Ask the Scholar
Document scope · 1 page
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory.
For page-specific OCR and visual context, open one of the page chats.
Scholar Source Context
Document identity
localId
41052005
label
[3/27/1996 - 9/27/2000] [Biomedical, Reproductive, and Surrogacy]
core
doc
dtoType
document
citationUrl
pageCount
1
Source metadata
id
41052005
sourceUrl
contentType
document
title
[3/27/1996 - 9/27/2000] [Biomedical, Reproductive, and Surrogacy]
citationUrl
collections
Presidential Electronic Mail from the Automated Records Management System (ARMS)
Automated Records Management System (ARMS) Email from the White House Office (WHO) Bucket
largeImageUrl
imageCount
1
hasImages
yes
source
import
hasTranscription
no
Source extras
naId
41052005
levelOfDescription
fileUnit
otherTitles
42-t-26444785-20130365F-016-002-2016
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
51e9fa6db64daf5a
ocrText
Withdrawal/Redaction Sheet
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001. email
SSN (Partial) (1 page)
12/17/1998
P6/b(6)
COLLECTION:
Clinton Presidential Records
Automated Records Management System
WHO (Biomedical, Reproductive, & Surrogacy)
OA/Box Number: 500000
FOLDER TITLE:
[3/27/1996 - 9/27/2000]
2013-0365-F
wr10696
RESTRICTION CODES
Presidential Records Act - 144 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information |(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office [(a)(2) of the PRA]
h(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRA|
an agency |(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information [(a)(4) of the PRA
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy |(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Julie E. Mason (MASON_J) (WHO)
CREATION DATE/TIME:27-MAR-1996 08:37:19.39
SUBJECT: fyi - summary of gang o'4 meeting
TO: Stuart Schear
(SCHEAR_S) (WHO)
READ:27-MAR-1996 08:51:27.22
TEXT:
PRINTER FONT 12_POINT_ROMAN
RE: SUMMARY OF 3/26 GANG OF 4 MEETING:
FR: MASON
Here is a brief outline of what was discussed/decided by Gang of
4.
1. RE: POTUS interviews with columnists.
Strategy:
Structure interviews around events, chosing the
columnists according to their
areas of
specialty.
examples:
EJ Dionne (4/3) re corporate
responsibility
Tom Friedman (early April) will preview
Japan/Russia trip
POTUS is interested in doing more off
-the
-record conversations
with these columnists. Suggestion: do these on deep background
with the caveat that they can come back to McCurry if they want
to quote POTUS on a specific thought.
2. RE: profiles, personality pieces on POTUS
Strategy: We should be using these -- free media blitz.
Dole is doing many of these
interviews, and so should we. We need to emphasize putting out
POTUS as
opposed to surrogates.
Baer suggested looking at POTUS' personal side (i.e.,
his mother's death).
Decision
was made wait until after Japan/Russia trip to really focus on
these
personal
interviews.
examples:
Todd Purdum, NYT (4/4) FYI: we're probably
putting Alison
Mitchell in the
interview too
3. RE: convention interview requests
We have a few (Chicago Tribune, Chicago Magazine). Mason will
organize and give to Joe Lockhart, do as written q
-and
-a.
4. RE: national tv interview requests
see notes on the attached list of requests.
Focus is on these interviews, post Japan/Russia trip (to be done
in this order):
1st CNN (Blitzer, Shipman, Dougherty) - use to frame the
next 6 weeks
2nd Lehrer NewsHour - key to a commencement address,
subject TBD
3rd Barbara Walters - for May
George mentioned the possibility of POTUS doing a quick 60
Minutes interview after the Japan/Russia trip looking back at the
past year (POTUS can make hits on the anti
-terrorism bill, etc.)
(continued)
Baer brought up POTUS doing Court TV's new series, "Court TV:
Kids & Teens" (or some similar title) in mid
-April to discuss tv
violence. We decided to have FLOTUS do this.
Ann Lewis /Baer will follow up.
Wolf has also pitched a POTUS interview with Inside Politics for
their ananniversary.
With weekend/morning shows, we will put POTUS on in the fall at a
few key, tactical moments.
5. RE: print interview requests
The Advocate -- decision was made to wait until we have a line on
gay marriages. We'll do interview in late July/early August, on
the advice of Sosnik. The interview will be done via written
qs
-and
-as. We will also offer Moss a 5 minute interview with
POTUS as photo op/opportunity to get clarification on writtten
answers.
see attached list of other pending print interview requests
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Elizabeth Drye ( CN=Elizabeth Drye/OU=OPD/O=EOP [ OPD ])
CREATION DATE/TIME: 9-JUN-1997 17:17:32.00
SUBJECT: unofficial Q&A
TO: Joshua Silverman ( CN=Joshua Silverman/OU=WHO/O=EOP @ EOP [ WHO ])
READ:UNKNOWN
CC: Laura Emmett ( CN=Laura Emmett/OU=WHO/O=EOP @ EOP [ WHO 1)
READ:UNKNOWN
CC: Elena Kagan ( CN=Elena Kagan/OU=OPD/O=EOP @ EOP [ OPD 1)
READ:UNKNOWN
TEXT:
Q.
Why is the Federal government getting involved? Shouldn't that
be left to the states?
A.
The federal government has the experience and expertise to
evaluate emerging technologies -- particularly biomedical technologies --
and ensure that the public is not put at risk. This is why, for example,
the Federal government has responsibility for ensuring the safety and
development of pharmaceuticals and medical devices.
Q.
But does the Constitution give the Federal government authority to ban
cloning?
A.
Under the Commerce Clause of the Constitution it is clear we
have authority to act. Cloning facilities, like reproductive health
facilities and biomedical research centers, would likely affect interstate
commerce in a number of ways -- for example, by acquiring equipment and
medical products from other states; by serving clients from other states;
by advertising accross state lines, and by sharing information and
research findings in a national arena.
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Rachel E. Levinson ( CN=Rachel E. Levinson/OU=OSTP/O=EOP [ OSTP 1)
CREATION DATE/TIME:31-JUL-1997 16:19:07.00
SUBJECT: Ehlers Cloning bill
TO: Lucia A. Wyman ( CN=Lucia A. Wyman/OU=WHO/O=EOP @ EOP [ WHO ])
READ:UNKNOWN
CC: Clifford J. Gabriel ( CN=Clifford J. Gabriel/OU=OSTP/O=EOP @ EOP [ OSTP ])
READ:UNKNOWN
TEXT:
H.R. 922 states that federal funds may not be used to conduct or support
any research that includes the use of human somatic cell nuclear transfer
technology to create an embryo. Our bill language would extend the
prohibition to the private sector and would prohibit somatic cell nuclear
transfer with the intent of introducing the product of that transfer into
a woman's womb or in any other way creating a human being. We stayed away
from the issue of embryo research, as did the National Bioethics Advisory
Commission. Our language is not perfect but does try to make clear a very
narrow scope so as not to impede biomedical and agricultural research.
The current Congressional ban on embryo research already covers Ehlers
scope. His vagueness is a source of concern to the biotech,
pharmaceutical and reproductive biology research communities.
I will fax you an article on the mark up.
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: [email protected]@INET@LNGTWY ([email protected]@INET@LNGTWY
[ UNKNOWN ])
CREATION DATE/TIME:17-NOV-1997 14:09:39.00
SUBJECT: NIH press release--NIH Office of Research on Women's Health Spo
TO: Sarah S. Knight@EOP ( Sarah S. Knight@EOP [ WHO ])
READ:UNKNOWN
TO: Barbara A. Menard@EOP ( Barbara A. Menard@EOP [ OMB ])
READ:UNKNOWN
TEXT:
National Institutes of Health
Office of the Director
For Release: November 13, 1997
Ellyn Pollack
301-402-1770
NIH Office of Research on Women's Health Sponsors National
Scientific Workshop
To Set the Agenda for Research on Women's Health for the
21st Century
BETHESDA, MD!The Office of Research at the National
Institutes of Health is sponsoring a public hearing and
scientific workshop on November 17-19, 1997, at the Bethesda
Marriott, 5151 Pooks Hill Road. This final meeting,
following a series of national meetings at regional sites,
will bring together more than 400 advocates, policymakers,
researchers, and other national leaders in women's health to
set the women's health research agenda for the 21st century.
"This meeting will commemorate recent attention to women's
health and provide multidisciplinary interaction between
women's health advocates and scientists to focus on a new
era in women's health research," says Dr. Vivian W. Pinn,
NIH Associate Director for Research on Women's Health and
Director of the Office of Research on Women's Health. "This
public hearing and scientific workshop can provide a
springboard for women's health research into the 21st
century."
A public hearing will be held from 1 p.m. to 6 p.m. on
Monday, November 17. More than 50 individuals representing
themselves or organizations interested in various aspects of
women's health and biomedical careers will present
testimony. The two-day workshop will begin at 8 a.m. on
Tuesday, November 18, and will focus on scientific advances
in women's health through plenary sessions, panel
discussions, and smaller working groups.
On Tuesday afternoon and Wednesday morning, participants
will break into 14 working groups. Each group will focus on
a different area of women's health, identify scientific
progress, and recommend future direction for research. The
groups will consider the following topics: alcohol and other
drug use, disorders and consequences; behavioral and social
science; bone and musculoskeletal disorders; cancer;
cardiovascular and pulmonary diseases; career issues for
women scientists; digestive diseases; immunity and
autoimmune diseases; mental disorders; neuroscience; oral
health; pharmacologic issues; reproductive issues; and
urologic and kidney conditions.
"Since the Office of Research on Women's Health was
established seven years ago," Dr. Pinn reflects, "it has
dedicated its efforts to building collaboration and
encouraging interaction among the scientific, health care
and public policy communities, as well as women's health
advocates, to improve women's health through biomedical and
behavioral research. The regional meetings have provided
the groundwork to make this a positive and productive
scientific workshop to help formulate a future focus for
women's health research. Participants in this meeting, in
accordance with the dramatic pace of progress in science,
will be building on the first national conference to set the
agenda for research on women's health, which was held in
Hunt Valley, Maryland in 1991. "
U.S. Senator Barbara A. Mikulski and U.S. Representative
Constance A. Morella will open the scientific workshop on
Tuesday morning. At a Tuesday evening reception, U.S.
Representative Louise M. Slaughter will speak on women's
health research. U.S. Representative Louis Stokes will
provide remarks on Wednesday afternoon. Audrey T. Haynes,
Deputy Assistant to the President and Director, White House
Office for Women's Initiatives and Outreach, will also
address the meeting. Other keynote speakers at the two-day
scientific workshop include Dr. Francis Collins, Director of
the National Human Genome Research Institute; Dr. Claude
Lenfant, Director of the National Heart, Lung & Blood
Institute; Dr. Richard Klausner, Director of the National
Cancer Institute; Bylle Avery, Founder of the National Black
Women's Health Project; Dr. Linda Villa-Kamaroff, Professor
at Northwestern University; and Dr. Antonia Novello, former
U.S. Surgeon General.
A press briefing will be held at 3:15 p.m. on Wednesday,
November 19. The two workshop cochairs, Dr. Donna Dean of
the National Institutes of Health and Dr. Marianne Legato of
Columbia University will provide a summary of the workshop
highlights, including recommendations from each working
group. Working group cochairs and task force members also
will be available to answer questions at the press briefing
and throughout the two-and-a-half-day program.
Beyond Hunt Valley: Research on Women's Health for the 21st
Century
PRELIMINARY AGENDA
November 17, 1997 PUBLIC HEARING
1-6 p.m.
Public Testimony
November 18, 1997 SCIENTIFIC WORKSHOP: Putting it All
Together: The Agenda for the 21st Century
8 a.m.
Opening Plenary Session:
Opening Remarks Dr. Vivian W. Pinn
Welcome Dr. Ruth L. Kirschstein
Remarks
The Honorable Barbara A.
Mikulski, U.S. Senate
The Honorable Constance A.
Morella, U.S. House of Representatives
Overview of Women's Health Research Dr. Vivian W. Pinn
10 a.m.
Keynote Address: Francis S. Collins,
M.D., Ph.D., Director, NHGRI
Genetics, Genomics, and Women's Health
Panel Discussion: Legal and Ethical Issues
John Fletcher, Ph.D.
Karen Rothenberg, J.D.
Robert Murray, Ph.D.
11 a.m.
Keynote Address: Claude Lenfant, M.D.,
Director, NHLBI
Heart Disease Research in Women: A Look
Back and a View to the Future
Remarks by Julie Buring, Sc.D. Research on
Women: An Investigator's View
12 noon Lunch: Richard D. Klausner, M.D., Director,
NCI, Speaker
The Cancer Program at the End of the 20th
Century
1:30 p.m.
Concurrent Working Groups
Alcohol and Other Drug Use
Disorders and Consequences
Behavioral and Social Science
Bone and Musculoskeletal Disorders
Cancer
Cardiovascular and Pulmonary Disease
Career Issues for Women Scientists
Digestive Diseases
Immunity/Autoimmune Diseases
Mental Disorders
Neuroscience
Oral Health
Pharmacologic Issues
Reproductive Issues
Urologic and Kidney Conditions
4:30 p.m.
Panel Discussion: Women's Health Research
Antonia C. Novello, M.D., M.P.H. Women and Research -
- Quo vadis?
Maureen Henderson, M.D., D.P.H. Beyond Hunt Valley:
Perspectives
Barbara Ross-Lee, D.O. Women's Health Research--
Implications for Education and Public Policy
Remarks by Audrey T. Haynes, Deputy Assistant to
the President and Director, White House Office
for Women's Initiatives and Outreach
6 p.m.
Networking Reception
The Honorable Louise M. Slaughter, U.S.
House of Representatives
November 19, 1997 -- SCIENTIFIC WORKSHOP (continued)
8 a.m.
Plenary Session:
Speaker: Lydia Villa-Kamaroff, Ph.D. Women
in Biomedical Careers
Remarks by Margaret Chesney, Ph.D. Women
and Health: Towards a New Paradigm
9 a.m.
Concurrent Working Groups Continue
12 noon Lunch: The Honorable Louis Stokes, U.S. House
of Representatives
Byllye Avery, Speaker Putting It All
Together
1:15 p.m.
Plenary Session: Presentation of Working Group
Reports
3 p.m. Closing Remarks and Adjournment
3:15 p.m.
Press Briefing
ATTACHMENT
1
ATT CREATION TIME/DATE: 0 00:00:00.00
TEXT:
RFC-822-headers:
Received: from conversion.pmdf.eop.gov by PMDF.EOP.GOV (PMDF V5.0-4 #6879)
id <[email protected]>; Mon, 17 Nov 1997 13:59:35 -0500 (EST)
Received: from storm.eop.gov (storm.eop.gov)
by PMDF.EOP.GOV (PMDF V5.0-4 #6879) id <[email protected]>; Mon,
17 Nov 1997 13:59:30 -0500 (EST)
Received: from list.nih.gov ([165.112.130.6])
by STORM.EOP.GOV (PMDF V5.1-7 #6879)
with ESMTP id <[email protected]>; Mon,
17 Nov 1997 13:59:09 -0500 (EST)
Received: from list.nih.gov (terrific.net.nih.gov [165.112.130.6])
by list.nih.gov (8.8.5/8.8.5) with ESMTP id NAA04995; Mon,
17 Nov 1997 13:56:18 -0500 (EST)
Received: from LIST.NIH.GOV by LIST.NIH.GOV (LISTSERV-TCP/IP release 1.8c)
with spool id 3416538 for [email protected]; Mon,
17 Nov 1997 13:55:49 -0500
Received: from imc.nih.gov (imc.nih.gov [128.231.90.85])
by list.nih.gov (8.8.5/8.8.5) with ESMTP id NAA04919 for
<[email protected]>; Mon, 17 Nov 1997 13:55:47 -0500 (EST)
Received: by imc.nih.gov with Internet Mail Service (5.0.1458.49)
id <XC0FH7JG>; Mon, 17 Nov 1997 13:55:49 -0500
X-Mailer: Internet Mail Service (5.0.1458.49)
X-Priority: I
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Jeffrey M. Smith ( CN=Jeffrey M. Smith/OU=OSTP/O=EOP [ OSTP ])
CREATION DATE/TIME:14-JAN-1998 16:31:38.00
SUBJECT:
TO: Michelle Crisci ( CN=Michelle Crisci/OU=WHO/O=EOP @ EOP [ WHO ])
READ:UNKNOWN
TO: Paul E. Begala ( CN=Paul E. Begala/OU=WHO/O=EOP @ EOP [ WHO )
READ:UNKNOWN
TO: Rahm I. Emanuel ( CN=Rahm I. Emanuel/OU=WHO/O=EOP @ EOP [ WHO 1)
READ:UNKNOWN
CC: Donald H. Gips ( CN=Donald H. Gips/O=OVP @ OVP [ UNKNOWN ])
READ:UNKNOWN
CC: Rachel E. Levinson ( CN=Rachel E. Levinson/OU=OSTP/O=EOP @ EOP [ OSTP ])
READ:UNKNOWN
CC: Holly L. Gwin ( CN=Holly L. Gwin/OU=OSTP/O=EOP @ EOP [ OSTP ])
READ:UNKNOWN
CC: John H. Gibbons ( CN=John H. Gibbons/OU=OSTP/O=EOP @ EOP [ OSTP ])
READ:UNKNOWN
TEXT:
Rahm -- per our recent conversation on cloning, you asked that we keep
you up-to-date...and also that we make sure Paul Begala is in the loop.
