The InterDependent

In recent legislation, two U.S. House of Representative committees have mounted an intense campaign against American aid for family planning internationally. Valerie DeFillipo has been on the front lines of this battle for more than three decades and in July she was named president of Americans for UNFPA, a nongovernmental citizens’ support group for the United Nations Population Fund.

Later this year, the world will reach a population of 7 billion, with pressure felt most in the poorest countries, home to many of the 215 million or more women who have no access to contraceptives or to family-planning education programs. Several hundred thousand women die annually in preventable pregnancy or related causes, often in unintended pregnancies.

"As the world is going to reach seven billion, there has never been a time when we've had as much opportunity or challenge to invest in women and girls," DeFillipo said in an interview. She hopes to "break the paradigm" of old, tired battlegrounds around these issues, working with a new executive director of the Population Fund, Babatunde Osotimehin, a former Nigerian health minister.

DeFillipo said that she hoped that her organization and the new leadership of the UNFPA could energize American backing for family planning globally, "to ensure that women are able to have safe deliveries, and every pregnancy is wanted."

"I hope that we can tap into that support so our government remains involved in the tradition of contributing to multilateral organizations," she said.

At the end of July, before adjourning for summer holidays, a House of Representatives subcommittee approved a draft bill that would cut off all United States contributions to the Population Fund beginning next year.

This year, the agency known as UNFPA from the initials of its former name, the UN Fund for Population Activities, received $40 million in American contributions. The same House subcommittee cut 25 percent of funds requested for all international reproductive health programs. The Obama administration had asked for $769 million; it was given a limit of $461 million, an analysis by Population Action International reported.

A policy called the global gag rule was also reinstated. It prevents any American family planning aid from going to any foreign nongovernmental organization that promotes or performs abortions, with few exceptions.

In developing countries, ironically, potentially unsafe fatal abortions are the last resort when family planning services are not available. DeFillipo points to a 2011 study by the Population Fund’s technical division, which concluded: "The loss of U.S. funding would have a tremendous negative effect on the lives of many women, men, and young people in the world's poorest nations. UNFPA estimates that with $50 million per year, 7,000 maternal and newborn deaths can be averted, 10,000 women afflicted by a fistula can have a surgical repair, and around 1 million couples can benefit from modern methods of family planning thus preventing unintended pregnancies and unsafe abortions."

Martine Perret/UN Photo

As the world fast approaches seven billion people, birth control programs become ever more important, especially among women and girls. Here, a mobile health clinic in Asulau, a village in the Ermera district of Timor Leste.

The Fund does not condone abortion as a form of birth control, but it does call for safe procedures where abortion is legal.

In part because of the controversies in the U.S. over abortion here and abroad, as well as the differences of opinion on promoting family planning internationally, the American support group for the Population Fund has never achieved the success of its counterpart at Unicef, the UN children’s fund, which raises millions of dollars annually to bolster the agency’s programs.

There is much work still to do to get the message to Americans about the Population Fund’s varied and successful programs worldwide.

In a 30-year career in reproductive health issues, Valerie DeFillipo served from 2009-2011 as a member of a steering committee for an initiative to strengthen U.S. leadership in reproductive health, led by the United Nations Foundation. She was also vice president for international health at Abt Associates, a research and program implementation organization in health, social and economic policies and international development. Before that, she was director of external affairs for the International Planned Parenthood Federation, based in London.

"There’s a whole reframing going on in talking about the world at seven billion -- the interrelated issues of reducing poverty and really working with young people for the future and insuring the reproductive health and rights of women," she said. "It is clear that we cannot reduce poverty
unless we invest in women and girls. Make family planning as an integral part of development, along with education and economic opportunities for women, and you’re going to unleash the potential of 50 percent of the population of the world that is now not at the level it should be, because of old inequities and patterns that need to be changed."

De Fillipo has seen what works and what doesn’t in introducing family planning in many societies where women and men have never known its benefits. "I think the programs that work the best are when you get the trained midwives out into the community, working with the women around safe pregnancy and delivery, and then using that entry point to also reach them about family planning," she said.

"We have to strengthen the primary health care system," she added. "Women and children depend on it. We need to make sure that the services are clustered and available as close to the community as possible."

Valerie DeFillipo, the new chief of Americans for UNFPA, a nonprofit citizens' support group for the United Nations Population Fund.

Asked about a lingering concern in donor nations, particularly in northern Europe, that promoting family planning in poor countries is tantamount to population control or runs counter to local cultures -- accusations virtually never heard from the poor women in developing countries who most need good reproductive health care, contraceptive advice and commodities -- DeFillipo said that Babatunde Osotimehin, the new Fund director, has an important role to play in countering qualms.

"This incredible opportunity of having an African leader for the first time is important at the Population Fund," she said. "I think if I can get enough opportunities for Dr. Babatunde to get out and speak in the United States, it’s going to be very difficult to talk about family planning as being imposed by Western feminists. An African former minister of health speaking about these issues can shatter some of those unfair and false barriers that have been out there."