Susana Silva
Galdos heads a non-governmental organization in Peru that is
trying to work under the limitations imposed by the gag rule.
Dr. Nirmal Bista works for a non-governmental organization in
Nepal that has refused USAID funding because of the harsh
restrictions of the gag rule.
In fact, Ms. Galdos, our first witness from these foreign,
non-governmental organizations, had to seek a temporary
restraining order in Federal court yesterday in order to be
allowed to testify before Congress on informing us of the
abortion laws in Peru. It's almost unimaginable that a witness
that a United States Senator asked to come here actually had to
go to court to get a restraining order in order to speak in
this, the freest and greatest country in the world.
We were fortunate yesterday in that court case. The Bush
administration conceded on this issue, so we're fortunate to
have Ms. Galdos' uncensored testimony before the committee
today.
Why does the United States provide international family
planning assistance? Because by providing family planning,
counseling and care, by working to increase child survival
rates, by improving maternal health and preventing the spread
of HIV/AIDS and other infectious diseases, we help save lives.
As a result of USAID funds, more than 50 million couples in
the developing world use family planning. In the last 30 years
the percentage of couples using family planning has risen
fivefold. Fewer than 10 percent of the couples used
contraception in the 1960's. More than 50 percent of the
couples use contraception today. So 50 percent of the couples
are planning their families.
But the need for family planning assistance continues
because the other side of it is that 50 percent of the couples
in the developing world still do not use contraception. As a
result, approximately 78,000 women throughout the world die
each year as a result of unsafe abortions, and at least one-
fourth of all unsafe abortions in the world are to girls aged
15 to 19.
The problem is growing. By the year 2015 contraceptive
needs in developing countries will grow by more than 40
percent. Make no mistake, the Mexico City gag rule is
restricting family planning, not abortions. International
family planning assistance prevents abortions by helping women
avoid unwanted pregnancies, and it saves the lives of thousands
of poor women in developing countries who would otherwise die
from unsafe abortions.
For example, the recent increased availability of modern
family planning methods has already resulted in a 33 percent
drop in the abortion rate in Russia and a 60 percent reduction
in Hungary. Family planning can significantly improve the
health of these girls and young women by teaching them to
postpone childbearing until the healthiest times in their
lives, which would in turn prevent abortions.
That is why I have introduced bipartisan legislation with
Senators Snowe, Chafee, Collins, and 26 other co-sponsors to
overturn the global gag rule. This legislation that we have
introduced aims to overturn the Draconian restrictions on
international family planning programs put into place by
President Bush on January 22, one of his very first acts as
President of these United States.
Our bill will allow these organizations to continue to
provide legal family planning services without needlessly
restricting their funds. Our bill does nothing to change the
fact that no U.S. funds can be used for abortion services. Let
me repeat that. Since 1973 no U.S. funds may be used for
abortion services. What our bill does is lift the restrictions
on foreign organizations that would be unconstitutional here in
the United States, and that's why the Bush administration was
quick to just give in to us on our lawsuit. We would never gag
people here. We couldn't do it. But they are doing it in
foreign countries.
I believe firmly that family planning organizations should
not be prevented from using their own privately raised funds to
provide legal abortion services, including counseling and
referral, and these groups should not be forced to relinquish
their right of free speech in order to receive U.S. funding, so
I am very anxious to hear from all of our witnesses.
I want to get an update on the other Senators. What do we
know about the Congresswoman?
They are on their way. There is one. We have our assistant
majority leader. I am going to call on Senator Reid first
because of his duties on the floor, and then right to you,
Senator Hutchinson.
Senator Reid, I just made my opening remarks. I know your
time with us this morning is limited. I made the point that we
believe that family planning saves women's lives, and I would
be happy to hear from you.
STATEMENT OF HON. HARRY REID, U.S. SENATOR FROM NEVADA
Senator Reid. I appreciate very much Senator Hutchinson
accommodating me. The Senate is in recess now, and I have to go
back and finish the bill I am managing. I really appreciate the
opportunity to testify here today.
Senator Boxer. Could you speak a little louder into the
microphone, Senator.
Senator Reid. I appreciate the opportunity to speak here
today.
About 2 years ago I took a trip. One of the places that I
went was Nepal, an unusual and beautiful country. Eighty-four
percent of the people in Nepal have no electricity, but also,
in addition to that, Nepal has one of the highest maternal
mortality rates in the whole world. Over 1,000 women out of
every 100,000 women in Nepal die from pregnancy related
complications compared to our country of about six or seven of
every 100,000 women.
The Mexico City Policy, in my opinion, threatens efforts
aimed at reducing mortality rates and improving access to basic
health care in Nepal and all over the world. Nepal is only an
example.
Our support of international family plan programs literally
means, in my opinion, the difference between the life or death
of women in developing countries. At least one woman dies every
minute of every day from causes related to pregnancy and
childbirth. One woman dies every minute of every day from
causes related to pregnancy and childbirth. This means, Madam
Chair, that almost 600,000 women die every year from causes
related to pregnancy. Family planning efforts prevent
unintended pregnancies and save the lives of thousands of women
each year.
In addition to reducing maternal and infant mortality
rates, family planning helps prevent the spread of sexually
transmitted diseases. The World Health Organization reports
that about 6 million individuals, the majority of whom live in
developing nations, become infected with HIV and that has gone
up almost every year. At present in Africa we have 6,000 people
dying every day from HIV-related diseases, every day, no
weekends off, no vacations, every day. And that number is going
up and will double, it's believed, within a dozen years.
President Bush's rationale for imposing the gag rules is
that he wants to decrease the number of abortions abroad. The
last time the Mexico City Policy was in effect there was no
reduction in the number of abortions. It only reduced access to
quality health care services, increased unintended pregnancies,
and actually increased the number of abortions.
Research shows that the only way to reduce the need for
abortion is to improve the family planning effort to decrease
the number of unintended pregnancies. Access to contraception
reduces the probability of having an abortion by 85 percent.
Madam Chair, let me be clear, I do not support the use of
one single taxpayer dollar to inform or promote abortion
overseas. The law explicitly prohibits such activities for
almost 30 years, since 1973. Instead, the legislation written
by Senator Boxer, S. 367, supports family planning efforts that
will reduce unintended pregnancies and reduce the need for
abortions.
Not only does the Mexico City Policy run counter to our
country's commitment to women's health, it restricts foreign
organizations in a way that would be unconstitutional in our
own country. The Mexico City Policy violates a fundamental
tenet of our democracy, freedom of speech. Exporting a policy
that's unconstitutional at home is, in my opinion, the ultimate
act of hypocrisy. Surely this is not the message we want to
send to struggling democracies, which are looking to the United
States as an example and for guidance.
The bipartisan Global Democracy Promotion Act, S. 367,
written by Senator Boxer, would ensure that United States
foreign policy is consistent with American values, including
free speech and medical ethics. I support this legislation, and
I commend the Senator from California, Senator Boxer, for her
efforts to protect and defend the rights of women around the
world.
Senator Boxer. Thank you, Senator. Your testimony is most
welcome.
I am extremely honored that you support the bill, and I
want to also announce that Senator Daschle is as well a
sponsor, as is Senator Chafee. Welcome, and I would be happy to
hear from you at this time.
Senator Chafee. Thank you, Senator Boxer. I am just
listening to Senator Reid talk about what is constitutional in
this country, and the hypocrisy of it is a main point.
Senator Boxer. Thank you so very much. I want to welcome my
former colleague in the House, Representative Chris Smith.
Senator Hutchinson, we will turn to you. You and the
Honorable Chris Smith will have differing views from ours, and
we welcome you here to bring those views out.
STATEMENT OF HON. TIM HUTCHINSON, U.S. SENATOR FROM ARKANSAS
Senator Hutchinson. Thank you, Madam Chair, and members of
the committee. I want to thank you for inviting me to testify
on what truly is an important topic.
President Bush's decision to re-implement the Mexico City
Policy ensures that our legacy to the world does not include
systematic violence against innocent, unborn children. It
ensures that our citizens' tax dollars are used to enhance the
lives of those in the developing world, not destroy them.
In 1973 Senator Helms sponsored legislative language that
prohibited U.S. monetary aid from being used to pay for
abortions or involuntary sterilizations overseas. The intent of
that legislation is clear. American taxpayers should not be
compelled to fund overseas abortions. It sends a message to the
world that the United States does not stand for the despair and
hopelessness of attacking the most vulnerable group in the
human race, the unborn.
The Mexico City Policy builds on that goal by prohibiting
aid to organizations that were involved in abortion activities.
President Reagan took this step to prevent foreign, non-
governmental organizations from playing accounting games that
result in the use of American tax dollars to pay for abortions,
so, while we can pretend that allowing these organizations,
these NGOs, to perform abortions with their own money and use
American taxpayers' dollars for family planning, that we all
know is a fiscal fiction, that these funds are fungible, and
that the intent of the Helms legislation back in 1973 was not
to compel American taxpayers to subsidize something that they
believe is morally wrong. And that is what is happening if you
do not have the Mexico City Policy in place. Every American tax
dollar that went to an abortion provider freed up another
dollar to pay for more abortions. That's wrong. And I am very
pleased that President Bush has reinstated this prohibition.
As this committee hears testimony on this issue, I just
want to make a few points clear from my perspective. This
policy does not affect the amount of United States aid going to
international family planning by one cent. For fiscal year 2002
President Bush is seeking over $400 million for population
assistance, which is comparable to previous years. In fact, the
policy will barely change the number of NGOs that receive the
money.
When the Mexico City language was re-instituted in fiscal
year 2000, 448 groups accepted the policy. Only nine groups
refused the policy. So family planning is not affected and to
raise the specter of not having U.S. aid for family planning
is, I believe, a red herring.
Frankly, those NGOs that refused to abide by a simple and
fair Mexico City language are precisely the kind of extremist
organizations that the United States should not be associated
with. As I said, 448 groups accepted the policy. Only nine
groups refused the policy. Those groups that refused the policy
truly have a radical abortion agenda, and our foreign aid money
should not be to assist them.
There are approximately 100 countries in the world--Madam
Chairman, approximately 100 countries in the world still have
strong pro-life laws. In the past, U.S. grantees like
International Planned Parenthood Federation have actively
lobbied some of those governments for anti-life legislation.
The Mexico City Policy guarantees that our tax dollars will not
be used to promote an agenda antithetical to millions of
Americans.
I had an opportunity to meet with a number of NGOs and
individuals that have had firsthand experience with
international development. I've been told about the need for
more food, about the need for more medical supplies, about the
need for safe drinking water, but not once have I heard about
the need for more abortions. The Mexico City Policy will not
affect the amount of funding that goes to HIV and AIDS at all.
That totally remains the same, untouched.
Madam Chairman, millions of Americans believe that abortion
is fundamentally wrong and that it is the taking of a human
life. Madam Chairman, you and I may disagree on that. In fact,
our society is and will continue to be deeply divided over this
issue. But one point in which there has been broad agreement in
the past has been that Americans who believe it is wrong should
not be forced by our government to subsidize a practice that is
fundamentally against their deepest-held religious views.
Pro-choice people often make the argument to me, as a pro-
lifer, ``It's fine for you to be pro-life, but don't impose
your pro-life views on me in law.'' And, yet, that is precisely
what the pro-choice individual is doing in opposing the Mexico
City Policy. They are forcing me and millions who share my deep
convictions on the sanctity of human life to violate our own
beliefs and convictions by subsidizing that practice with my
tax dollars in a foreign country. No American should be
compelled to participate in an event which they believe is so
wrong.
So, Madam Chairman, I, with deepest respect for you, must
oppose your legislation, and I thank you for the opportunity to
express my viewpoint.
Senator Boxer. Senator, I really do appreciate your very
straightforward testimony. We know that we come from different
places on this in this sense, I believe this policy causes
abortion; you think it prevents it. That's where we have a
disagreement. I think that this policy is completely against
what you want to do, which is to reduce abortion. That's why we
have an agreement over it. Family planning, having groups walk
away from it because of this is counterproductive to what we
both want, fewer abortions. We will have this agreement, I am
sure, in another venue.
Senator Hutchinson. May I be excused?
Senator Boxer. Of course, you may. You have my deepest
thanks for your testimony.
And, Representative Smith, we will turn to you.
STATEMENT OF HON. CHRIS SMITH, U.S. REPRESENTATIVE FROM NEW
JERSEY
Mr. Smith. Thank you very much, Madam Chairwoman, and I
deeply appreciate the opportunity to testify today. I know some
things will be said at this hearing about the Mexico City
Policy, which prohibits U.S. subsidies of foreign abortionists
and abortion lobbyists. I also recognize that we have a strong
difference on this policy, as you just expressed again, and I
know Mr. Chafee as well disagrees.
Nevertheless, I hope the committee will consider my
argument, that a strong, effective U.S. international family
planning program should welcome the opportunity to put a wall
of separation between that family planning program and the
contentious issue of abortion.
Madam Chairwoman, the overriding justification for the
Mexico City Policy is the protection and the safeguarding of
human life. Simply put, abortion is violence against children
and in no way can abortion be construed as humane and
compassionate. Abortion methods include dismembering innocent
children with razor blade tip suction devices, some with the
power of 20 or 30 times a household vacuum cleaner, or
injections of chemical poisons designed to kill the child.
Salt poisoning abortion entails injecting high concentrated
salt water into the baby's amniotic sac. The baby breathes in
the salty water and is burned alive, internally and externally.
It takes about 2 hours to kill the child in this way.
In recent years most Americans have been shocked to
discover yet another hideous method to destroy an unborn child,
partial birth abortion. Performed in the second and third
trimester, the abortionist delivers the entire body except for
the child's head. He then stabs the back of the child's head
with a pair of scissors. The abortionist then sucks out the
brains of that child and kills him or her. If that isn't
violence against children, I don't know what is.
Abortion treats pregnancy as a sexually transmitted
disease, a tumor, a wart, a piece of junk to be destroyed. And,
yet, if you ever watched an unborn child's image on an
ultrasound screen, you can't help but be awed by the miracle of
human life, by the preciousness of the child's being, and moved
to pity by the helplessness and the vulnerability of that
child. This is a human rights issue, Madam Chairwoman.
To see an unborn child turning and twisting, kicking, and
sucking his or her thumb while still in utero--and my wife and
I have four children, three of those we saw with an ultrasound.
And even though I've worked in the pro-life movement for many
years, I was amazed and awed to see the intricate detail of
their bodies very, very early in pregnancy.
Senator Boxer. I saw my grandsons.
Mr. Smith. So you know.
Senator Boxer. It's great.
Mr. Smith. But it does shatter the myth, I would
respectfully submit, that this is mere tissue or ``products of
conception.''
Madam Chairwoman, while the Mexico City Policy is pro-life
it is not, and I repeat, it is not anti-family planning. It
does not cut by one penny the $425 million the United States
spends every year promoting family planning overseas. And years
of experience have shown that we can run a good, solid, family
planning project without retaining abortionists or abortion
lobbyists to administer that for us.
During the 9 years the policy was originally in force, only
two organizations refused to agree to the pro-life safeguards.
We had hundreds of organizations left to choose from. Over 350
family planning organizations agreed to abide by the Mexico
City Policy. In fact, U.S. family planning appropriations
increased dramatically during this time, in part because pro-
life Americans no longer felt an obligation to limit such
spending in order to avoid subsidizing the international
abortion industry.
Some opponents of the Mexico City Policy like to call it a
gag rule. They say it violates free speech, the right to free
speech, although the Federal courts have upheld the policy as
consistent with the first amendment. The restrictions on
abortion promotion that it imposes are narrow and reasonable.
In fact, they are absolutely necessary to ensure that the
organizations function effectively as highly visible partners
and representatives of the United States.
The organizations that work with the United States overseas
are our surrogates. They are an extension of U.S. policy. They
are our ambassadors. Their promotion of abortion in these
countries on issues closely related to the U.S. programs they
administer as well as their activities, such as the actual
performance of abortions, are inevitably going to be associated
with the United States. So these activities are highly relevant
to whether they can effectively administer our programs.
Specifically, among the most important stated purposes of
U.S. family planning programs overseas is to reduce the number
of abortions. The United States has no obligation to administer
these programs through agents whose other activities suggest
otherwise, that they do not really agree with this goal. We
would not hire the Tobacco Institute to run an anti-smoking
campaign, not even if the organization carried out its pro-
tobacco activities with its own money. There's just too strong
a conflict of interest, too high a probability of sending a
mixed and confusing message to the people we are trying to
reach.
Similarly, it makes no sense to hire abortionists or
abortion lobbyists to run programs that purport to reduce
abortions. Money is fungible. When we give money to an
organization, we unavoidably enrich and empower all those
activities. U.S. support also enhances the domestic and the
international prestige of the organization by giving it an
official U.S. seal of approval.
And, remember, the people we are trying to reach are not
likely to have seen their organization's books. They don't know
which activities are funded and from which spigot. So when the
very same organizations offer U.S. family planning assistance
with one hand and the killing of an unborn child by way of
abortion with the other, the message is that the United States,
its representatives and partners, are perfectly comfortable
with abortion as a method of family planning.
Finally, perhaps the most outrageous claim that has been
made by opponents of the Mexico City Policy is that it will
somehow interfere with efforts to address the HIV/AIDS
epidemic. This claim is simply false. For one thing, the United
States currently spends over a half a billion dollars per year
on fighting AIDS, plus many millions that go to WHO and UNDP
and many other NGOs and international organizations.
This money, plus the new money promised by the Bush
administration, and the significant increase today in the Hyde-
Lantos Global Access to HIV/AIDS Prevention and Treatment bill,
which I am a very strong supporter of and actually offered a
strengthening amendment in the area of hospice care, was
recently approved by the House International Relations
Committee. And I think that does demonstrate our real, tangible
commitment to the victims of AIDS.
To sum up, Madam Chairwoman, the Mexico City Policy is a
reasonable exercise of the President's power to set terms and
conditions on U.S. foreign aid projects. With or without the
policy, the same amount of money will be available for family
planning programs and the same number of people can be provided
with these services. The only difference is whether our service
providers will be abortionists or not abortionists.
You may disagree, as I know you do so vigorously, with the
Mexico City Policy because it is pro-life, but it is simply
unfair and I would respectfully submit it is inaccurate to call
it anti-family planning. Again, I thank you for this
opportunity to be here.
Senator Boxer. Thank you, Congressman, and I hope you will
look at our position that we believe the imposition of this, in
fact, leads to thousands and thousands of unsafe abortions.
But, we respect our differences. Congresswoman Lowey, you are
free to leave if you have to. If you would like to stay and
hear your friend, you are welcome to do that.
Ms. Lowey. Thank you. I keep hoping I'm going to convince
my good friends in Congress.
Senator Boxer. Well, we thank you for all your efforts on
behalf of this. I also want to ask unanimous consent at this
time that I place into the record a statement by Senator
Olympia Snowe, who is the key Republican, along with Senator
Chafee, on this particular piece of legislation.
[The prepared statement of Senator Snowe follows:]
Prepared Statement of Hon. Olympia J. Snowe, U.S. Senator from Maine
Madam Chairman, thank you for providing me with the opportunity to
offer testimony to the committee today on international family
planning. I appreciate the committee taking the time to address this
important matter. This has, as you know, long been a concern of mine
and an issue that I have continued to advocate for during my tenure in
both the House and here in the Senate.
There is no question that U.S. population assistance is of critical
importance, as the primary deliverer of health education, health care
and pre-natal care to millions of women in developing countries.
According to USAID, studies in several countries have shown that for
every dollar invested in family planning programs, governments save as
much as $16 in reduced expenditures in health, education, and social
services. It is not only an investment for the health of women, and
their children, but for whole nations.
There is also no question that U.S. population assistance in
developing countries has been successful. The average family size in
countries that have received U.S. population assistance has decreased
from six children to four. AID assistance has increased the use of
contraceptives in developing countries from 10 percent of married
couples in the 1970s, to 50-60 percent today.
I would also like to make it clear for the record that the issue
before us today is not abortion, because current law already prohibits
the use of any U.S. funds for abortion-related activities. That law, by
the way, is the Helms Amendment of 1973, which I support as an
important guarantee that our international family planning programs
stay apart from domestic debates on the issue of abortion.
The real issue before us today is often referred to as the ``Mexico
City Policy'' because it was at the 1984 U.N. Population Conference in
Mexico City that the Reagan Administration adopted this policy. Under
the Mexico City Policy, the Reagan Administration withheld
international family planning funds from all groups that had the
slightest involvement in legal abortion-related services even though
they were paid for with their own private funds. This was done despite
the fact that similar restrictions were not placed on funding programs
run by foreign governments that related to legal abortions. It is also
often referred to as the international ``gag rule'' because it prevents
organizations from even providing abortion counseling or referral
services.
The matter before us is in part about leadership. The United States
has traditionally been the leader in international family planning
assistance. This has been the case ever since this issue rose to
international prominence with the 1974 U.N. Population Conference in
Bucharest. At that time, a great number of the world's developing
countries perceived family planning as a Western effort to reduce the
power and influence of Third World countries. However, in the years
since, the need and importance of family planning has been recognized
and embraced by most developing nations.
If, as a country, we believe in volunteerism in family planning--
and we do--then we should maintain our leadership. Because of our
leading role in international family planning, we have unrivaled
influence in setting standards for family planning programs. A great
number of other donors and recipient countries adopt our models in
their own efforts.
According to the Center for Reproductive Law and Policy, the Mexico
City Policy will penalize 59 countries whose non-governmental
organizations--NGOs--receive family planning assistance funds from the
U.S. NGOs will be prohibited not only from providing abortion-related
services, but also counseling and referrals regarding abortions. And,
the final piece of the Mexico City Policy, bars NGOs from even lobbying
for abortion rights or on abortion related issues.
That's the policy, let's consider the real effect on people.
According to the Alan Guttmacher Institute, about four in every ten
pregnancies worldwide are unplanned, and 40 percent of unintended
pregnancies end in abortion. Knowing this, the net effect of the Mexico
City Policy on these 59 nations is to limit or eliminate critical
family planning work that has a very real impact on the quality of
life. Moreover, the absence of family planning is likely to increase
the instance of the one thing that the advocates of the Mexico City
Policy are most opposed to--abortion.
Family planning is also about health care. Too often, women in
developing nations do not have access to the contraceptive or family
planning services they need because contraceptives are expensive,
supplies are erratic, services are difficult or impossible to obtain,
or the quality of care is poor. In a March report by the Population
Action Institute it was estimated that about 515,000 women die each
year in pregnancy and childbirth, or almost one death every minute, and
millions more women become ill or disabled. In addition, an estimated
78,000 women die every year from illegal and unsafe abortion and
thousands more are injured. How many more women would die if access to
these services were even more limited?
The bottom line is, the Mexico City Policy is bad public policy. It
not only limits discussion, counseling, and referrals for abortion, but
it also limits the ability of organizations, in at least 59 nations, to
carry out needed family planning work. We must remember that family
planning is about--just that--planning one's family. By spacing births
at least two years apart, family planning can prevent an average of one
in four infant deaths in developing countries. Family planning provides
access to needed contraceptives and gives women worldwide the ability
to properly space out their pregnancies so that they can have healthier
babies, which will lead to healthier children and healthier nations.
Again, I appreciate the opportunity to offer my comments today. I
look forward to working with you, Madam Chairman, and the other members
of the committee who believe, like I do, that the Mexico City Policy
should be lifted for once and for all.
Thank you.
Senator Boxer. Congresswoman Lowey.
STATEMENT OF HON. NITA LOWEY, U.S. REPRESENTATIVE FROM NEW YORK
Ms. Lowey. Thank you, Madam Chairwoman, Senator Chafee. I
want to thank you and members of the committee for holding this
hearing and for inviting me to testify on the effects of the
global gag rule on the United States' support of international
family planning. Senator Boxer, you have shown such
extraordinary leadership and I am very pleased that we have the
opportunity to examine this issue today. We are familiar with
the global gag rule, and I know that we will hear from many
experts during the hearing.
I would like to focus today on just a few critical points.
First of all, the most common misconception about the global
gag rule is that it stops U.S. funds from going to perform
abortions overseas. As you know, spending U.S. money on
abortions overseas has been illegal since 1973 and spending
U.S. money to conduct abortion-related lobbying is prohibited
as well.
