Is Foreign Aid Too Fat?

The incoming chairwoman of the House Foreign Affairs Committee, Rep. Ileana Ros-Lehtinen (R-FL), said yesterday that the economy would be "foremost" in the decisions she makes regarding foreign assistance, and that she will trim the "fat" in existing aid programs. The current chair of the committee, Rep. Howard L. Berman (D-CA) said today that we have to make foreign aid more efficient and effective, regardless of the size of the budget. Depending on how you define "fat," we may have a bi-partisan consensus on our hands. It's that definition we have to be careful with -- it could translate into successful foreign aid reform, or it could cost those we intend to reach with our foreign assistance dollars their basic human rights, and women and girls their sexual and reproductive health.

"Fat" is not equivalent to funding. The foreign assistance budget makes up approximately one percent of the entire federal budget. Cutting foreign assistance wouldn't even dent our current deficit. It also will not strengthen national security, a stated concern of the incoming chairwoman. Foreign assistance is a critical component of effective diplomacy. There just is not much to gain, fiscally or politically, from cutting foreign aid. "Fat" can, however, refer to inefficient strategies and programs that cost money and bear little yield.

Both representatives agree we need to "shift our foreign aid focus from strategies that don't work" (Rep. Ros-Lehtinen) and "find out what works and stop funding what doesn't" (Rep. Berman). They also agree that aid programs should "reflect current realities and challenges and empower grassroots and civil society" (Rep. Ros-Lehtinen) and get the "money to people who need it" (Rep. Berman). Given these statements, we have some recommendations for the incoming chairwoman and her minority counterpart:
  • Completely eliminate funding for programs that exclusively teach Abstinence-Be Faithful (AB-only): AB-only programs have repeatedly proven to have no effect on HIV prevalence rates, to increase women's risk of HIV infection, and to ignore the realities of those most at risk of HIV. As Rep. Ros-Lehtinen says, we need to "shift our foreign aid focus from strategies that don't work." Abandoning AB-only programs would be a great first step.
  • Increase funding and support for voluntary family planning: There is a gross unmet need for family planning methods, including male and female condoms, in the world's poorest countries. Voluntary family planning allows women to plan and space their pregnancies, and raise and provide for healthy children. There is a vehement demonstrated demand for increased access to voluntary family planning, and health advocates and congressional leaders are calling for U.S. funding levels of at least $1 billion to meet it. Doing so would reflect "current realities and challenges" (an expressed concern of Rep. Ros-Lehtinen).
  • Integrate sexual and reproductive health services: Co-locating (or linking through seamless referral processes) necessary health services, such as maternal health, family planning, and HIV prevention, treatment, and care makes sense. If women can get related services in one place, it increases the likelihood they will access the services and will improve their and their families' health outlook. That gets the "money to people who need it."

We are encouraged and heartened that there will be a focus on foreign aid efficiency in the 112th Congress. We hope, however, that in our quest to lose weight, we don't compromise our global health.

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