On Wednesday, January 14th, staff from OSTP, OVP, DPC, WH Counsel, and Leg
Affairs met with representatives of the Biotechnology Industry
Organization, the Pharmaceutical Research and Manufacturers of America and
the American Society for Reproductive Medicine. While the three groups
are not in complete agreement on legislative approaches to dealing with
cloning of human beings, they all expressed support for the intent of
President's draft bill to limit the prohibition to the use of cloning
technology to create a child. They appreciated the protection of other
biomedical and agricultural research, the &findings8 section and the
sunset clause.
The key issue now before us is that legislation to prevent cloning a human
being (using private funding) could well become a prime vehicle for
constraining embryo research in the near term and abortion in the long
term. The professional associations are trying to educate key Members of
Congress about the risk to biomedical research posed by broadly worded
legislation.
Following the briefing, EOP staff agreed to promptly produce an options
paper and map out a legislative strategy. We will work with input from
technical experts on the implications of each option, e.g., what we learn
from research, who are the affected parties in each option, possible
fallout, etc... This should be ready by Friday, January 16th.
We will keep you posted.
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Nicole R. Rabner ( CN=Nicole R. Rabner/OU=WHO/O=EOP [ WHO 1)
CREATION DATE/TIME:15-JUL-1998 14:45:42.00
SUBJECT:
TO: Katharine Button ( CN=Katharine Button/OU=WHO/O=EOP @ EOP [ WHO ])
READ:UNKNOWN
TEXT:
This is more than you need, and is at: http://www.plannedparenthood.org/
The 1910s
1916
Margaret Sanger and her sister, Ethel Byrne, both nurses, and a third
woman, Fania Mindell, open the first birth control clinic in America in the
Brownsville community of Brooklyn, New York. All three women are
arrested and indicted under New York State's 1873 "Comstock Law,"
which forbids the dissemination of birth control information.
The Comstock laws, named after Anthony Comstock, a self-appointed
anti-vice crusader, had been passed by Congress and by nearly every state
in the 1870s. Among other measures, they defined contraceptive information
and materials as obscene and forbade their dissemination throughout the
U.S. Sanger's arrest in Brooklyn is her second for violating a Comstock
law:
two years earlier she had been indicted under a federal Comstock statute
for
sending birth control information through the U.S. mails in her
publication,
THE WOMAN REBEL. Eventually, that indictment was dropped.
1917
Byrne is found guilty and sentenced to Blackwell's Island, where she holds
a
hunger and thirst strike and becomes the first woman to be force-fed in an
American prison. Mindell is found guilty and fined $50 for distributing
copies
of a pamphlet written by Sanger, called WHAT EVERY GIRL SHOULD
KNOW. Sanger is found guilty and, declining to pay a fine, serves 30 days
in the Queens County Penitentiary. She then appeals her conviction. Only
Mindell's conviction is later overturned.
1920
The 19th Amendment to the U.S. Constitution is ratified -- women win the
right to vote.
1930
Almost 100 national, regional, and local groups in the fields of medicine,
education, and religion pass resolutions favoring birth control.
1935
The American Birth Control League holds a mass meeting at Carnegie Hall
in New York City, which draws protests from Cardinal Hayes. Thirteen
prominent ministers reply to Hayes in a statement that defends the ethical
and
moral significance of birth control.
1936
Judge Augustus Hand, writing for a U.S. Circuit Court of Appeals in the
case of U.S. V. ONE PACKAGE, rules that the U.S. Tariff Act of 1930,
which contains Comstock language, cannot be construed to forbid the
importing of contraceptives for use by physicians in saving lives or
promoting
well-being. Judge Hand bases his decision in part on clinical data
outlining
the dangers of pregnancy and the usefulness of contraception, saying that
if
this evidence had been available to Congress earlier, Congress would never
have defined birth control as obscene.
As a result of this ruling, the National Committee on Federal Legislation
for
Birth Control disbands, considering that its objectives have been
realized.
Sanger retires from the forefront of the family planning movement and moves
to Tucson, Arizona.
1937
The American Medical Association officially recognizes birth control as an
integral part of medical practice and education.
North Carolina becomes the first state to recognize birth control as a
public
health measure and to provide contraceptive services to indigent mothers
through its public health program.
1939
The American Birth Control League and the Clinical Research Bureau merge
to form the Birth Control Federation of America.
The 1940s
1940
The Connecticut Supreme Court of Errors upholds a state Comstock statute
that makes the use of contraceptives illegal and denies any exception to
allow prescription by physicians.
1942
Planned Parenthood Federation of America, Inc., is adopted as the new,
more comprehensive name for the Birth Control Federation of America.
Contraceptive services are available in 218 Planned Parenthood clinics
across the country.
1944
A U.S. Court of Appeals further liberalizes the Comstock laws by ruling, in
CONSUMERS UNION V. FRANK WALKER, that the Consumers Union
can mail to members who request it a pamphlet about contraceptives that
have been found to be effective.
1945
The Sanger Bureau establishes a fertility service to help childless
couples.
1947
Six Protestant physicians are dismissed from the staffs of three Roman
Catholic hospitals in Connecticut for refusing to withdraw from the
"Committee of 100," a group of doctors supporting a birth control bill that
would overturn the federal Comstock law.
1948
Largely as the result of Margaret Sanger's efforts, representatives from
more
than 20 nations attend the International Conference on Population and
World Resources in Relation to the Family. The conference leads to the
formation of the International Planned Parenthood Committee.
Dr. Gregory Pincus, a research biologist and cofounder of the innovative
Worcester Foundation for Experimental Biology, is awarded a small grant
from Planned Parenthood Federation of America to test the contraceptive
value of steroids.
The 1950s
1948
Dr. Gregory Pincus, a research biologist and cofounder of the innovative
Worcester Foundation for Experimental Biology, is awarded a small grant
from Planned Parenthood Federation of America to test the contraceptive
value of steroids.
1951
Showing that injections of the steroid progesterone suppress ovulation in
laboratory animals, Dr. Pincus persuades the Searle Company to undertake
extensive research aimed at developing a contraceptive injection or pill.
1952
The International Planned Parenthood Federation, the first truly
international
league representing worldwide advocates of family planning, is launched at
a
conference in Bombay. Planned Parenthood Federation of America is one of
the founding members.
1953
Katharine Dexter McCormick makes the first of many donations to Planned
Parenthood, totaling $2,000,000, toward the development of the oral
contraceptive.
1959
A presidential commission on foreign aid recommends that family planning
assistance be given to foreign governments that request it. Catholic
bishops
denounce the suggestion, and President Eisenhower turns it down.
The American Law Institute's Model Penal Code recommends that states
allow licensed physicians to perform abortions if two physicians certify in
writing that pregnancy threatens the woman's physical or mental health,
results from rape or incest, or if the fetus is gravely deformed.
Opposition to
such reform of the anti-abortion laws begins to take shape under the
leadership of the Catholic church.
1960
The Food and Drug Administration approves the sale of oral steroid pills
for
contraception.
1961
Distinguished citizens from 19 countries present a statement urging the
United Nations to help develop population limitation programs all over the
world.
President Kennedy defines population growth as a "staggering" problem. He
formally endorses reproductive research to make new knowledge and
methods available worldwide.
1962
The First International Conference on IUDs (intrauterine devices) is held
in
New York, leading to a major collaborative effort to evaluate the safety
and
effectiveness of IUDs, under the leadership of Dr. Christopher Tietze.
Hundreds of women in the U.S. and Europe who had taken the drug
thalidomide during pregnancy give birth to children missing arms and legs.
Sherri Finkbine is refused an abortion in the U.S. even though she, too,
had
been prescribed thalidomide. She flees to Sweden where an abortion is
performed and the fetus found to be gravely deformed. The Finkbine case,
and others in which pregnant women had taken thalidomide, convinces much
of the public of the need to reform anti-abortion laws.
1963
The U.N. General Assembly approves by a 690 vote a resolution on
population growth and economic development.
Congress amends the foreign aid bill to authorize funds for research into
problems of population growth.
The U.S. government establishes the National Institute of Child Health and
Human Development (NICHD). Part of its mandate is to support and
oversee research in reproductive science and contraceptive development.
1964
The Office of Economic Opportunity funds the first project grant for family
planning to the city of Corpus Christi, Texas.
A rubella epidemic causes a high incidence of fetal deformity. The
epidemic,
combined with the thalidomide tragedy, the Finkbine case, a growing public
desire for openness about sexuality, and the affirmation of women's rights,
helps to persuade the public to recognize the need for legal and safe
abortion.
1965
The U.S. Supreme Court in the case of GRISWOLD V. CONNECTICUT
rules that Connecticut's law prohibiting the use of birth control by
married
couples violates a newly defined right of marital privacy. As a result, ten
states liberalize their family planning laws and begin to provide family
planning services with tax funds.
Congress amends the Social Security Act to authorize special grants for
maternal and infant care projects, including family planning.
The amendment to the Social Security Act known as Title XIX establishes
the Medicaid program, under which states may treat family planning as a
reimbursable service.
The Department of Health, Education, and Welfare begins to fund maternity
care projects that enable some states to provide family planning services
through their own health departments.
1966
As a central element of his administration's War on Poverty, President
Johnson singles out family planning as one of four critical health
problems in
the nation needing special attention. To carry out his mandate, HEW
outlines
an expanded program for all requesting birth control.
The National Organization for Women is founded to secure full equality for
women by promoting passage of the Equal Rights Amendment and by
ending prejudice and discrimination against women in America.
Margaret Sanger dies in Tucson on September 6, eight days short of her
87th birthday.
photo, Martin Luther King, who equated the equal rights &
reproductive rights movements
1967
The United Nations Declaration on Population proclaims family planning a
basic human right and establishes the United Nations Fund for Population
Activities.
Amendments to the Social Security Act require that at least six percent of
the annual appropriations for maternal and child health be earmarked for
family planning and that family planning services be provided to public
assistance recipients who request them.
The Agency for International Development (AID) is authorized to provide
contraceptives in its overseas development programs.
Colorado reforms its abortion law to conform to American Law Institute
recommendations. Within the next three years, 13 other states also
liberalize
their anti-abortion laws.
1968
After an exhaustive review, the FDA issues a report stating that it has
found
"adequate scientific data attesting to the effectiveness and utility of
intrauterine contraceptive devices (IUDs)."
Pope Paul VI issues an encyclical affirming the church's traditional
prohibitions against "artificial" means of birth control, including the
Pill.
Planned Parenthood Federation of America establishes the Center for
Family Planning Program Development as its arm for research, policy
analysis, and public education. The center is now an independent
corporation and special affiliate of Planned Parenthood known as The Alan
Guttmacher Institute.
The Planned Parenthood membership approves policies that recognize
abortion and sterilization as legitimate medical procedures, the decision
for
which must rest with the individual and the individual's physician. The
membership calls for the abolition of existing criminal laws regarding
abortion, and the recognition that information, counseling, and referral
with
regard to abortion are integral elements of sound medical care.
1969
President Nixon delivers a message on population and family planning that
calls for increased federal support for domestic family planning services,
biomedical and social research, and foreign aid assistance. He requests the
appointment of a Commission on Population Growth and the American
Future to report on the U.S. population problem.
The National Association for the Repeal of Abortion Laws, now known as
the National Abortion and Reproductive Rights Action League, is founded to
develop and sustain a pro-choice political constituency in order to secure
and preserve the right to safe, legal abortion for all women.
1970
Congress enacts Title X of the Public Health Services Act, providing
support
and funding for family planning services and educational programs and for
biomedical and behavioral research in reproduction and contraceptive
development. Title X also authorizes funding for a Center for Population
Research within NICHD. This marks the first time Congress has ever voted
for a separate authorization of family planning services.
New York state enacts the most progressive abortion law in the nation,
permitting abortion through the 24th week of pregnancy if performed by a
licensed physician. Planned Parenthood of Syracuse, New York, becomes
the first affiliate to offer abortion services.
1971
Congress repeals most of the provisions of the federal Comstock laws.
Planned Parenthood Federation of America establishes its own international
program, Family Planning International Assistance (FPIA). Funded largely
by the U.S. Agency for International Development, within 15 years FPIA
becomes the largest U.S. non-governmental provider of family planning
services to million of women and men in developing countries.
The National Family Planning and Reproductive Health Association
(NFPRHA) is founded to serve as an umbrella organization for family
planning and reproductive health care providers and consumers.
1972
In EISENSTADT V. BAIRD, the U.S. Supreme Court strikes down a
Massachusetts statute that bars the distribution of contraceptives to
unmarried people.
The Committee on Population Growth and the American Future releases its
final report, stating that "no substantial benefits would result from
continued
growth of the nation's population" and recommending that the U.S.
"welcome and plan for a stabilized population." It outlines comprehensive
recommendations to achieve stabilization.
Over 2.5 million patients are served by U.S. family planning clinics, an
increase of 200 percent since 1968.
1973
In ROE V. WADE, the U.S. Supreme Court strikes down the 1859 Texas
law that prohibited abortions except to save a woman's life. The court
rules
that the constitutional right of privacy extends to a woman's decision, in
consultation with her doctor, to have an abortion.
On the same grounds, DOE V. BOLTON strikes down a 1968 abortion
reform statute in the state of Georgia that had prohibited abortions
except in
cases of medical necessity, rape, incest, and fetal abnormality, had
required
all abortions to be performed in hospitals, and had mandated the approval
of
two doctors and a committee before an abortion could be performed.
The National Right to Life Committee is organized by the U.S. Catholic
Conference's Family Life Division, which is administered by the National
Conference of Catholic Bishops. The express purpose of the committee is to
overturn these U.S. Supreme Court decisions, by constitutional amendment
if necessary. The legislation it supports would outlaw the most effective
forms of birth control as well as abortion.
Believing that reproductive freedom is intrinsically tied to religious
liberty, the
Religious Coalition for Abortion Rights and Catholics for a Free Choice,
are
founded to support the right to family planning and abortion.
1974
The United Nations World Population Conference, the first
government-sponsored conference on population, is held in Bucharest.
Attendees adopt the World Population Plan of Action, establishing voluntary
family planning as a basic human right, pledging to improve the status of
women worldwide, giving high priority to contraceptive research, and
recognizing that population policies and programs must be part of overall
social and economic development plans. Only the Vatican abstains from
voting to support the plan.
The Dalkon Shield IUD is found defective and withdrawn from the market.
Federal District Court Judge Gerhard A. Gesell enjoins the U.S. Department
of Health, Education, and Welfare (DHEW) from using federal funds for the
sterilization of minors and other persons who are legally incompetent to
give
informed and binding consent to the procedure. Revised regulations issued
by DHEW state that individuals are free to refuse sterilization without
prejudicing future care and without loss of other project or program
benefits.
1975
The results of a national study show that, among U.S. couples who have had
all the children they want, 43.1 percent are using sterilization as their
method
of birth control an increase of more than 300 percent in ten years.
1976
In PLANNED PARENTHOOD OF CENTRAL MISSOURI V.
DANFORTH, the U.S. Supreme Court strikes down state requirements for
parental and spousal consent for abortion and sets aside a state
prohibition
against saline abortions.
In BELLOTI V. BAIRD, the U.S. Supreme Court returns to the
Massachusetts courts a statute that requires a minor seeking an abortion to
first obtain the consent of both parents or a judge. The court asks the
Massachusetts Supreme Court to define more precisely the grounds on
which a judge could approve or deny an abortion to a minor (see entry for
1979).
Congress passes the "Hyde Amendment," which prohibits the use of federal
Medicaid funds for the abortions of indigent women while continuing to
allow
these funds to be used for pregnancy, delivery, and child care costs. The
amendment is enjoined by Federal District Court Judge John F. Dooling.