When the President announced in January that he would
reinstate this policy because, ``taxpayer funds should not be
used to pay for abortions or advocate or actively promote
abortions,'' we just respectfully disagree with him. These
prohibitions are already well entrenched in U.S. law.
I have other concerns as well. The policy ignores the laws
of other sovereign countries. Under the global gag rule, an
overseas NGO must promise not to use any money from any source
to perform abortions regardless of the abortion laws in the
NGO's home country. The options for counseling and referral are
also severely limited. A health care provider may only discuss
abortion as an available option or refer women for services
elsewhere under the following unlikely scenario:
A woman enters the clinic, announces that she is pregnant,
declares that she has already decided to terminate the
pregnancy, and specifically requests a referral. And in a
further example of the sheer folly of the policy, an NGO will
remain eligible for United States funding even if it uses non-
U.S. funds to advocate for tighter restrictions on abortions.
Only pro-choice speech is prohibited. That's what's so
interesting about this.
The global gag rule undermines U.S. support, in my
judgment, for basic human rights around the world, and it
weakens our efforts to promote democracy abroad. Because U.S.-
based groups and their personnel are protected by the first
amendment, they are not subject to these restrictions, so the
practical effect is this: U.S.-based organizations using
Americans to provide family planning services abroad are not
restricted in what they can say or do with private funds, but
indigenous NGOs working alongside them are. American
organizations can come to Capitol Hill to advocate for a repeal
of the global gag rule, but foreign NGOs risk losing their U.S.
funds if they follow suit. The global gag rule says in no
uncertain terms that only Americans should be entitled to the
basic protections our Constitution provides.
I believe this is a dangerous double standard. The global
gag rule is clearly not about crafting rational foreign policy.
If it were evaluated under this lens, the gag rule would be
defeated soundly at every turn.
There is no evidence that the global gag rule will decrease
the number of abortions. It may, in fact, in my judgment, have
the opposite effect. By forcing NGOs to choose between
providing lifesaving health services and receiving U.S. funds
we will decrease the resources certain groups have to provide
contraceptives, counseling and advocacy services that reduce
the incidence of abortion.
Since the Mexico City Policy was initially reinstated last
year I've been working with my colleagues to repeal it. I first
introduced the Global Democracy Promotion Act during the last
Congress, and I was honored to reintroduce the bill with
Senator Boxer this year. I call the Global Democracy Promotion
Act the ``golden rule'' bill. It will keep an overseas group
from being denied U.S. funding solely on the basis of services
it provides with non-U.S. funds as long as those services are
legal in the United States and legal in the country where the
group operates.
And it would prohibit overseas NGOs from being subject to
advocacy and lobbying restriction which cannot be applied to
U.S.-based NGOs. It essentially says that we should treat
people in other countries the way we ourselves would like to be
treated. It's a principle we all learned as children and we
should not forget it now.
The votes in the House to repeal this misguided policy are
bipartisan and very close, and I believe we will ultimately
prevail. I hope this hearing and our combined efforts will
convince people that the global gag rule is bad policy. It
undermines U.S. efforts to promote democracy in the developing
world. It thwarts USAID's global health initiatives. It sullies
our country's global reputation, and it does nothing to reduce
the incidence of abortion worldwide.
Let me just say to Senator Boxer and Senator Chafee, and to
my good friend, Congressman Smith, many of us have traveled to
other parts of the world, and I know you, as a leader in human
rights, have done so.
I remember a trip to Egypt very recently where I visited a
maternal-child clinic, and the nurse was telling me of stories
where a woman was brought in bleeding to death because of a
botched abortion, but they couldn't do anything. Because this
has such a chilling effect, they were afraid to refer this
woman to help save her life, to take care of her, because of
the chilling effect.
I also remember, when we talk of rights and protecting
women and families, a recent trip to Cambodia. Only 40 percent
of the people in that country currently receive family planning
assistance, contraceptive assistance. Seventy percent want it.
And when we look at these families and children who desperately
need these services, I think it is the right thing for us to do
to encourage family planning as much as we can, and it would be
irresponsible for us to cause any kind of chilling effect.
So let me close by again restating the golden rule. Let's
not do unto others what we wouldn't impose on ourselves, and
let's make sure that we do all we can to preserve human life
around the world and protect these families, protect these
children, provide these services. I'm very proud of the work
that the United States is doing in providing family planning
services and assisting these families in planning their lives.
And I thank you again for your important leadership, Madam
Chairwoman.
Senator Boxer. Thank you very much. Thank you both. We'll
call our second panel.
Mr. Smith. Madam Chairwoman, may I respond?
Senator Boxer. We're not going to have a response back and
forth. I'm so sorry. The tradition of the committee is that our
witnesses speak and we don't question Members of Congress,
because we take your testimony for what it is worth, and it's
worth a lot to us and we thank you for it.
We will move on to the second panel. Mr. Alan Kreczko is
Acting Assistant Secretary of the Bureau of Population,
Refugees and Migration, Department of State. He is a
representative of the Bush administration. He will speak in
favor of their policy. He is accompanied by Barbara Turner,
Acting Assistant Administrator for Global Programs, USAID. We
welcome you, and we're going to ask that you try to limit your
opening statements to--how much time do you think you need?
Mr. Kreczko. Ten minutes, Madam Chairman.
Senator Boxer. If you could try to keep it to 10 minutes,
because we need to move ahead. Thank you. Please proceed.
STATEMENT OF ALAN J. KRECZKO, ACTING ASSISTANT SECRETARY,
BUREAU OF POPULATION, REFUGEES AND MIGRATION, DEPARTMENT OF
STATE; ACCOMPANIED BY: BARBARA TURNER, ACTING ASSISTANT
ADMINISTRATOR FOR GLOBAL PROGRAMS, USAID, WASHINGTON, DC
Mr. Kreczko. Thank you, Madam Chairman and members of the
committee. I am pleased to be here today to represent the
administration in discussing the Mexico City Policy and to
reaffirm the administration's commitment to international
family planning.
Throughout the more than 30-year history the U.S.
International Family Planning Program has had strong support
from the American public as well as the Congress. This program
is recognized worldwide as one of the most successful
components of our foreign assistance. We remain the largest
donor in the world with programs in more than 58 countries.
More than 50 million couples in the developing world use
voluntary family planning services as a result of programs
supported by U.S. tax dollars. These programs enable couples to
choose the number and spacing of births, promote enhancement of
maternal and child health, reduce the incidence of abortion,
and enable parents to better provide for their children. And we
know that voluntary family planning saves lives by reducing up
to a quarter of the 515,000 annual pregnancy-related deaths
around the world.
President Bush has reaffirmed the United States' commitment
to a strong international family planning program. On January
22 the White House indicated that the President was committed
to maintaining the $425 million funding level provided for in
fiscal year 2001 appropriations, noting that this support
recognizes our country's long history of providing
international health care services including voluntary family
planning for couples around the world who want to make free and
responsible decisions about the number and spacing of their
children and also noting that providing quality family planning
services is one of the best ways to prevent abortion.
The administration's commitment to international family
planning is further reflected in the President's fiscal year
2002 budget request, which includes $425 million for USAID's
population program with an additional $25 million for the U.N.
population fund, UNFPA.
One standard applied in making decisions about how limited
U.S. international family planning assistance funds are
allocated to potential foreign grantees or sub-grantees is
whether their family planning programs are consistent with the
values and principles the President decides to promote as part
of his broader foreign policy. Congress recognized this when it
stipulated that fiscal year 2001 population assistance funds
would not be available for expenditure until February 15, 2001.
The accompanying conference report noted that this restriction
was designed to allow the new President to decide what terms
and conditions to impose on such assistance.
The programs of foreign NGOs that provide or actively
promote abortion are not consistent with the family planning
values President Bush wants to promote as part of his foreign
policy agenda. Consequently, President Bush restored the Mexico
City Policy. While USAID's population assistance program had
been prohibited since 1973 from supporting abortion-related
activities, the Mexico City Policy ensures that USAID's family
planning assistance only goes to foreign organizations that do
not perform or actively promote abortion with a clearly stated
exception for post-abortion care. This policy had previously
been in place from 1984 until 1993, during the Reagan and first
Bush Presidencies, but was rescinded by President Clinton.
The Department of State and USAID worked closely together
in issuing the implemented clauses for the Mexico City Policy.
They are nearly identical with the previous clauses. While few
organizations have decided not to comply with these clauses, we
expect more than 450 foreign, non-governmental organizations
will ultimately elect to accept assistance subject to the
clauses as they did when the policy was in place under
Presidents Reagan and Bush and will therefore continue to
receive USAID funding.
USAID will do its very best to assure that any gaps in
services created by organizations that are now under Mexico
City Policy ineligible for USAID population assistance will be
filled by other eligible organizations.
Let me briefly express concerns raised regarding the
limitations on abortion advocacy by NGOs operating abroad. In
order to avoid any misperception of U.S. Government endorsement
of what a government's foreign organization's message may be on
abortion, foreign NGOs that engage in advocacy on abortion are
prohibited under the Mexico City Policy from receiving USAID
family planning assistance. Foreign NGOs that choose not to
comply with the policy can, of course, seek funding from other
donor governments, the private sector, or from their own
governments.
While family planning assistance has broad support in the
United States, abortion is an issue on which Americans
sincerely and deeply disagree. The Mexico City Policy seeks to
clearly separate the U.S. Government's support of family
planning assistance from abortion-related activities.
I would also like to note that USAID's family planning
program operates under a variety of restrictions. Its own
monitoring and independent audits from the inspector general
and GAO have routinely found their programs in compliance with
these restrictions.
In closing, Madam Chair, let me reiterate this
administration's strong commitment to international family
planning. As I said earlier, we are the largest bilateral
provider of voluntary family planning and related health
services. The President's fiscal year 2002 budget supports our
position as the leading donor. With this committee's support
and that of the entire Congress, we expect that to remain the
case in the years to come.
That concludes my remarks. As USAID is the responsible
implementing agency for the Mexico City Policy, I have asked
Barbara Turner, who is the Acting Assistant Administrator for
Global Programs, USAID, to join me in answering any questions
you may have. Thank you.
[The prepared statement of Mr. Kreczko follows:]
Prepared Statement of Alan J. Kreczko
Madam Chairman and members of the Committee, I am pleased to be
here today to represent the Administration in discussing the Mexico
City Policy and to reaffirm the Administration's commitment to
international family planning.
Throughout its more than 30-year history, the U.S. international
family planning program has had strong support from the American public
as well as Congress. This program is recognized worldwide as one of the
most successful components of our foreign assistance. We remain the
largest bilateral donor in the world, with programs in more than 58
countries.
More than 50 million couples in the developing world use voluntary
family planning services as a result of programs supported by U.S. tax
dollars. These programs enable couples to choose the number and spacing
of births, enhance maternal and child health, reduce the incidence of
abortion, and enable parents to better provide for their children. And
we know that voluntary family planning saves lives by reducing up to a
quarter of the 515,000 annual pregnancy-related deaths around the
world.
President Bush has reaffirmed the U.S. commitment to a strong
international family planning program. On January 22, the White House
indicated that the President was committed to maintaining the $425
million funding level provided for in the FY 2001 appropriation, noting
that this support recognizes our country's long history of providing
international health care services, including voluntary family planning
to couples around the world who want to make free and responsible
decisions about the number and spacing of their children, and also
noting that providing quality family planning services is one of the
best ways to prevent abortion. The Administration's commitment to
international family planning is further reflected in the President's
FY 2002 budget request of $425 million for USAID's population program,
with an additional $25 million for the UN Population Fund (UNFPA).
One standard applied in making decisions about how limited U.S.
international family planning assistance funds are allocated to
potential foreign grantees or subgrantees is whether their family
planning programs are consistent with the values and principles a
President decides to promote as part of his broader foreign policy.
Congress recognized this when it stipulated that FY 2001 population
assistance funds would not be available for expenditure until February
15, 2001. The accompanying conference report noted that this
restriction was designed to allow the new President to decide what
terms and conditions to impose on such assistance.
The programs of foreign NGOs that provide or actively promote
abortion are not consistent with the family planning values President
Bush wants to promote as part of his foreign policy agenda.
Consequently, President Bush restored the ``Mexico City Policy.'' While
USAID's population assistance program has been prohibited since 1973
from supporting abortion-related activities, the Mexico City Policy
ensures that USAID's family planning assistance only goes to foreign
organizations that do not perform or actively promote abortion, with
the clearly stated exception of post-abortion care. This policy had
previously been in place from 1984-1993 during the Reagan and first
Bush presidencies, but was rescinded by President Clinton.
The Department of State and USAID worked closely together in
issuing the implementing clauses for the Mexico City Policy. They are
nearly identical with the previous clauses. While a few organizations
have decided not to comply with these clauses, we expect more than 450
foreign non-governmental organizations (NGOs) will ultimately elect to
accept assistance subject to the clauses, as they did when the policy
was in place under President's Reagan and Bush, and will, therefore,
continue to receive USAID funding. USAID will do its very best to
assure that any gaps in services created by organizations that are now,
under the Mexico City Policy, ineligible for USAID population
assistance will be filled by other, eligible organizations.
Let me address briefly concerns raised regarding the limitations on
abortion advocacy by NGOs operating abroad. In order to avoid any
misperception of U.S. government endorsement for what a foreign
organization's message may be on abortion, foreign NGOs that engage in
advocacy on abortion are prohibited under the Mexico City Policy from
receiving USAID family planning assistance. Foreign NGOs that choose
not to comply with the policy can of course seek funding from other
donor governments, the private sector, or from their own governments.
While family planning assistance has broad support in the United
States, abortion is an issue on which Americans sincerely and deeply
disagree. The Mexico City Policy seeks to clearly separate U.S.
government support for family planning assistance from abortion-related
activities.
I would also like to note that USAID's family planning program
operates under a variety of restrictions. Its own monitoring and
independent audits from their Inspector General and GAO have routinely
found their programs in compliance with these restrictions.
In closing, let me reiterate this Administration's strong
commitment to international family planning. As I said earlier, we are
the largest bilateral provider of voluntary family planning and related
health services. The President's FY 2002 budget supports our position
as the leading donor. With this Committee's support--and that of the
entire Congress--we expect that to remain the case in the years to
come.
That concludes my remarks. As USAID is the responsible implementing
agency for the Mexico City Policy, I have asked Barbara Turner, USAID
Acting Assistant Administrator for Global Programs to join me in
answering any questions you may have.
Senator Boxer. Thank you very much. I note the presence of
two members of the committee and am honored that they took time
out of their schedules to be here. Before I ask any questions
and open it up for questions, I would ask Senator Feingold if
he would like to make an opening statement.
Senator Feingold. I would, and I want to thank the Chair,
Senator Boxer, for chairing this very important hearing, and I
want to thank the witnesses.
I have consistently opposed the so-called Mexico City
restrictions on U.S. assistance to these programs, which are
also know as the gag rule restrictions. Current U.S. law
already prohibits U.S. funds from being used to promote
abortion-related activities overseas. The gag rule restrictions
traditionally prohibit U.S. funds from going to any
organization abroad that uses its own funds for the purposes of
providing abortion services or counseling, or even speaking out
about abortion laws in their own country.
I find it difficult to believe that these restrictions
really prevent abortions. More likely, I think they actually
increase their likelihood by cutting off funds to reputable
family planning organizations, which happen also to use their
own money for abortion-related activities.
All over the world these gag rule restrictions also bring
U.S. Government into what should be private consultation
between a woman and her health care provider, effectively
somehow setting the parameters of these discussions from here
in Washington. I think this is really beyond presumptuous. I
believe that this policy actually directly conflicts with our
national values. Gag rule restrictions basically demand the
recipients of U.S. family planning to surrender their rights to
free speech if they wish to receive U.S. family planning
assistance, a policy that runs counter to cherished American
principles.
I strongly support voluntary international family planning
programs which help to educate women about contraception,
prenatal care, birth spacing, the prevention of sexually
transmitted diseases and other important lifesaving issues. And
I am greatly concerned that this misguided policy will
undermine these programs and hinder global progress toward
better maternal/child health.
I look forward, of course, to reading over the witnesses'
testimony. And, again, I just want to thank the Chair for her
tremendous leadership on this issue. Thank you.
Senator Boxer. Thank you so very much, and I appreciate
your support.
Senator Allen.
Senator Allen. Thank you, Madam Chairman. It's good to be
with you again. You have convened a hearing on issues, actually
two issues, that understandably stir emotions----
Senator Boxer. Actually, this was Senator Biden's----
Senator Allen. So, Senator Biden pulled this off?
Senator Boxer. This is actually a full committee hearing
that he has given me the honor of chairing.
Senator Allen. He ought to be here to handle this, but
it's----
Senator Boxer. He trusts me.
Senator Allen. I think it's much more enjoyable to have you
doing this, in essence, and for you to have this hearing on
these very controversial issues, and those are the issues,
really, of foreign aid and the issue of abortion, which are
issues that clearly stir emotions and controversy in our
country.
I've read and listened to Mr. Kreczko's statement.
Regardless of pronouncing his name incorrectly, I think it's a
very articulate statement, but I also think it's a statement of
the administration that shows a very reasonable, principled
statement of policy, which I support. I would go on to say to
the chairman on the issue of abortion I have a position of what
I call one of reasonable moderation, and it's one which uses
scientific ways of looking at when there is a quality of life
or development of life, when there is a compelling state
interest to protect the unborn child, fetus, product, whichever
term one would want to use.
But I've always taken the strong stand against taxpayer
funding of elective abortions unless they are in the case of
rape or incest or the physical health of the woman, the mother,
being in danger. And if you look at the details of this so-
called Mexico City Policy, it actually fits in as far as the
taxpayer funding issue: Abortions may be performed if the life
of the mother would be in danger if her fetus were carried to
term, or following rape or incest. And so funds can be used in
that way.
Health care facilities may treat injuries or illnesses
caused by legal or illegal abortions, post-abortion care. As I
understand it, that is covered by such funding. Passive
responses by family planning counselors to questions about
abortion from pregnant women who have already decided to have a
legal abortion are not considered acts of promoting or
advocating abortion, and referrals for abortion as a result of
rape, incest, or where a mother's life would be in danger or
support of post-abortion care are permitted. So this is
generally my view of the way it ought to be, as everyone has
their own views, have very strongly held views on this issue.
But as far as I'm concerned, it's pretty close to my general
view of taxpayer funding.
I might have a different status or view as far as what goes
on in the United States versus foreign aid, because, after all,
this is the taxpayers' money that will be going to support
foreign groups that support abortion, fund abortions, or
encourage or advocate abortions.
And I think we all want to help women. I support family
planning. I support funding by the United States of programs
that help women decide how many children they may want to have,
or spacing of their children. Our Government, which means the
taxpayers of the United States, spend over $400 million a year
for family planning programs, and I just don't think we need to
use this money to give it to groups that perform abortions or
advocate abortions.
The so-called Mexico City rule has been in effect in the
past, and the international family planning groups have not run
out of business. They've survived all those years just fine
during the Reagan and first Bush administration. And there will
always be funds from other countries. They can support it.
There are private organizations. There are individuals that
want to support these groups. So I don't see why the taxpayers
ought to be compelled to do so.
The reason I say the private groups can fund it is that it
is the right of an individual to fund whatever they want, to
fund as they see fit. The question here is what is the proper
use of U.S. taxpayers' money.
So, in summary, Madam Chairman, I pretty much agree with
the statements made here on behalf of the Bush administration,
and I would hope that policy stands because it's consistent
with my views and principles, and I consider my stand to be one
of a status of reasonable moderation on the issue of abortion.
So thank you, Madam Chairman, and thank you all for bravely
coming before this committee.
Senator Boxer. Thank you, Senator.
This is a good start. This is common ground. Let me say,
Senator, how much I respect your being here this morning. So I
guess where I disagree with you is you think this is a very
controversial hearing and controversial subject. I think family
planning is not.
I also want to point out that you said a couple of things
that I just want you to look at, because I know you are a very
serious legislator, and that is you said very strongly that you
don't believe public funding should be used for abortion, and
that has been the law since 1973. When I got to the Congress in
1983, that had been the law for 10 years. So the fact that it
is written without the gag rule, U.S. funds may not be used.
And what this gag rule says is, if they spend their own money
on abortion, they cannot receive Federal funds. So I just urge
you to look at that.
You also said you support abortion in the case where the
physical health of the mother is impaired. This gag rule makes
no exception for the physical health of the mother. It does for
life of the mother, not physical health. So I'd love to see
that section added. We're with you on it if you would like to
do that, because that might be an area we could work on
together.
Senator Allen. May I----
Senator Boxer. Please, please. We're taking a little time
out here. Maybe we can reach some----
Senator Allen. The concern I would have for the chairman is
that, if you give money to these organizations, these foreign
organizations----
Senator Boxer. Yes, nongovernmental.
Senator Allen. All right, non-governmental organizations
that perform abortions, obviously you can switch money around.
It could supplant other funds. They'll say, ``Oh, yes, we are
not using it for this,'' so they use the money for one way or
the other. So money is fungible. That's a concern I have there.
Senator Boxer. I would say in this country we do give tax
dollars to organizations that use their own funds. They have to
give very strict----
Senator Allen. Such as Planned Parenthood?
Senator Boxer. Well, several.
Senator Allen. Correct.
Senator Boxer. And we do have very strict laws. So this is
a different set of rules for non-governmental entities abroad
in developing countries. That's why we think, many of us, that
this is just so unfair.
Senator Allen. Let me ask you this. This so-called gag
rule, which was an issue in the first Bush administration,
which applied to the United States, that issue--maybe the Bush
administration is going to bring it back, but as I understood
during the Clinton administration, that's been settled and the
policy as far as Federal funding for organizations on planning,
while it doesn't fund abortions as far as abortion counseling,
the gag rule, as I remembered it from 10 years ago, was one
that even prohibited----
Senator Boxer. That's correct.
Senator Allen [continuing]. Discussion of abortion.
Senator Boxer. And that's what this does, the Mexico City
Policy. We had that, but it's unconstitutional and we can't
have it here, so that's why we don't have it in this country
but we have it in developing countries.
Senator Allen. Just so you know, when I was for a short
time a Member of Congress, my stand was opposed to that so-
called gag rule. I thought it went too far in prohibiting, and
got some nice blasting letters and faxes from folks on it, but
nevertheless that was the position I took during the campaign.
This, though, is overseas.
Senator Boxer. Yes.
Senator Allen. These are foreign operations.
Senator Boxer. And you're going to meet some of these good
folks who are going to testify today.
Senator Allen. It's important and the whole issue of
foreign aid and how much foreign aid we ought to have is
another issue, and what we should be funding and what sort of
certainty is there that it won't be used--and especially if an
organization does perform abortions. But I'm glad that the gag
rule issue as far as domestic, here in this country, is
settled. Who knows? Maybe it will come back again.
Senator Boxer. I don't think so.
Senator Allen. Good. I hope it doesn't.
Senator Boxer. We have a good Constitution.
Senator Allen. Well, I didn't know it was a
constitutional----
Senator Boxer. Well, free speech is the basis of our----
Senator Allen. Yes, but you don't have the right to have
our taxpayers pay for your speech. I just thought it was a bad
medical policy to not allow medical professionals to even
discuss the option of abortion. I didn't think they should----
Senator Boxer. Senator?
Senator Allen. Just let me say one thing.
Senator Boxer. Yes.
Senator Allen. The reason I used the words ``physical
health'' as far as exceptions, which are in this policy, for
rape and incest and----
Senator Boxer. Life of the mother.
Senator Allen. You used life of the mother. The reason I
used the words ``physical health,'' is simply an adjective to
make sure that we are thinking of physical health as opposed
to----
Senator Boxer. Mental health.
Senator Allen. Because some people can use that as a way--
without the proper adjectives it's too big of a loophole.
Senator Boxer. I agree.
Senator Allen. Maybe I should use the word ``life,'' but
I'm just always--there could be a situation detrimental to a
woman's physical health.
Senator Boxer. Yes.
Senator Allen. An impairment disabling----
Senator Boxer. Exactly, and that's a very big issues
surrounding the whole debate. Thank you, Senator. We did this
little, mini debate, because I think it's helpful to see
different views, but the point, I hope, Senator Allen, you will
keep in mind, and if you do I have some confidence, maybe, that
you will rethink your position on this, that this global gag
rule is the same thing as that domestic gag rule we had, same
thing.
