You are hard pressed to find an American who thinks 529,000 women dying each year from preventable complications of pregnancy and childbirth is not a problem worth solving. Ask around and you'll find that while they may be overwhelmed, Americans do care that 14,000 people are newly infected every day with HIV. In fact, you can't find too many people in this country who object to widespread access to contraception and family planning for women in low-income countries as a way to help them escape poverty.
So it follows that every year, Congress allocates a U.S. contribution to UNFPA, essentially the United Nations women's health agency. But every year, the President withholds the money.
With all the public support for global women's health, you'd think a small annual donation ($34-50 million) for an organization that works to solve these problems would be generally supported by Americans. And it would be if Americans had ever heard of UNFPA. But most of them haven't. It's an agency with an unclear name (the United Nations Population Fund) and a difficult acronym under the auspices of the UN, which Americans have conflicted feelings about.
The Bush Administration uses that lack of knowledge to their benefit because if Americans knew our government withheld a contribution to an organization that provides women's health care and promotes the rights of women around the world, they'd be outraged.
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This week I'm in Mongolia visiting Dr. Dorj Munkhuu, who is one of three women Americans for UNFPA will be honoring in October. Dr. Munkhuu is an amazing force for the women of her country, particularly women from the nomadic herder families who have extremely limited access to health care. Mobile clinics in Mongolia are an absolute necessity in a country where the maternal mortality rate in rural areas is 380 per 100,000 live births verses 93 per 100,000 in the urban areas. (In the U.S. the overall rate is 45 per 100,000).
Dr. Munkhuu's work is an example of the kinds of initiatives that the U.S. does not help fund when the Administration withholds funds to UNFPA. She and women like her have been working for change within their communities for decades and whether the U.S. helps or not is dependent on the political winds and the person who wins our Presidential elections.
And so, we have a vested interest in our next President understanding these issues enough to know that you cannot address women's health or human rights in a vacuum, that they almost always develop alongside one another and that such change must come largely from within a society. You can't expect, for example, to reduce maternal mortality without elevating the value of women in a society when there is the opinion that it is easier and cheaper to get a new wife than to save the one who is hemorrhaging.
And while the United States might be able to directly help a country like, say, Mexico build a better health care system, our assistance might not be so welcome in a place like Iran, for example. But I think most Americans would agree that all women deserve health care and human rights, regardless of whether their present government is allied with the U.S. or not.
What we need is a serious discussion of the causes and consequences of women's health — no nation in the world can develop its economy (let alone democracy) while it excludes women from economic and political participation — and a sustained, long-term commitment from our leaders to assist the international programs that are already working.