The Alan Guttmacher Institute (AGI) publishes 11 MILLION
TEENAGERS, the first nationally distributed document to focus attention on
the problem of teen pregnancy and childbearing in the United States.
The Republican Party adopts its first anti-choice platform. The Democratic
Party adopts its first pro-choice platform.
1977
In MAHER V. ROE and POELKER V. DOE, the U.S. Supreme Court finds
that state and local governments have the right to refuse to fund
nontherapeutic Medicaid abortions for the indigent and that localities may
refuse to provide "elective" abortions in publicly funded hospitals.
The U.S. Supreme Court vacates Judge Dooling's injunction against the
Hyde Amendment.
Congress passes a new version of the Hyde Amendment, and three dozen
states move to cut off their state Medicaid reimbursements.
In CAREY V. POPULATION SERVICES INTERNATIONAL, the U.S.
Supreme Court rules unconstitutional a New York statute that prohibited the
sale or distribution of contraceptives to persons under 16, the display and
advertising of contraceptives, and the sale of non-prescription methods
outside drugstores.
The National Abortion Federation is founded to ensure quality care in the
provision of safe and legal abortion by establishing standards, guidelines,
training, and education for providers of abortion services. NAF also
provides information that will allow women to obtain quality abortion
services.
The Alan Guttmacher Institute is separately incorporated as the first
independent agency devoted solely to research, policy analysis, and public
education in family planning and population.
Family Planning International Assistance serves hundreds of thousands of
contraceptive clients in 23 nations of the developing world.
1978
Congress passes a third version of the Hyde Amendment and adds
anti-abortion restrictions to a number of federally funded programs,
including
the Defense Department and the Peace Corps. Extending Title X funding for
three years, Congress expands the program to include community-based sex
education and other preventive services for teenagers at risk of
pregnancy.
The City of Akron, Ohio, passes a restrictive ordinance, requiring that
women seeking abortions undergo a 24-hour waiting period and an
elaborate "informed consent" procedure, including viewing of photographs of
fetal development and a recital of half-truths about the procedure and the
fetus. It also requires that minors obtain the consent of their parents or
a
judge and that second-trimester abortions be performed in hospitals.
1979
In BELLOTTI V. BAIRD (II), the U.S. Supreme Court finds that the
Massachusetts statute restricting minors' access to abortion is
unconstitutional as interpreted by the Massachusetts Supreme Court. The
U.S. Supreme Court rules that if states require minors to obtain parental
consent for an abortion, they must also give minors the alternative of
obtaining the consent of a judge, in confidential proceedings and without
first
notifying their parents.
In COLAUTTI V. FRANKLIN, the U.S. Supreme Court strikes down a
Pennsylvania law that requires a physician about to perform an abortion to
first determine whether the fetus "is or may be viable" on the grounds
that the
meaning of "viable" or "may be viable" is unclear. The court holds that the
determination of when a fetus is viable must be made by physicians on a
case-by-case basis.
The 1980s
1980
Federal reimbursement for medically necessary abortions under Medicaid is
reinstated after Judge Dooling rules in HARRIS V. McRAE that the Hyde
Amendment unconstitutionally deprives indigent women of their First and
Fifth Amendment rights by refusing to pay for medically necessary
abortions.
Five months later, the U.S. Supreme Court overturns the Dooling decision,
holding that the Hyde Amendment, by encouraging childbirth over abortion
except in the most urgent circumstances, is rationally related to the
legitimate
governmental objective of protecting potential life.
For the first time, a U.S. president with political commitments to the
anti-choice movement -- Ronald Reagan -- is elected to office. The
Republican party takes control of the Senate.
1981
One of President Reagan's first official actions is to congratulate
anti-abortion demonstrators on the occasion of the anniversary of ROE V.
WADE.
In H.L. V. MATHESON, the U.S. Supreme Court upholds a Utah statute
requiring a physician to notify the parents of an unemancipated, immature
minor before performing an abortion, in the absence of any proof that harm
would result to the minor if her parents were notified.
The administration urges folding the national family planning program
(Title
X) into a block grant. This would allow states not to offer subsidized
family
planning services but to use the funds for other programs. Congress defeats
this proposal and re-authorizes Title X as a categorical grant for three
more
years.
Hearings are held in the U.S. Senate on the so-called Human Life Bill.
This is
a bill that would seek to overturn Roe V. Wade by declaring that human life
begins at conception and awarding full constitutional rights to fetuses.
The Alan Guttmacher Institute (AGI) publishes TEENAGE PREGNANCY:
THE PROBLEM THAT HASN'T GONE AWAY, a definitive analysis of
teen sexuality, contraceptive knowledge and use, and pregnancy experience
that convincingly documents the need for making confidential contraceptive
services accessible to sexually active teens.
Family Planning International Assistance serves 921,582 contraceptive
clients in 36 nations of the developing world.
1982
Planned Parenthood Federation of America, the American Civil Liberties
Union, the National Abortion Rights Action League, the Religious Coalition
for Abortion Rights, and other pro-choice activists orchestrate major
victories by successfully lobbying against passage of the Hatch Human Life
Federalism Amendment and other proposed "Human Life Bills."
The Reagan administration defies Congress by issuing an administrative
regulation that orders the nation's 4,000 Title X-funded clinics to notify
parents when teens are issued prescription contraceptives. This regulation
becomes known as the "squeal rule."
1983
Challenges by family planning providers and by the state of New York lead
to decisions by three different Federal district courts overturning the
so-called "squeal rule." These decisions are affirmed by two Circuit Courts
of Appeal, and the Reagan administration does not appeal to the Supreme
Court.
In CITY OF AKRON V. AKRON CENTER FOR REPRODUCTIVE
HEALTH, the U.S. Supreme Court overturns the Akron ordinance (see
entry for 1978), reaffirming the basis of Roe V. Wade, establishing the
right
of women to obtain second-trimester abortions in outpatient facilities, and
protecting the confidentiality of minors who seek abortion.
In PLANNED PARENTHOOD OF KANSAS CITY, MISSOURI V.
ASHCROFT, the U.S. Supreme Court finds that states cannot require
hospitalization for abortions after the first trimester, but that states
can
require pathology tests after every abortion, parental consent with
judicial
bypass, and the presence of two doctors during abortions after the first
trimester.
In SIMOPOULOS V. VIRGINIA, the U.S. Supreme Court upholds a
conviction of a physician under a Virginia statute requiring abortions
after the
first trimester to be performed in hospitals. Since Virginia law provides
for
licensing of freestanding ambulatory facilities as "hospitals," the
Virginia law is
not as restrictive as the law struck down in PLANNED PARENTHOOD
OF KANSAS CITY the same year, and is therefore constitutional.
The high court, in BOLGER V. YOUNGS DRUG PRODUCTS CORP.,
also strikes down as unconstitutional the last vestige of the Comstock laws
by allowing unsolicited advertisements for contraceptives to be sent
through
the U.S. mail.
1984
The Reagan administration announces the "Mexico City policy," which will
bar most non-governmental foreign recipients of U.S. government family
planning funds from using non-U.S. government funds to support
"abortion-related activities."
The Food and Drug Administration approves the distribution of the Copper
T380A IUD, but no manufacturers or distributors are willing to make it
available to women in the U.S. Violent attacks on family planning and
abortion clinics escalate. While four incidents occurred in 1983, in 1984
30
major attacks are reported, including bombings, arson, and attempted
bombings and arson.
The death toll from AIDS (acquired immune deficiency syndrome) since
1981 rises to 3,665 Americans. The year ends with a total of 7,699
reported cases.
1985
The Mexico City policy goes into effect; Planned Parenthood Federation of
America announces its refusal to comply; International Planned Parenthood
Federation and the United Nations Fund for Population Activities are
defunded. U.S. funding for international family planning is cut by $40
million.
Anti-abortion riders that would effectively eliminate the Title X program
are
proposed by administration allies in Congress. They are defeated in a
last-minute compromise.
The Alan Guttmacher Institute (AGI) publishes its report on TEEN
PREGNANCY IN INDUSTRIALIZED COUNTRIES, demonstrating that
the U.S. teen pregnancy rate of 96 per 1,000 is the highest in the
developed
world. The study found that developed countries with the most accessible
contraceptive services, the most effective programs for sexuality
education,
and the most liberal societal attitudes toward sex, have the lowest rates
of
pregnancy, abortion, and childbearing among teens.
A two-year study by the National Academy of Sciences concurs with the
AGI study and concludes that "prevention of adolescent pregnancy should
have the highest priority," and "making contraceptive methods available and
accessible to those who are sexually active and encouraging them to
diligently use these methods is the surest major strategy for pregnancy
prevention."
Anti-family planning zealots launch a "Year of Pain and Fear." Targeted at
family planning and abortion clinics, an epidemic of firebombing,
vandalism,
burglary, death threats, and assault and battery breaks out.
1986
The risk of expensive product liability resulting from litigation leads
G.D.
Searle to withdraw its Copper 7 and Copper T IUDs from the market.
In THORNBURGH V. AMERICAN COLLEGE OF OBSTETRICIANS
AND GYNECOLOGISTS and in DIAMOND v. CHARLES, the U.S.
Supreme Court reaffirms a woman's constitutional right to abortion and
reverses state-imposed barriers to the free exercise of that right by
striking
down certain informed consent and reporting requirements, as well as
constraints regarding "post-viability abortions."
Also, in BABBITT V. PLANNED PARENTHOOD OF CENTRAL AND
NORTHERN ARIZONA, the high court affirms a Ninth Circuit Court
decision overturning an Arizona law prohibiting grants of state money for
family planning to organizations that provide abortion or abortion
counseling
and referral.
Planned Parenthood affiliate facilities in New York City; Kalamazoo,
Michigan; Kansas City, Missouri; and Cambridge and Worcester,
Massachusetts, are targets of arson, bombs, and other violent acts.
Planned Parenthood's international program, Family Planning International
Assistance, serves four million women and men in 41 developing countries,
becoming the largest non-government provider of family planning services to
women and men in the developing world.
1987
President Reagan proposes the "gag rule," for Title X-funded clinics,
similar
to the Mexico City policy, which forbids clinics from counseling a client
about abortion -- even if she specifically requests such information, and
even
if withholding the information would endanger her health.
Planned Parenthood Federation of America and other plaintiffs file a joint
lawsuit against the U.S. Agency for International Development (AID) in U.S.
District Court for the Southern District of New York to block
implementation of the Reagan administration's Mexico City policy.
In an unprecedented coalition effort, Planned Parenthood joins more than
250 civil rights, civil liberties, religious, labor, education, legal,
environmental,
health, and women's groups to successfully block the appointment of Judge
Robert Bork to the U.S. Supreme Court. Judge Bork, nominated by
President Reagan, holds restrictive views on freedom of speech and the
press and denies the constitutional right to privacy.
Plans for "Operation Rescue," an organization to martial ongoing nationwide
barricades against family planning and abortion clinics, are unveiled at
the
annual convention of the Pro-Life Action Network.
1988
Demographic figures reflect dramatic reductions in maternal and infant
deaths
and unwanted births since 1965, when contraception was legalized. These
health benefits result largely from Americans' shift to more effective
contraceptive methods that have become widely available. Since 1965, the
percentage of married contraceptors using more effective methods
(sterilization, the Pill, and the IUD, which have failure rates of three
percent
or less) more than doubles, from 37.5 percent to 69 percent.
Between 1965 and 1988, the maternal death rate declines more than 75
percent, from 31.6 to 8.4 per 100,000 live births; deaths of infants under
one year of age drop 60 percent, from 24.7 to 9.7 per 1,000 live births;
only
12 percent of all births are unwanted, compared to 21 percent in 1965.
Despite President Bush's promise of a kinder, gentler nation, he
demonstrates callous disregard for the needs of women, children, and
families. On his first working day in office, he declares his solidarity
with
anti-choice extremists and calls for passage of the Human Life Amendment.
He pressures Secretary of Health and Human Services Louis Sullivan into
publicly recanting his pro-choice position. At Mr. Bush's urging, the
Justice
Department aggressively presses the U.S. Supreme Court to overturn ROE
v. WADE.
France begins distribution of RU-486, a new drug developed by Dr.
Etienne-Emile Baulieu and other researchers of the Roussel-Uclaf
corporation as an alternative to early aspiration abortion. U.S.
anti-family
planning, anti-abortion organizations pledge to keep RU-486 off the world
market despite the fact that it could help reduce the number of women who
die from illegal abortion worldwide -- 200,000 each year.
Four years after the FDA approved the Copper T380A IUD, developed by
the Population Council, the GynoPharma Corporation makes it available to
U.S. women.
The Prentiff Cavity Rim cervical cap is approved by the FDA for use and
distribution in the U.S.
PPFA and others file suit against the Title X "gag rule," proposed by
President Reagan in 1987, claiming it violates the Title X statute, medical
ethics, the principle of informed consent, and health care providers'
constitutionally protected right to free speech.
PPFA obtains a court order to continue federal funding of its international
programs pending resolution of the lawsuit challenging the administration's
Mexico City policy.
1989
Hundreds of thousands of pro-choice advocates travel to Washington, D.C.
on April 9 to join the March for Women's Equality/Women's Lives.
The U.S. Supreme Court on July 3 rules in WEBSTER V.
REPRODUCTIVE HEALTH SERVICES that states may place increased
restrictions on women's access to abortion. With the issue of abortion
rights
thrown back to the states, divisive legislative and electoral battles at
the state
level quickly ensue.
In November, two million pro-choice advocates participate in "Mobilization
for Women's Lives Across the U.S.A. and Washington, D.C.," comprising
1,000 pro-choice events across the country.
One hundred and forty-seven pro-choice leaders in the U.S. House of
Representatives and Senate introduce the Freedom of Choice Act to codify
the rights enumerated by the U.S. Supreme Court in its 1973 ROE V.
WADE ruling.
More than half (90) of Planned Parenthood's 172 affiliates now offer HIV
antibody testing and counseling. The year closes with 171,781 cases of
AIDS reported to the U.S. Centers for Disease Control.
Strengthening its commitment to advocate reproductive rights, Planned
Parenthood Federation of America establishes the Planned Parenthood
Action Fund© to meet the need for increased lobbying efforts to preserve
the right to reproductive choice. The Action Fund, incorporated under
section 501(c)(4) of the Internal Revenue Code, is allowed to lobby without
limitation and participate in electoral politics as a secondary activity.
1990
The American Medical Association announces its support for testing and
possible use of RU-486 (mifepristone) in the U.S.
The U.S. Supreme Court on June 18 rules in OHIO V. AKRON CENTER
FOR REPRODUCTIVE HEALTH and HODGSON V. STATE OF
MINNESOTA that states may require notification of one or both parents
before a teenager may have an abortion, as long as she has the option of a
court bypass.
The Second Circuit Court of Appeals rules against Planned Parenthood
Federation of America in its suit against the government's Mexico City
policy, and the U.S. Agency for International Development announces that
funding to Family Planning International Assistance will be terminated on
October 31. Planned Parenthood prepares to seek Supreme Court review
and vows to seek private funding to preserve its international family
planning
programs.
Thirty states and the District of Columbia mandate AIDS education in
schools, but only 12 states and the District of Columbia mandate
comprehensive sexuality education in grades K-12.
1991
In hundreds of commemorative events throughout the U.S., PPFA
celebrates its 75th anniversary with the theme, "A Tradition of Choice for
75
Years."
The U.S. Supreme Court upholds the Title X gag rule in RUST V.
SULLIVAN. In the aftermath, Congress votes overwhelmingly to overturn
the gag rule, but an effort to override President Bush's veto fails
narrowly.
1992
The Supreme Court upholds new Pennsylvania roadblocks to abortion,
including a mandatory 24-hour waiting period, a parental-consent provision
for minors, and the provision of state-authored anti-abortion materials.
PLANNED PARENTHOOD OF SOUTHEASTERN PENNSYLVANIA
V. CASEY reaffirms the right to abortion but outlines a weaker standard of
review, allowing restrictions unless they constitute an "undue burden" to
the
woman. Four of the nine justices argue that ROE should be overturned
outright.
1993
On the 20th anniversary of ROE V. WADE, newly inaugurated President Bill
Clinton announces administrative actions that reverse the Title X family
planning gag rule; rescind the Mexico City policy; lift the ban on
importation
of mifepristone (RU-486); permit privately funded abortions in overseas
military hospitals; and lift the ban on the use of fetal tissue for medical
research.