Doctors, or nurses, in foreign countries cannot tell a
patient their options. It has to be a passive question. But no
one can come in and say, ``What are my choices? What can I do?
I'm in trouble here.'' Doctors may not speak if they receive
Federal funds. So I think this is crucial.
Well, Mr. Kreczko, I'm sure you were thrilled that you
didn't get on the hook for a couple of these questions, so I'm
going to return to you. And I would like to go to the 5-minute
rule for us as well. So let me say, I was stunned when George
Bush did this, frankly, 2 days after he was elected, and I have
his statement here. He said, ``It is my conviction that
taxpayer funds should not be used to pay for abortions or
advocate or actively promote abortion, either here or abroad.''
So I just want to make sure you know, and I know you know
this, but just for the record, do you not agree that since
1973, taxpayer funds have not been able to be used to provide
abortion, to promote abortion, in this country or abroad?
Mr. Kreczko. Senator, you are correct. Since 1973 U.S.
taxpayer funds cannot go directly to support abortion
activities.
Senator Boxer. You agree with that?
Mr. Kreczko. Yes.
Senator Boxer. So I just might say for the record then, and
I don't ask you to comment at all, that in my opinion this
statement is incorrect, because he said, ``The Mexico City
Policy must be restored because taxpayer funds should not be
used to pay for abortions.'' That's why so many of us were
stunned. He didn't say ``fungible'' or any of these things that
others have said. So I think that this statement is incorrect
on its face, and I would put it in the record and make the
point that the Bush administration has now stated that. It is
an accurate statement that since 1973 taxpayer funds have not
been able to be used for abortion or promote abortion here or
abroad.
Mr. Kreczko, you pointed out some of the exceptions, and
Senator Allen also did, of this global gag rule I call it.
Others call it the Mexico City Policy. But we agree that the
life of the mother, rape, incest--and I believe you said you
didn't say medical emergency. What is the exact----
Mr. Kreczko. Care for the consequence of abortion.
Senator Boxer. Right. So that in your opinion if a woman
walked into one of these USAID clinics that was living under
the global gag rule and she was bleeding from a botched
abortion or an incomplete abortion, and they helped her get
through the rest of this operation, they would not lose their
funding?
Mr. Kreczko. Correct. The President made that explicitly
clear when he enacted the Mexico City Policy.
Senator Boxer. Well, let me----
Ms. Lowey. I would just like to comment that under the
original Mexico City Policy in the 1980's and 1990's, that was
not correct. President Bush changed that in the new policy.
It's the one thing he specifically asked that we adjust because
we felt that was something groups had brought to us as a
concern.
Senator Boxer. OK, well, I would recommend that you might
consider discussing this with Secretary Powell or people from
the State Department or USAID. I think we really need to
clarify that because Congresswoman Lowey says that the groups
are fearful of the chilling effect of this policy where when a
woman comes in in that circumstance they are afraid or fearful,
or even if she asks a passive question.
I want to ask you, do we have this gag rule in any other
USAID activity?
Mr. Kreczko. I don't know the answer to that.
Ms. Lowey. Not to my knowledge.
Senator Boxer. We don't. And it seems to be amazing that we
have a gag rule--on no other USAID program, but we have this
gag rule on family planning. I think that says volumes. If
we're so worried about it--I mean, theoretically, if somebody
goes in to get treatment because they're afraid that they have
AIDS, let's say, the people there in those non-governmental
organizations aren't gagged from talking about abortion or
anything else. So I'm saying this not to give you an idea to
now go out and gag those people, but I'm saying the fact that a
gag rule applies strictly to family planning is very hostile.
It is very hostile to women. It's very hostile to the notion of
freedom of speech when it comes to a woman's reproductive
rights.
Mr. Kreczko. Senator Boxer, can I comment on this?
Senator Boxer. Yes, go ahead.
Mr. Kreczko. I actually think that the narrowness of the
Mexico City Policy demonstrates exactly the opposite. The
Mexico City Policy only applies to the family planning money.
It does not apply to any other source of U.S. Government
funding, so clearly the intent is not simply to go out and
target any foreign NGO because of its advocacy. If so, it would
apply no matter what the source of funding. Instead, it applies
to family planning because of the President's desire to draw a
clear line of separation between family planning and abortion.
Now you mentioned in your comments that family planning is
not controversial. There is a strong consensus in the United
States that we ought to be doing family planning, but there is
not a consensus on the abortion issue in the United States, and
we actually can encourage and promote and secure support for
family planning by keeping a clear separation between family
planning and abortion. And that's what the Mexico City Policy
does. We choose our partners for the implementation of family
planning on the basis of what their views are.
Senator Boxer. Well, that's a good try, but we don't do
that at home. We don't do these things to our family planning
people at home. We don't gag them. We permit doctors to tell
them their options. We don't stop them from being able to
advocate.
Do you know that we have a witness on the next panel that
had to go to court because she was fearful of speaking out here
and the Bush administration showed up in court and very wisely
said, ``Oh, we won't contest this. We'll let her talk.'' Thank
you. Thank you, for allowing someone to speak.
I would say to you that, because this is just attached to
family planning organizations and no one else, it is hostile to
family planning. It is hostile to those groups. I hope you can
stay and hear those groups and what it is like for them because
they are so fearful. They see 78,000 women dying of illegal,
botched abortions. They believe that your policy, which you are
defending here today, is going to lead and is leading to more
illegal abortions.
So I respect your view. I think you made a good try to show
how friendly this administration is to family planning, but you
are putting a gag on groups outside of America. You can't do it
here. The administration would love to do it here, but it
can't, because we're protected here by our Constitution. And I
think that is a shameful situation, but I appreciate--I have a
sense that in your heart you don't see it this way. And so,
good, I'm glad, you sleep at night much better. But I see it a
completely different way.
Senator Chafee.
Senator Chafee. Thank you, Senator Boxer. I think you are
making the key point here, and that's the hypocritical aspect
of this law. Senator Boxer's bill, S. 367, declares that
``ineligibility to termination for certain assistance under the
Foreign Assistance Act of 1961: Foreign NGOs shall not be
ineligible for assistance solely based on the health and
medical services, including counseling and referral services,
provided by them with non-U.S. Government funds if such
services do not violate the laws of the country in which they
are being provided and would not violate U.S. Federal law if
provided in the United States.'' These are the key points here.
How can the administration not support S. 367 under those
circumstances?
Mr. Kreczko. If I can try to respond to that, Senator. The
issue is what organizations we want to choose as our partners.
There's no obligation to fund everyone regardless of their
views, and I think that would be uncontested if there were a
group that was arguing that abortion ought to be coerced or
that abortion ought to be used in order to choose the sex of
the child that was going to be delivered. We have no obligation
to fund any organization because of the views that it advances.
You have to bear in mind that we are associated with the
groups that we fund. We do not fund anonymously. In fact, we go
out of our way overseas to take credit for the family planning
services that we provide. So when we provide financial support
to a foreign, non-governmental organization, organization x, we
go out of our way to make it clear and visible and public that
the U.S. Government is supporting that organization's
activities. Now we don't want to create any confusion about
what this administration's view is on appropriate family
planning, and therefore we do not fund those groups which
support abortion activities.
So I think that is the explanation. And again, as I say,
the intent is to keep a clear line between family planning,
which everyone supports, and abortion, which is divisive.
Senator Chafee. I just add that we have to be careful about
blurring the line between the 1973 law, as has been pointed
out, and how that exists and the laws that--what is
constitutional here in the United States and how can we have
different standards for foreign countries.
Mr. Kreczko. Senator, I understand the difference between
the 1973 law. The 1973 law only applies to what happens
directly with our funding. But it is a fact that we perpetuate
intentionally that when we fund an organization, that
organization becomes associated with us overseas, and it is
known that we fund them.
Senator Chafee. Thank you, sir.
Senator Boxer. Senator Allen.
Senator Allen. Thank you, Madam Chairman.
I do think that the issue is which hearings on
appropriation policies, so to speak, as to which foreign
organizations the taxpayers of this country ought to fund. We
make all sorts of decisions on appropriations and have
conditions on appropriations. To me, this seems very
reasonable.
Again, you know, this was not anything that was all that
hard, prior to the Clinton administration--they came in after 2
days in office and they changed the rules that were in the
first Bush administration, so Presidents use their Executive
powers quite quickly, and that's within the prerogatives in
changing it.
But I do think it's important to note a new aspect of this
law, and I assume this was along and blurred from this hearing,
that if someone has complications from an abortion, some
physical problems, whatever the problems may be, that these
organizations are perfectly--that there is no prohibition and,
in fact, probably what needs to be done in this is one thing
that I think everyone can agree on out of this hearing that
could be very beneficial if there is a chilling effect somehow
on this Mexico City problem. But those who do have medical
problems after an abortion, not performed, obviously, in that
particular facility, but they want to go to the other
organization, that that certainly would be allowed.
And probably you need to work with whatever these non-
governmental organizations are, and there may be some of these
non-governmental organizations that may not have applied
previously for these funds that do perform that very important
service that need to know that. Because I think it's a good
change. I think it should have been there before. It just never
arose or came to my attention, nor was I here to worry about
such matters when one is worrying simply about the Commonwealth
of Virginia.
The chairman had some questions about your heart there, Mr.
Kreczko, and I'm going to allow my final time for you to--the
chairman is very persuasive, as you can see, and she's very,
very sharp and smart. Is there anything that you would want to
add? I can tell that you want to respond, but the time has
expired so I'll give you whatever moments I have left on my
time.
Mr. Kreczko. Thank you, Senator.
I would like to make two comments. No. 1, the actual White
House statement that indicated the restoration of Mexico City
Policy included in it a statement about being able to provide
care for people who went through botched abortions, so
attaching visibility to that is something that we have tried to
do to remove any questions that might have existed under the
former policy on that.
The other point that I welcome an opportunity to make is
this question about impact on family planning, because there is
a consensus around the room that we all support family
planning. The fact is that we are given by Congress $425
million for a family planning program, and we will program that
$425 million with or without Mexico City Policy. We can and
will program effectively the $425 million of funding we are
provided, so there is not going to be a significant adverse
impact on family planning programs as has been argued. Thank
you, Senator.
Senator Allen. Thank you. Thank you, Madam Chairman.
Senator Boxer. Thank you so much. Maybe there is room for
us to work on a way together to the Bush administration asking
them to send out a clarification of their rule, because we did
get testimony from Nita Lowey that--I don't know if you were
here at that point.
Senator Allen. I was not.
Senator Boxer. That in Egypt a woman desperately seeking
help after a botched abortion came into one of these
organizations that was a very good organization, and they were
afraid to treat her because it had that chilling effect.
Senator Allen. Let's do that.
Senator Boxer. I would love to. And so that's a place that
we could work together on and hopefully get your support on
that, and that we could work together on something would be
very good.
Mr. Kreczko. I can say that it's there in the amended
policy guidelines that were issued after the Mexico City Policy
was restored by the President, so it is there.
Senator Allen. It seems like a notification needs to--at
least in Egypt, and who knows where else in the world, that
needs to be clarified. Not everyone reads all these missives.
Most people do, but not everyone all over the world.
Senator Boxer. That's true. People in Nepal may not read
the Federal Register. This is true. So if we want to get
something out there, it seems to me we might send a letter--
and, Senator Allen, maybe or maybe not we could hope to agree
on something.
Let me thank you. I would want to say, however, sort of the
irony of this in my mind, not in yours and not in Senator
Allen's, but I think in Senator Chafee's and mine, I think I
would speak for the both of us in saying this, as we seek to
make the best of the circumstance by clarification of what we
have in place, it seems to me, it is a separation where,
because we have these different rules for the international
organizations who are doing this, we have this chilling effect
and we certainly know they cannot let people know what their
rights are unless it's the answer to a passive question. They
cannot. We all admit that.
That's what this global gag rule is. A doctor can't say to
you, if he sees you, what he or she might not want to be
fearful of doing, but they can't do that or they will lose
their funds.
So what we have set up then is perhaps some of the base
organizations that you fund, that we all fund as Americans.
We're picking out the best. You're absolutely right, the best
of the best family planning organizations are getting our
funding. And they are the very same ones that are gagged. They
are the very same ones that cannot use their own funds to
provide safe abortions. Now a woman doesn't go there. She goes
to some back alley. Then she comes bleeding into one of the
organizations we fund, and, with your magnanimous exception, if
she arrives bleeding on the floor, they have the help for her.
Well, good for you. I'm glad you have that exception, but how
much better it would be if that woman could go to that fine
organization and not to the back alley.
That's why many of us are upset about this. I respect that
we see it differently. Believe me, I do respect that
difference. And I think we have to be real honest about what
this is about. From my perspective, it is about family planning
and avoiding abortion. It's what I believe. But sometimes life
doesn't go exactly right and a woman is forced into a terrible
circumstance and she makes this difficult personal choice with
herself, her doctor, her family, and her God.
Now in this country it's a legal choice. In other countries
it's a legal choice. But because of this gag rule she can't get
all the options. She can't choose what's best, really, for her.
I think this is backward. I don't feel good that the only time
she could get the help from these good organizations that you
fund, and we agree with you that we should fund, she can only
get it in a desperate type of situation and we can't do it in
this country.
So that's why we have so many people who consider
themselves anti-choice, if you will, or pro-life, whatever way
they phrase it, on our bill as co-sponsors. We have Harry Reid
as one of our leading supporters. He testified here today,
Senator Allen. He has got a pro-life record. We don't agree on
the issue of choice, but we agree on this one.
In any event, I think you get my point, and I thank you
both very, very much for coming. And I hope we can find common
ground on some of these issues that Senator Allen and I have
discussed. And we dismiss you and we hope you have a good day.
Thank you very much.
Senator Allen. Madam Chairman, may I--I don't know
protocol. If it's out of order, fine.
Senator Boxer. Anything you want. What do you need?
Senator Allen. You're wonderful. I think we can agree----
Senator Boxer. I knew he wouldn't give me the last word.
Senator Allen. No, you'll always get the last word. And I
was listening very closely to everything you were saying, and I
think we should work together in making sure that these foreign
operations, foreign, non-governmental organizations know the
change. I think it's very, very important.
None of us, none of us want back--well, I'm going to speak
only for myself. I don't want people having back alley
abortions or unsafe abortions. And you're saying, oh, gosh, if
the United States--here's the import of all of this, is if the
United States, out of $427 million--when you start allocating
that around the world, that really doesn't come out to very
much money. I'm not advocating any big increases.
Senator Boxer. Well, we almost had a----
Senator Allen. No, national defense, education and basic
scientific research, take care of those.
Senator Boxer. Well, wait a minute. Are we getting our
campaign platform in here?
Senator Allen. No.
Senator Boxer. I'm just kidding.
Senator Allen. But the point is I don't want anyone--
advocating anyone having a back alley abortion or an unsafe
abortion. This amount of money, even if it was going to these
organizations, would not necessarily prevent that. There is a
responsibility, by the way, for those who care about this, if
they so desire, to fund the organizations so that they can
provide safe abortions. But beyond all that, what about the
countries in which these people reside? You know, it's nice if
there's no governments around or in those countries they can
advocate better hospitals, better medical care and so forth. So
the question is not whether or not, gosh, if we change this, if
we delineate or delete this Mexico City Policy that all of a
sudden health care and safe abortions will occur. That's really
not--I don't think it's going to make much of a difference
whatsoever as a practical matter, because not everyone is going
to be able to go to these very few facilities that $400 million
would cover around the whole world.
So I do think there is an obligation and the primary
responsibility on the part of the governments of those
countries to make sure there is good quality health care. This
is just the United States and our charitable way of trying to
help out with family planning, which we understand is important
as a world issue, and a hunger issue, and a quality of life
issue.
Senator Boxer. Well, Senator, I agree with you that the
countries have to do more. Sadly, in the developing world we
have countries that are just so poor and they just don't have
the funding. They barely can feed their own people. We're
talking about the developing world. We're not talking about--we
don't help France with this. You know, we're helping the
roughest and the toughest, and the most undeveloped nations.
But we would certainly hope that they would, with whatever
resources they could, deliver this health care.
But the reason that you're needed and the reason we do
these programs is we do try to stretch our dollars. And I
personally would like to see us do a little more, because I
think when we really get into the analysis--you talk about a
priority of defense, which we all share, you're going to have
to do a lot less of that if people are fed and people have good
health care. So I think helping with these kinds of programs
abroad does help us. And I'm sure that if we were to have the
Secretary of Health he would agree that helping these people
does help bring people to our side. It does help bring
democracy.
So in any event, I greatly appreciate the panel and my
colleagues in Congress. If you'd like to stay you are welcome
to stay. I think what is extremely interesting is that we do
have a person here who felt she had to go to court to get the
gag rule lifted. And I hope from what happened--this is a news
release from this morning, ``U.S. Government Backs Away From
Gag Rule Limitation on Abortion Right Advocacy.'' It's a
headline, New York. ``Today the Bush administration, faced with
the embarrassing possibility that its abortion gag would censor
the testimony of a witness before Congress, backed away from
the global rules limitation on abortion rights advocacy. As a
result, Susana Silva Galdos, a Peruvian reproductive rights
advocate, is free to speak before a hearing at the U.S. Senate
on Thursday about the gag rules limitations on abortion in her
formative nation without jeopardizing her organization's
funding.''
Mr. Kreczko. If I can comment on that, Senator.
Senator Boxer. Yes.
Mr. Kreczko. I want to comment on the characterization that
the Bush administration was forced to back away. The Bush
administration never believed that the Mexico City Policy would
interfere with an individual's ability to testify before
Congress. We made that clear to the judge and the judge agreed
with that and, therefore, no restraining order was issued.
Senator Boxer. I understand.
Mr. Kreczko. So the suggestion that the Mexico City Policy
would preclude an individual from testifying before Congress is
inaccurate and the individual was informed of that so that
there wouldn't be any question about that.
Senator Boxer. And I'll finish, ``although free to testify
before the Senate on one occasion, Ms. Galdos remains censored
by the gag rule's restrictions against discussing abortion law
or in any other circumstance on any other day.'' This means she
was censored from speaking before Peru's legislature, the U.N.
or to members of the press. Now I'm embarrassed about this. I
mean, I am.
Anyway, we're going to call on our next panel, and we thank
you very, very much. May I ask that both panels, because of the
time situation, come up together, and I would ask our wonderful
staff to accommodate that. We want to put our ``now free to
speak'' witness Susana Silva Galdos and Dr. Nirmal Bista right
in the center if we can. They came a very long way to be here
today.
We would like to have the other panel as well. Dr.
Pellegrom, Dr. Eberstadt, Mr. Neier, Ms. Cleaver, Professor
Aguirre. We welcome all of you.
I'm going to ask Ms. Galdos, since you had to go through a
lot to get to speak here today, you are ungagged and you are
here in the U.S. Senate, and you may take that gag off, and we
hope that you will speak to us about the impact of the Mexico
City rule on your ability to deliver care to people in Peru.
And we would ask that--we're going to keep the 5-minute
light on, and, if each of you needs to have another minute or
two, we'll do that, but we can't go much over that or we'll run
into votes and other things.
So, Ms. Galdos, we welcome you.
STATEMENT OF SUSANA SILVA GALDOS, PRESIDENT, MOVIMIENTO MANUELA
RAMOS, LIMA, PERU
Ms. Galdos. Senator Boxer and members of the committee,
good morning.
Senator Boxer. Ma'am, move the mike closer and please speak
a little louder. Now that you are ungagged we all want to hear
you.
Ms. Galdos. Thank you very much for inviting me. Thank you
for this opportunity to testify before the committee today. I
am here today in the United States to testify about the impact
of the global gag rule. I come from Peru, a developing country
with the second highest maternal mortality rate in South
America. I belong to Movimiento Manuela Ramos, a Peruvian non-
governmental organization with more than 20 years of experience
in focusing for women's rights and well-being.
We are partners with USAID on two projects, one of which is
the Reproductive Health in the Community Project known as
ReproSalud. This project is our passion because it is a big
project to reach the poorest women in my country in the area of
family planning and other essential health services.
I would like to discuss two things. First, I would like to
discuss about unsafe abortion and, second, I would like to
discuss the impact that the gag rule has on free speech and
democracy.
This first issue is one that I have not been allowed to
speak about under the global gag rule. Yesterday, your
government gave me some assurances in court that I could speak
freely about it, but only in this hearing. And because a judge
has affirmed this understanding, I feel comfortable speaking
out, but as soon as this hearing is over, I cannot speak on
this issue. I will return to my country tomorrow; I will again
be silenced. But now, at least for today, I can speak freely
here in the United States, not my country. I cannot speak in my
own country about my own problems because they are off limit.
I have worked on reproductive rights issues for many years,
which has included advocacy to decriminalize abortion, because
in my institution we believe that it is important to work on an
issue that has a big impact on women's reproductive lives.
Research shows that unsafe abortion is one of the most
widespread causes of death of low-income women around the
world. Recently, United Nations conferences have recognized
that unsafe abortion is one of the most significant public
health problems. Abortion is illegal in Peru. It is considered
a crime against life, the body, and health, with the exception
of therapeutic abortion to save the pregnant woman's life or to
protect her from serious and permanent harm.
History has taught us that throughout the world desperate
women will seek abortion regardless of its legal status. It is
estimated that each year 60 percent of pregnancies in Peru are
unwanted and 30 percent of all the pregnancies end in abortion
despite Peru's existing law.
Senator Boxer. Could you repeat that again.
Ms. Galdos. Yes. It is estimated that each year 60 percent
of pregnancies, more than 50, more than a half are unwanted
pregnancies and 30 percent----
Senator Boxer. Do you ban contraceptives?
Ms. Galdos. Well, I think we should--I've told you about
the contraceptive.
Senator Boxer. Just go ahead. Just do your thing and then--
--
Ms. Galdos. Thirty percent of all the pregnancies end in
abortion despite Peru's existing law Peru is no different.
Because abortion is a crime in Peru, most women unfortunately
undergo clandestine abortions, performed in unsafe conditions.
I don't want to make you a picture like one of the persons did
about the waste, what terrible waste. It is really sad to see a
woman in that condition after an unsafe abortion. While the
clandestine nature of such procedures makes it difficult to
know the prevalence of dangerous abortions, it is estimated
that 69 percent of poor rural women who undergo abortions
suffer from complications, as do 44 percent of women living in
poor urban areas.
Unsafe abortion has serious consequences. It is estimated
that every year 65,000 Peruvian women are harmed to the point
of needing hospitalization due to complications of unsafe
abortion. The Ministry of Health reports that in 1997 15
percent of all obstetrical and gynecological admissions were
due to abortion complications. And adding to the problem, most
of those women do not receive adequate health care once
admitted. Tragically, unsafe abortion is a significant cause of
morbidity and mortality among low-income Peruvian women. Simply
put, women are dying.
In my country, unsafe abortion causes 22 percent of
maternal deaths in Peru. It's a high risk there. Peru has the
second highest rate of maternal mortality in South America.
Unintended pregnancy and unsafe abortion has a dramatic
impact on the lives of adolescents in Peru as well. Three-
quarters of sexually active young women in Peru are not using a
modern contraceptive method, and one-half are using no
contraception at all. In fact, 13.4 percent of adolescents
between the ages of 15 and 19 are mothers or are pregnant for
the first time. Poverty compounds the problem. The number of
births is greater among the young women in this age group who
live in areas with higher levels of poverty.
I am saddened to report that a recent survey indicates that
90 percent of pregnant adolescent patients between the ages of
12 and 16 in the Lima Maternity Hospital were pregnant as a
result of sexual abuse. These statistics indicate that
desperate young women are too often forced to make difficult
choices in a country where abortion is illegal. As a result,
one-third of those who are hospitalized for abortion
complications are young women between the ages of 15 and 24
years old.
Manuela Ramos would like to contribute to efforts to
decriminalize abortion. Abortion is a difficult issue in Peru,
but we need to work gradually to legalize abortion and make it
safe and available to all Peruvian women, rich and poor, rural
or urban. Now it is safe for the rich only. If you have money,
you don't have risks.
Senator Boxer. You have another 2 minutes.
Ms. Galdos. Thank you.
Our first step would be to decriminalize in cases of rape
and incest. In the face of these serious problems such as
sexual abuse, dangerous abortion practices, and alarming rates
of maternal mortality, how can the United States tell us that
we must be silent?
This brings me to my second concern that I would like to
discuss. The gag rule is against very important values: freedom
and democracy. The gag rule has taken away my freedom to speak
about an important issue in my country, a serious issue that is
about the life and death of women in Peru. A freedom that I had
to ask a judge to give me back, temporarily, so that I could
speak to you today. In particular, this policy gags the very
individuals who, like me, are directly affected by this policy.
It is as though the global gag rule has a built-in ban on
speaking out against it.
I have traveled to the United States on two previous
occasions to share my views on the global gag rule. I was
invited to participate in meetings with USAID and State
Department officials. I was asked to speak at a congressional
briefing, and I was invited to share my views at two press
conferences. At each of these events I have been gagged from
discussing abortion, even when U.S. officials asked me
questions directly. Until today, I have been unable to stand
here in your country--where you so value free speech--and
discuss openly the impact of unsafe abortion on the lives of so
many Peruvian women and they need a lot of reform.
We in Peru believe in democracy, as do you, citizens of the
United States. But democracy is not only for one country. The
global gag rule, we feel, is against democracy because it makes
a distinction between the United States and the rest of the
world. It is very discriminatory.
We at Manuela Ramos want to think of ourselves as partners
with the U.S. Government and other funders, and we are working
on these issues as partners, but the global gag rule changed
our relationship from partnerships to ``father-ship.'' It
implies that in the world we are like children, that we in poor
and low-income countries cannot be trusted to make and
implement our own rules.
Historically, we women have had to fight for things like
family planning, for ending violence against women. The only
way to do this is through talking, lobbying, advocacy, and open
debate. We have a right to find our own way to deal with these
problems. As the United States should know, democracy is
nourished and strengthened with free speech.
Senator Boxer. Ms. Galdos, finish in one sentence, please.
Ms. Galdos. I would like to say that when I was here, many
citizens apologized to me for this global gag rule. It made us
hope.
I would like to finish to beg you to please let us be the
masters of our destiny. Please, we don't want to choose between
health services for poor women or free speech. We need both.
[The prepared statement of Ms. Galdos follows:]
Prepared Statement of Susana Silva Galdos
Senator Boxer, Senator Helms, Members of the Committee, good
morning. Thank you for this opportunity to testify before the Committee
today.
I am here today in the United States to testify about the impact of
the global gag rule. I come from Peru, a developing country, with the
second highest maternal mortality rate in South America. I belong to
Movimiento Manuela Ramos, a Peruvian non-governmental organization with
more than twenty years of experience in advocating for women's rights
and well being.
We are partners with USAID on two projects, one of which is the
Reproductive Health in the Community Project. Known as ReproSalud, it
is an innovative reproductive health project that seeks to empower
women to exercise their right to family planning and other essential
reproductive health services.
Our history as women has always been to fight for our rights, such
as family planning or to live without violence. My personal history has
been one of advocating for women's rights in Peru.
I would like to discuss two things today. First, I would like to
discuss the impact of the gag rule on abortion, and the terrible
consequences in illness and deaths for poor women when abortion is
criminalized, as it is in my country. And second, I would like to
discuss the impact that the global gag rule has on free speech and
democracy.
This first issue is one that I have not been allowed to speak about
under the gag rule. Yesterday your government gave assurances in court
that I could speak freely about abortion. And because a judge has
affirmed this understanding, I feel comfortable speaking out. When I
return to my country tomorrow, I will again be silenced.
But now, at least for today, I can speak freely.
I have worked on reproductive rights issues for many years, which
has included advocacy to decriminalize abortion, because in my
institution we believe that it is important to work on an issue that
has a big impact on women's reproductive lives.
Research shows that unsafe abortion is one of the most widespread
causes of death of low-income women around the world. Recently, United
Nations conferences have recognized that unsafe abortion is one of the
most significant public health problems.
Abortion is illegal in Peru. It is considered a crime against life,
the body, and health, with the exception of therapeutic abortion to
save the pregnant woman's life or to protect her from serious and
permanent harm.
It is estimated that each year 60% of all pregnancies in Peru are
unwanted. And, 30% of all pregnancies end in abortion despite Peru's
restrictive law.
History has taught us that, throughout the world, desperate women
will seek abortion regardless of its legal status. Peru is no
different. Because abortion is a crime in Peru, most women
unfortunately undergo clandestine abortions, performed in unsafe
conditions.
While the clandestine nature of such procedures makes it difficult
to know the prevalence of dangerous abortions, it is estimated that 69%
of poor rural women who undergo abortions suffer from complications, as
do 44% of women living in poor urban areas.
Unsafe abortion has serious consequences. It is estimated that
every year 65,000 Peruvian women are harmed to the point of needing
hospitalization due to complications of unsafe abortion. The Ministry
of Health reports that, in 1997, 15% of all obstetrical and
gynecological admissions were due to abortion complications. And adding
to the problem, most of these women do not receive adequate health care
once admitted.
Tragically, unsafe abortion is a significant cause of morbidity and
mortality among low-income Peruvian women. Simply put, women are dying.
Unsafe abortion causes 22% of maternal deaths in Peru. Peru has the
second highest rate of maternal mortality in South America.
Unintended pregnancy and unsafe abortion has a dramatic impact on
the lives of adolescents in Peru as well. Three quarters of sexually
active young women in Peru are not using a modern contraceptive method,
and one-half are using no contraception at all.
In fact, 13.4% of adolescents between the ages of 15 and 19 are
mothers or are pregnant for the first time. Poverty compounds the
problem. The number of births is greater among the young women in this
age group who live in areas with higher levels of poverty.
I am saddened to report that a recent survey indicates that 90% of
pregnant adolescent patients between the ages of 12 and 16 in the Lima
Maternity Hospital were pregnant as a result of sexual abuse.
These statistics indicate that desperate young women are too often
forced to make difficult choices in a country where abortion is
illegal. As a result, one-third of those who are hospitalized for
abortion complications are young women between the ages of 15 and 24
years old.
Manuela Ramos would like to contribute to efforts to decriminalize
abortion--neither women who seek abortions nor trained providers who
perform them should be subject to prosecution and imprisonment.
Abortion is a difficult issue in Peru, but we need to work gradually to
legalize abortion and make it safe and available to all Peruvian
women--rich and poor.
Our first step would be to legalize it in cases of rape and incest.
Although our current law provides that a therapeutic abortion may be
performed, it is almost impossible for a low- or middle-income woman to
access a safe, legal procedure even when she has a severe threat to her
life or health. We need to broaden the interpretation and work for a
broader health exception in our law. Manuela Ramos would like to do
something to help the thousands of women and girls who die or are
injured by unsafe abortion procedures--one important step would be to
reform our abortion law. Eventually, we would like Peru to have a
liberal law like those in so many countries in the world, including the
U.S., that protects abortion as a basic right. In short, we support
reform of Peru's abortion laws so that women need not fear for their
lives when they face an unwanted pregnancy. But because of the global
gag rule, this work is forbidden to us.
In the face of serious problems such as these--sexual abuse,
dangerous abortion practices, and alarming rates of maternal
mortality--how can the U.S. tell us that we must be silent?
And yet, we must promise to be silent--even with our own, non-U.S.
funds--if we are to save the programs that thousands of women depend
upon.
Which brings me to my second concern that I would like to discuss.
The gag rule is against very important values: freedom and democracy.
The gag rule has taken away my freedom to speak about an important
issue in my country--a serious issue that is about the life and death
of women in Peru. A freedom that I had to ask a judge to give me back,
temporarily, so that I could speak to you today.
In particular, this policy gags the very individuals who, like me,
are directly affected by this policy. It is as though the global gag
rule has a built-in ban on speaking out against it.
I have traveled to the U.S. on two previous occasions to share my
views on the global gag rule. I was invited to participate in meetings
with USAID and State Department officials, I was asked to speak at a
congressional briefing, and I was invited to share my views at two
press conferences. At each of these events I have been gagged from
discussing abortion, even when U.S. officials asked me questions
directly.
Until today, I have been unable to stand here in your country--
where you so value free speech--and discuss openly the impact of unsafe
abortion rates on the lives of so many Peruvian women.
In Peru, Manuela Ramos has worked with elected officials and
policy-makers in drafting laws and policies to address those issues
that are critical for women's health. But if members of congress or
other Peruvian officials ask our advice about reforming the punitive
abortion laws, we must refuse to help them.
Previously, Manuela Ramos has participated freely in regional
networks that promote women's reproductive rights in Latin America and
the Caribbean. But now we must be silent about abortion in our work
with our partners throughout the region.
Manuela Ramos has also participated in United Nations conferences
that have addressed women's reproductive health issues, including
abortion. But now, we cannot tell the world community about how
abortion affects the lives of women in Peru.
We in Peru believe in democracy, as do you, citizens of the United
States. But democracy is not only for one country.
The global gag rule, we feel, is against democracy because it makes
a distinction between the U.S. and the rest of the world. It is very
discriminatory--it tells us that we in low-income countries cannot seek
to make and implement our own laws, nor make changes to them.
We at Manuela Ramos want to think of ourselves as partners with the
U.S. government and other funders, and that we are working together on
these development issues. But the global gag rule changed our
relationship from partnership to ``father-ship.'' It implies that
except for institutions in the U.S., all the rest of the institutions
in the world are like children, so the U.S. can tell us what we can do
with our money.
Historically, we have had to fight for things like family planning
and ending violence against women, among other things. The only way to
do this is through talking, lobbying, advocacy, and open debate.
This kind of debate, and the internal political process in our
country, should not be subjected to restrictions about what we can say.
The global gag rule limits our ability to talk about a severe public
health problem. We have a right to find our own way to deal with these
problems.
As the U.S. should know, democracy is nourished and strengthened
with free speech.
Since the global gag rule was passed, when I talk with U.S.
citizens, they have apologized to me. They feel that it is
imperialistic, and apologize for having this regressive policy in the
year 2001. Even they cannot understand. It really made an impression on
me when I heard this from them. It has given me hope.
Please let us be the masters of our destiny. Please, we don't want
to choose between health services for poor women or free speech. We
need both.
I hope your Committee and the United States Congress will pass a
law very soon to end this terrible global gag rule. I appreciate the
invitation to testify and I thank you very much.
Senator Boxer. Thank you so much. We appreciate your very
moving testimony.
We are going to go back and forth so we have different
views instead of just taking all the pros and all the cons, so,
Dr. Nicholas Eberstadt, a scholar at the American Enterprise
Institute, where he holds the Henry Wendt Chair of Political
Economy, testifying in support of the gag rule, we welcome you.
We'll set the clock for 5 minutes, and we'll give you an extra
couple of minutes to finish.
STATEMENT OF DR. NICHOLAS N. EBERSTADT, SCHOLAR, AMERICAN
ENTERPRISE INSTITUTE, WASHINGTON, DC
Dr. Eberstadt. Madame Chairman, I am always honored to
testify before the Senate Foreign Relations Committee, but I'm
not testifying in favor of the gag rule.
I was asked to give the demographic assessment of the
impact----
Senator Boxer. Oh, I'm sorry. I had that in an incorrect
order. I apologize.
Dr. Eberstadt. My remarks today actually address a somewhat
technical, but I think important question which has to do with
the health and mortality impact of the restrictions on U.S.
international population assistance called by its critics the
gag rule and by its proponents, the Mexico City Policy.
There is considerable apprehension among many critics of
this policy that the new restrictions would have direct and
perhaps severely adverse consequences: higher rates of maternal
mortality, higher rates of infant mortality, higher rates of
unwanted pregnancy and perhaps even higher ultimate levels of
abortion.
Because vital registration systems in the developing world
are often rudimentary and technically cannot provide complete
registration of births and deaths or medical events, the
concrete data that we would need to evaluate these concerns
are, sad to say, simply not available to us at this moment.
However, as I will try to explain, the expectation that the
new Bush administration's restrictions on U.S. international
population assistance would significantly set back child/
maternal health in the Third World seems to me misplaced.
The ultimate effect of these restrictions may be slightly
to increase maternal and infant deaths or to slightly decrease
the number of deaths--or it may have no impact whatever. But
whatever its ultimate impact, that impact is unlikely to be
large enough to quantify. It is unlikely to be dramatic in
magnitude.
Now this assessment of mine will surely seem quite counter-
intuitive to many listeners. So why do I draw this conclusion?
I will try to explain by way of analogy.
Over the past 20 years we have had in place something like
a controlled experiment regarding restrictions on U.S.
international population assistance.
We've had the Mexico City Policy in place from 1984 to
1993. Then we overturned it from 1993 through early 2001. By
the same token, we have seen significant increases and
decreases in the U.S. international population funding. Between
fiscal year 1992 and fiscal year 1995, U.S. population funding
increased from $322 million to $576 million, and then after
fiscal year 1995 it fell very sharply. It was down to $384
million in fiscal year 2000.
Now at the time some critics claimed these past changes in
U.S. population assistance would have dramatic and devastating
repercussions on the health and well-being of vulnerable, Third
World populations. In 1996 for example, Dr. Nafis Sadik, then
Executive Director of the U.N. Population Fund, UNFPA, had this
to say about the cuts or the pending cuts in U.S. population
funding: ``The way U.S. funding is going, 17 to 18 million
unwanted pregnancies are going to take place, a couple million
abortions will take place, and I'm sure that 60,000 to 80,000
women are going to die because of those abortions.''
By the same token, the Planned Parenthood Federation warned
that maintaining that 35 percent cut would result in four
million women experiencing unintended pregnancies, 1.6 million
more abortions, and 134,000 more infant deaths.
But as we now know, those dire forecasts were bad
forecasts, although, as I have already noted, vital statistics
in low-income countries are highly incomplete. International
demographic and health experts did not detect any measurable
upsurge in global birthrates, abortion rates, maternal
mortality rates or infant mortality rates after the 1996 cuts
in U.S. international population funding.
And conversely, the significant increase in U.S. population
funding in the early 1990's did not result in any noticeable
decrease in birthrates, abortion rates, child or infant
mortality rates. Why not? Because the world is a more
complicated place than we may sometimes assume.
There are three reasons to expect that the new restrictions
on U.S. population systems will have a limited demographic and
health impact. First, the restrictions themselves are not, in
fact, quite as Draconian as some seem to imagine. We've had
some discussion about that already this morning.
According to a March 2001 report by the Congressional
Research Service, the new regulations contain the following
exceptions--we've gone through many of those already. Abortions
may be performed if the life of the mother would be endangered.
Health care facilities may treat injuries and illnesses
resulting from abortion. Passive responses about abortion
counseling may be given. Referrals for abortion as a result of
rape, incest or where a mother's life could be endangered are
all permitted. And the United States will further continue to
support either directly or through a grantee to foreign
governments even in cases where the governments include
abortion in their family planning programs.
Given the rather broad leeway that can be read into those
regulations and the fact that the administration is committing
itself to maintaining and even increasing the overall level of
U.S. population funding, the restrictive impact would seem to
be less severe than impacts that we have already seen and
experienced in the past.
Second, U.S. population assistance is only one component of
the total resources----
Senator Boxer. We'll give you another couple of minutes.
Dr. Eberstadt [continuing]. Is only one component of the
total resources used in family planning in low-income regions,
and, while the United States is a very major funder, it is by
no means the dominant funder. U.S. funding today accounts for
about 20 percent of Western population aid, meaning about four-
fifths of international population aid comes from other
sources. A still greater portion of family planning funding can
be raised in low-income governments by low-income governments
themselves.
Restrictions or shortfalls in U.S. funding may be overcome
through applications of additional funds from these other
sources. The European Union, for example, has indicated that it
may increase its international population funding as a result
of the new U.S. policies.
If current events follow the course we have seen in the
past with U.S. restrictions on funding for UNFPA, other
governments will end up not only making up the U.S. shortfall
but actually augmenting overall resources.
And third and finally, the correspondence between public
health spending and personal health outcomes, far from being
very precise and mechanistic, is infact very broad and diffuse.
This is because the parents in question are independent actors
in this drama and act in order to safeguard and improve the
health of their families irrespective of government programs
and resources. Third World women, Third World adults are not
passive, helpless victims in this drama, nor do they believe
that babies are born under cabbages. Through their own
independent decisions, they do much to control very important
outcomes in family life.
Finally, Madame Chairman, I would say that there is perhaps
good news and bad news for the contestants in this debate. One
piece of bad news for proponents of the gag rule or Mexico City
Policy is that, in my estimate, the new restrictions are
decidedly unlikely to have any significant impact on global
levels of abortion. It is most unlikely that these restrictions
will tangibly reduce the rate of abortions in regions affected.
At the same time, however, as I've indicated, the fear that
the restrictions will lead to higher levels of maternal
mortality and infant mortality can be assuaged. There is no
reliable evidence that this is about to take place, reasonable
as that apprehension may seem. Claims of dramatic, adverse
consequences are undocumentable and, at least for now, should
be treated as political theater.
Senator Boxer. Thank you very much for your testimony, Dr.
Eberstadt, which I guess is ``What's the difference?'' That's
what I get out of it. It doesn't seem to take either side, so
thank you for laying that all out.
I think we're going to go to Dr. Bista, who will tell us if
it makes a difference. You're in your office saying it doesn't
make a difference. Let's hear what someone on the ground has to
say about the rule. We already heard one such witness, and now
we have Dr. Bista, who is, and let me say, he serves as the
director general of the Family Planning Association of Napal,
an organization that recently made the decision to refuse U.S.
family planning funding because of the gag rule.
Dr. Bista. Thank you, Madame Chairman.
Senator Boxer. And pull the mike really close, and we want
you to speak because--well, you're not gagged because you don't
take USAID funding, but we think your message is very
important, Dr. Bista.
STATEMENT OF DR. NIRMAL K. BISTA, DIRECTOR GENERAL, FAMILY
PLANNING ASSOCIATION OF NEPAL, KATHMANDU, NEPAL
Dr. Bista. Senator Boxer and distinguished members of the
Senate Foreign Relations Committee, it is a great honor and
privilege to speak before you this morning about the impact the
Bush administration's global gag rule is having on the women of
my country, Nepal. I would like to ask to have my extended
remarks entered for the record.
I am the director general of the Family Planning
Association of Nepal, the FPAN, the oldest and the largest
reproductive health and family planning non-governmental
organization in Nepal. FPAN provides comprehensive reproductive
health care services, education and counseling to the needy in
clinics throughout the country. The FPAN is a member of the
International Planned Parenthood Federation [IPPF] and is known
for its strong commitment to the Nepal national family planning
program--and for its role to protect the health and rights of
women in Nepal.
For nearly 30 years the FPAN has received generous support
from the U.S. Government to help provide vital reproductive
health care services. We are tremendously grateful for this
support. We have enjoyed a long and productive friendship and
working relationship with USAID as we all work toward a common
cause, to improve the health and lives of women in my country.
I am testifying before you today because the FPAN has
recently made the difficult and painful decision to refuse
USAID family planning funds because of the global gag rule
restrictions. This was by no means an easy decision. It will
lead to the loss of almost $250,000 in U.S. funds and it will
have a major impact on our ability to continue to operate
reproductive health clinics in Nepal's three most densely
populated areas, Kathmandu, Chitwan, and Sunsari. This may not
sound like a lot of money in U.S. terms, but in Nepal it means
we will likely have to close one or all of these clinics,
discontinuing critical services to thousands of needy women.
Why did we make this decision? Because, as a health care
provider, the FPAN is part of a growing movement in Nepal, led
by our own government and overwhelmingly supported by
physicians, to begin to address the shockingly high maternal
mortality rate in Nepal. Nepal has one of the highest maternal
mortality rates in the world and much of it is due to unsafe
abortion.
It is estimated that six women die every day in Nepal due
to unsafe abortions performed by unskilled providers. Many,
many more women suffer serious physical injury and chronic
disability. In addition, Nepal has one of the most punitive
abortion laws in the world. Women are imprisoned for having
abortions and there is no exception, not even for rape, incest
or life of the woman.
Government officials at the Nepalese Ministry of Health
have themselves concluded that liberalizing abortion should be
the first step toward preventing the existing high level of
maternal mortality and morbidity in my country. The Ministry's
advocacy plan to decriminalize abortion called for the
formation of a network of non-governmental organizations to
address the problem.
In response, the Family Planning Association of Nepal
spearheaded an advocacy effort joined by a coalition of medical
professionals, health non-governmental organizations, human
rights advocates, women's groups and journalists to raise
awareness and introduce legislation on this issue. The campaign
favors legalizing abortion under certain conditions and
improved access to safer services.
Yet, the global gag rule policy would disqualify us from
participating in this public awareness campaign if we continued
to receive U.S. family planning assistance. Under the
conditions of the policy, we cannot engage in any advocacy
effort to legalize abortion, even if it is with our non-U.S.
money and at the behest of our own government.
This is the challenge: Do I listen to my own government
that has asked FPAN to help save women's lives or do I listen
to the U.S. Government? Were we to accept the restricted U.S.
funds, I would be prevented from speaking in my own country to
my own government about a health care crisis I know firsthand,
but, by rejecting U.S. funds, I put our clinics, clinics
addressing that same health care crisis, in very real jeopardy.
It is an untenable situation. But, we simply could not
stand by and watch countless women suffer and die without doing
everything we could to prevent this misery. There is agreement
in Nepal that women need access to safer abortion services and
laws that don't incarcerate women for having an abortion. We
must work to make that happen.
On Tuesday I left my home to travel 36 hours to arrive in
your beautiful city, and I left a very different world behind
to get here. Where I come from, the per capita annual income is
$220, compared to over $21,000 in the United States. Only 30
percent of women can read. They are generally married by the
time they turn 18, and few will have their childbirth attended
by trained health professional.
It is hard, then, to understand how U.S. lawmakers are so
easily able to implement such a far-reaching and damaging
policy when the differences between our countries are so vast
and the realities that women in Nepal face are so unimaginable.
Perhaps the example of one young girl in my country can
help illustrate the situation in Nepal and explain to you why
our advocacy efforts are so important to us that we have given
up our U.S. funding. Four years ago Min Min Lama was living
peacefully in her home in the mountains of Nepal. Like many
other teenage girls of 13 in Nepal, Min Min didn't go to
school. She stayed at home helping her stepmother with
household chores.
But early in 1997 when nobody was home a relative raped
her. Terrified and ashamed, Min Min tried to hide her torment
from her strict Hindu family. She tried to forget the trauma,
but it wasn't long before another relative realized she was
pregnant. Min Min's relatives arranged for an illegal abortion,
despite the fact that abortion is illegal in Nepal and that the
illegal abortion could have killed Min Min.
She survived, but her trauma was only beginning. After the
abortion her sister-in-law reported the abortion to the police
and Min Min was arrested. She was taken to the central jail in
Nepal's capital, Kathmandu. Her crime? Abortion.
Min Min's relatives were not punished for the rape or the
abortion. Instead, at the age of 13 Min Min was sentenced to 20
years in jail. Her family abandoned her and the only visitors
she had were charity workers, one of whom contacted FPAN. The
FPAN started a campaign to help Min Min and to begin to change
the laws regarding abortion. As a result, Min Min's sentence
was reduced to 12 years.
But the FPAN and others kept on fighting for her cause,
telling people across the world about her plight. Finally, on
21 September 1999, Min Min was released after 2 years in
prison. She is now working at FPAN and living in Kathmandu.
Min Min was one of the lucky girls in Nepal and, although
her ending is happy, there are a lot of girls and women with
sadder tales to tell. One in five women are currently
imprisoned in Nepal for the same reason. Is there any
justification for stalling even one more day? How can the FPAN,
which fought so hard for Min Min, turn its back on these other
women and all of the women who die or are injured daily due to
unsafe abortion?
As I have stated, the decision to reject the USAID funding
was a difficult one, and I fear for the future of our clinics,
but, as you can see, ours was an impossible decision. Whatever
we decide, the women of Nepal suffer. And we are by no means
the only ones forced to make this decision. Our colleagues all
over the world face this same agonizing decision.