The Supreme Court rules in BRAY V. ALEXANDRIA WOMEN'S
HEALTH CLINIC, an appeal by the militant anti-abortion organization
Operation Rescue, that a federal civil rights statute known as the "Ku Klux
Klan Act" does not protect women seeking abortions.
Dr. David Gunn, an abortion provider in Pensacola, Florida, is shot and
killed by an anti-abortion protester outside the clinic where he worked. In
the following year, four more health care center workers -- Dr. John Bayard
Britton, James Barrett, Shannon Lowney, and Leanne Nichols -- fall victim
to anti-abortion terrorism.
As Congress begins to engage in a protracted debate over health care
financing and reform, Planned Parenthood announces a national health care
campaign to ensure that universal access to reproductive health care,
including abortion, becomes part of any reform efforts at the state and
national levels. While in the end Congress fails to create a more equitable
and humane national health care system, PPFA successfully ensures that
coverage for reproductive health care remains a critical element of the
plans
under consideration.
1994
Recognizing in the face of the BRAY decision that federal laws are
inadequate to deal with growing violence at reproductive health care
centers,
Congress enacts the Freedom of Access to Clinic Entrances (FACE) Act.
FACE makes it a federal crime to use or attempt force, the threat of force,
or physical obstruction to injure, intimidate, or interfere with providers
of
reproductive health care services or their patients.
In NATIONAL ORGANIZATION FOR WOMEN V. SCHEIDLER, the
Supreme Court rules unanimously that the Racketeer Influenced and Corrupt
Organizations (RICO) Act can be used in the absence of an economic
motive, allowing its use against violent anti-abortion protesters who
attempt
to eliminate access to abortion by using extortion and intimidation to
drive
the clinics out of business.
In MADSEN V. WOMEN'S HEALTH CENTER, an appeal by
anti-abortion protesters in Florida, the Supreme Court holds as
constitutional
a buffer zone around health care clinics that is intended to protect
access to
the clinic.
Dr. John Bayard Britton, an abortion provider, and James Barrett, his
volunteer escort, become the second and third victims of anti-abortion
assassination outside an abortion clinic in Pensacola, Florida. Throughout
the
year, violent attacks by abortion opponents include death threats; stalking
incidents; assaults and kidnappings; and bombings, arson, invasions,
blockades, and butyric-acid attacks at health care facilities.
The United Nations International Conference on Population and
Development (ICPD) is convened in Cairo, Egypt. More than 160 official
government delegations negotiate a Programme of Action for addressing
population over the next two decades. Evidencing a dramatic shift in
position
since the 1984 population conference, where the Reagan administration
announced the "Mexico City policy," the Clinton administration expresses
strong leadership in promoting the ICPD's support for reproductive health
and family planning services and the empowerment of women.
The year closes on a tragic note as two receptionists at Brookline,
Massachusetts, health centers -- Shannon Lowney, at Planned Parenthood
League of Massachusetts, and Leanne Nichols, from a Preterm clinic on the
same street -- are shot in yet another episode of anti-abortion violence.
1995
U.S. clinical trials are conducted on mifepristone (RU-486), which has
already been available to women in France, Sweden, and the United
Kingdom. Eight Planned Parenthood affiliates participate in the Population
Council-sponsored clinical trials, which will lead to submission of the
medical
regimen for approval by the FDA.
1996
Following on the heels of the 1994 ICPD in Cairo, the Fourth World
Conference on Women is held in Beijing, China. The conference, which is
the largest gathering ever to attend a U.N. conference, produces a Platform
for Action that reaffirms women's rights as human rights, calls for the
decriminalization of women who undergo abortions in countries where it is
illegal, affirms the concept of sexual rights, and affirms the right of
all women
to control their own fertility.
As in other recent years, contraceptive services provided by Planned
Parenthood affiliates avert an estimated 500,000 unintended pregnancies, of
which 213,000 would have resulted in unintended birth. While Planned
Parenthood provides approximately 8 percent of abortions in the U.S., it
prevents an estimated 217,000 abortions in 1995 -- more than
one-and-a-half times as many procedures as it provides.
Gloria A. Feldt, a longtime executive director of Planned Parenthood's
Phoenix affiliate, is named president of Planned Parenthood Federation of
America.
Through the services of 152 affiliates operating more than 900 clinics in
49
states and the District of Columbia, Planned Parenthood's more than
400,000 donors and 21,000 volunteers and staff members nationwide
continue to meet the family planning needs of more than five million
Americans.
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001. email
SSN (Partial) (1 page)
12/17/1998
P6/b(6)
COLLECTION:
Clinton Presidential Records
Automated Records Management System
WHO (Biomedical, Reproductive, & Surrogacy)
OA/Box Number: 500000
FOLDER TITLE:
[3/27/1996 - 9/27/2000]
2013-0365-F
wr10696
RESTRICTION CODES
Presidential Records Act - |44 U.S.C. 2204(a)|
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information [(b)(1) of the FOIAJ
P2 Relating to the appointment to Federal office [(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRAJ
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information [(a)(4) of the PRA|
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors |a)(5) of the PRA
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions |(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Ellen Dahl ( Ellen Dahl [ UNKNOWN 1)
CREATION DATE/TIME:17-DEC-1998 11:19:34.00
SUBJECT: re: Press Guidance on South Korean Cloning
TO: Sarah E. Gegenheimer (CN=Sarah E. Gegenheimer/OU=WHO/O=EOP [ WHO ])
READ:UNKNOWN
[001]
TEXT:
P6/(b)(6)
Original Text
From: , on 12/17/98 11:14 AM:
FYI -
P.S. Pls e-mail me your DOB and SSN by noon for the party! Thanks!
Forwarded by Sarah E. Gegenheimer/WHO/EOP on
12/17/98 11:12 AM
Nanda Chitre
12/17/98 11:02:40 AM
Record Type: Record
To: See the distribution list at the bottom of this message
cc:
Subject: Press Guidance on South Korean Cloning
PRESS GUIDANCE
December 17, 1998
SOUTH KOREAN SCIENTISTS CLAIM TO CLONE HUMAN EMBRYO
CONTEXT: Both the Washington Post and the New York Times carry reports
today of a claim made by South Korean scientists that they successfully
used cloning techniques to produce a human embryo. As far as we know, this
is the first time anyone has made such a claim. It is important to note
that none of their work has been published, and they have released no data
making it impossible to determine the veracity of their claim. According
to reports, the cloned embryo was not implanted into a woman?s womb, but
destroyed at the 4-cell stage. This is too early to know that the cloned
embryo would have the potential to develop into a child. However, most
scientists agree that their claim could be technically feasible. South
Korea is considering legislation that would restrict human cloning. The
scientists stated they conducted this research for therapeutic reasons--to
generate stem cells--not to produce a child. Human stem cells have enormous
potential to treat many diseases such as diabetes and Parkinson?s.
General
This report indicates that human cloning research is proceeding rapidly and
that the techniques are being used worldwide. There is growing
international consensus that use of cloning techniques for purposes of
reproduction is unethical and should be banned, but agreement on the
ethical ramifications of using these techniques for therapeutic purposes
are still being assessed. The South Korean scientists? work is consistent
with the recommendations made in the U.K. last week that would allow
limited human cloning research, but ban reproductive cloning.
Cloning techniques offer great promise in advancing biomedical research for
a large number of devastating conditions, including diabetes,
cardiovascular disease, neurodegenerative disorders, burns and spinal cord
injuries, and cancer.
Currently, the type of research conducted by the South Koreans would be
banned in the United States if the work were supported with public funds.
No restrictions are in place for work conducted by the private sector.
However, the President has called on the private sector to observe a
moratorium on reproductive cloning until all the ethical issues can be
sorted out.
Q: Can this type of research be conducted in the United States?
A: The answer to this question depends on the source of the funds used to
support the research. Current law prohibits the use of federal funds to
conduct human embryo research. Research supported entirely by private
sector funds has no such restrictions.
PRESS GUIDANCE - SOUTH KOREAN SCIENTISTS CLAIM TO CLONE HUMAN EMBRYO
Page Two
Q: What does the Administration plan to do about these kinds of
experiments?
A: The President asked his National Bioethics Advisory Commission to
address the ethical, medical and legal concerns associated with this
type
of experimentation.
The Commission has already issued a report
that recommends banning reproductive cloning. The President supports
this view and has called on Congress to pass appropriate
legislation. The Commission is now in the process of assessing the
ethical, medical and legal issues associated with therapeutic uses of
cloning technology. The President believes we should strive to achieve
the appropriate balance of medical and ethical considerations.
Q: Are we closer now to being able to clone humans?
A: There is no way to tell if the work reported by the South Koreans
resulted in a viable cloned human embryo. However, based on recent
work with sheep, cows and mice, there appear to be no known major
technical barriers to cloning humans. The scientific community and
the public worldwide have argued
against taking this step.
Per Jeff Smith/OSTP
Message Sent
To:
Barry J. Toiv/WHO/EOP
Amy Weiss/WHO/EOP
Julia M. Payne/WHO/EOP
Sarah E. Gegenheimer/WHO/EOP
Roger V. Salazar/WHO/EOP
Julie B. Goldberg/WHO/EOP
Elizabeth R. Newman/WHO/EOP
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Nanda Chitre ( CN=Nanda Chitre/OU=WHO/O=EOP [ WHO ])
CREATION DATE/TIME:17-DEC-1998 13:44:20.00
SUBJECT:
TO: vrivas-v ( vrivas-v @ os.dhhs.gov [ UNKNOWN ])
READ:UNKNOWN
TEXT:
PRESS GUIDANCE
December 17, 1998
SOUTH KOREAN SCIENTISTS CLAIM TO CLONE HUMAN EMBRYO
CONTEXT: Both the Washington Post and the New York Times carry reports
today of a claim made by South Korean scientists that they successfully
used cloning techniques to produce a human embryo. As far as we know,
this is the first time anyone has made such a claim. It is important to
note that none of their work has been published, and they have released no
data making it impossible to determine the veracity of their claim.
According to reports, the cloned embryo was not implanted into a woman,s
womb, but destroyed at the 4-cell stage. This is too early to know that
the cloned embryo would have the potential to develop into a child.
However, most scientists agree that their claim could be technically
feasible. South Korea is considering legislation that would restrict
human cloning. The scientists stated they conducted this research for
therapeutic reasons--to generate stem cells--not to produce a child. Human
stem cells have enormous potential to treat many diseases such as diabetes
and Parkinson,s.
General
This report indicates that human cloning research is proceeding rapidly
and that the techniques are being used worldwide. There is growing
international consensus that use of cloning techniques for purposes of
reproduction is unethical and should be banned, but agreement on the
ethical ramifications of using these techniques for therapeutic purposes
are still being assessed. The South Korean scientists, work is
consistent with the recommendations made in the U.K. last week that would
allow limited human cloning research, but ban reproductive cloning.
Cloning techniques offer great promise in advancing biomedical research
for a large number of devastating conditions, including diabetes,
cardiovascular disease, neurodegenerative disorders, burns and spinal cord
injuries, and cancer.
Currently, the type of research conducted by the South Koreans would be
banned in the United States if the work were supported with public funds.
No restrictions are in place for work conducted by the private sector.
However, the President has called on the private sector to observe a
moratorium on reproductive cloning until all the ethical issues can be
sorted out.
Q:
Can this type of research be conducted in the United States?
A:
The answer to this question depends on the source of the funds used to
support
the research. Current law prohibits the use of federal
funds to conduct human embryo research. Research supported
entirely by private sector funds has no
such restrictions.
PRESS GUIDANCE - SOUTH KOREAN SCIENTISTS CLAIM TO CLONE HUMAN EMBRYO
Page Two
Q:
What does the Administration plan to do about these kinds of
experiments?
A:
The President asked his National Bioethics Advisory Commission
to address the ethical, medical and legal concerns associated with
this type of experimentation. The Commission has already issued a
report that recommends banning
reproductive cloning. The President
supports this view and has called on
Congress to pass
appropriate legislation. The Commission is now in the process of
assessing the ethical, medical and legal issues associated with
therapeutic uses
of cloning technology. The President believes we
should strive to achieve the appropriate balance of medical and
ethical considerations.
Q:
Are we closer now to being able to clone humans?
A:
There is no way to tell if the work reported by the South
Koreans resulted in a viable cloned human embryo.
However, based on recent work with sheep,
cows and mice, there
appear to be no known major technical barriers to cloning humans.
The scientific community and the public worldwide have argued
against taking this step.
Per Jeff Smith/OSTP
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Richard Socarides ( CN=Richard Socarides/OU=WHO/O=EOP [ WHO ])
CREATION DATE/TIME:25-FEB-1999 07:54:32.00
SUBJECT: Child adoptions by gays/lesbians ignite legislative fights
TO: Nicole R. Rabner ( CN=Nicole R. Rabner/OU=WHO/O=EOP @ EOP [ WHO 1)
READ:UNKNOWN
TEXT:
Forwarded by Richard Socarides/WHO/EOP on 02/25/99
07:54 AM
Doug.Case @ sdsu.edu
02/25/99 01:52:00 AM
Record Type: Record
To: Stuart D. Rosenstein, Richard Socarides
cc:
Subject: Child adoptions by gays/lesbians ignite legislative fights
SCRIPPS HOWARD NEWS SERVICE, Recommended for release, Feb. 27-28, 1999
CHILD ADOPTIONS BY HOMOSEXUALS IGNITE LEGISLATIVE FIGHTS
By JOAN LOWY, Scripps Howard News Service
A movement to prevent gays and lesbians from adopting children or
becoming
foster parents is gathering steam across the nation as homosexuals become
more
outspoken about their desire to create families and conservative critics
more
organized in their opposition.
"What we're seeing this year in terms of attacks on lesbian and gay
prospective adoptive parents is unprecedented," said Kate Kendell,
executive
director of the National Center for Lesbian Rights in San Francisco.
Among the recent developments:
Bills have been introduced this year in the Texas and Indiana
-
legislatures to prohibit gays and lesbians from adopting children. A
similar
bill is expected to be introduced in Michigan. Only two states Florida
and
New Hampshire currently have laws that bar gays and lesbians from
I
adopting.
In January, Arkansas and Utah became the first states to adopt
-
regulations specifically preventing gays and lesbians from becoming foster
parents or adopting children. The Arkansas Child Welfare Agency approved
by a
vote of 6 to 1 a regulation barring gays and lesbians from becoming foster
parents. The rule does not expressly forbid gays and lesbians from adopting
children in the state's care, but it is expected to make it more difficult.
The Utah Division of Child and Family Services adopted a regulation
barring
gays and lesbians, unmarried couples and polygamists from becoming foster
parents or adopting children in the state's care. It does not pertain to
private adoptions, but many adoption agencies look to state agencies for
guidance.
Conservatives in Congress are expected to try again this year to pass
legislation barring gays and lesbians and unmarried couples from adopting
children in the District of Columbia. The House passed similar legislation
last year, but it was later dropped at White House insistence.
Meanwhile, gay and lesbian activists are fighting back:
The New Hampshire legislature held a hearing this month on a bill to
-
repeal the state's 1987 law barring gays and lesbians from adopting
children
or heterosexual couples from adopting if they have a gay or lesbian person
living with them or visiting overnight. The proposal has split the state's
religious community, with the Catholic Diocese opposing the repeal and the
Episcopal Diocese supporting it.
The American Civil Liberties Union is preparing a lawsuit in Florida
challenging the constitutionality of that state's ban on gay and lesbian
adoptions. It will be the ACLU's fourth attempt to overturn the 1977 law.
The
ACLU also expects to file legal challenges in Arkansas and Utah.
The American Bar Association this month approved by a 3-to-1 margin a
resolution in support of legislation to ensure that adoption is not denied
on
the basis of the adopting parents' sexual orientation when adoption is
determined to be in the best interest of the child.
The Family Pride Coalition, an umbrella organization for gay and lesbian
family support groups, conservatively estimates there are 2 million gay and
lesbian parents nationally raising 3 million to 5 million children, most of
them children from heterosexual marriages.
The National Adoption Information Clearinghouse, a federal agency, uses
a
higher estimate of 2.5 million to 8 million parents and 6 million to 14
million children.
While gays and lesbians in small numbers always have adopted children,
they
generally took pains not to draw attention to their sexual orientation.
But in
the late 1980s, the gay and lesbian community began to experience a baby
boom,
or ``gayby boom" as some have dubbed.
In addition to children born through former heterosexual marriages, gay
men
began hiring surrogate mothers to bear their children, lesbian couples
sought
sperm donors, and interest in adoption and foster parenting grew.
By the mid-1990s, gay and lesbian couples seeking to adopt were
increasingly open about their sexual orientation in their dealings with
state
officials, private adoption agencies and courts.