I would like to thank the Senate Foreign Relations
Committee for allowing me this opportunity to speak out on
behalf of Min Min Lama, the women of Nepal, the 78,000 women
who die from unsafe abortions every year, and the countless
women around the world who lack access to desperately needed
reproductive health care services. I urge you to do whatever
you can to make sure this destructive policy does not continue
to harm the women of Nepal and other women around the world.
Thank you.
[The prepared statement of Dr. Bista follows:]
Prepared Statement of Dr. Nirmal K. Bista
Senator Boxer and distinguished members of the Senate Foreign
Relations Committee, it is a great honor and privilege to speak before
you this morning about the impact the Bush Administration's ``global
gag rule'' is having on the women of my country, Nepal. I'd like to ask
to have my extended remarks entered for the record.
I am the Director General of the Family Planning Association of
Nepal (FPAN), the oldest and the largest reproductive health and family
planning non-governmental organization (NGO) in Nepal. FPAN provides
comprehensive reproductive health care services, education and
counseling to the needy in 34 districts of Nepal. FPAN is highly
regarded by donors and the government for its significant contribution
to the Nepal national family planning program. FPAN's contribution is
between 25-30 percent of the total national program each year.
FPAN is an innovative NGO that has been instrumental in introducing
new reproductive health technology and practices in the country,
including: DepoProvera, Norplant, Minilaparotomy, the
institutionalization of static service sites, counseling and improved
quality of care.
FPAN is a member of the International Planned Parenthood Federation
(IPPF) and is known for its strong commitment to protecting the heath
and rights of women in Nepal.
For nearly 30 years, FPAN has received generous support from the
U.S. government to help provide vital reproductive heath care services.
We are tremendously grateful for this support. We have enjoyed a long
and productive friendship and working relationship with USAID as we all
work toward a common cause--to improve the heath and lives of the women
in my country.
I am testifying before you today because FPAN has recently made the
difficult and painful decision to refuse USAID family planning funds
because of the global gag rule restrictions. This was by no means an
easy decision. It will lead to the loss of almost $250,000 in U.S.
funds and it will have a major impact on our ability to continue to
operate reproductive health clinics in Nepal's three most densely
populated areas--Kathmandu, Chitwan and Sunsari.
This may not sound like a lot of money in U.S terms--but in Nepal
it means we will likely have to close one or all of these clinics,
discontinuing critical services to thousands of needy women.
Why did we make this decision? Because, as a health care provider,
FPAN is part of a growing movement in Nepal--led by our own government
and overwhelmingly supported by physicians--to begin to address the
shockingly high maternal mortality rate in Nepal.
Nepal has one of the highest maternal mortality rates in the world
and much of it is due to unsafe abortion. Nepal's maternal mortality
rate is 1,500 deaths per 100,000 live births (compared to 7 in 100,000
in the United States). Worldwide, the percentage of maternal deaths due
to unsafe abortion is 13 percent. In Nepal, this figure rises to 50
percent. As a result of this high maternal mortality rate, Nepal is one
of the few countries where a woman's life expectancy is lower than that
of a man.
It is estimated that six women die every day in Nepal due to unsafe
abortion performed by unskilled providers. Many, many more women suffer
serious physical injury and chronic disability. In addition, Nepal has
one of the most punitive abortion laws in the world. Women are
imprisoned for having abortions and there is no exception--not even for
rape, incest or life of the woman.
The women who suffer the consequences of unsafe abortion--including
imprisonment--are most likely to be poor rural women who cannot afford
to pay for a safe abortion, available only to those who can pay to
travel to India, where abortion is legal, or go to a discreet private
physician. Safe, hygienic abortion services do exist in some urban
centers, but are relatively expensive--from $60-$100 for married women,
and four times that for unmarried--in a country with a per capita
annual income of only $220. Consequently, the rural and urban poor
mainly rely on the crude and dangerous methods of traditional birth
attendants or self-induced abortion.
Government officials at the Nepalese Ministry of Health have
themselves concluded that liberalizing abortion should be the first
step towards preventing the existing high level of maternal mortality
and morbidity in my country. The Ministry's advocacy plan to
decriminalize abortion called for the formation of a network of non-
governmental organizations (NGOs) to address the problem.
In response, the Family Planning Association of Nepal spearheaded
an advocacy effort joined by a coalition of medical professionals,
health non-governmental organizations (NGOs), human rights advocates,
women's groups and journalists to raise awareness and introduce
legislation on this issue. The campaign favors legalizing abortion
under certain conditions and improved access to safer services.
Yet the global gag rule policy would disqualify us from
participating in this public awareness campaign if we continued to
receive U.S. family planning assistance. Under the conditions of the
policy we cannot engage in any advocacy effort to legalize abortion--
even if it is with our non-U.S. money and at the behest of our own
government.
This is the challenge: do I listen to my own government that has
asked FPAN to help save women's lives or do I listen to the U.S.
government? Were we to accept the restricted U.S. funds, I would be
prevented from speaking in my own country to my own government about a
health care crisis I know first hand. But by rejecting U.S. funds, I
put our clinics--clinics addressing that same health care crisis--in
very real jeopardy.
It is an untenable situation. But, we simply could not stand by and
watch countless women suffer and die without doing everything we could
to prevent this misery. There is agreement in Nepal that women need
access to safer abortion services and laws that don't incarcerate women
for having an abortion. We must work to make that happen.
On Tuesday I left my home to travel 36 hours to arrive in your
beautiful city, and I left a very different world behind to get here.
Where I come from, the per capita annual income is $220, compared to
over $21,000 in the United States; only 30 percent of women can read,
they are generally married by the time they turn 18, and few will have
their childbirths attended by trained health professional.
It is hard, then, to understand how U.S. lawmakers are so easily
able to implement such a far-reaching and damaging policy when the
differences between our countries are so vast and the realities women
in Nepal face must seem so unimaginable.
Perhaps the example of one young girl in my country can help
illustrate the situation in Nepal and explain to you why our advocacy
efforts are so important to us that we have given up our U.S. funding.
Four years ago Min Min Lama was living peacefully in her home in
the mountains of Nepal. Like many other teenage girls of 13 in Nepal,
Min Min didn't go to school; she stayed at home helping her stepmother
with household chores.
But early in 1997 when nobody was at home, a relative raped her.
Terrified and ashamed, Min Min tried to hide her torment from her
strict Hindi family. She tried to forget the trauma, but it wasn't long
before another relative realized she was pregnant.
Min Min's relatives arranged for an illegal abortion--despite the
fact that abortion is illegal in Nepal and that the illegal abortion
could have killed Min Min.
She survived, but her trauma was only beginning. After the
abortion, her sister-in-law reported the abortion to the police and Min
Min was arrested. She was taken to the central jail in Nepal's capital,
Kathmandu. Her crime? Abortion.
Min Min's relatives were not punished for the rape or the abortion.
Instead, at the age of 13, Min Min was sentenced to 20 years in jail.
Her family abandoned her and the only visitors she had were charity
workers, one of whom contacted FPAN. FPAN started a campaign to help
Min Min and to begin to change the laws regarding abortion.
As a result, Min Min's sentence was reduced to 12 years. But FPAN
and others kept on fighting for her cause, telling people across the
world about her plight.
Finally, on 21 September 1999, Min Min was released after two years
in prison. She is now working at FPAN and living in Kathmandu.
Min Min was one of the lucky girls in Nepal and although her ending
is happy, there are a lot of girls and women with sadder tales to tell.
One in five women are currently imprisoned in Nepal for the same
reason.
Is there any justification for stalling even one more day? How can
FPAN, which fought so hard for Min Min, turn its back on these other
women and all of the women who die or are injured daily due to unsafe
abortion?
As I have stated, the decision to reject the USAID funding was a
difficult one and I fear for the future of our clinics. But as you can
see, ours was an impossible decision. Whatever we decide, the women of
Nepal suffer.
And we are by no means the only ones forced to make this decision.
Our colleagues all over the world face this same agonizing decision.
I would like to thank the Senate Foreign Relations Committee for
allowing me this opportunity to speak out on behalf of Min Min Lama,
the women of Nepal, the 78,000 women who die from unsafe abortion every
year, and the countless women around the world who lack access to
desperately needed reproductive health care services. I urge you to do
whatever you can to make sure this destructive policy does not continue
to harm the women of Nepal and other women around the world.
Thank you.
Senator Boxer. Thank you so much. Senator Chafee, I know
you need to leave. Do you have any questions for the three
witnesses that spoke so far?
Senator Chafee. No, I'm here to listen.
Senator Boxer. OK. I just wanted to take a few moments,
because the panel had so much to say, and I want to make sure
the people listening got the gist of it so after, I guess, Dr.
Eberstadt said it's political theater, which I respect your
decision. I disagree with it, but we'll get into that later.
I want to make sure people understand this. This is a 13-
year-old girl who was raped. According to his article, her
rapist went unpunished, but she received a 20-year prison
sentence that was later reduced because of help that was given
to her.
So here is a child who was raped. She's sent to jail
because in your country abortion is illegal, it is a crime, and
there is no exception for rape; is that correct?
Dr. Bista. Yes.
Senator Boxer. There is effectively no exception for
incest; is that correct?
Dr. Bista. Yes.
Senator Boxer. There is no exception for life of the
mother; is that correct?
Dr. Bista. Yes.
Senator Boxer. So you want to argue with your government
and lobby to change these laws, and, because of the USAID rule
that you cannot do that, you decided, because of cases like
this, that, even though it might mean that you have to close
down your clinic, to turn away the approximately $250,000 of
funding and not take the funding so that you would be ungagged
and be able to work to at least get some exceptions to these
types of abortion rules. Am I summarizing your testimony
correctly?
Dr. Bista. Yes, very correctly, Madam Chairman.
Senator Boxer. I just want to make sure that everyone got
that point.
Now it is my pleasure to call on Professor Maria Sophia
Aguirre, and we welcome you. And we will hear some opposing
views at this time.
Dr. Aguirre is an associate professor in the Department of
Economics and Business at the Catholic University of America
here in Washington, DC. She is a native of Argentina.
Please proceed.
STATEMENT OF DR. MARIA SOPHIA AGUIRRE, ASSOCIATE PROFESSOR,
DEPARTMENT OF ECONOMICS AND BUSINESS, CATHOLIC UNIVERSITY OF
AMERICA, WASHINGTON, DC
Dr. Aguirre. Madam Chairman and members of the committee, I
am honored to appear before this committee to address the issue
of the restoration of the Mexico City Policy. It is my hope
that the information that I will provide in this short
statement may assist the members of this committee in
understanding why the challenge that has been posted to the
referred policy, called Mexico City Policy, has no grounds.
First let me clarify that I'm not going to use the standard
numbers that have been quoted without any references. I am just
going to refer to World Health Organization official documents
and official statements and statistics.
Nearly 493,000 women died in 1998 in pregnancy and
childbirth because of early and frequent childbearing and poor
access to health care. Most of these maternal deaths occurred
in developing countries like my own and account for one-third--
not one-fourth, not one-fifth, not 50 percent but one-third,
according to the WHO numbers--of all death to women of
childbearing age in these countries. Included in that total are
estimated 66,000 deaths from unsafe abortions.
Now, some people have argued that the policy undermines the
principle of free speech in developing countries, signals a
reduction in the U.S. commitment to global family planning
efforts, is likely to increase, rather than decrease the number
of abortions, especially illegal abortions in poor countries,
and exclude some of the most competent, international family
planning services providers. Against these allegations, I would
like to present the following information.
First, about 71 percent of the population assistance all
over the world, as reported by the United Nations, is directed
toward countries in Asia and the Pacific, 25 percent; Latin
America, 13 percent; sub-Saharan Africa, 26 percent; Western
Asia and North Africa, 7 percent. The rest is going to research
on contraception in Europe. Very few countries where USAID
provides population assistance permit abortion under
circumstances broader than those allowed under the Mexico City
Policy. And just a point of correction, Nepal, in fact, allows
abortion to save the woman's life.
Senator Boxer. What about cases of rape and incest?
Dr. Aguirre. In cases of rape and incest, no, but, yes, to
save the woman's life.
Senator Boxer. So in the case of the girl that I----
Dr. Aguirre. Yes, abortion is not allowed under any
condition or no circumstances as we've mentioned before.
Senator Boxer. I agree with you. Is that correct? Dr.
Bista, do you agree with that correction? We will not take time
out of your testimony, we just need a clarification.
Dr. Bista. Actually, no, the people who are affected the
most in this case are the people from the rural areas where the
knowledge level is very low and the economic status there is
also very low, but we all know that the practices----
Senator Boxer. No, no, I was just asking, is there an
exception for life and not rape or incest? I just want to get
it straight.
Dr. Bista. Yes, there is provision, exception for life, but
it has to be looked at by a panel of doctors which means it is
ineffective in rural areas. But in the case of rape and incest
there is no exception.
Senator Boxer. I want to make sure the record is correct.
In your country, is there an exception for life of the mother?
So there's an exception for life, not health, not rape, not
incest; is that correct?
Dr. Bista. That's correct Madam Chair, because anybody, if
they just report the case to the police they are in trouble.
Senator Boxer. I understand. In other words, because it is
a crime in those other cases, it is very difficult to stand
behind it.
OK, go ahead, Ms. Aguirre.
Dr. Aguirre. In addition, abortion is not only illegal in
these last countries, but also unconstitutional because the
constitution in many of these countries upholds the protection
of life since the moment of conception. Therefore the Mexico
City Policy then is consistent with the desire of most of these
countries and with the effort that many countries around the
world are making to decrease the number of abortions.
Furthermore, it is consistent with the desire of the majority
of the population of these countries who in recent years have
overwhelmingly opposed any intent--and I speak especially about
women in the South American countries, by a minority within
those countries, to legalize abortion. The Mexico City Policy
imposes a reasonable restriction because it is a job
restriction rather than a violation of the freedom of speech,
and it is respectful of it as it is consistent with the
decision of the population of these countries to uphold the
right to life of the unborn child. Beside, the fact that some
groups in these countries want abortion, it doesn't mean that
we have some obligation to fund it as the previous
representation have claimed. Nothing in the MCP forbids these
groups from advocacy. It simply does not fund them
In addition to that, we have to keep in mind that article
8.25 says clearly, and I am quoting, ``In no case should
abortion be promoted as a method of family planning.'' So when
we talk about family planning, keep that in mind.
The second point is regarding the concern that this might
signal a decrease in the U.S. commitment to global family
planning efforts. I would like to point out that while the
overall funding of USAID to family planning increased steadily
between 1987 to 1995--and during that time, the Mexico City
Policy was interrupted--the funding allocated to this activity
started to decline from 1996 to 2000, before the Mexico City
Policy was re-enacted. Reasons, other than this policy should
explain the decline in funding then. Spending goes up when
there is a broader consensus and where population assistance is
funding abortionist there is no consensus.
It is to be borne in mind, however, and it's something that
again it has been mentioned in the different testimonies, that
the United States remains the principal contributor to
population assistance by a significant amount. And for that
information. We are saying that over 60 percent of the world
total funding for population assistance and family planning as
reported by the U.N. comes from the United States. It needs to
be borne in mind, therefore, that the United States remains a
big contributor and that the total funds toward population
assistance, again as it is reported by the United Nations, has
not decreased but rather has been channeled through other
avenues such as NGOs.
The third point is that the legalization of abortion across
the world, rather than decreasing, has increased the number of
abortions and this has happened in spite of a significant
increase in the use of contraceptives, developing countries
included. And this again is data. I understand this has been
mentioned several times, but the data is on the contrary.
According to a 1997 study of the World Health Organization,
mortality risk for abortion varies in developing countries
between 100 and 1,000 deaths per 100,000 cases while in the
United States the same measure is 50. There are other equally
high serious causes of death for women, however, such as
delivery of a live birth. We are talking in all between 250 and
800 deaths per 100,000 cases. That's very close to legal
abortions if you look at the numbers, and that can be easily
solved by the presence of a delivery kit, which costs $1.50,
and skilled personnel.
Let's keep in mind that this last case is considered legal
in those countries. To this must be added that in the history
of the organizations that participated in USAID-supported
family planning activities, that is over 450 foreign NGOs--and
I believe this morning it was said, in fact, 63 or something
along those lines of these 450 organizations--few organizations
have a history of lobbying for change in the legal status of
abortion. Therefore, the restoration of the Mexico City Policy
neither increases the number of abortions nor decreases
significantly the number of qualified family planning providers
as it has been stated.
And the last point. Finally, I would like to bring to the
attention of the committee the leading causes of death for
women, because obviously this is the concern. In developing
countries as reported in the 1999 World Health Report published
by the World Health Organization. In the table \1\ that I
provided, it is very clear the leading causes of death are
infectious disease, which involves 4,649,000 women; not 66,000,
4,649,000 who died because of these causes. Respiratory
infections, 1,726,000, and that could be solved by 5 cents a
pill per capita cost as again reported by the World Health
Organization; perinatal conditions, 1,034,000 are killed every
year; and----
---------------------------------------------------------------------------
\1\ The table referred to is in Dr. Aguirre's prepared statement
that begins on page 45.
---------------------------------------------------------------------------
Senator Boxer. Please conclude now----
Dr. Aguirre. I'm sorry.
And again, the major causes in illegal abortion is
hemorrhage and other diseases, again, that can be solved if
they are going to have the right means; and finally, nutrition
deficiencies, 210,000. So all these diseases are easily
treatable and are the leading causes of death for women.
With the exception of AIDS, these diseases are rare.
Treatment is accessible in developed countries. And their cost
is remarkably low. Furthermore, all the diseases mentioned are
significantly larger than the----
Senator Boxer. I must ask you to just finish because I gave
you an additional two minutes and then an additional two to
complete.
Dr. Aguirre. OK, I just will conclude saying that several
arguments have been put forward against the restoration of the
Mexico City Policy. The data presented to the committee in this
short response suggests that this is evidence to the contrary.
If anything, the enactment of this policy increases the
protection of freedom of choice of developing countries and
allows for a more needed and efficient allocation of funds.
Madam Chairman, this concludes my statement.
[The prepared statement of Dr. Aguirre follows:]
Prepared Statement of Dr. Maria Sophia Aguirre
the restoration of mexico city policy
Mr. Chairman and Members of the Committee:
My name is Maria Sophia Aguirre and I am a professor of Economics
at the Catholic University of America. I am honored to appear before
this Committee to address the issue of the restoration of the Mexico
City Policy. It is my hope that the information that I will provide in
this short statement may assist the members of this Committee in
understanding why the challenge that has been posted to the referred
policy has no grounds.
Nearly 493,000 women died in 1998 in pregnancy and childbirth
because of early and frequent childbearing and poor access to health
care. Most of these maternal deaths occurred in developing countries
and account for one third of all death to women of childbearing age in
these countries. Included in that toll, are estimated 66,000 deaths
from unsafe abortion. (Source: WHO)
Some people have argued that the policy undermines the principle of
free speech in developing nations, signals a reduction in the U.S.
commitment to global family planning efforts, is likely to increase,
rather than decrease the number of abortions, especially illegal
abortions in poor countries, and exclude some of the most competent
international family planning services providers. Against these
allegations, I would like to present the following information:
1. About 71% of the population assistance all over the world,
as reported by the UN, is directed towards countries in Asia
and the Pacific (25%), Latin America (13%), sub-Saharan Africa
(26%), Western Asia and North Africa (7%). (Figure 1) Very few
countries where USAID provides population assistance permit
abortion under circumstances broader than those allowed under
the Mexico City Policy. In addition, abortion is not only
illegal in these last countries, but also unconstitutional
because the constitution in many of these countries upholds the
protection of life since the moment of conception. The Mexico
City Policy then is consistent with the desire of most of these
countries and with the effort that many countries around the
world are making to decrease the number of abortions.
Furthermore, it is consistent with the desire of the majority
of the population of these countries who in recent years have
overwhelmingly opposed any intent, by a minority within those
countries, of legalizing abortion. The Mexico City Policy
imposes a resonable restriction because it is a job restriction
and it is respectful of it as it is consistent with the
decision of the population of these countries to uphold the
right to life of the unborn child. It is also respectful of the
sovereign right of countries to uphold their constitution and
domestic laws. Furthermore, the fact that some organizations
want to advocate abortion and to perform abortions does not
mean that U.S. tax money should pay for it. Nothing in the
Mexico City Policy forbids those groups from advocacy. It
simply denies the use of funds for this purpose. Let us keep in
mind, that point 8.25 of ICPD states clearly that ``in no case
should abortion be promoted as a method of family planning.''
2. To the concern that this might signal a decrease in the
U.S. Commitment to global family planning efforts, I would like
to point out that while the overall funding of USAID to family
planning increased steadily between 1987-1995, the funding
allocated to this activity started to decline from 1996-2000,
before the Mexico City Policy was reenacted. Reasons, other
than this policy should explain the decline in funding. (Figure
2) Population spending goes up when there is a broader
consensus and when population assistance is funding
abortionist, there is no consensus. It needs to be remembered,
however, that the U.S. remains the principal contributor to
population assistance by a significant amount (of the order of
60%) (Figure 3) and that the total funds toward population
assistance as the UN reports it has not decreased but rather
has been channeled through other avenues such as NGOs (Figure
4).
3. The legalization of abortion across the world, rather than
decreasing has increased the number of abortions and this has
happened in spite of a significant increase in the use of
contraceptives, developing countries included. According to a
1997 study of the World Health Organization (WHO),\1\ mortality
risk for abortion varies in developing countries between 100-
1,000 deaths per 100,000 cases while in the United States, the
same measure is 50. There are other equally high serious causes
of death for women, however, such as delivery of live birth
(250-800 deaths per 100,000 cases) which can be easily solve by
the presence of a delivery kit (which by the way costs a $1.50)
and skilled personnel. Lets keep in mind that this last case is
consider legal. To this must be added that in the history of
the organizations that participate in USAID-supported family
planning activities (over 450 foreign NGOs), few organizations
have a history of lobbying for change in the legal status of
abortion. Therefore, the restoration of the Mexico City Policy
neither increases the number of abortions, nor the number of
qualified family planning providers as it has been stated.
---------------------------------------------------------------------------
\1\ Unsafe abortion: Global and Regional Estimates of Incidence of
a Mortality Due to Unsafe Abortion With a Listing of Available Country
Data--Third edition, 1997--Ref. WHO/RHT/MSM/97.16.
---------------------------------------------------------------------------
4. Finally, I would like to bring to the attention of the
Committee the leading causes of death for women in developing
countries as reported in the ``1999 World Health Report''
published by WHO. Table 1 summarizes this information. The
leading cause of death for women among the communicable
diseases maternal and perinatal conditions, and nutrition
deficiencies, is infectious diseases. With the exception of
AIDS, these diseases are rare, treatment is accessible in
developed countries, and their cost is remarkably low.
Furthermore, all the diseases mentioned are significantly
larger than the toll caused by abortion, even when the maternal
condition, as the cause of death, is taking into account alone.
This suggests that the funding provided by USAID can be put to
better use if this organization is aiming at helping the health
of women in need. Hemorrhages and other diseases cause twice as
many deaths as the estimates for abortion predict.
To conclude, there have been several arguments put forward against
the restoration of the Mexico City Policy. The data presented to the
Committee in this short response, suggest that there is evidence on the
contrary. If anything, the enactment of this policy increases the
protection of freedom of choice of developing countries and allows for
a more needed and efficient allocation of funds.
Mr. Chairman, this concludes my statement. I would be glad to
respond to any questions.
Senator Boxer. Thank you. I'm sure that you didn't mean to
say that the 78,000 women a year who die of illegal abortion
that you're pitting that against infectious diseases. I mean, I
think we want to help everyone, don't we?
Dr. Aguirre. That is a rough estimation, 66,000 women.
Senator Boxer. Well, we have 78,000, but let's not quibble.
The point is I hope you didn't mean to suggest that we ignore
that and go after the other problems, because, in my view, I
want to go after all the problems. I want to help those who are
dying of back-alley abortions, that can't go to a clinic now
and get family planning, and I want to help, of course, the
children and the families, men and women, who have these other
problems. Child nutrition is a major issue with me as well. I
don't think that's what you meant. You were just saying illegal
abortion isn't the biggest problem. Is that correct?
Dr. Aguirre. That's right.
Senator Boxer. It just is for the 78,000 women who die and
their loved ones, but I get your point. I don't mean to in any
way undermine you except to say that I don't like to see us set
one group of dying people against another group of dying
people.
I would like to now call on Professor Pellegrom, president
of Pathfinder International. Pathfinder International is a
nonprofit organization based in Massachusetts which, among
other things, works to improve reproductive health and family
planning in the developing world. We welcome you.
STATEMENT OF DR. DANIEL E. PELLEGROM, PRESIDENT, PATHFINDER
INTERNATIONAL, WATERTOWN, MA
Dr. Pellegrom. Thank you, Senator, and your colleagues who
are concerned for this issue, and thank you for receiving my
remarks.
The gag rule is an unfortunate injection of the American
domestic anti-abortion agenda on U.S. foreign policy. This year
the current administration has reinstated the gag rule. Its
supporters argue that it will stop abortion. But what really
happens when we explore this domestic controversy abroad is
something quite different.
It will not reduce abortion, but it does hurt family
planning. It does damage female reproductive services. And it
undermines American foreign policy objectives that promote
democracy and free speech.
I have led Pathfinder International since 1985 just after
President Reagan's original version of the gag rule was
imposed. Pathfinder was the first organization to negotiate a
cooperative agreement with USAID after the so-called Mexico
City Policy was placed into all USAID cooperative agreements
and grants. The gag rule was ineffective in doing what its
proponents sought.
Over the ensuing years in which it was in place, I observed
no decline in abortion rates. I am not aware of any research
that points to a decline in abortion rates, and I know of no
one who attributes any decline to the American gag rule of the
1980's.
If this is the case, if it did not reduce abortion rates,
why exactly has the administration revived it? The gag rule has
had serious consequences on delivering family services in less-
developed countries. Indeed, if a hospital or clinic which
operates in a country where abortion is legal offers a full
range of reproductive health services in accord with U.S. laws
and medical practices, how does the gag rule affect that
provider of patient care if that provider offers abortion
services or even abortion counseling? It is subject to the gag
rule, and consequently termination of financial support for
contraceptive services.
This is the penalty that the U.S. imposes. The loss of
contraceptive funds is inclined to increase unintended
pregnancies which logically will result in increasing reliance
on abortion as well as increasing maternal deaths.
You are hearing today from two reproductive health care
leaders. Each represents an excellent family planning provider,
one from Nepal and one from Peru. Both organizations have been
faced with difficult decisions. Each has come to a different
conclusion. These organizations and countless similar ones have
been put in jeopardy, trapped between reliance on American
foreign assistance and their own nation's laws and medical
practices. Their stories are among countless others, each
unique to circumstance and culture and situation. All are
result of the gag rule.
As you will see, whichever choice is made, there is harm.
The harm is to organizations and finally to the patients the
organizations serve. Usually the patients are women. Mostly
they are poor, young and anything but independent. They are
people who rely on our good will.
Let me share with you some late-breaking news from
Bangladesh. Within the last few days I have received a letter
from Bangladesh Rural Advancement Committee [BRAC], a large,
multi-service non-government organization that provides a
variety of family planning services to millions of families in
one of the world's most impoverished nations. We have worked
with BRAC for several years. For various reasons, it is an
exceptional agency, but it is only one of hundreds that is
being forced to make a damaging decision which has been imposed
by the new United States gag rule.
In Bangladesh menstrual regulation [MR], is legal. In the
United States, we typically refer to menstrual regulation as
very early abortion. MR is often performed prior to pregnancy
being established. In Bangladesh, MR is promoted by the
government as an essential element of the national health care
package.
BRAC is not an NGO that is trying to skirt local laws or
customs. It is a responsible, even exceptional provider of
health and human development services that has been put in a
position to choose between obeying its own government or ours.
That is not a fair choice to ask that NGO to make.
It is not as though BRAC is out of step with the Government
of Bangladesh on this; quite the contrary. U.S. policy in this
instance is hurting BRAC, but it is also adversarial to the
Government of Bangladesh and to its people.
And who exactly benefits from withdrawing U.S. funds that
were being used for the purpose of preventing pregnancy? It
certainly does not appear that Bangladesh, the people of
Bangladesh are going to benefit. BRAC certainly isn't.
BRAC has informed me that it will not sign the gag rule. It
says that it cannot permit a foreign government to dictate how
it uses non-USAID funding. They have never used USAID funding
for these purposes of course; therefore, beginning October 1,
they will not be eligible to receive U.S. support.
Proponents of the gag rule claim that it is not an assault
on family planning. You will recall that I told you that BRAC
is a broad-based provider of human services, and hence it
continues to receive other support from USAID for other
services and initiatives. BRAC's refusal to sign does not
deprive it of all USAID funds, but its refusal to sign the gag
rule does deprive it of family planning funds. How am I to
conclude that the gag rule is anything other than hostile to
family planning?
U.S. foreign assistance funds have been given to people and
organizations all over the globe for purposes of fostering
democracy. Our leaders boast that America invests in civil
society, builds democracy in nation after nation. Developing
voices for democracy in nations where democratic ideals are
only a concept is a high priority, one that the American
taxpayers appear to support. Free expression, free speech is a
requirement of a democratic society. How can we, indeed how
dare we, spend Federal money teaching democratic aspirations on
the one hand and then deny free speech on the other just
because a particular subject happens at that moment to
displease us.
In this particular instance, the irony expands when one
considers that abortion counseling and referral brings about a
gag rule abroad while access to abortion services are
guaranteed in the United States.
What does all this mean to my organization, a U.S.-
incorporated NGO that does reproductive health work abroad?
Pathfinder International has labored in the cause of
reproductive health for more than 70 years if you reach back to
its founder, and 45 years if you go back to the date of its
incorporation. We have provided seed money that launched the
initial family planning activity in over 30 countries. In all
these years, first with private funds and since the late 1960's
with public funds as well, we all have taken pride in our work,
work that depends centrally and necessarily on with whom we
partner in developing countries.
Our criteria for selecting partners reads like a good
management diary, but now, with the gag rule in place, the
overriding question for us for how we spend U.S. Government
funds is, first and foremost, ``How against abortion is this
organization?'' This is the question, in spite of the fact that
the money we are discussing could never have been used for
abortion in the first place. How are we to conclude that this
is not an assault on family planning?
Between now and October 1, Pathfinder will scramble to find
some other way to get family planning assistance to women in
Bangladesh. We will attempt to patch together other providers,
calling upon them to consider whether they are willing to
accept the American Government's gag rule. We will attempt to
do this as best we can in other countries as well, but there
will be added costs, reduced efficiencies and diminished
respect for American foreign assistance. Meanwhile, we will do
everything in our power to get family planning services to
women who will never know anything about today's proceedings.
[The prepared statement of Dr. Pellegrom follows:]
Prepared Statement of Dr. Daniel E. Pellegrom
I would like to begin, Senator Boxer, by thanking you and your
Senate colleagues for this opportunity to offer testimony on this vital
subject.
The gag rule is an unfortunate political interjection of the
American domestic anti-abortion agenda on U.S. foreign policy. This
year, the current Administration has reinstated the gag rule. Its
supporters argue that it will stop abortion. But what really happens
when we export this domestic controversy abroad is something quite
different. It will not reduce abortion. It does hurt family planning,
it does damage to female reproductive health services, and it
undermines American foreign policy objectives that promote democracy
and free speech.
I have led Pathfinder International since 1985, just after
President Reagan's original version of the gag rule was imposed (also
known as the Mexico City Policy). Pathfinder was the first organization
to negotiate a cooperative agreement with USAID, after the so-called
Mexico City Policy was placed into all USAID cooperative agreements and
grants. That gag rule was ineffective in doing what its proponents
sought. Over the ensuing years in which it was in place I observed no
decline in abortion rates. I am not aware of ANY such research that
points to a decline in abortion rates and I know of no one who
attributes any decline to the American gag rule of the 1980s. If it did
not reduce abortion rates, why exactly has the Administration revived
it?
The gag rule has had serious consequences in delivery of family
planning services in less developed countries. Indeed, if a hospital or
clinic, which operates in a country where abortion is legal, offers a
full range of reproductive health services in accord with its laws and
medical practices, how does the gag rule affect that provider of
patient care? If that provider of medicine provides abortion services
or abortion counseling, it is subject to the ``Gag Rule'' and
consequently the termination of financial support for contraceptive
services. Thus, the penalty that the U.S. imposes, the loss of
contraceptive funds, is inclined to increase unintended pregnancies,
which logically will result in increasing reliance on abortion as well
as an increase in maternal deaths.
In a few minutes you will hear from two reproductive health
leaders. Each represents an excellent family planning provider, one
from Nepal, the other from Peru. Both organizations have been faced
with a difficult decision; each has come to a different conclusion.
These organizations, and countless similar ones, have been put at
jeopardy, trapped between reliance on American foreign assistance and
their own nation's laws and medical practices.
Their stories are among countless others, each unique to
circumstances of culture and situation; all are the result of the gag
rule. As you will see, whichever choice is made there is harm. This
harm is to organizations and, finally to the patients the organizations
serve. Usually the patients are women, mostly very poor, young and
anything but independent. They are people who rely on our good will.
Let me share with you some late breaking news from Bangladesh.
Within the last few days I have received a letter from the Bangladesh
Rural Advancement Committee (BRAC), a large, multi-service non-
Government organization (NGO) that provides a variety of services to
millions of families in one of the world's most impoverished nations.
We have worked with BRAC for several years. For various reasons it is
an exceptional agency, but it is only one of hundreds that is being
forced to make a damaging decision imposed by the new United States gag
rule.
In Bangladesh menstrual regulation (MR) is legal. In the United
States we typically refer to menstrual regulation as very early
abortion. MR is often performed prior to pregnancy being established.
In Bangladesh, it is referred to as MR and it is promoted by the
Government as an essential element in the national health care package.
BRAC is not an NGO that is trying to skirt local laws or customs. It is
a responsible--even exceptional--provider of health and human
development services that has been put in a position to choose between
obeying its own government or ours. That is not a fair choice to ask
any NGO to make.
It is not as though BRAC is out-of-step with the Government of
Bangladesh on this. Quite the contrary. U.S. policy, in this instance,
is hurting BRAC, but it is also adversarial to the Government of
Bangladesh and its people. And, who, exactly benefits from withdrawing
U.S. funds that were being used for the purpose of preventing
pregnancy? It certainly doesn't appear that the women of Bangladesh are
the beneficiaries. BRAC doesn't benefit.
BRAC has informed me that it will not sign the gag rule. It says
that it cannot permit a foreign government to dictate how it uses its
non-USA funding. Therefore, beginning October 1 they will not be
eligible to receive USAID family planning funds.
Proponents of the gag rule claim that this is not an assault on
family planning. You will recall that I told you that BRAC is a broad-
based provider of human services and hence it continues to receive
other support from USAID for other services and initiatives. BRAC's
refusal to sign does not deprive it of all USAID funds; but its refusal
to sign the gag rule does deprive it of family planning funds. How am I
to conclude that the gag rule is other than hostile to family planning?
Foreign Assistance funds have been given to people and
organizations all over the Globe to foster democracy. Our leaders boast
that America invests in civil society and builds democracy in nation
after nation. Developing voices for democracy in nations where
democratic ideals are only a concept is a high priority, one that
American taxpayers appear to support.
Free expression--free speech--is a requirement of a democratic
society. How can we--indeed, how dare we--spend Federal money teaching
democratic aspirations, on the one hand, and then deny free speech, on
the other, when the subject happens to displease us?
In this particular instance the irony expands when one considers
that abortion counseling and referral brings about a gag rule abroad,
while access to abortion services is guaranteed in the United States.
What does all this mean for my organization, an U.S. incorporated
NGO that does reproductive health work abroad? Pathfinder International
has labored in the cause of reproductive health for more than seventy
years, if you reach back to our founder and for 45 years if you go back
to the date of our incorporation.
We have provided the seed money that launched the very first family
planning work ever undertaken in 30 different countries. In all these
years, first with private funds, and, since the late 1960's, with
public funds as well, we have taken pride in our work, work that
depends centrally on with whom we partner in a developing country. Our
criteria for selecting partners reads like a good management diary.
These are some of the questions:
What is the most cost effect organization?
Which organization is managed well?
Which organization provides the highest quality of care?
Which organization has the best capacity to expand in order
to reach the poorest of the poor?
Which organization is the most sincerely committed to
improve the conditions of its people?
With the gag rule in place, the over-riding question for how we
spend U.S. government funds must be first and foremost:
Is the organization anti-abortion enough?
This is the question in spite of the fact that the money we are
discussing could never be used for abortion in the first place. How are
we to conclude that this is not an attack on family planning?
Between now and October 1, Pathfinder will scramble to find some
other way to get family planning assistance to three million mothers in
Bangladesh. We will attempt to patch together other providers, calling
upon them to consider whether they are willing to accept the American
Government's gag rule. We will attempt to do this as best we can in
other countries, as well. But there will be added costs, reduced
efficiencies, and diminished respect for American foreign assistance.
Meanwhile, we will do everything in our power to get family
planning services to women who will never know anything about today's
proceeding. Family planning will save the lives of some of these
women--and it will enrich the lives of all of them.
Pathfinder International, a nonprofit organization headquartered in
Watertown, Massachusetts, provides women, men, and adolescents
throughout the developing world with access to quality family planning
and reproductive health information and services. Pathfinder works to
halt the spread of HIV/AIDS, to provide care to women suffering from
the complications of unsafe abortion, to address the sexual health
needs of adolescents, and to advocate for sound reproductive health
policies in the U.S. and abroad.
Senator Boxer. Thank you very much. And I think that's a
good point.
I'm going to call on Kathy Cleaver and tell you about her
in a moment, but I want to place in the record a page out of
this booklet which talks about a study. It's a study on the
implications of restrictive abortion laws in Nepal, and it says
that, in fact, the only exception in Nepal is ``unintentional
termination while undergoing medical treatment.'' It does not
say there is an exception for life. So I am going to put this
in the record and ask you if you have other documentation, so
we don't leave this hearing--we now have two different views.
We have the view that the only exception is unintentional
termination while undergoing medical treatment and the
professor here who says there is an exception for life. So we
will put both sides into the record.
[The material referred to follows:]
[Crehpa 2000]
Women in Prison in Nepal for Abortion
A study on implications of restrictive abortion law on women's
social status and health.
1.1. Background
Around the world, laws governing induced abortion range from those
prohibiting abortion with no explicit exceptions to those establishing
it as a right of pregnant women. Nepal is one of the few countries
where abortion is legally restricted. In this country, induced abortion
is a criminal act under any circumstances, even in case of rape or
incest, punishable by imprisonment for both the woman undergoing an
abortion and abortion service provider. The only exception is
unintentional termination while undergoing medical treatment.
Despite the restrictive abortion law, every year thousands of
induced abortions are performed clandestinely in the country. Most of
these abortions are conducted by untrained or unqualified personnel or
quacks, which adversely affect both the interests of the women and the
society at large. Since most clandestine procedures either remain
incomplete or they are associated with severe complications, these
women have no choice but to visit hospitals in critical conditions,
thereby severely straining the finite hospital resources of the
country.
It is estimated that deaths due to unsafe abortion procedures
account for more than half of the maternal deaths in the country.
Because of the illegal status of abortion, a considerable proportion of
Nepalese women especially from rural areas who are poor, illiterate and
have low social status, frequently fall victim to exploitation and
imprisoned on charges of abortion and infanticides. As the present law
does not clearly differentiate between Garbhapaat (abortion) and Jaatak
(infanticide), prosecutors tend to choose the latter and rarely, women
accused of such acts are represented by a lawyer. Although in all
circumstances abortions are motivated and carried out with the
assistance of spouse or male partner, in most cases it is the women and
not their spouse or male partner, . . .
Senator Boxer. I want to thank you and I will get back to
you in a minute with some questions, Dr. Pellegrom.
So we're going to hear from Ms. Kathy Cleaver, director of
Planning and Information for the U.S. Conference of Catholic
Bishops here in Washington, DC. And we welcome you.
STATEMENT OF KATHY CLEAVER, DIRECTOR OF PLANNING AND
INFORMATION FOR THE SECRETARIAT FOR PRO-LIFE ACTIVITIES, U.S.
CONFERENCE OF CATHOLIC BISHOPS, WASHINGTON, DC
Ms. Cleaver. Thank you very much, Senator Boxer. I am very
grateful for the opportunity to present testimony today on the
importance of the Mexico City Policy.
As director of Planning and Information for the Secretariat
for Pro-Life Activities of the United States Conference of
Catholic Bishops, I have the privilege of playing a role in the
Church's mission to teach and deepen respect for all human
life, especially the most vulnerable members of the human
family, the poor, the unborn, the disabled, and the dying.
The Mexico City Policy is the most significant policy
initiative on abortion taken by the United States in the area
of foreign assistance in the last 20 years. To state it
clearly, the Mexico City Policy simply requires non-
governmental organizations receiving U.S. aid to refrain from
performing or promoting abortion as a method of family planning
in developing nations. And we, of course, commend President
Bush for reinstating this very important policy.
The argument has been made by abortion proponents that the
Mexico City Policy is nothing more than powerful U.S.
politicians forcing their policies on poor nations. But,
frankly, quite the opposite is true. First, the policy forces
nothing and in that sense could be viewed as pro-choice. The
non-governmental organizations may choose to apply for U.S. tax
funds, and to be eligible, they must refrain from abortion
activity. On the other hand, NGOs may choose to do abortions or
to lobby foreign nations to change their laws which restrict
abortion, and, if they choose that path, they render themselves
ineligible for U.S. money. As we saw last time the policy was
in place, only two out of hundreds of organizations elected to
forfeit the U.S. money for which they were otherwise eligible.
But it was and will be entirely their choice. Far from forcing
a policy on poor nations, the Mexico City Policy ensures that
NGOs will not themselves force their abortion ideology on
countries without permissive abortion laws in the name of the
United States as U.S. grantees.
And as we have learned from our experience in international
conferences on population, it is not the Mexico City Policy but
the United States' promotion of permissive abortion attitudes
through funding of such programs that is likely to cause
resentment in these countries. This is especially true when it
is perceived as a means by which the West is attempting to
impose population control policies on developing nations as
conditions for development assistance.
The Mexico City Policy is needed because the agenda of many
organizations receiving U.S. population aid has been to promote
abortion as an integral part of family planning. That's no
secret. And they do this even in developing nations where
abortion is against the law. So, far from being perceived as an
imposition on developing nations, the Mexico City Policy
against funding abortion programs has been greeted by those
nations as a welcome reform. The vast majority of these
countries have legal policies against abortion, and virtually
all forbid the use of abortion as merely another method of
birth control.
Moreover, the Mexico City Policy is remarkably mainstream.
The vast majority of Americans do not want their tax dollars
used for programs that promote or provide abortion as a method
of family planning. The Mexico City Policy simply brings
American foreign policy back in line with the views of the
American people.
Finally, some opponents of the Mexico City Policy are fond
of using the slogan, global gag rule, to refer to the policy,
and that is a smart public relations move. But it does not
reflect reality. The truth of the matter is poor women in
developing nations are not calling for help to abort their
children. They are calling for food, housing, and medicine for
themselves and their children so that they can lead lives of
full human dignity. With the Mexico City Policy in place, the
United States can best respond to their pleas, and respond with
respect for their personal dignity and their humanity. Thank
you very much.
[The prepared statement of Ms. Cleaver follows:]
Prepared Statement of Cathleen A. Cleaver, Esq.
Chairman Boxer, Members of the Committee, I am grateful for the
opportunity to present testimony today on the importance of the Mexico
City Policy.
As Director of Planning and Information for the Secretariat for
Pro-Life Activities of the United States Conference of Catholic
Bishops, I have the privilege of playing a role in the Church's mission
to teach and deepen respect for all human life, especially the most
vulnerable members of the human family--the poor, the unborn, the
disabled, and the dying.
The ``Mexico City Policy'' is the most significant policy
initiative on abortion taken by the United States in the area of
foreign assistance in the last twenty years. To state it clearly: the
Mexico City Policy simply requires non-governmental organizations
receiving U.S. aid to refrain from performing or promoting abortion as
a method of family planning in developing nations.
We commend President Bush for reinstating this important policy.
The argument has been made by abortion proponents that the Mexico
City Policy is nothing more than ``powerful'' U.S. politicians forcing
their policies on poor nations. But, frankly, the opposite is true.
First, the policy forces nothing: Non-governmental organizations (NGOs)
may choose to apply for U.S. tax funds, and to be eligible, they must
refrain from abortion activity. On the other hand, NGOs may choose to
do abortions or to lobby foreign nations to change their laws which
restrict abortion, and if they choose that path they render themselves
ineligible for U.S. money. As we saw last time the policy was in place,
only two out of hundreds of organizations elected to forfeit the U.S.
money for which they were otherwise eligible.\1\ But it was and will be
entirely their choice.
---------------------------------------------------------------------------
\1\ The London-based International Planned Parenthood Federation
(IPPF) received approximately $17 million from the U.S. Agency for
International Development (U.S. AID) in 1984 but forfeited all its
federal funding under the Mexico City Policy. Approximately 57 IPPF
affiliates worldwide agreed to the Policy and continued to receive U.S.
funds. Planned Parenthood Federation of America also refused to agree
to the limitations resulting in the cessation of its grant of
approximately $18 million in 1990. According to U.S. AID congressional
testimony, approximately 400 NGOs were receiving funds under the Mexico
City Policy terms in 1991. Congressional Record, June 12, 1991, H4336-
4338. U.S. AID testified that, under the Mexico City Policy, the United
States provided ``about 45 percent of all international family planning
assistance in more than 100 countries . . . 85 of those countries were
developing countries.'' Congressional Record, June 12, 1991, H4338.
---------------------------------------------------------------------------
Far from forcing a policy on poor nations, the Mexico City Policy
ensures that NGOs will not themselves force their abortion ideology on
countries without permissive abortion laws in the name of the United
States as U.S. grantees.
And as we have learned from our experience in international
conferences on population, it is not the Mexico City Policy but the
United States' promotion of permissive abortion attitudes through
funding of such programs that is likely to cause resentment.\2\ This is
especially true when it is perceived as a means by which the West is
attempting to impose population control policies on developing nations
as conditions for development assistance.
---------------------------------------------------------------------------
\2\ In 1985, the U.S. Agency for International Development told
Congress:
---------------------------------------------------------------------------
Abortion is a controversial issue in many countries,
especially those with large Catholic or Moslem populations.
The U.S. has been criticized in developing countries for
its funding of groups (such as IPPF and some of its
affiliates) which perform abortions with their own funds .
. . The Administration believes that it is important to
avoid the damage to U.S. interests which results from the
belief it supports abortion.
The Program of Action of the 1994 United Nations International
Conference on Population and Development held in Cairo reaffirmed the
position first adopted by United Nations delegates at the 1984 Mexico
City population conference: ``In no case should abortion be promoted as
a method of family planning.''
The Mexico City Policy is needed because the agenda of many
organizations receiving U.S. population aid has been to promote
abortion as an integral part of family planning--even in developing
nations where abortion is against the law.\3\ So, far from being
perceived as an imposition on developing nations, the Mexico City
Policy against funding abortion programs has been greeted by those
nations as a welcome reform. The vast majority of these countries have
legal policies against abortion, and virtually all forbid the use of
abortion as merely another method of birth control.\4\
---------------------------------------------------------------------------
\3\ Perhaps one of the most striking examples of this was seen in a
1983 resolution signed by then-PPFA President Faye Wattleton:
---------------------------------------------------------------------------
Family Planning Associations and other non-governmental
organizations should not use the absence of a law or the
existence of an unfavorable law as an excuse for inaction;
action outside the law, and even in violation of it is part
of the process of stimulating change.
---------------------------------------------------------------------------
\4\ In 1984 the laws of only 5 of 126 less developed nations
permitted abortion upon request, and only 8 permitted abortion for
socio-economic reasons. Concise Report on the World Population
Situation in 1983, Department of International Economic and Social
Affairs, United Nations (Population Studies No. 85) (New York 1984). In
1994 the United Nations reported that abortion upon request and
abortion for socio-economic reasons was legal in only 12 of 133
developing nations. Today, approximately half of the developing nations
allow abortion only to protect the mother's life or in cases where the
pregnancy resulted from rape or incest. Virtually all prohibit the use
of abortion as a method of birth control. (A. Rahman, L. Katzive and S.