"There are some of us who choke on the notion that we should hide or be
ashamed of who we are. We want to actually present to the agencies and the
social workers or whoever the families that we intend to be," said
Beatrice
Dohrn, legal director of the Lambda Legal Defense and Education Fund.
A turning point came in December 1997 when New Jersey state officials
settled a lawsuit filed by a gay couple trying to adopt a 2-year-old boy.
The
state agreed to drop its policy prohibiting adoptions by unmarried couples
and
not to discriminate against prospective parents based on sexual
orientation.
The old policy had effectively ruled out gay and lesbian couples because no
state recognizes same-sex marriages.
"That was the clarion call for resistance among pro-family groups to
this
trend," said Robert Knight, director of cultural studies at the Family
Research Council and a prominent conservative critic of gay and lesbian
adoptions.
Knight says that children raised by gay or lesbian parents are more li
kely
to become homosexual themselves - a notion not supported by most scientific
research. Knight, however, dismisses those studies as biased or conducted
by
gay and lesbian researchers.
"The point is children do best in homes that have a mother and father
married to each other and, if you can establish that, why go for less? The
interest of the child should come first," Knight said.
Conservatives gained a cause celebre last year when a Texas social
worker
was reprimanded and demoted for removing a foster child from the home of a
lesbian couple seeking to adopt him. The social worker claimed the couple's
lifestyle was immoral and a violation of the state's anti-sodomy law.
The conservative Liberty Legal Institute in Plano, Texas, has filed a
lawsuit on behalf of the social worker and is seeking to ban gays and
lesbians
from adopting or becoming foster parents based on the anti-sodomy law.
"We're asking the state be enjoined from placing any child in a home
where
they know there is on-going criminal activity," said Kelly Shackelford,
the
institute's chief counsel.
Gays and lesbians contend they are as qualified as anyone else
-
including
the traditional married heterosexual couple to raise children, and that
-
each
adoption case should be decided on the particular circumstances involved
without bias based on sexual orientation.
They also point out that they are sometimes a last resort for
difficult-to-
adopt children who might otherwise not gain a family.
The North American Council on Adoptable Children, one of the nation's
largest adoption advocacy groups, estimates there were about 36,000 foster
children adopted in the United States last year out of a pool of 100,000
children in need of adoption.
The pool of parents seeking healthy infants is ``unlimited," but ``if
you've got a sibling group of three and they've been sexually abused and
one
of them is 12 years old, you're going to have to recruit like the dickens.
There aren't any lines at the door for those kids," said Joe Kroll, the
council's executive director.
In 1997, the council gave its Adoption Activist award to a gay Virginia
father who adopted five boys over a period of several years while leading a
support group for single adoptive parents and children.
Gay and lesbian parents have gained greater acceptance in recent years
from
the professionals who deal with adoption and foster care.
The Child Welfare League of America, the nation's largest organization
concerned with child welfare, recommends `gay and lesbian adoptive
applicants
should be assessed the same as any other adoptive applicant. It should be
recognized that sexual orientation and the capacity to nurture a child are
separate issues."
The National Association of Social Workers has adopted a policy opposing
discrimination against gays and lesbians. The policy of the American
Psychological Association, which dropped homosexuality from its list of
mental
disorders in 1973, is that ``the sex, gender identity or sexual
orientation of
natural or prospective adoptive or foster parents should not be the sole or
primary variable considered in custody or placement."
Gays and lesbians said they fear the adoption issue will replace the gay
marriage issue of recent years as a means for critics to undermine what
many
polls show is a growing public acceptance of homosexuals.
"There is no doubt in my mind that there is a very intentional and
methodical strategy on the part of the radical right to make the issue of
lesbian and gay families their cash cow wedge issue for this coming
decade,"
Kendell said.
``Most Americans don't believe gays and lesbians should be discriminated
against in things like housing and employment or other aspects of public
life,
but there is still a very entrenched prejudice in the area of gay and
lesbian
parenting."
Knight denied conservatives are appealing to prejudice in order to
generate
contributions.
"They have no idea what's in our hearts and what motivates us," Knight
said. "We do this not to raise money, but to protect children and to
discourage behavior that is destructive to individuals, families and
communities."
(Joan Lowy is a reporter for Scripps Howard News Service. Her e-mail
address is [email protected])
SCRIPPS HOWARD NEWS SERVICE, Recommended for release, Feb. 27-28, 1999
SAME-SEX PARENTS SHARE SAME CONCERNS AS HETEROSEXUALS
By JOAN LOWY, Scripps Howard News Service
In many ways, little Nora's parents are much like the parents of any
other
2-year-old. They worry about how to get her to eat a wider variety of foods
and what to do when she gets colds. They are trying to spend less time at
work
and more time at home.
The big difference is that Nora has two fathers, but no mother. Charles
Spiegel and Jim Emery, two San Francisco attorneys who have been together
since they met in law school 14 years ago, brought Nora home from the
hospital
to live with them shortly after she was born on Valentine's Day 1997. The
adoption was finalized a few months later.
Spiegel and Emery are among a growing number of gay and lesbian parents
who
are choosing to adopt children or to become foster parents, a trend that
has
prompted a conservative backlash.
The couple said they knew from the beginning of their relationship that
they wanted to have children. The decided four years ago to adopt rather
than
search for a surrogate mother because they felt there were enough children
in
need of a good home.
Their first attempt at adoption failed when the mother delivered
prematurely and decided to keep the child, who was born with health
problems.
But with the help of a private attorney specializing in adoptions, Emery
and
Spiegel were hooked up with Nora's mother, who chose them from among
several
dozen prospective parents to raise her daughter. She spoke to them on the
phone before Nora was born and briefly met them at the hospital after
delivery.
``I presume she wanted a family where her child would be open to
different,
progressive values," Emery said.
They each took three months family leave after bringing Nora home, Emery
first and then Spiegel. Co-workers threw a baby shower for Spiegel at his
law
firm. Spiegel also recently cut back on his hours at the office so that he
can
leave work early to take Nora to swim classes.
The couple sends Nora to a preschool which boasts that 12 percent of its
children come from gay or lesbian families.
``That's exciting to me because it reflects that a dominant value in San
Francisco's straight families is that they want their kids to have the
experience of going to school with kids from alternative families," Emery
said.
But he adds: ``I still believe we could provide a wonderful home for a
child no matter where we lived."
From the start, the couple told Nora, who is Latino, that she is
adopted.
``It's not like we're a heterosexual couple and we can hide from her for
very long that she's adopted. As soon as she goes to school, she's going to
see that her family is different," Spiegel said.
But he isn't overly concerned that Nora will be teased by other children
because her parents are gay, Spiegel said.
"Kids get taunted about a lot of things. The quality of this is whether
you are a parent who is going to help your kid put that in perspective,"
Spiegel said.
Conservative critics of gay and lesbian adoptive parents contend that
it is
wrong to deprive children of the experience of having a traditional family
with a married mother and father.
``When you deliberately deprive a child of a father or a mother and then
give a child an abnormal view of sexuality on top of it, you are serving
the
interest of gay activism and not the interests of the child," said Robert
Knight, director of cultural studies for the conservative Family Research
Council.
Spiegel said he and Emery decided to talk publicly about their family in
the hope that critics will ``see that what we're doing looks like what
every
other parent of a 2-year-old is doing."
``People seem so upset on this issue," Spiegel said, ``but it seems to
have nothing to do with what really creates a family, which is caring
adults
with as much energy and love as possible."
(Joan Lowy is a reporter for Scripps Howard News Service. Her e-mail
address is lowyj(at)shns.com)
This message has been distributed as a free, nonprofit informational
service, to those who have expressed a prior interest in receiving this
information for non-profit research and educational purposes only. Please
do not publish, or post in a public place on the Internet, copyrighted
material without permission and attribution. (Note: Press releases are
fine to reprint. Don't reprint wire stories, such as Associated Press
stories, in their entirety unless you subscribe to that wire service.)
Forwarding of this material should not necessarily be construed as an
endorsement of the content. In fact, sometimes messages from anti-gay
organizations are forwarded as "opposition research."
ATTACHMENT 1
ATT CREATION TIME/DATE: 00:00:00.00
TEXT:
RFC-822-headers:
Received: from conversion.pmdf.eop.gov by PMDF.EOP.GOV (PMDF V5.1-9 #29131)
id <[email protected]>; Thu, 25 Feb 1999 01:55:47 EST
Received: from storm.eop.gov by PMDF.EOP.GOV (PMDF V5.1-9 #29131)
with ESMTP id <[email protected]>;, Thu,
25 Feb 1999 01:55:43 -0500 (EST)
Received: from mail.sdsu.edu ([130.191.25.1]) by EOP.GOV (PMDF V5.2-29 #34437)
with ESMTP id <[email protected]> Thu,
25 Feb 1999 01:55:10 -0500 (EST)
Received: from [130.191.242.121] ([130.191.242.121])
by mail.sdsu.edu (8.8.7/8.8.7) with ESMTP id WAA10446; Wed,
24 Feb 1999 22:52:49 -0800 (PST)
X-Sender: [email protected]
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Molly Melching <[email protected]> ( Molly Melching <[email protected]> [
UNKNOWN ])
CREATION DATE/TIME: 9-APR-1999 02:26:36.00
SUBJECT: Information on FGC meeting
TO: Margaret L. Buford ( CN=Margaret L. Buford/OU=WHO/O=EOP [ WHO ])
READ:UNKNOWN
TEXT:
Hi Molly B -
Thanks for sending the email address. I have just learned that the
meeting at USAID has been changed again to June 3 from 8:30 to 1 PM because
so many people want to attend. A larger meeting area was not available
until this date.
Mrs. Clinton could intervene at ANY TIME she is available during the
morning. The schedule would then be readjusted to fit her speech.
This symposium is crucial for the future of programs on Female Genital
Cutting at USAID. Its success will have great impact on the way USAID will
and should deal with the problems, especially if there is success in
raising
the awareness of the staff as to how this problem is affecting the status
of
women and their participation in all aspects of life.
Since the First Lady has shown great interest in the subject and has
been cited internationally for her support of the women and men at the
grassroots level struggling to end the practice, I think it is crucial that
she speak on June 3. Obviously, her presence would make a great impact on
those hesitating to work in this field at a time when there is real hope
for
success using the new strategy of education combined with public
declarations. We are now working to encourage other countries to use this
strategy and if that happens, this really could be the beginning of the
end.
I would very much like Mrs. Clinton to continue to be associated with what
appears to be a promising strategy for the end of suffering for millions of
women.
Gerry Mackie was also recently invited to the symposium and will be
included somewhere on the agenda. I am sending you the article he wrote on
FGC for the New York Review of Books. He learned last week that it has
been
accepted for publication!
I will be anxious to hear from you. If you need any other information,
please let me know. Also if Mrs. Clinton wants other case studies from the
field on FGC, I will be glad to provide these. I will be travelling to our
villages quite a bit before that date and can send her new information on
reaction to the law and new developments concerning the public
declarations.
Indeed we are scheduling another declaration for 11 Bambara villages soon
and we have just received word from our villages in the North that many
want
to go ahead with their declaration despite the influence of Muntaga Tall
the
religious leader from that area who has so strongly opposed the end of FGC.
More later! Warm greetings from Senegal. Molly M.
USAID SYMPOSIUM ON FGC
RRB, Washington DC
June 3, 1999
Subject: FEMALE GENITAL CUTTING (FGC): THE FACTS AND THE MYTHS
In 1993, USAID designated the WID office as the Bureau's co-ordinator on
issues relating to female genital cutting (FGC). To co-ordinate activities
in the different offices and bureaux of the Agency, a Working Group on
(FGC) was formed in early 1994. The purpose of the group was to assess the
Agency's approach to FGC, raise awareness, and share information within and
outside the Agency. In 1997 the "Agency Program Guidelines for Integrating
Activities to Eradicate FGC into USAID Programs," was completed. These
guidelines were to assist in future programming for agency involvement in
FGC
eradication. In line with the guidelines the Center for Population Health
and Nutrition, the WID Office and the Africa Bureau sponsored a fellow from
the Population Fellowship Program at the University of Michigan to work on
FGC issues at USAID.
To raise awareness of the relevance of FGC to USAID's work, and enable the
staff to integrate this issue in their work, the FGC group is planning a
symposium to disseminate information.
The purpose of this symposium is to:
- Provide information about FGC from a cultural, human rights, health and aholistic developmental perspective, that
can be helpful for the successful
integration of FGC into USAID programs.
- Discuss successful interventions by local NGOs and the impact of thoseinterventions on reducing the incidence of
FGC.
- Highlight new strategies that are now being tested. The objective of this event is to raise awareness among USAID
staff and
illustrate the broad range of sectors under which the issue can be
addressed. Cultural appropriateness of approaches and the effectiveness of
intervention have always been the concern not only on FGC, but all other
programs geared toward behaviour change. In this respect, the work on FGC
can provide useful experiences for other programs, as well as benefit from
other experiences.
8:30-8:45 Registration
8:45- 9:15 Plenary, opening session
Tentative speakers:
Chair: Ms. Vivian Derryck, AA Africa
15 Min.
Asma Abdel Halim, Office of population - Research
10 Min.
9:15-10:15 FGC as a human rights and reproductive health issue.
Chair: Asma Abdel Halim
? Nahid Toubia - President of RAINBO. 15 Min.
The presentation will propose a framework for analyzing different
approaches
to stopping FC/FGM as a basis for monitoring and evaluating different
projects and programs. This will be followed by an overview of some
projects
and
programs undertaken in different countries and communities over the past 20
years and provide a preliminary evaluation of their approaches and outcomes
based on the proposed framework. Interwoven in the presentation are
examples of some of RAINBO's own programs and products as a demonstration
of one particular approach to FC/FGM.
? Molly Melching - President of Tostan.
15 Min.
Tostan experience and the recent developments in Senegal. This presentation
will highlight Tostan's interventions and how they addressed the different
communities according to the priorities identified
by the people themselves. Using local languages Tostan developed nine
modules that addressed issues from personal hygiene to human rights. Women
who received training by Tostan are spearheading social change. The
presentation will address the importance of participatory approaches and
how they equip the people to address issues with a voice of their own.
? Qs & As
10:15-10:45- Video show, coffee break, information fair and publications
display
? 10:45- 12:00 Successful field interventions
Chair : Marge Horn
10 Min.
? Asha Mohamed - Senior Program Officer- PATH
10 Min.
Alternative Rites of Passage: Building on Positive Community Traditions.
The alternative rites of passage program in Kenya brought together
individuals who chose not to circumcise their daughters or are ambivalent
about it. Such individuals usually remain silent and their stand does not
affect the community. Using the positive parts of circumcision ceremonies,
e.g. education of young girls by elders, a program known as circumcision
by words was developed. The program involved the community at all the
stages from conceptualisation to implementation. Members of the community
who participated at all stages, from concept to design, were able to talk
to others who wanted to keep the tradition and convince them to join the
alternative rites.
? Romany Abadir - CEDPA-Egypt
10 Min.
The Positive Deviance Initiative (PDI) , Egypt. What is it? How is it
used as an empowerment tool.
The Positive Deviance Inquiry (PDI) is a fresh look at the practice of FGC
in its attempt to instead answer the question, "What are the factors that
enables some families to not circumcise their daughters?" In this way,
communities themselves discover what is inherently positive and "working"
within the community and are able to plan their own actions based on this
information. Because community members themselves are conducting the
research, analysis and program planning, the process builds the capacity of
individuals and local organizations and fosters sustainability. Thus, the
process of PDI becomes as empowering as the outcomes.
? Nafissatou Diop - Population Council
10 Min.
The results of Training programs for community leaders and circumcisors.
Different countries have been trying different approaches. This
presentation will identify interventions that targeted community leaders
and circumcisors in Mali, Burkina Faso and Senegal and explore the
successes of such programs.
? Qs & As
? 11:55-1:00
Chair: Ms. Sally Shelton-Colby
Integration of FGC into USAID programs.
Margaret Lycette, director WID office
John Flynn, Africa/AA
How can missions incorporate FGC: The Guinea experience
Liz Maguire, Director Office of Population
Guidelines for integrating FGC.
On display
1. Information Board: A poster highlighting FGC, its consequences,
prevalence and why it is performed.
2. Information Packet that contains a background paper on USAID's
activities on FGC, USAID strategy, Pamphlets, brochures and booklets that
provide information on the issue.
3. Posters produced by different CA's will be displayed on the walls of the
conference room.
4. Publications from CA's, especially the new publications that document
experiences and advocate eradication.
List of Participating Organizations
1. Center for Development and Population Activities (CEDPA) is a
non-profit international organization dedicated to empowering women at all
levels of society to be full partners in development.
2. Equality Now: an advocacy organization based in New York. EN has an
international membership of over 3000. NE is an active advocate against
FGC and helps Indigenous organizations obtain public international support
when those organizations call for it.
3. Program for Appropriate Technology in Health (PATH) is an international,
non-profit organization whose mission is to improve health, especially the
health of women and children. PATH works in partnership with host-country
governments and local agencies to assess health problems and identify and
implement creative and effective solutions.
4. The Population Council is a nonprofit, non-governmental institution that
seeks to improve the well-being and reproductive health of current and
future generations around the world and to help achieve a humane,
equitable,
and sustainable balance between people and resources. The Council conducts
biomedical, social science, and public health research and helps build
research capacities in developing countries.
5. Research, Action and Information Network for Bodily Integrity of Women
(RAINBO) is a not-for-profit organization working at the intersection
between Health and Human Rights. Its approach is a holistic one which
includes physical, psychological and social health. Currently RAINBO is
focusing on the issue of FGC to assert women's rights to their bodily
integrity.
6. Department of State
7. Tostan: a Senegalese based organization that pioneered educational
modules
that lead to the eradication of FGC in several villages in Senegal.
8. Center for Communication Programs (JHCCP) is part of the Johns Hopkins
School of Hygiene and Public Health. The Center works with many
international agencies, foundations, governments, and non-governmental
organizations in the US and overseas to promote healthy behavior.
>De?: [email protected]
>? : [email protected]
>Objet?: Hello from D.C.
>Date?: Mer 7 avr 1999 22:30
>
>] got the book in the mail today. Thank you very much. I hope you had a
>safe trip back to Senegal. I will look forward to getting your email and
I
>will pass it on to the appropriate people. Thanks.
>
>Molly
>
>
- new nyrb Gerry
ATTACHMENT
1
ATT CREATION TIME/DATE: 0 00:00:00.00
TEXT:
Unable to convert ARMS_EXT:[ATTACH.D44]MAIL44623231T.136 to ASCII,
The following is a HEX DUMP:
Breakthrough in Senegal
Female Genital Cutting: Findings from the Demographic and Health
Surveys Programs
by Dara Carr
Macro International, 94 pp., single copy gratis
http://www.macroint.com/dhs/hom1.html
Breakthrough in Senegal: The Process Used to End Female Genital
Cutting in 31 Villages
by Molly Melching
The Population Council, PAGES, PRICE
Female Genital Mutilation: An Overview
by Nahid Toubia and Susan Izett
World Health Organization, 73 pp., $23.40
http://www.who.int/dsa/cat98/fgmbook.htm
Gerry Mackie
Malicounda, a village in Senegal with a population of 3000 from
the Bambara ethnic group, announced to the world on July 31, 1997 its
decision to abandon female genital cutting (FGC) and urged other
villages to follow its example. This was a public and collective
commitment to stop the practice, and local media and dignitaries attended
the unprecedented event. A neighboring village, Nguerigne Bambara,
decided to renounce FGC forever on November 6, 1997. Another
neighboring village, Keur Simbara, decided that they needed to consult
with their extended family, among whom they married, in ten other
villages near Joal. All 13 of these villages then joined together to enact
the Diabougou Declaration announcing "a firm commitment to end the
practice of female circumcision in our community" on February 14 and
15, 1998. The Clintons met with and congratulated the women of
Malicounda on April 2, 1998, during their state visit to Senegal. Next, in
an entirely different region, and among an entirely different ethnic group,
the Fulani, 18 villages met together and, citing the example of
Malicounda, enacted the Medina Cherif Declaration on June 1 and 2,
1998 which decisively renounced the practice of female circumcision.
More such mass declarations will emerge shortly. As a result, Senegal
enacted legislation against FGC on January 13, 1999 (there is hope that
the government will emphasize needed education rather than
counterproductive coercion).
Automated Records Management System
Hex-Dump Conversion
FGC affects up to 136 million women in 28 countries across
Africa. The practice is distributed more or less contiguously from
Senegal in the west to Yemen in the east and from Egypt in the north to
Tanzania in the south, and with explainable exceptions is unique to that
zone. Rather than receding with modernization, this painful and
dangerous practice is expanding as population expands. In some places
FGC has even spread to new groups or has increased in severity. An
estimated two million girls a year suffer the operation, according to the
authoritative overview published by the World Health Organization
(WHO).
Twenty-five years ago the wide prevalence of this perplexing
tradition was barely suspected, often went unmentioned or was even
denied by its practitioners, and was disregarded by international
development agencies. Since then there have been an abundance of
international and national meetings, publications, declarations, and plans
of action. Opposition to FGC is now part of American human rights
policy, and the U.S. Agency for International Development (USAID) is
assisting the African organizations working to promote its abandonment,
as is the United Nations Children's Fund (UNICEF), WHO and other
agencies. Despite a surge of international publicity over the last five
years, and new funding not so spectacular as the publicity, results have
been disappointing. There have been individual abandonments,
sometimes among the most cosmopolitan segments of the population, and
also as a consequence of various programs, but these are collectively
marginal. That is why the unequivocal, collective and contagious
abandonments of FGC in a series of villages in Senegal in the last year
and a half are of such great importance.
These dramatic events arose after women in the lead villages
participated in a basic education program conducted by a
nongovernmental organization called Tostan (which means breakthrough
in Wolof, the primary language in Senegal). Tostan did not directly
intend to end FGC. This innovative "literacy-plus" program provides a
background of information and skills that facilitates autonomous changes
in community health, education, and welfare. Participants say that a
consequence of the program is that one is able to tiim sa xel, "to look
down upon one's mind." Tostan never tells people what to do. It was the
women of Malicounda themselves who decided to end FGC, as did the
remainder of their village, and then their neighbors and kin who joined in.
Indeed, the Tostan staff were surprised and sometimes even worried as
the movement unfolded. Change was not slow and incremental, but
rather was swift and general. The story is told in Breakthrough in
Automated Records Management System
Hex-Dump Conversion
Senegal, written by Molly Melching, director of Tostan. This publication
describes the sequence of change, and the narration is vivid and often of
rich human interest.
***
Clitoridectomy involves the removal with the aid of a sharp
instrument of part or all of the clitoris, and excision the removal of the
clitoris as well as part or all of the labia minora. More than 80% of FGC
is of this type. Less than 20% of FGC is infibulation, which includes
clitoridectomy and excision and adds incision or removal of the inner
walls of the labia majora. Then, the raw edges of the labia majora are
stitched together or adhered by tying the legs together so that the opposite
sides will heal into a wall over the vaginal opening. A small opening is
left at the back. Typically, urination and later menstruation is difficult,
upon marriage penetration is dreadful to accomplish, and reinfibulation
follows childbirth. Sealing is a poorly understood variant that might be
classed under infibulation: it involves at least incision of the infant's
labia which then are healed together by coagulated blood from the
wounds. FGC may take place from a few days after the girl's birth to
after the birth of the her first child, depending on local custom, but most
often seems to be performed on girls around ages six to ten, safely before
puberty. Except recently among the affluent, the operation is inflicted
without painkiller or antiseptic precautions. Potential complications are
numerous and sometimes severe. The immediate risks of any FGC
include bleeding, infection, and death. The more severe practice,
infibulation, entails more prolonged risks as well, such as repeated
infections, keloid scarring, dermoid cysts, obstructed menstruation, pelvic
infections, and obstructed labor, among others. FGC has sexual and
psychological consequences as well.
***
Why? Why all this suffering and death? There are some
distinctive clues that suggest an answer. Where practiced, FGC is nearly
universal within a group whose members marry one another. In such a
group FGC is persistent from generation to generation. The most
common reasons given for FGC is that it is tradition and that it is required
for proper marriage. Most puzzling is that in a number of places people
who oppose FGC nevertheless feel constrained to practice it. These
generalizations are supported by the most thorough survey research on
FGC, findings from fresh demographic and health surveys in seven
countries, summarized by Carr. For example, in Eritrea, 95 percent of
women are treated and 90 percent of mothers report that their eldest
Automated Records Management System
Hex-Dump Conversion
daughter is cut. Yet, the continuation of FGC is opposed by well more
than half of urban dwellers, and by well more than half of those with any
education.
All this suggests that practitioners of FGC are trapped within a
certain kind of "convention," as that concept was developed by the game
theorist Thomas Schelling. Almost all adherents say that FGC is
required for proper marriage, and many say that it is required for the
virtue of the woman, or for the honor of her family. FGC is the
conventional prerequisite of marriage. However the custom originated,
as soon as women believed that men would not marry an uncut woman,
and men believed that an uncut woman would not be a suitable partner in
marriage, the convention was locked in place. Moreover, because FGC is
locally universal, many have been unaware until recent years that other
peoples do not practice FGC, and many have believed that the only
people who do not do FGC are unfaithful women or indecent people.
Like many outsiders I find FGC horrifying to imagine, but for an insider
FGC is more like orthodontia than it is like violence.
FGC is a matter of proper marriage. An individual in an
intramarrying group that practices FGC can't give it up unless enough
other people do too. FGC is a certain kind of convention such that what
one family chooses depends on what other families choose. To
understand, imagine that there is a group that has a convention whereby
audiences (at the cinema, at plays, at recitals) stand up rather than sit
down. Sitting has been forgotten. Standing is both universal and
persistent. An outsider comes along and explains that elsewhere
audiences sit. After the shock of surprise wears off, some people begin to
think that sitting might be better, but it would be better only if enough
other people sit at the same time. If only one person sits, she doesn't get
to see anything on the stage. If only one family abandons FGC, its
daughter doesn't get married (because of the belief that only unsuitable
women forgo FGC). However, if a critical mass of people in the
audience can be organized to sit, even just a column of people who are
less than a majority, they realize that they can attain both the ease of
sitting and a clear enough view of the stage. This critical mass then has
incentives to recruit the rest of the audience to sitting, and the rest of the
audience has incentives to respond to the recruitment. Similarly, if a
critical mass of people in an intramarrying group pledge to refrain from
FGC, then the knowledge that they are a critical mass makes it
1
See my "Ending Footbinding and Infibulation: A Convention
Account," American Sociological Review, 1996, 61:999-1017.
Automated Records Management System
Hex-Dump Conversion
immediately in their interest to keep their pledges, and in their interest to
persuade others to join in, and after persuasion makes it in everyone
else's interests to join them. Without an understanding of the underlying
mechanism, the abrupt end of such an entrenched practice by means of a
mere public declaration would seem to be nearly miraculous.
A peculiar characteristic of a convention like this is that even if
each individual in the relevant group comes to think that it would be
better to abandon the practice, no one individual acting on her own can
succeed. Every family could come to think that FGC is wrong, but that is
not enough; FGC would continue because any family abandoning it on its
own would ruin the futures of its daughters. Enough families must
abandon it at once so that their daughters' futures are secured. One way
to do this is to declare a public pledge that marks a convention shift.
***
The convention model explains the binding of women's feet in
China, both the former universality and persistence of footbinding and its
sudden demise. At about the age of eight, the mother would bend the toes
under her daughter's feet, force the sole to the heel, and tightly wrap the
girl's foot so that as she matured her feet remained tiny, perhaps a mere
five inches in length. Footbinding was painful, dangerous, and disabling.
Why did the Chinese do it? Again, it was necessary for a proper
marriage, for the virtue of the woman, for the honor of her family.
Footbinding and FGC are essentially equivalent practices, and originate
from similar causes. Footbinding and FGC persist because of the same
convention mechanism. Footbinding lasted for a thousand years, was
universal among all "decent" Chinese, and was undented by liberal
agitation and imperial prohibition in the 19th century. The most
optimistic reformers in 1899 thought that it would take several
generations to end, but to everyone's surprise footbinding ended for the
vast majority by 1911. In localities where it did end, it ended quickly and
universally, just as the convention model predicts. Therefore, the
methods used to end footbinding in China, properly adapted, should work
to end FGC in Africa.
The work of the antifootbinding reformers had three aspects. First,
they carried out a modern education campaign, which explained that the
rest of the world did not bind women's feet. The discovery of an
alternative is necessary but not sufficient for change. Second, they
explained the advantages of natural feet and the disadvantages of bound
feet in Chinese cultural terms. Credible new information about health
consequences, again, is necessary but not sufficient for change. Third,
Automated Records Management System
Hex-Dump Conversion
they formed natural-foot societies, whose members publicly pledged not
to bind their daughters' feet nor to let their sons marry women with
bound feet. The problem is that if only one family renounces footbinding
their daughters are thereby rendered unmarriageable. The pledge
association solves this problem - if enough families abandon footbinding
together then their children can marry one another.
The pledge technique had not been applied to the problem of FGC
in Africa. The technique was reinvented by villagers around Malicounda,
with explosive results: collective and contagious abandonments as with
footbinding in China. I believe that the practice in Senegal supports the
convention theory, and reformers there believe that the theory supports
their practice. I recently completed a two-week visit to Senegal where I
visited nine villages.
***
The country of Senegal is at the westernmost tip of Africa, where
the savanna meets the Atlantic. It is an unusually open, democratic, and
materially impoverished country. Its capital, Dakar, used to be the capital
of colonial French West Africa, and is cosmopolitan in its own way.
French tourists swarm the coast over the winter holidays. The Wolof
ethnic group, which does not practice FGC, is almost half of Senegal's
population. Some of the other major ethnic groups are the Bambara and
the related Mandinka, and the Fulani and the related Tukolor, all of whom
practice FGC. The country is 95% Islamic. The flat savanna unfolds as
far as one can see, covered with scrub, and accented by the uncanny
baobab tree, the national symbol. Large villages dot the countryside,
each of a few hundred to several thousand people. Men and women dress
in gorgeous, flowing clothing on most occasions. Villagers live in
circular structures topped with conical thatched roofs, along dirt lanes
lined by mango trees, lively with children, chickens, sheep, goats, and
ass-drawn carts. Women congregate at the well in the morning, and
village meetings take place under a shade tree in the crossroads of the
village, just as in Rousseau's portrayal. People grow peanuts, cotton,
millet, sorghum, rice, maize, calabash, keep cattle, and catch fish.
Almost everything is grown or made locally. People work hard to get by,
and women are always busy - fetching water, tending crops, shelling
peanuts, pounding millet, drying fish, cooking meals, minding children.
Rural literacy is rare or recent.
I went south of Dakar near the coast with Demba Diawara and his
nephew Cheikh Traoré to some of the villages around Malicounda that
had joined in the Diabougou Declaration. The practice in these Bambara
Automated Records Management System
Hex-Dump Conversion
villages was often sealing. Diawara is the imam of the village of Keur
Simbara and a former student in the Tostan program. He is a gentle yet
magnetic figure, much admired, with a gift for turning the right phrase at
the right time, and is an energetic 66 years of age. The women of
Malicounda heard that cuttings were being organized for the village of
Keur Simbara, and went there to put on their play about a girl who dies
from the operation, followed by public discussion of the issue. The
problem, as Diawara said, is that "Keur Simbara is a small village but it is
a very large village." It was Diawara who realized that for Keur Simbara
it was necessary for the whole marriage pool to discuss the issue amongst
themselves and coordinate on an end, culminating in the Diabougou
Declaration. "Only when all members of the extended family agree will
we assure that uncircumcised girls will be free from prejudice and able to
find men to marry," he explained to Melching.
Over three months Diawara and Traoré went one by one to Keur
Simbara's ten sister villages. This required courage, as there was a belief
that even to mention this tradition would bring doom to all concerned.
The wrong approach would provoke serious trouble. That the
Malicoundans had succeeded at a collective abandonment and had
avoided bad consequences proved a powerful message. Also, because
FGC was locally universal, its connection to negative health
consequences was unrecognized. When the connection was credibly
presented, people immediately recognized the causal relation, and were
motivated to change. Diawara agreed with my formulation: "The people
who do FGC are honorable, upright, moral people who love their children
and want the best for them. That is why they do FGC, and that is why
they will decide to stop doing it, once a safe way of stopping is found."
We asked if there had been any cuttings since the declaration.