Henshaw, ``A Global Review of Laws on Induced Abortion, 1985-1997,''
International Family Planning Perspectives, vol. 24 no. 2, June 1998).
---------------------------------------------------------------------------
Moreover, the Mexico City Policy is remarkably ``mainstream.'' The
vast majority of Americans do not want their tax dollars used for
programs that promote or provide abortion as a method of family
planning. The Mexico City Policy simply brings American foreign aid
policy back in line with the views of the American people.
Finally, some opponents of the Mexico City Policy are fond of using
the slogan ``Global Gag Rule'' to refer to the policy, and that is a
smart public relations move. But it doesn't reflect reality. The truth
of the matter is: Poor women in developing nations are not calling for
help to abort their children. They are calling for food, housing, and
medicine for themselves and their children so that they can lead lives
of full human dignity. With the Mexico City Policy in place the United
States can best respond to their pleas, and respond with respect for
their personal dignity and their humanity.
Thank you.
Senator Boxer. Thank you. I guess we have a different view
of when a woman is treated with dignity, and we will bring that
out.
I do want to correct the record because you are about the
third witness who has made the statement that this was done so
that U.S. tax dollars wouldn't be used for abortion, and I'm
going to put in the record at this time the section of the law
that was actually written by our ranking member in the full
committee, Senator Helms in 1973, which has prohibited since
1973 the spending of U.S. dollars on abortions, and I just want
to make sure that that appears in the record.
[The information referred to follows:]
SEC. 2151b. POPULATION PLANNING AND HEALTH PROGRAMS
(a) * * *
* * * * * * *
(f) Prohibition on Use of Funds for Performance or Research
Respecting Abortions or Involuntary Sterilization.--
(1) None of the funds made available to carry out subchapter
I of this chapter may be used to pay for the performance of
abortions as a method of family planning or to motivate or
coerce any person to practice abortions.
(2) None of the funds made available to carry out subchapter
I of this chapter may be used to pay for the performance of
involuntary sterilizations as a method of family planning or to
coerce or provide any financial incentive to any person to
undergo sterilizations.
(3) None of the funds made available to carry out subchapter
I of this chapter may be used to pay for any biomedical
research which relates, in whole or in part, to methods of, or
the performance of, abortions or involuntary sterilization as a
means of family planning.
* * * * * * *
Senator Boxer. Our last and certainly not least panelist we
want to welcome at this time is Mr. Neier. And he is president
of the Open Society Institute, which is based in New York. His
organization promotes the development of open societies around
the world. Mr. Neier is also a founder of what is today one of
the most respected organizations, I think, in the world, Human
Rights Watch. So we're very honored that you're here today and
please proceed.
STATEMENT OF ARYEH NEIER, PRESIDENT, OPEN SOCIETY INSTITUTE,
NEW YORK, NY
Mr. Neier. Thank you very much, Chairman Boxer. I have
spent the past four decades promoting rights first as director
of the American Civil Liberties Union dealing with domestic
rights in the United States, then as the founding director of
Human Rights Watch, and in my present capacity as president of
the Open Society Institute. The network of Soros foundations of
which I am also the president is perhaps the leading supporter
of human rights work worldwide.
I want to focus on the significance of the global gag rule,
and I think the name is an appropriate one, for human rights.
In particular, I want to focus on the way in which promoting
abortion is defined in the global gag rule. One of the
provisions says that conducting a public information campaign
in USAID-recipient countries regarding the benefits and/or the
availability of abortion as a method of family planning; that
is, if you conduct a campaign on benefits or availability, you
cannot receive U.S. funding.
That seems to me a very serious interference with the free
speech rights of the non-government organizations that are the
recipients of U.S. funding. As has been pointed out, if such a
prohibition were enacted in the United States, it would violate
the first amendment. One should also note that subsequent to
the earlier Mexico City Policy, the United States ratified the
International Covenant on Civil and Political Rights. That
ratification means that the covenant is binding on the United
States. The covenant has a provision dealing with free speech
that is the counterpart of the first amendment. It provides
that ``Everyone shall have the right to freedom of expression.
This right shall include freedom to seek, receive and impart
information and ideas of all kinds regardless of frontiers,
either orally, in writing or in print, in the form of art, or
in any other media of his choice.''
It does seem to me that a prohibition on a public
information campaign on availability of abortion flatly
violates the treaty obligation that the United States undertook
when it ratified the International Covenant on Civil and
Political Rights.
Beyond that, I want to indicate how this also affects the
free speech rights of Americans. Americans are indirectly or
perhaps even directly affected in their free speech rights by
the rule. It has to do with the way the international human
rights effort takes place.
American organizations such as the one of which I was the
founder and director, Human Rights Watch, conduct
investigations worldwide. The way we conduct investigations,
except in a handful of the most repressive countries on Earth
where non-governmental organizations cannot function, is to go
to counterpart non-government organizations and find out from
them about human rights abuses in their countries, and then
conduct investigations of those abuses.
There is a kind of partnership between U.S.-based human
rights organizations and non-government organizations in other
countries. They depend on us for international resonance for
their findings and for protection in case their governments
take reprisals against them.
We depend on them for information and to point us in the
right direction in examining abuses. That effort essentially is
blocked in the field of abortion or reproductive rights; that
is, American organizations cannot gather information on these
problems if the non-governmental organizations that are active
in the field of family planning, that are likely to be the
repositories of information on these issues may not provide
information to them on the benefits or availability of abortion
as a method of family planning as specified in the global gag
rule. It's a restriction on their rights. It's a restriction on
our rights. If it were applied in any other field of
international human rights, it would be disastrous for the
human rights field. It's disastrous in this field.
Moreover, I point out that the United States is replete
with laws--the Foreign Assistance Act, the International
Financial Institutions Act--which make U.S. policy favor the
activities of non-governmental organizations in providing
information on rights. Section 502(b) of the Foreign Assistance
Act, Section 116 of the International Financial Institutions
Act specify that the availability of information from non-
governmental institutions is one of the ways the United States
assesses the human rights situation of other countries.
This global gag rule seems to me to violate our obligations
under the Covenant on Civil and Political Rights and to
contradict U.S. legislation dealing with international human
rights.
Thank you very much.
[The prepared statement of Mr. Neier follows:]
Prepared Statement of Aryeh Neier
INTRODUCTION
Senator Boxer, Senator Helms, Members of the Committee, good
morning. Thank you for inviting me here today to testify before the
Senate Committee on Foreign Relations. I am here to testify in
opposition to the Administration's policy known as the ``Global Gag
Rule,'' and in favor of Senator Boxer's bill, the Global Democracy
Promotion Act of 2001 (S. 367), which would overturn the Global Gag
Rule.
I am the President of the Open Society Institute (OSI), a United
States-based charitable foundation based in New York City. The Open
Society Institute was established in 1993 to promote the development
and maintenance of open societies around the world. OSI does this by
supporting an array of activities dealing with education, social, legal
and health care reform, and by encouraging alternative approaches to
complex and controversial issues. OSI funds projects both domestically
and in over sixty foreign countries for the purpose of promoting
democratic governments, robust political debate, human rights, and the
rule of law. We promote these goals primarily by supporting non-
governmental organizations (NGOs).
My testimony addresses the central advocacy role NGOs play in
formulating and monitoring international agreements, shaping
international human rights law, influencing the policies and laws of
the United States, and promoting open and civil societies worldwide. I
would also like to emphasize my strong support for the Global Democracy
Promotion Act, which would overturn the censorship imposed by the
United States Agency for International Development (USAID) on privately
funded speech that promotes abortion law reform, otherwise known as the
``Global Gag Rule.''
In over 38 years of experience in the human rights field, the
Global Gag Rule is the only time I have encountered U.S. censorship of
speech promoting law reform through democratic processes. The entire
human rights movement relies on the ability of NGOs to gather
information and speak without impediment and to associate freely with
foreign NGOs to increase the effectiveness of their speech and
advocacy.
This law reform gag not only irreparably damages the association,
free speech, and political advocacy rights of international human
rights advocates. but causes continuing irreparable injury to the
American public. Impeding the information gathering and freedom of
expression of human rights advocates sends a message worldwide that we
are willing to diminish First Amendment protections for political ends
and undermines the commitment of the United States to free
dissemination of information and democratic values worldwide.
BACKGROUND AND EXPERIENCE
I have spent my career as a human rights advocate and scholar
promoting the establishment and enforcement of civil and human rights
under the United States Constitution and international treaties,
agreements and norms.
I have been the President of OSI since it was founded in 1993. The
Institute began by funding local NGOs in Eastern Europe and the former
Soviet Union to encourage political debate and law reform. Over the
last 8 years, OSI has funded and supported hundreds of NGOs in the
United States and around the world. A number of these NGOs work on
human rights issues, including many whose work focuses on reproductive
rights and health.
In 1978 I was a founder of what is now Human Rights Watch (HRW),
and spent twelve years as its Executive Director. HRW is dedicated to
protecting the human rights of people around the world, and is the
largest U.S.-based NGO operating internationally to protect human
rights. HRW began with my participation in the establishment of the
Helsinki Watch committee to monitor the implementation of the 1975
Helsinki Final Accords, a human rights treaty with thirty-five European
and North American countries as parties including the Soviet Union and
the countries of Central and Eastern Europe it controlled. Helsinki
human rights monitoring was a critical catalyst for human rights and
democracy movements that created political opportunities for some of
the forces that ultimately overthrew Communist rule. Central to this
effort (and illustrative of the harm of the Global Gag Rule) were the
advocacy networks of domestic and international NGOs, which my
colleagues and I formed with the Watch Committees to monitor and
publicize abuses under communist governments.
Prior to my work at HRW, I spent fifteen years with the American
Civil Liberties Union (ACLU), eight of those as National Executive
Director. The ACLU is a nonprofit civil rights organization with nearly
300,000 members and supporters. Founded in 1920, the ACLU is the
largest U.S. NGO protecting the Bill of Rights. The ACLU fulfills its
mission of defending the individual rights and liberties of all people
under the Constitution through litigation, advocacy and public
education. Our docket historically stressed protection of First
Amendment rights and expanded to include voting rights, women's rights,
racial equality efforts and privacy rights. A copy of my curriculum
vitae is attached hereto as Exhibit A. [Exhibits A and B have been
retained in the committee's files.]
I have worked with virtually every major human rights group
internationally and am familiar with the advocacy process across
national frontiers that has resulted in enormous gains in acceptance of
and compliance with international human rights law.
BACKGROUND OF THE HUMAN RIGHTS MOVEMENT
The human rights movement seeks to have certain fundamental human
rights principles accepted as international norms. If universally
accepted, these human rights would establish basic enforceable
protections and rights for all people.
The movement for human rights took on a global perspective after
World War II as a result of the Holocaust and the War Crimes Tribunals.
The events of World War II galvanized the international community and
led to the creation of the United Nations in 1945.
The United Nations committed itself in its Charter to protect human
rights and spelled out its understanding of universal rights through
the adoption of the Universal Declaration of Human Rights (UDHR),\1\
which was adopted without dissent by the General Assembly in 1948. The
UDHR proclaims that all men and women are entitled to the right to
life, liberty, nationality, and to participate in government, and to
freedom of thought, conscience and religion. Eleanor Roosevelt and the
United States delegation to the United Nations were instrumental in
drafting the UDHR and securing its passage.
---------------------------------------------------------------------------
\1\ Universal Declaration of Human Rights, adopted 10 Dec. 1948,
G.A. Res. 217A (III), UN Doc. A/810, at 71(1948).
---------------------------------------------------------------------------
The principles set forth in the UDHR are legally binding on party
nations, including the United States, through two international
covenants: the International Covenant on Civil and Political Rights
(ICCPR) \2\ and the International Covenant on Economic, Social and
Cultural Rights (ICESC),\3\ both of which entered into force in 1976
when ratified by 35 countries. The United States has ratified the
International Covenant on Civil and Political Rights.
---------------------------------------------------------------------------
\2\ International Covenant on Civil and Political Rights, adopted
16 Dec. 1966, entered into force 23 Mar. 1976, 999 U.N.T.S. 171.
\3\ International Covenant on Economic, Social and Cultural Rights,
adopted 16 Dec. 1966, entered into force 3 Jan. 1976, 999 U.N.T.S. 3.
---------------------------------------------------------------------------
Collectively, the UDHR, ICCPR and ICESC are commonly known as the
International Bill of Rights. They are attached hereto as Exhibit B.
Since 1976, numerous countries have signed and ratified the treaties,
taking important steps towards the implementations of their provisions.
In addition to these documents, more than 80 other conventions and
declarations related to human rights have been adopted, including
conventions to end discrimination on the basis of race and gender, and
declarations for the protection of refugees and to end genocide.
A central tenet of the International Bill of Rights and many of the
subsequently drafted documents is the recognition of freedom of
expression and the right to ``seek, receive and impart information and
ideas through any media and regardless of `frontiers.' '' See, e.g.,
article 19 of UDHR and article 19(2) of ICCPR. Like the First
Amendment's rights to freedom of speech, of the press and of peaceable
assembly, these rights are not only freestanding human rights, but are
essential tools for advancing all other rights.
The human rights movement over the last fifty years has had
tremendous success in securing the adoption of human rights treaties as
part of international and U.S. domestic law.
As human rights and international law have developed, the United
States has endorsed many covenants and declarations, and has ratified a
number of human rights treaties in accordance with the treaty-making
authority prescribed by the Constitution. This has created new avenues
for the human rights movement and NGOs to influence the United States.
The Global Gag Rule, however, interferes with the development of
international and domestic law related to reproductive health and
rights at every stage in the development of such law.
THE HUMAN RIGHTS ADVOCACY PROCESS
The process of political advocacy in the context of the advance of
international human rights is revolutionary. An understanding of this
process is crucial to understanding the degree of harm caused by the
Global Gag Rule due to the critical stage of development of the global
reproductive rights movement. It also illustrates the direct effect of
the law reform gag on human rights organizations, individual human
rights attorneys, and other individuals who are instrumental in that
movement.
There are two main components to human rights advocacy: 1) the
development and adoption of human rights norms into domestic and
international law; and 2) encouraging and ensuring compliance by
governments with human rights standards through the collection and
dissemination of information about practices that may diverge from
those norms. Transnational advocacy networks of human rights NGOs, both
international (like HRW) and domestic, are essential participants in
each stage of this process.
The first step in the human rights advocacy process is to define
human rights. This has primarily been accomplished through coalitions
of NGOs working with government delegations at regional and
international meetings or forums to establish certain human rights
norms. Through this process human rights theories are transformed from
ideals into enforceable rights. Language is drafted and agreed upon,
and the resulting documents are adopted by participating countries.
These documents establish international law, and upon adoption may
become incorporated into the adopting country's domestic law.
There are numerous examples illustrating the influence of NGOs in
the development of human rights norms. The 1997 Nobel Peace Prize was
awarded to an NGO coalition, the International Campaign to Ban
Landmines for its leadership in the adoption of a treaty banning
antipersonnel mines by 123 governments meeting that December in Ottawa.
Another such example is the 1998 Rome treaty calling for the
establishment of the International Criminal Court (ICC). This treaty
was endorsed by 120 governments at a conference in Rome in which NGOs
played a major part. It was the work of these human rights groups that
provided the impetus to adopt the treaty and obtain the signatures and
ratifications necessary for it to take effect. The organization of
which I was a founder, Human Rights Watch, played a leading role in
both treaties. NGOs were also critical in ensuring the recognition of
gender-sensitive and reproductive specific issues (such as forced
pregnancy as war crimes) were included in the mandate of the ICC. When
the government of Libya tried to block NGOs from speaking at the Rome
Conference, the United States government took a leading role in
upholding the rights of NGOs.
NGOs will continue to work domestically and internationally to
increase the number of countries becoming state parties to treaties,
covenants and declarations protecting human rights. As support builds
for the acceptance of a human rights norm, demonstrated by the
endorsement of documents enshrining those norms by an increasing
numbers of countries, international pressure builds on those countries
that have not yet endorsed the documents. Pressure can be brought to
bear through tangible actions, such as a United Nations censure or
economic sanctions. Human rights movements can also come from within a
country, such as the non-governmental democracy movement in Poland,
``Solidarity,'' which played a leading role in the fall of communism in
that country and throughout the former Soviet bloc. International
pressure legitimizes and supports the efforts of local NGOs.
Once a human rights norm has been defined and accepted, it provides
a yardstick by which to measure the compliance of governments, whether
or not a particular country has agreed to be bound by a document. Many
of the international agreements on human rights include requirements
that adopting governments report to the United Nations on compliance,
and that they must assist in efforts to monitor the compliance of other
governments. Thus, a critical component of human rights advocacy is the
ability to hold countries accountable.
In fact, the United States has adopted a set of statutes by which
the State Department monitors and reports to Congress upon compliance
with international human rights norms. A particularly important statute
is Sec. 502B of the Foreign Assistance Act of 1961, as amended (22 USC
2304). It requires the State Department to submit an annual report to
Congress on human rights practices worldwide. The law provides that in
preparing such reports ``the relevant findings of appropriate
international organizations, including non-governmental organizations''
should be considered (3)(b)(1); as well as ``the extent of cooperation
by such government in permitting an unimpeded investigation by any such
organization of alleged violations of internationally recognized human
rights'' (3)(b)(2). In doing so, the State Department relies
extensively on information supplied by HRW and frequently cites HRW's
findings.
NGOs play a critical role in monitoring compliance because they
often have direct access to information through their contacts with
their NGO counterparts worldwide and the ability to document human
rights abuses, and are in a position to put governments on notice of
how they are violating an international norm or right.
One of the most powerful weapons for ensuring government compliance
with human rights norms is the dissemination of information about
abuses. The presentation of such information through the media and in
international forums often ``shames'' the government into responding,
and can lead to international isolation and sanction if governments
fail to remedy abuses.
The information necessary to bring such abuses to light may be
difficult to obtain without the assistance of local NGOs, as this is
the very type of information that non-compliant governments are likely
to suppress. Local NGOs, however, often do not have the knowledge,
resources or international contacts necessary to disseminate the
information, and need to form partnerships and coalitions with other
NGOs in order to advocate effectively. The most effective engine for
change comes when local and international NGOs work together. Indeed,
the human rights movement as it exists would not have occurred without
transnational coalitions of NGOs.
The process that I have described reflects both my personal
experience and extensive academic analysis in the fields of
international relations and political science.\4\
---------------------------------------------------------------------------
\4\ Henkin, Louis, Neyman Orentlicher, Leebron Human Rights
(Foundation Press, 1999). Keohane, and Nye, eds. Power and
Interdependence (Addison Wesley, 2000). Cook, Rebecca Human Rights of
Women: National and International Perspectives (University of
Pennsylvania Press, 1994). Henkin, Louis Foreign Affairs and the U.S.
Constitution (Oxford, 1996). Risse-Kappen, Thomas Bringing
Transnational Relations Back In: Non-State Actors, Domestic Structures
and International Institutions (Cambridge University Press, 1995). Sen,
Gita, Adrienne Germain, Lincoln C. Chen Population Policies
Reconsidered: Health, Empowerment and Rights.
---------------------------------------------------------------------------
REPRODUCTIVE RIGHTS ADVOCACY AND THE HUMAN RIGHTS MOVEMENT
In order to explain fully the pernicious effect of the Global Gag
Rule, it is necessary to understand the history of reproductive rights,
and particularly the right to abortion, within the context of human
rights law.
Compared to the civil and political rights recognized in the
Helsinki Accords and ICCPR, reproductive rights (along with other
women's rights) have not progressed very far yet in their acceptance as
human rights norms.
It has only been quite recently that discussion of reproductive
rights as human rights has occurred at the international level. Much of
the progress on this issue has come through conferences sponsored by
the United Nations, including the World Conference on Human Rights,
held in Vienna in 1993, the International Conference on Population and
Development, held in Cairo in 1994, the Fourth World Conference on
Women, held in Beijing, China, in 1995, and the five-year review
conferences for both the Cairo and Beijing conferences.
The right to legal abortion is considered by many to be inseparable
from the unified whole of reproductive rights. Failure to incorporate
the right to abortion within the human rights norms recognizing
reproductive rights renders the protection afforded incomplete and
undermines the implementation of those rights that are recognized.
Because of the controversy surrounding abortion, although other
aspects of reproductive health are recognized, such as the right to
family planning,\5\ health,\6\ and physical integrity,\7\ there is yet
no universally recognized right to legal abortion per se.
---------------------------------------------------------------------------
\5\ The Vienna Declaration includes an affirmation of the rights of
women to ``accessible and adequate health care and the widest range of
family planning services.'' Vienna Declaration and Programme of Action
para. 41, U.N. Doc. A/CONF.157/23 (1993). The Beijing Declaration
states: ``The explicit recognition and reaffirmation of the right of
all women to control all aspects of their health, in particular their
own fertility, is basic to their empowerment.'' Report of the Fourth
World Conference on Women, para. 17, U.N. Doc. A/CONF.177/20 (1995).
The Cairo Report devotes several provisions to family planning. Report
of the International Conference on Population and Development,
para.para. 7.12-.26, U.N. Doc. A/CONF.I71/13 (1994).
\6\ One of the goals adopted in the Beijing Declaration is to:
``Ensure equal access to and equal treatment of women and men in
education and health care and enhance women's sexual and reproductive
health as well as education.'' Report at para. 30. ICESCR, Art. 12.2.
\7\ Physical integrity is embodied in the concept of security of
the person, recognized in the UDHR (Article 5) and ICCPR (Article 7).
---------------------------------------------------------------------------
While not affording abortion full status as an enforceable human
right, groundbreaking progress on the abortion issue was made at the
Cairo and Beijing conferences.
The Cairo Programme of Action recognizes that unsafe abortion is a
major public health issue and urges that in locations where it is
legal, abortion should be safe.\8\
---------------------------------------------------------------------------
\8\ Report of the International Conference on Population and
Development, para. 8.25, U.N. Doc. A/CONF.171/13 (1994).
---------------------------------------------------------------------------
The Beijing Platform of Action goes even further, urging countries
to ``consider reviewing laws containing punitive measures against women
who have undergone illegal abortions'' and calling for ``research to
understand and better address the determinants and consequences'' of
unsafe abortion. Beijing Platform for Action para. 106(k); 109(i).
Although the platforms are only incremental steps toward universal
norms on legal abortion, the Cairo and Beijing conference reports are
normative documents that have been endorsed by 180 countries, including
the United States.
The Cairo and Beijing documents thus create measures by which U.S.-
based human rights organizations, in coalition with foreign NGOs, can
hold governments accountable through monitoring and reporting. The
Global Gag Rule, however, prohibits (or at least chills) hundreds of
the most influential NGOs in the reproductive health field, active in
dozens of countries, from engaging in advocacy related to
implementation or monitoring of the abortion provisions of these
agreements.
Over 1500 NGOs from 180 countries participated in the Cairo
conference, and the robust debate made possible by their wealth of
knowledge and their vigorous advocacy was instrumental in the
recognition of reproductive rights as human rights, and in the adoption
of the statements on abortion described above. Many of these NGOs could
not have engaged in open discussion of the abortion issue (except
pejoratively) in 1993 or 1994 had the Global Gag Rule been in effect.
In addition to preventing those organizations from direct participation
and advocacy, the loss of information that they possessed would have
limited the advocacy of many other NGOs.
Precluding organizations from creating coalitions and networks with
strategic NGOs in the countries affected by the Global Gag Rule for the
purpose of monitoring the Cairo and Beijing agreements significantly
devalues these agreements as normative documents.
The current period is a critical one in history for the advocacy of
reproductive rights as human rights, including the right to abortion.
The gains made throughout the 1990s and the worldwide attention
resulting from the Cairo and Beijing Conferences and their five-year
reviews all show that momentum is building behind the efforts of the
transnational coalitions to give international legal protection to
abortion. As a result, censorship by the United States of an important
piece of this advocacy will likely have a devastating impact.
THE IMPORTANCE OF ASSOCIATIONS AMONG NGOS
Human rights law reform advocates will be significantly hampered in
achieving their goal of recognition of reproductive rights, including
the right to abortion, as human rights, if they cannot obtain
information and persuasive evidence from, speak for purposes of
persuasion to, and otherwise work with the NGOs affected by the law
reform gag.