Absolutely not. You couldn't hide such things in a village! The public
declaration makes it a matter of honor. A committee is established to
monitor compliance. Anyone cutting would be taken to the police. They
are determined to prevent a single exception as they want to assure the
declarants that the reputations and marriageability of their daughters are
secured. One hot afternoon we were meeting the influentials in Samba
Diallo, one of the Diabougou villages. A man in his twenties edged up to
the circle and said, loudly, "We heard you people were going to be here,
so we made it a point to come over from Fimela to visit our relatives here
today. You know, the Bambara are one family, and what happens to one
part of the family affects the whole family." "Uh-oh," I thought, "here
comes trouble." "What we want to know," he continued, "is why weren't
we invited to the declaration?" People are not forsaking the declaration,
Automated Records Management System
Hex-Dump Conversion
but are clamoring to join in. Many Bambara villages and neighborhoods
have made the same request, and Demba Diawara is organizing a new
declaration. I looked at his notes. When he goes to a village he records
the name of every individual, which indicates his or her conditional
commitment to the declaration. It is important that everyone knows that
everyone else will stop.
Trustworthy new information, the opportunity for a critical mass to
form, a period when the critical mass conducts persuasion among the
remainder of the population, climaxed by a coordinated decision on
abandonment, the news that a positive alternative can be safely attained,
followed by replication of the process among neighbors: this parallels
Chinese events and supports the convention hypothesis for FGC.
Much reform activity across Africa is simple education and
publicity about health consequences of FGC, which helps, because there
must be some critical level of attitude change before convention shift can
be organized. Harsh propaganda or criminal prohibition have been
shown to backfire. One strategy is to compensate the cutters, but such
programs have not yielded abandonments of FGC, since it is the concern
of the parents over their daughter's marriageability, not the incidental
benefit to the cutters, that maintains the practice. Another strategy
understands FGC as essentially an initiation rite, though it is not over
much of its range. Even where initiation and FGC were once found
together, usually initiation has faded but FGC stubbornly remains. 2
These strategies were discussed at the Diabougou Declaration, according
to Melching. A former cutter told the meeting, "I have heard that some
cutters have asked for projects or money to stop this practice. I don't ask
for money, I ask for forgiveness for having caused girls and women such
suffering in their lives. We will now be like all the other women in the
village who together must work to create income generating projects."
The declarants also unanimously opposed substitute initiation rituals.
One said, "We need to do away with these rites altogether. We need a
means of controlling what goes on and if you have the drumming and
singing, it will be associated with cutting. People will use this pretext to
cut in secret. This must end." Another said, "Let's be honest, we were
cutting our girls at 2 weeks to 3 months over the past years so this was
2 I discuss heterogeneity in meaning and form of FGC, and
alternative reform strategies, in "Female Genital Cutting: The Beginning
of the End," in Female "Circumcision": Multidisciplinary Perspectives,
edited by Bettina Shell-Duncan and Ylva Hernlund (Lynne Rienner
Publishers, forthcoming).
Automated Records Management System
Hex-Dump Conversion
not even part of the ritual any longer. This is a romantic notion you
westerners have and want to impose on us now!"
***
We also journeyed to the region of Kolda, beyond the Gambia in
the southeast of Senegal, to the Futa Jallon where the Fulani dwell. We
arrived in distant Medina Cherif three hours late because of a punctured
radiator (one of three breakdowns in the bush of our decrepit 1986 Toyota
- Tostan employs 48 staff and educates thousands of people on a budget
equivalent to the expense of posting a single western aid official abroad).
Nevertheless we were welcomed with enthusiasm. I have seldom seen,
anywhere, such a group of confident, determined, organized, and
articulate women. Before the education program, women hereabouts did
not speak at meetings. Lala Baldé, head of the women's group, told me
that the day the class first understood the contents of the lesson on FGC,
which included the Diabougou Declaration, they sat down together and
cried. Her daughter Mani was in very good health before cutting, but she
bled badly, and she's had many health problems since then because of
that. They thought of girls who were the same age, and realized that the
smaller and sicklier were those who had hemorrhaged at cutting. Also,
"to be honest, it had killed many girl children." Once they worked
through the connection, they devised a plan to end the practice. Right
after class they went to the chief and asked him to call a meeting.
Meanwhile, they went to the other women in Medina Cherif with the
news.
They held a big village meeting, with both women and men. "We
decided to call the men, especially the young men. They are the future
husbands. If they were not involved in the decision then they would
refuse to marry uncircumcised women. We had to show them that
circumcision has nothing to do with marriageability." The women put on
their play about a girl dying from cutting. At the beginning of the
discussion there was some opposition, mostly from some men, but the
women had rehearsed their facts and arguments. The defenders of FGC
said one reason we do this is to prevent premarital sex, and if you stop
then girls will go running wild. The women answered that, as is too well
known, there is no evidence that circumcised girls are able to avoid
pregnancy. The way to keep girls from getting pregnant is to give them
education, not circumcision. Finally, since women were the victims of
this practice, their views should count most. That was the end of it.
Everyone understands and agrees now because of the public deliberation.
The Medina Cherif women then took their message on FGC to the
women of a second village, Saré Moody, and women from both those
Automated Records Management System
Hex-Dump Conversion
villages went to Saré Kadri, and the three villages had a meeting on it,
and this extended to a further 15 villages, then all 18 villages met to enact
the Medina Cherif Declaration, and now more villages want to join in.
They said they were sure that all the declarants had stopped. One
village didn't join in the declaration. "They did their circumcision rites
this year and a girl hemorrhaged and died, just like in the theater we did.
Then they stopped! Because now they know that the death is from the
cutting and not from bad spirits." Melching asked if the men had
anything to say. One said, "I don't know, this is a women's meeting."
Lala Baldé said, "This is a democracy, the men can speak too." The man
continued, "I was worried about the cutters. They got money for this and
I thought they would never stop. But the cutters themselves said they
would stop, and they did, we check up on it. It's incredible that this has
happened!"
The day before, we had visited Mampatim, a very large village that
joined the declaration but has not yet undertaken basic education. There
we met privately with a respected grandmother. She provided several
reasons why it had been easy to stop FGC, and why the decision will
stick. She added, though, that the women miss the circumcision
ceremonies, a special time for them to get together, dance, and sing. I
asked the women of Medina Cherif the next day how they would answer
her concern. One said, "The class replaces that experience. At the
learning center we sing, we dance, we do learning games, but at the same
time we learn about child development, nutrition and health." A second
said, "Those ceremonies were a big waste of money. Now we can spend
that money on something important: the education of our children." A
third added, vehemently, "Suppose you have your ceremony and the girl
dies. What about that? When death comes to the little girl, what good is
your singing and dancing then?"
Automated Records Management System
Hex-Dump Conversion
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Molly Melching <[email protected]> (Molly Melching <[email protected]>
UNKNOWN ])
CREATION DATE/TIME:14-APR-1999 23:55:03.00
SUBJECT: Re : Alice J. Pushkar/WHO/EOP is out of the office.
TO: Alice J. Pushkar ( CN=Alice J. Pushkar/OU=WHO/O=EOP WHO ])
READ:UNKNOWN
TEXT:
Dear Alice -
Hello again! I hope you had a great trip to North Africa. I heard
very
good things about it in the press and was so pleased!
Molly Buford called while I was at my mother's house in Arizona and I
explained that I was no longer going to be in Washington as originally
planned because the meeting had been cancelled for April 8. Now the
meeting
is rescheduled for June 3 and I'm really hoping that Mrs. Clinton will be
able to speak at this meeting. I sent the details to Molly B and have
included them with this email for your information. I would really like
Mrs.
C to continue to be associated with this successful movement to raise
awareness on FGC and end the practice. Her involvement has already helped
so
much and now that USAID is finally getting interested she could make a real
impact!
We have such great hope now for Senegal. Things look quite good at this
point - we have produced short television spots (3 minutes each) with
Unicef
using influential people here - a leading religious leader, traditional
village leaders and respected members of the government who speak for
women's health and against practices which can harm women's health. There
has been a wonderful reaction to these! (showing no bloody pictures or
shocking scenes - very respectful messages which are culturally sensitive)
Also, the Senegalese Parliament has called me in several times now and
has decided that they want to do a project with Tostan to cover 1,500
villages for basic education for women in areas where FGC is practised. An
ambitious program but one which would be very exciting!! I am writing up
the proposal for them now. Meanwhile, the Global Parliamentarians for
Action is holding a seminar here in Dakar next week and I will be speaking
with Waris Dire (the Somalian model who wrote the book on her experience
and
did the interview with Barbara Walters) at the session on FGC. I was very
worried about her coming at first because she is a supermodel and thus
could
be seen as Western and rejecting African traditions in general. The
religious leaders could use this to say - look at the women who end FGC -
they pose half naked in the West, etc. - But since she has already been
invited, we are going to make sure she wears traditional Senegalese dress
and speaks in a manner which will help our movement here. I have heard she
is very nice and her manager says she is very excited to be coming to
another African country. I will be meeting with her this Sunday and we may
possibly go to Malicounda so that she can meet the women there. I also
began to realize this past week that NO ONE knows her here anyway (no one
can afford international magazines!!).
Anyway, please say hello to everyone for me! I sent Melanne and Mrs. C
2
copies of the book by Tostan on FGC (have you seen it?) How is Katie?
Warm greetings and hope we can meet when I come the week of June 3
(I'll
probably come for one week or more - I am going to do some fund raising
while there hopefully!)
Warm greetings - Molly
USAID SYMPOSIUM ON FGC
RRB, Washington DC
June 3, 1999
Subject: FEMALE GENITAL CUTTING (FGC): THE FACTS AND THE MYTHS
In 1993, USAID designated the WID office as the Bureau's co-ordinator on
issues relating to female genital cutting (FGC). To co-ordinate activities
in the different offices and bureaux of the Agency, a Working Group on
(FGC) was formed in early 1994. The purpose of the group was to assess the
Agency's approach to FGC, raise awareness, and share information within and
outside the Agency. In 1997 the "Agency Program Guidelines for Integrating
Activities to Eradicate FGC into USAID Programs," was completed. These
guidelines were to assist in future programming for agency involvement in
FGC eradication. In line with the guidelines the Center for Population
Health
and Nutrition, the WID Office and the Africa Bureau sponsored a fellow from
the Population Fellowship Program at the University of Michigan to work on
FGC issues at USAID.
To raise awareness of the relevance of FGC to USAID's work, and enable the
staff to integrate this issue in their work, the FGC group is planning a
symposium to disseminate information.
The purpose of this symposium is to:
- Provide information about FGC from a cultural, human rights, health and a
holistic developmental perspective, that can be helpful for the successful
integration of FGC into USAID programs.
- Discuss successful interventions by local NGOs and the impact of those
interventions on reducing the incidence of FGC.
- Highlight new strategies that are now being tested.
The objective of this event is to raise awareness among USAID staff and
illustrate the broad range of sectors under which the issue can be
addressed. Cultural appropriateness of approaches and the effectiveness of
intervention have always been the concern not only on FGC, but all other
programs geared toward behaviour change. In this respect, the work on FGC
can provide useful experiences for other programs, as well as benefit from
other experiences.
8:30-8:45 Registration
8:45- 9:15 Plenary, opening session
Tentative speakers:
Chair: Ms. Vivian Derryck, AA Africa
15 Min.
Asma Abdel Halim, Office of population - Research
10 Min.
9:15-10:15 FGC as a human rights and reproductive health issue.
Chair: Asma Abdel Halim
- Nahid Toubia - President of RAINBO. 15 Min.
The presentation will propose a framework for analyzing different
approaches
to stopping FC/FGM as a basis for monitoring and evaluating different
projects and programs. This will be followed by an overview of some
projects
and
programs undertaken in different countries and communities over the past 20
years and provide a preliminary evaluation of their approaches and outcomes
based on the proposed framework. Interwoven in the presentation are
examples of some of RAINBO's own programs and products as a demonstration
of one particular approach to FC/FGM.
- Molly Melching - President of Tostan.
15 Min.
Tostan experience and the recent developments in Senegal. This presentation
will highlight Tostan's interventions and how they addressed the different
communities according to the priorities identified
by the people themselves. Using local languages Tostan developed nine
modules that addressed issues from personal hygiene to human rights. Women
who received training by Tostan are spearheading social change. The
presentation will address the importance of participatory approaches and
how they equip the people to address issues with a voice of their own.
- Qs & As
10:15-10:45- Video show, coffee break, information fair and publications
display
- 10:45- 12:00 Successful field interventions
Chair : Marge Horn
10 Min.
- Asha Mohamed - Senior Program Officer- PATH
10 Min.
Alternative Rites of Passage: Building on Positive Community Traditions.
The alternative rites of passage program in Kenya brought together
individuals who chose not to circumcise their daughters or are ambivalent
about it. Such individuals usually remain silent and their stand does not
affect the community. Using the positive parts of circumcision ceremonies,
e.g. education of young girls by elders, a program known as circumcision
by words was developed. The program involved the community at all the
stages from conceptualisation to implementation. Members of the community
who participated at all stages, from concept to design, were able to talk
to others who wanted to keep the tradition and convince them to join the
alternative rites.
- Romany Abadir - CEDPA-Egypt
10 Min.
The Positive Deviance Initiative (PDI) , Egypt. What is it? How is it
used as an empowerment tool.
The Positive Deviance Inquiry (PDI) is a fresh look at the practice of FGC
in its attempt to instead answer the question, "What are the factors that
enables some families to not circumcise their daughters?" In this way,
communities themselves discover what is inherently positive and "working"
within the community and are able to plan their own actions based on this
information. Because community members themselves are conducting the
research, analysis and program planning, the process builds the capacity of
individuals and local organizations and fosters sustainability. Thus, the
process of PDI becomes as empowering as the outcomes.
- Nafissatou Diop - Population Council
10 Min.
The results of Training programs for community leaders and circumcisors.
Different countries have been trying different approaches. This
presentation will identify interventions that targeted community leaders
and circumcisors in Mali, Burkina Faso and Senegal and explore the
successes of such programs.
- Qs & As
- 11:55-1:00
Chair: Ms. Sally Shelton-Colby
Integration of FGC into USAID programs.
Margaret Lycette, director WID office
John Flynn, Africa/AA
How can missions incorporate FGC: The Guinea experience
Liz Maguire, Director Office of Population
Guidelines for integrating FGC.
On display
1. Information Board: A poster highlighting FGC, its consequences,
prevalence and why it is performed.
2. Information Packet that contains a background paper on USAID's
activities on FGC, USAID strategy, Pamphlets, brochures and booklets that
provide information on the issue.
3. Posters produced by different CA's will be displayed on the walls of the
conference room.
4. Publications from CA's, especially the new publications that document
experiences and advocate eradication.
List of Participating Organizations
1. Center for Development and Population Activities (CEDPA) is a
non-profit international organization dedicated to empowering women at all
levels of society to be full partners in development.
2. Equality Now: an advocacy organization based in New York. EN has an
international membership of over 3000. NE is an active advocate against
FGC and helps Indigenous organizations obtain public international support
when those organizations call for it.
3. Program for Appropriate Technology in Health (PATH) is an international,
non-profit organization whose mission is to improve health, especially the
health of women and children. PATH works in partnership with host-country
governments and local agencies to assess health problems and identify and
implement creative and effective solutions.
4. The Population Council is a nonprofit, non-governmental institution that
seeks to improve the well-being and reproductive health of current and
future generations around the world and to help achieve a humane,
equitable,
and sustainable balance between people and resources. The Council conducts
biomedical, social science, and public health research and helps build
research capacities in developing countries.
5. Research, Action and Information Network for Bodily Integrity of Women
(RAINBO) is a not-for-profit organization working at the intersection
between Health and Human Rights. Its approach is a holistic one which
includes physical, psychological and social health. Currently RAINBO is
focusing on the issue of FGC to assert women's rights to their bodily
integrity.
6. Department of State
7. Tostan: a Senegalese based organization that pioneered educational
modules
that lead to the eradication of FGC in several villages in Senegal.
8. Center for Communication Programs (JHCCP) is part of the Johns Hopkins
School of Hygiene and Public Health. The Center works with many
international agencies, foundations, governments, and non-governmental
organizations in the US and overseas to promote healthy behavior.
>De?: : [email protected]
>? : [email protected] (Molly Melching)
>Objet?: Alice J. Pushkar/WHO/EOP is out of the office.
>Date?: Ven 19 mars 1999 23:12
>
>[ will be out of the office from 03/19/99 until 04/05/99.
>
>[ will respond to your message when I return.