The importance to the human rights movement of the ability of NGOs
to associate with, communicate freely with, and exchange information
with one another cannot be overestimated. Perhaps the most important of
these associations are those between international NGOs and local
(national or regional) organizations. These partnerships are the
cornerstone of effective human rights advocacy. Indeed, I am aware of
no instance, and do not believe it would be possible, for an
international NGO (or indeed any NGO working in a country that is not
its base of operations) working alone to have a significant impact at
the national level. Progress in changing national laws and ensuring
compliance with international norms through monitoring and exposing
abuses depends on the work of local NGOs.
Human rights advances and law compliance would likely not occur if
dependent solely on a government's initiative. The resources of NGOs
are limited, however, and to be effective advocacy strategies must be
strategic.
International human rights groups that have technical expertise and
the freedom and resources to operate across borders must rely on local
NGOs (such as those subject to the law reform gag) who provide the
knowledge of the local politics, the local law and the local people
suffering from abuses. Successful political advocacy and change needs
the association of these two together. The international groups bring
external public opinion to bear, can have free access to the press, and
can usually be freer in monitoring and publicizing a dangerous
situation than a local entity which might be afraid to do so.
In many countries it is forbidden for a non-citizen to set up an
NGO. Therefore, international groups must operate in conjunction with
local NGOs in order to effect political change.
For example, HRW works extensively in coalition with strategic
local NGOs and could not have furthered its mission of implementing and
monitoring the ICCPR without these critical associations. I cannot
imagine how different the state of human rights around the world would
be today if hundreds of NGOs relevant to HRW campaigns had been
censored over the past twenty years.
My experience provides many examples both within the United States
and abroad that illustrate the importance to NGOs of the ability to
work in association with one another. It was critical for the ACLU to
work in association with other like-minded religious or civil rights
groups toward the realization of many civil rights and liberties goals.
In fact, it was only by such political associations that the movements
for racial equality and women's rights were successful.
In 1991, leaders of several other NGOs and I launched an NGO-
centered movement that advocated for a treaty on landmines. The
landmine campaigns garnered influential and wide support only when HRW
and Physicians for Human Rights, working with an NGO treating victims
of landmines in Cambodia, published our first human rights report on
the issue highlighting the plight of the victims. This humanitarian
NGO, which gave prostheses to victims, received funds from the Unites
States Government. If there had been censorship of organizations that
dealt with these victims of land mines, as there is with the law reform
gag as to the harmful effects of illegal abortion, the landmine treaty
might not exist today, and its adoption would certainly have been
significantly retarded. Effective advocacy was only possible through
unimpeded access to the victims of the mines.
In Argentina, the Center for Legal and Social Studies monitored
torture and worked with torture victims. HRW was able to work with the
Center to publicize the problem, and the effectiveness of the campaign
helped lead to the end of the military government in Argentina. The
campaign also affected United States policy because it resulted in
human rights conditions on U.S. assistance to Argentina. It was only
through the unfettered association between HRW and this particular NGO,
the only one with the necessary information and access to victims of
torture, that these changes were possible.
In Chile, a Roman Catholic organization, the Vicaria de la
Solidaridad, also documented torture. This NGO was the main source for
HRW to document these human rights abuses. Although unable to influence
the Pinochet government directly, the Vicaria and HRW were very
effective in bringing about reform by getting the U.S. government to
bring pressure on the Chilean government. If the U.S. government had
censored Vicaria, severe human rights abuses in Chile may have
persisted much longer. In both Argentina and Chile, effective advocacy
was dependent on HRW's ability to work with those NGOs.
In my experience, it is frequently the case that only one NGO in a
particular country has gathered the human rights information needed by
the international human rights movement to bring effective pressure
against abuses in that country. Frequently, there is only one such
group in a country or only one group may have the nationwide structure
and the trust required to gather information. The proliferation of NGOs
in the United States is not matched in most other countries. Especially
in former communist countries or other states that experienced
authoritarian rule, NGOs were forbidden or severely harassed and it is
often the case that only a single group has subsequently emerged as a
reliable source of human rights information. An example is Yugoslavia
which only ended the authoritarian rule of Slobodan Milosevic in
October 2000. A single group, the Humanitarian Law Center, has been the
indispensable source of human rights information in that country. If it
were silenced, no other group could have provided reliable human rights
information.
Thus, in the time of globalization, and international agreements on
many issues such as land mines, endangered species, environmental
issues, and global warming, it is essential that political advocacy be
protected without respect to national borders. Indeed, the United
States has endorsed this principle by its ratification of Article 19 of
the ICCPR, which explicitly protects freedom of expression and the
freedom to gather and disseminate information regardless of frontiers.
THE GLOBAL GAG RULE CENSORS INFORMATION CRITICAL TO PERSUADING U.S.
POLICYMAKERS
The United States holds a unique position among all other nations.
Because of its power and resources, policy decisions by the U.S. often
have worldwide impact. The United States is also responsible for a
significant amount of the foreign assistance provided to developing
nations. Decisions affecting these appropriations affect numerous
governments, NGOs and individuals.
The United States is also influential within the international
community on human rights issues. It has endorsed many of the
significant human rights agreements, and has thereby obligated itself
to monitor compliance both within its borders and in other countries.
This is also required by many U.S. laws including Section 502B of the
Foreign Assistance Act. The Global Gag Rule notwithstanding, several
provisions of United States law condition foreign assistance on
compliance by recipient countries with human rights norms, including
free speech and political association. In addition to Section 502B of
the Foreign Assistance Act, see Section 701 of the International
Financial Institutions Act of 1977 (22 USC 262g).
The United States is also a participant at all major international
United Nations sponsored conferences, and can bring significant
influence to bear on the drafting and negotiating process of human
rights documents.
Although influential in the arena of human rights, the United
States does not often take a leading role in the adoption of human
rights norms. It is usually only after significant international
support has been demonstrated that the United States endorses human
rights agreements. For example, the United States was one of the last
developed countries to ratify the ICCPR, and the United States is one
of only a handful of nations that has not yet ratified the Convention
on the Elimination of All Forms of Discrimination Against Women.
The ability of U.S. NGOs to work directly with foreign NGOs is
central to human rights advocacy directed at the U.S. government. The
most effective way to shape U.S. foreign policy on human rights is to
bring people from the affected countries to provide firsthand
information. In my experience at HRW, bringing the victims of abuses
and representatives from foreign NGOs to talk to members of Congress,
the State Department and the National Security Council was exceedingly
effective. Direct exposure to FNGOs and the witnesses and victims to
whom they have access continues to be a critical component of the U.S.
advocacy of many U.S. human rights organizations.
I have seen many times how foreign NGOs can affect United States
policy. When the Yugoslavian government shut down a foundation funded
in that country by OSI, we brought members of this NGO to Washington,
D.C., to educate U.S. policymakers. As a result, then Vice President Al
Gore issued a statement critical of the closure, and the following day
the foreign minister of Yugoslavia informed the NGO it would be
reopened.
Similarly, the most effective strategy that OSI has found for
bringing attention to human rights abuses in Belarus, Kosovo and Bosnia
was to bring representatives of NGOs from those regions to Washington.
In striking contrast is the experience of South African activists
who came to Washington during apartheid. Under South African law at
that time, citizens of that country were prohibited from speaking in
favor of sanctions aimed at eliminating apartheid. When these activists
met with members of Congress, they could not advocate for sanctions
because to do so would put them at risk of severe criminal penalties.
The Global Gag Rule affects many aspects of United States policy,
and, therefore, advocacy on these issues by domestic and foreign NGOs.
For example, due to the gag, human rights organizations are prevented
from bringing representatives of gagged NGOs to brief members of
Congress about the pernicious effect of the gag itself without first
having to obtain explicit permission from government attorneys. As a
result, NGOs with the most relevant information about the effects of
the law reform gag may not provide it to Congress without jeopardizing
essential funding. In my experience, this will impede, and possibly
prevent, efforts by organizations to repeal the Global Gag Rule and to
pass the Global Democracy Promotion Act.
Information in the possession of foreign NGOs is also relevant to
congressional deliberations as to the amount and scope of funding for
both USAID and UNFPA. As noted, both the Cairo and Beijing documents
recognize unsafe abortion as a major public health threat. Limiting
advocacy in Congress to information about this issue from U.S.-based
NGOs results in an incomplete picture as to how appropriated funds may
be put to best advantage to improve reproductive health in recipient
countries.
The United States has an independent obligation to monitor and
promote compliance with the agreements it has adopted both within the
U.S. and in other countries. The Global Gag Rule interferes with this
obligation in two ways. First, by restricting speech in other
countries, it undermines freedom of expression, a right expressly
recognized in the UDHR and ICCPR. Second, by limiting discussion and
the free flow of information, the gag limits the ability of the United
States to monitor compliance by other countries with agreements such as
Cairo and Beijing.
Human rights are by definition global, or universal. The political
advocacy of NGOs working on human rights issues, such as reproductive
rights, is therefore, by definition, global. Organizations cannot
engage in necessary political speech, nor engage in effective political
advocacy, without unfettered associations and communications with
foreign NGOs affected by the Global Gag Rule. In order to truly
effectuate the constitutional guarantees that ensure full debate and
consideration of important political issues, these extraterritorial
associations and communications must be afforded the highest
protection.
THE GLOBAL DEMOCRACY PROMOTION ACT ENSURES RESPECT FOR HUMAN RIGHTS
The Global Democracy Promotion Act's main purpose is to ensure that
U.S. foreign policy is consistent with fundamental human rights values,
including medical ethics and practice, as well as freedom of speech. It
prevents the imposition of requirements that are unconstitutional or
untenable as a matter of policy here in the U.S. from being exported as
a matter of U.S. foreign policy. The bill has two main provisions.
The first provision of the Global Democracy Promotion Act provides
that foreign NGOs cannot be denied funding based on the medical
services they provide with their own funds, including counseling and
referral services. As a fundamental principle of medical ethics and
heath care practice, health care providers in the United States are
expected to supply patients with all of the information they need to
make appropriate decisions about their health care. In the United
States it would be considered an intolerable intrusion into the health
care provider/patient relationship if the government were to determine
what information providers can or cannot give to their patients.
Requiring foreign health care providers to withhold critical medical
information from their patients as a condition of receiving U.S.
assistance constitutes unjustifiable interference by the U.S.
government into the delivery of health care in other countries.
Conditioning the eligibility for U.S. assistance on a foreign NGO's
willingness give up providing, with its own funds, the legal medical
services it deems appropriate for its own patients demonstrates a
disregard and disrespect for the ability of independent organizations
to serve the critical heath care needs of their fellow citizens. The
Global Democracy Promotion Act would ensure that such restrictions are
abolished.
The second provision of the Global Democracy Promotion Act provides
that foreign NGOs, as a condition of eligibility for U.S. development
assistance, cannot be forced to sacrifice their right to use their own
funds to engage in free speech and assembly activities any more than
U.S.-based groups are asked to do.
Furthermore, conditioning the receipt of federal funds upon the
sacrifice of the constitutionally-protected ``right of the people to
peaceably assemble and to petition the government for a redress of
grievances'' (First Amendment to the U.S. Constitution) is itself
unconstitutional where U.S. citizens are concerned. Exporting a policy
that is an violation of both the U.S. Constitution and internationally-
recognized human rights is contrary to the great weight of U.S. foreign
policy in support of such rights.
A principal goal of U.S. foreign policy is the promotion of
democracy. To this end, supporting--as opposed to hindering--the
ability of foreign organizations to use their non-U.S. funds to engage
in advocacy--regardless of the subject or point of view--is essential
to nurturing an independent and politically active civil society. The
Global Democracy Promotion Act would ensure that freedom of speech and
the support of democracy are restored as fundamental tenets of U.S.
foreign policy.
CONCLUSION
With this testimony, I have outlined the importance of freedom of
speech and association of human rights advocacy organizations to the
evolution of international human rights law. The significance of these
fundamental freedoms underscores the necessity of overturning the
Global Gag Rule. I strongly urge your support of the Global Democracy
Promotion Act of 2001, appreciate your kind attention to my testimony
and your thoughtful consideration of these critical matters.
Senator Boxer. Thank you very much. I have a couple of
questions, and then I have a one o'clock meeting that I must
attend.
First let me start off by saying that each of you, I
thought, was terrific in terms of presenting your point of
view. In the case of Dr. Eberstadt, an interesting question for
us all, which is the practical effect of this. I just disagree
with him that it's theater. I think it's lives, and I think we
saw very much a little girl here and what we're talking about.
I want to pick up, Mr. Neier, on your point about the
Americans being impacted. I want to ask you a question because
I really don't have the answer at this point, and I'm looking
for the answer. If an American is working in Peru let's say for
Ms. Galdos' organization or working in Nepal for Dr. Bista or
in Bangladesh with the organization Dr. Pellegrom talked about,
is that American gagged?
Mr. Neier. I would say yes on the ground that the
prohibition applies to the organization. If the person is
acting on behalf of the organization, it would be a violation
for the organization to have an American or anyone else who is
working for it provide information on the availability or the
benefits of abortion.
Senator Boxer. So then this gag rule takes away freedom of
speech from American citizens who would be working abroad, not
by the country in which they are serving, their duty if they
feel it is such, but by the American Government.
Mr. Neier. Yes. My foundation funds many Americans to work
in non-governmental organizations in other countries. We
support internship programs of various sorts, and any of those
interns or any of the people we support, if they were working
for an organization receiving U.S. family planning funds, those
persons would be barred from this activity.
Senator Boxer. Well, I would be really interested to see a
legal matter on whether or not our freedom of speech by our
Government can be taken away by virtue of the fact that we have
to get on a plane and go somewhere else. I just raise that. I
think it is an interesting question.
Let me switch to Dr. Pellegrom here. You mentioned sadly
that another organization in addition to the one we heard about
today is refusing to take USAID funds because they don't want
to be gagged on what they can do in their own country. Do you
know how much we are talking about in terms of dollars? You
said you are going to try very hard to make up those dollars.
Do you know in this case what we are talking about here?
Dr. Pellegrom. It is in the vicinity of a million dollars a
year for that particular organization, and it is three million
women who are served in that particular instance.
Senator Boxer. Well, then I would love to know if you could
help us to find, and maybe some of our other witnesses can as
well, with that million dollars, the family planning services
that could have been given to these women and for how long a
period because I think we need to quantify because I think Dr.
Eberstadt makes a good point, that we don't have the
quantification of this issue. And I think if this organization
were not to get the million dollars, and even if they did, even
if we said no to the gag rule, the fact of the matter is I am
not sure--what happens is, if you replace the million, then
that is a million they can't use for additional contraceptive
help for women. If you could please get us that information and
send a copy to Dr. Eberstadt so he can try to put that in his
math equation as real people being denied real service and what
that means. We would appreciate it.
Ms. Cleaver, you represent very eloquently the U.S.
Conference of Catholic Bishops. I have seen you many times
doing the best job that a human being could do for them, so I
am complimenting you on that.
Do you know if the Conference of Catholic Bishops supports
contraception.
Ms. Cleaver. Well, Senator Boxer, the position of the
Catholic Church with regard to contraception is very clear and
very well-known, artificial contraception.
Senator Boxer. Well, I don't know, so perhaps you can
enlighten me because it may have changed from when I was paying
attention to it.
Ms. Cleaver. Well, that's also one of the doctrines of the
Catholic Church. We don't change very often, and for a long
time it has been the belief and the doctrine of the Catholic
Church that artificial contraception is not something that
adherents to the Catholic Church may do licitly.
Senator Boxer. Artificial you mentioned. Let me be clear.
In other words, that is not contraception. I mean, if you say
the rhythm method, that is not contraception because it does
not really work a lot of the time, so I mean--so the U.S.
Conference of Catholic Bishops does not believe in family
planning other than telling women a certain time of the month
you should abstain from activity; is that accurate?
Ms. Cleaver. Well, definitely family planning, I'm
guessing, in your book would include abortion, and the Catholic
Church's book does not include either abortion----
Senator Boxer. No, no, time out.
Ms. Cleaver [continuing]. Or artificial contraception.
Senator Boxer. Time out. I don't tell you what you believe,
and you don't tell me what I believe. I do not believe abortion
is family planning, so don't tell me that I do. I view it as
something that is available for a woman in the face of a
crisis, and it is between her God and her doctor and her family
and her conscience and her morality and all of that. It is not
family planning. It is a failure, a failure of family planning.
So let's start from scratch and let's start over.
The U.S. Conference of Catholic Bishops opposes then any
type of contraceptive devices that a woman might use; is that
correct?
Ms. Cleaver. We don't publicly oppose artificial
contraception. It is a doctrine that our adherents are asked to
follow. It is a religious doctrine for Catholics. We take no
position----
Senator Boxer. I am trying to understand this.
Ms. Cleaver. I am sorry, but I am trying to help answer
your question.
Senator Boxer. So in other words, do you support outside of
the rhythm method, let's put that aside, do you support any
other means of contraception such as a diaphragm, women having
a diaphragm?
Ms. Cleaver. And I would have to ask you for further
clarification. As a matter of public policy, public funding or
as a matter of religious belief or Catholic adherence, because
the answer would be different in those questions?
So, as a matter of Catholic belief, the Church does not
support artificial contraception of any nature. We support--you
are calling it the rhythm method what we call natural family
planning. It does have to do with following the natural rhythms
of your body. But we do not oppose it as a matter of public
policy.
Senator Boxer. OK, that is important. So you support family
planning around the world?
Ms. Cleaver. I say we don't oppose it as a matter of public
policy.
Senator Boxer. So you don't support it?
Ms. Cleaver. We have long taken the position that when
family planning programs overseas are expanded to include the
use of abortion----
Senator Boxer. I'm not talking about abortion.
Ms. Cleaver. Well, that is what the hearing is about. That
is what I am here to testify to today, the Catholic Church's
position with regard to the Mexico City Policy, and the Mexico
City Policy simply clarifies the distinction between family
planning funding and abortion.
Senator Boxer. Well, let me reiterate. No U.S. funds since
1973 have been able to be used for abortion, abortion
counseling, abortion services overseas, so that is not at all
what we are talking about here today. It may be what you are
talking about, but it is not what this committee is talking
about. We are talking about the Mexico City gag rule.
So publicly--I am really confused. You don't oppose or
support family planning. You oppose abortion, but you do not
either support or oppose family planning other than that you
support--how do you phrase the rhythm method?
Ms. Cleaver. But otherwise, we don't support family
planning.
Senator Boxer. OK, let me move on. Do you support, not you
personally, the organization, any exceptions to your anti-
abortion policy? For rape or incest, for example, do you
support exceptions for rape or incest as an organization?
Ms. Cleaver. The position of the Catholic Church on this
also is well-known, and I will restate it for you.
Senator Boxer. Well, ma'am, I just asked you--honestly, if
I knew the answer, I wouldn't--I have a meeting at one, so just
tell me yes or no.
Ms. Cleaver. The Catholic Church never finds it licit to
intentionally kill anyone.
Senator Boxer. Never finds it what?
Ms. Cleaver. Licit, licit.
Senator Boxer. Licit?
Ms. Cleaver. A licit act to intentionally kill innocent
human life of any sort.
Senator Boxer. Do you support an exception to your anti-
abortion policy for rape or incest; yes or no?
Ms. Cleaver. No.
Senator Boxer. OK. Do you support exceptions for life of
the mother; yes or no?
Ms. Cleaver. Not as stated. That is a more complicated
question. The casual way of talking about saving a mother's
life when an abortion threatens her life is known as life of
the mother, and that is a casual reference to it.
What is a more precise reference to it is the notion of the
doctrine of double effect whereas, if a doctor is required to
undertake an action to save a woman's life and the unintended
but necessary result of that is the death of an unborn child,
then that is a licit undertaking. It is the principle of the
double effect. You see it at the end of life as well where, if
you, unintending to hasten the death of someone, you increase
the morphine and your intent--it all has to do with intent, so
it is never--the Catholic Church never believes it is
appropriate to intend to kill innocent human life. If it is the
unfortunate but necessary result to save the life of a mother--
that's why life of a mother, as stated, we wouldn't say it is
OK to undergo an abortion if any exception. We would say if
that is the necessary result----
Senator Boxer. But if that is an unintended consequence of
trying to save a woman's life?
Ms. Cleaver. Correct.
Senator Boxer. The reason I am asking you these questions
is not in any way a theological exercise or to put you in a
difficult position, which I don't think you feel that you are
in any case because you must believe these things and support
these things.
But it is because I do believe, despite Dr. Eberstadt's
mathematical presentation that we cannot really decide one way
or the other, I believe as a thinking person that, if a woman
in Nepal can no longer walk into Dr. Bista's clinic to get
contraception because he has closed his clinic because he is
out there defending little girls like this who go to jail
because they were raped--I don't even want to get into whether
we think--I'm not going to go there.
The fine line is I think you are going to see more
abortions. That is my belief. And because I do not believe
abortion is family planning, but instead it is an end result of
the failure of family planning and because I want to stop these
78,000 illegal abortions which the professor here says is
66,000, so we will pick something in the middle, I believe the
Mexico City gag rule, this global gag rule, is not only a
violation of democracy and freedom and a slap at women around
the world, but I think it will lead to more abortion, and that
is why I am so confused and appalled that the people who say
they are against abortion will come out in favor of this.
I also think it is very interesting that the Catholic
Conference today chooses to support the gag rule when there is
no exception for rape and incest. I think you ought to, being
intellectually honest, you ought to take a look at that.
But, bottom line, I think that today's hearing has been
very instructive. To me, the most moving testimony is from the
people on the ground. The most moving part of this hearing
perhaps is the fact a woman had to go to court to be able to
testify here today. And I know that we have had a very
carefully balanced presentation with the witnesses, which is
the way we do things here in this committee. Senator Helms and
others who oppose me on this had every right to have the
witnesses they wanted. I am pleased that you were able to be
here.
But I just want to, as one Senator, not speaking for anyone
else because no one else is here to speak on this, I want to
apologize to you, Ms. Galdos, I do, as a U.S. Senator under the
auspices of chairing this hearing, apologize that you had to go
to court to be able to speak to us today from your heart and
from your soul about what you are seeing happening in your
country and the fact that you have made a decision to be gagged
in order to provide whatever services that you can to your
people. It is moving to me. I am saddened deeply that in this
land of the free and home of the brave, that is what happened.
But you were able to speak.
When you walk out this door and the press comes up to you,
you can't speak to them. I apologize to you for that, but I
will carry on. I will speak to them, and I will speak for you.
Anita Lowey will speak for you. And Senator Chafee will speak
for you. And Senator Snowe will speak for you. We had five
partisan voices here. We will speak for you.
And to Dr. Bista, who had to close or may have to close his
clinic to go out and change a heinous law which puts 13-year-
old girls in jail, I apologize to you.
And to Dr. Pellegrom, who is going to have to escalate his
fund-raising activities away from other things to help clinics
in Bangladesh because they have informed him that they--I am
sorry. I am saddened. And all I want you to know is that I know
that this Senate does not agree with this President. I know it
because I have counted the votes and I have the votes,
Democrats and some Republicans, enough to overturn this.
Whether it will be overturned or not, I can't tell you. When we
have the votes to override a veto by this President, I don't
know, but your voices today, those of you who argued eloquently
for the overturning of this rule will be heard. You will be
heard, and you will not be forgotten indeed. And to the other
witnesses who came on the other side of the issue, I guarantee
your voices are heard, too. You have eloquent proponents, too,
in this Senate. And that is what our democracy is about, and I
guess that is where I will conclude.
I just want this democracy to happen in other countries. I
don't want people like Ms. Cleaver or you in Peru to be back. I
don't. I want you to go there to the Peruvian Government--right
on. No more abortions, no circumstances, it is your right, just
as much as I fight for Ms. Galdos to go before that body and
say you are killing women, you are hurting people and you are
hurting families.
That is all I want. I mean, this is the greatest country in
the world. I don't want us to take away these freedoms from
other people. I want us to share these freedoms, not take them
away. The debate was emotional. It was difficult. But you know
what? It's a debate that we have had with civility and dignity,
and I want to fight for that all across the world.
I want to thank you all for being here, and we stand
adjourned.
[Whereupon, at 12 noon, the committee adjourned, to
reconvene subject to the call of the Chair.]