>
>
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Jeffrey M. Smith ( CN=Jeffrey M. Smith/OU=OSTP/O=EOP [ OSTP ])
CREATION DATE/TIME:22-JUL-1999 10:00:20.00
SUBJECT: add'l message material for stem cell event
TO: Loretta M. Ucelli ( CN=Loretta M. Ucelli/OU=WHO/O=EOP@EOP [ WHO 1)
READ:UNKNOWN
CC: Arthur Bienenstock ( CN=Arthur Bienenstock/OU=OSTP/O=EOP@EOP [ OSTP ])
READ:UNKNOWN
CC: Joanne S. Tornow ( CN=Joanne S. Tornow/OU=OSTP/O=EOP@EOP [ OSTP ])
READ:UNKNOWN
CC: Richard A. Kostro ( CN=Richard A. Kostro/OU=OSTP/O=EOP@EOP OSTP ])
READ:UNKNOWN
CC: Holly L. Gwin ( CN=Holly L. Gwin/OU=OSTP/O=EOP@EOP [ OSTP )
READ:UNKNOWN
CC: Rosina M. Bierbaum ( CN=Rosina M. Bierbaum/OU=OSTP/O=EOP@EOP [ OSTP 1)
READ:UNKNOWN
CC: Rachel E. Levinson ( CN=Rachel E. Levinson/OU=OSTP/O=EOP@EOP OSTP ])
READ:UNKNOWN
CC: Anthony J. Gibson ( CN=Anthony J. Gibson/OU=OSTP/O=EOP@EOP [ OSTP )
READ:UNKNOWN
CC: Neal Lane ( CN=Neal Lane/OU=OSTP/O=EOP@EOP [ OSTP ])
READ:UNKNOWN
TEXT:
Loretta -- to build on Neal Lane's earlier note to you here's some
additional meat for you to consider for the message bones on the stem cell
event
Stem Cells are about Health!
Stem cells are cells that have the potential to form any cell of the
body. They can be isolated from embryos, fetuses and adults, although the
stem cells from adults have more limited capacity to form different types
of cells and are often difficult to locate. The discovery of embryonic
stem cells is a major scientific breakthrough, the full value of which
cannot be underestimated. Potential applications for stem cells include
alleviation of virtually any disease or disorder resulting from defective
tissue. The range covers neuronal cells for treating Parkinson,s disease,
Alzheimer,s and other brain disorders or spinal cord injury; islet cells
for alleviating diabetes; bone marrow cells for cancer patients or sickle
cell anemia; and skin cells for burn victims. Scientists are just
beginning to discover ways to make stem cells grow into the desired cell
types. It is too early to say which stem cell sources will work for each
possible application and too risky to close the doors on research that may
one day offer an actual cure for juvenile diabetes, for example, instead
of merely treating the symptoms. Robust government funding is the only
avenue to turning potential into real medical uses of stem cells. Strong
government oversight is the only way to ensure that such research is
conducted under the highest ethical standards.
Plus here's a draft letter that is ready to go we can influence when it
goes and tie it and the leaders of these organizations into the
event it is signed by over 110 national organizations.
July 21, 1999
The Honorable
U.S. House of Representatives
Washington, DC 20515
Dear Representative
:
This past February we wrote to you regarding our support for federal
funding of research using human pluripotent stem cells. With the
Appropriations process progressing we write now to reiterate that support
and to urge you to allow this research to move forward.
Human pluripotent stem cells have enormous potential for treatment of
disease because they have the ability to form into any type of cell in the
body. But only a fraction of the work that will be necessary to transform
this potential into reality has yet begun, and only a fraction of the
biomedical research community has been able to participate because the
federal government has not yet funded any of this work. The National
Institutes of Health are in the process of completing guidelines that will
permit and govern the use of these cells by federally funded
investigators. Only when these guidelines are in place will it be possible
to unleash the full capability of the biomedical research workforce toward
bringing the remarkable potential of human pluripotent stem cells to
fruition.
It is also clear that the American public supports federal funding of this
research. A recent nationwide survey conducted by Opinion Research
Corporation International has found that 74% of those polled favor funding
of stem cell research by the NIH.
Some have argued that "adult" stem cells will be sufficient in our pursuit
of treatments or cures of various diseases. While we believe that research
in the area of adult stem cells is vital to the research effort, we are
concerned that to restrict work to that area alone will prove insufficient
and would be a grave mistake. The prospect of cutting off an avenue of
research as promising as that with embryonic stem cells at this very early
stage of discovery deeply troubles those of us who conduct and promote
health research. Such a prohibition could delay possible treatments for
diseases like diabetes, cancer,
Alzheimer's and Parkinson's by years. Past work on animals has shown us
that it is the embryonic stem cells that hold the greatest potential in
their ability to be manipulated for treatments of disease.
We are also concerned by the argument that embryonic stem cell research
can be left to the private sector. While it is clear that a few privately
funded centers are working on pluripotent stem cell research, it is not
generally the practice of private companies to conduct this kind of basic
research into fundamental developmental processes. That is why it has been
and remains the role of the federal government to make the lion's share of
the investment in basic research, which has then been used by
biotechnology and pharmaceutical companies to develop products used for
treating diseases. And that is
why we cannot rely on private industry to conduct the kind of basic
research necessary to move the field of stem cell research from the
laboratory bench to the clinic.
Our intent is simply to ensure that research on stem cell lines is not
unduly restricted. With appropriate ethical safeguards, such as those
being developed by the National Institutes of Health, we believe that a
balance can be achieved, which respects both the moral status of the
embryo and the public's sensitivity to this issue while ensuring progress
in critical medical research. As we have said before, the government can
play an important role of oversight so that our nation's federally funded
scientists can conduct this critical work. Federal support will also
increase the financial resources directed to this area of research, which
will speed the pace of scientific discovery.
With the great hope pluripotent stem cell research provides to patients
ailing or dying from devastating diseases we urge the Congress to allow
this research to move forward with federal support.
Sincerely,
Academy of Clinical Laboratory Physicians and Scientists
Alliance for Aging Research
Alliance for Lung Cancer Advocacy, Support and Education
American Academy of Allergy, Asthma and Immunology
American Academy of Child and Adolescent Psychiatry
American Academy of Ophthalmology
American Association for Dental Research
American Association of Anatomists
American Association of Dental Schools
American Association of Immunologists
American Autoimmune Related Diseases Association
American Burn Association
American College of Clinical Pharmacology
American College of Neuropsychopharmacology
American College of Obstetricians and Gynecologists
American College of Physicians - American Society of Internal Medicine
American Gastroenterological Association
American Medical Association
American Neurological Association
American Pediatric Society
American Physiological Society
American Society for Biochemistry and Molecular Biology
American Society for Bone and Mineral Research
American Society for Cell Biology
American Society for Clinical Nutrition
American Society for Investigative Pathology
American Society for Microbiology
American Society for Pharmacology and Experimental Therapeutics
American Society for Reproductive Medicine
American Society of Clinical Oncology
American Society of Hematology
American Society of Human Genetics
American Thoracic Society
American Veterinary Medical Association
Americans for Medical Progress
Association for Research in Vision and Ophthalmology
Association of Academic Health Centers
Association of American Cancer Institutes
Association of American Medical Colleges
Association of American Universities
Association of Chairs of Departments of Physiology
Association of Independent Research Institutes
Association of Medical and Graduate Departments of Biochemistry
Association of Medical School Pediatric Department Chairs
Association of Medical School Psychologists
Association of Professors of Medicine
Association of Subspecialty Professors
Association of Teachers of Preventive Medicine
Association of University Radiologists
Boston University School of Medicine
Cancer Research Foundation of America
Citizens for Public Action on High Blood Pressure and Cholesterol
Coalition for American Trauma Care
Columbia University
Cure for Lymphoma Foundation
Dartmouth Medical School
Duke University
East Carolina University School of Medicine
Easter Seals
The Endocrine Society
Eye Bank of America
Federation of American Societies for Experimental Biology
Fred Hutchinson Cancer Research Center
Genetics Society of America
Glaucoma Research Foundation
Harvard University
Interstitial Cystitis Association of America, Inc.
Johns Hopkins University
Joint Council of Allergy, Asthma, and Immunology
Juvenile Diabetes Foundation International
Krasnow Institute for Advanced Study
March of Dimes
Massachusetts Institute of Technology
Medical College of Wisconsin
Myasthenia Gravis Foundation of America, Inc.
Myositis Association of America, Inc.
National Alliance for Eye and Vision Research
National Alliance for the Mentally III
National Association of State Universities and Land-Grant Colleges
National Caucus of Basic Biomedical Science Chairs
National Childhood Cancer Foundation
National Coalition for Cancer Research
National Health Council
National Osteoporosis Foundation
The National Pemphigus Foundation
National Psoriasis Foundation
National Spinal Cord Injury Association
New York University School of Medicine
Oncology Nursing Society
Osteogenesis Imperfecta Foundation
Paralyzed Veterans of America
Parkinson's Action Network
The Protein Society
Research!America
Resolve, the National Infertility Association
Roswell Park Cancer Institute
Scleroderma Foundation
Sjogren's Syndrome Foundation
Society for Investigative Dermatology
Society for Pediatric Research
Society for Reproductive Endocrinology and Infertility
Society for the Advancement of Women's Health Research
University of California
University of California, San Diego, School of Medicine
University of Florida
University of Illinois at Chicago
University of Michigan Medical School
University of Pittsburgh
University of Rochester Medical Center
University of Utah Health Sciences Center
University of Washington
University of Wisconsin-Madison
UPMC Health System
Vanderbilt University Medical Center
Yale University
Forwarded by Jeffrey M. Smith/OSTP/EOP on 07/22/99
09:51 AM
Neal Lane
07/22/99 08:45:59 AM
Record Type: Record
To:
Loretta M. Ucelli/WHO/EOP@EOP
cc: Betty J. Fountain/OSTP/EOP@EOP, Jeffrey M. Smith/OSTP/EOP@EOP,
Holly L. Gwin/OSTP/EOP@EOP
Subject:
followup comment on scheduling
Dear Loretta,
It seems to me that if at all possible--before Congress
departs--we ought to have a POTUS energy budget event and a 'stem cell
research' event.
It's timely to challenge their drastic cuts on the domestic and
international funding fronts that contradict the alleged spirit of the BRT
report (released yesterday) and the Murkowski bill. We have the perfect
reason to hold such an event. I submitted an event request on July 2 and
Roger Ballentine submitted one 7/20 along the same lines--use the occasion
of industry and academic leaders delivering the just-completed PCAST
energy report to the President (it calls for bolstering our domestic and
international efforts) as a rallying around our CCTI FY2000 request. This
would be best next week if either the Tuesday or Wednesday POTUS message
times can be used. If not, the last chance would be the following
week--the first week in August.
On the 'stem cell research' issue, the potus has been visible on
supporting such research - that could directly improve the health of 128
million Americans while being sensitive to ethical and moral concerns.
There are efforts in Congress to kill all such research.
I also support the POTUS and VP request for dual biomass events in
early August--one here and one in lowa,as submitted by Roger Ballantine
and George Frampton on July 2. This would have bipartisan support, and
will build goodwill in the farming communities. We have been working for
3 years to build a biomass initiative, and the technical analysis, agency
buy-in and community support are finally all in place.
Please call if I can answer any questions or help you move these along.
Many thanks. Neal
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Barbara D. Woolley ( CN=Barbara D. Woolley/OU=WHO/O=EOP [ WHO ])
CREATION DATE/TIME:27-SEP-1999 18:06:27.00
SUBJECT: List of Members on Patient Advocacy Coalition - Stem Cell.
TO: Mary E. Cahill ( CN=Mary E. Cahill/OU=WHO/O=EOP@EOP [ WHO ])
READ:UNKNOWN
CC: Joseph D. Ratner ( CN=Joseph D. Ratner/OU=WHO/O=EOP@EOP [ WHO )
READ:UNKNOWN
TEXT:
Should you need the list for JP.
Forwarded by Barbara D. Woolley/WHO/EOP on 09/27/99
06:05 PM
Rachel E. Levinson
09/27/99 05:50:23 PM
Record Type: Record
To:
Barbara D. Woolley/WHO/EOP@EOP
cc:
Subject:
Here are the groups who signed on to the recent letter. Below are
those who should have. This is more than Patients' CURe.
It's about 120. I would have just the CURe members plus a few,
including the larger patient groups in the second category.
I'll try to get CURe member today.
Academy of Clinical Laboratory Physicians and Scientists
Alliance for Aging Research
Alliance for Lung Cancer Advocacy, Support and Education
American Academy of Allergy, Asthma and Immunology
American Academy of Child and Adolescent Psychiatry
American Academy of Ophthalmology
American Association for Cancer Research
American Association for Dental Research
American Association of Anatomists
American Association of Dental Schools
American Association of Immunologists
American Autoimmune Related Diseases Association
American Burn Association
American College of Clinical Pharmacology
American College of Neuropsychopharmacology
American College of Obstetricians and Gynecologists
American College of Physicians - American Society of Internal
Medicine
American Gastroenterological Association
American Medical Association
American Neurological Association
American Parkinson's Disease Association
American Pediatric Society
American Physiological Society
American Society for Biochemistry and Molecular Biology
American Society for Bone and Mineral Research
American Society for Cell Biology
American Society for Clinical Nutrition
American Society for Investigative Pathology
American Society for Microbiology
American Society for Pharmacology and Experimental Therapeutics
American Society for Reproductive Medicine
American Society of Clinical Oncology
American Society of Hematology
American Society of Human Genetics
American Thoracic Society
American Veterinary Medical Association
Americans for Medical Progress
Association for Research in Vision and Ophthalmology
Association of Academic Health Centers
Association of American Cancer Institutes
Association of American Medical Colleges
Association of American Universities
Association of Chairs of Departments of Physiology
Association of Independent Research Institutes
Association of Medical and Graduate Departments of Biochemistry
Association of Medical School Pediatric Department Chairs
Association of Medical School Psychologists
Association of Professors of Medicine
Association of Subspecialty Professors
Association of Teachers of Preventive Medicine
Association of University Radiologists
Boston University School of Medicine
Cancer Leadership Council
Cancer Research Foundation of America
Citizens for Public Action on High Blood Pressure and Cholesterol
Coalition for American Trauma Care
Columbia University
College on Problems of Drug Dependence
Cornell University
Cure for Lymphoma Foundation
Dartmouth Medical School
Duke University
East Carolina University School of Medicine
Easter Seals
The Endocrine Society
Eye Bank of America
Federation of American Societies for Experimental Biology
Fred Hutchinson Cancer Research Center
Genetics Society of America
Glaucoma Research Foundation
Harvard University
Interstitial Cystitis Association of America, Inc.
Johns Hopkins University
Joint Council of Allergy, Asthma, and Immunology
Juvenile Diabetes Foundation International
Krasnow Institute for Advanced Study
March of Dimes
Massachusetts Institute of Technology
Medical College of Wisconsin
Memorial Sloan-Kettering Cancer Center
Myasthenia Gravis Foundation of America, Inc.
Myositis Association of America, Inc.
National Alliance for Eye and Vision Research
National Alliance for the Mentally III
National Association for Biomedical Research
National Association of State Universities and Land-Grant Colleges
National Caucus of Basic Biomedical Science Chairs
National Childhood Cancer Foundation
National Coalition for Cancer Research
National Health Council
National Mental Health Association
National Osteoporosis Foundation
The National Pemphigus Foundation
National Psoriasis Foundation
National Spinal Cord Injury Association
New York University School of Medicine
Oncology Nursing Society
Osteogenesis Imperfecta Foundation
Paralyzed Veterans of America
Parkinson's Action Network
The Protein Society
Research Society on Alcoholism
Research!America
RESOLVE, the National Infertility Association
Roswell Park Cancer Institute
Scleroderma Foundation Scleroderma Research Foundation
Sjogren's Syndrome Foundation
Society for Investigative Dermatology
Society for Pediatric Research
Society for Reproductive Endocrinology and Infertility
Society for the Advancement of Women's Health Research
Society of Critical Care Medicine
Stanford University School of Medicine
University of California
University of California, San Diego, School of Medicine
University of Florida
University of Illinois at Chicago
University of Michigan Medical School
University of Pittsburgh
University of Rochester Medical Center
University of Utah Health Sciences Center
University of Washington
University of Wisconsin-Madison
UPMC Health System
Vanderbilt University Medical Center
Yale University
Here are some of other groups we might invite who are not part of CURe.
American Cancer Soceity
American Heart Association
Alzheimer's Association
American Academy of Pediatrics
American Lung Association
National Multiple Sclerosis Society
National Organization for Rare Disorders
Society for Neuroscience
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Rebecca Werbel <[email protected]> ( Rebecca Werbel <[email protected]> [ UNKNOWN D
CREATION DATE/TIME: 3-FEB-2000 14:20:29.00
SUBJECT: accomplishments
TO: Irma L. Martinez ( CN=Irma L. Martinez/OU=WHO/O=EOP [ WHO 1)
READ:UNKNOWN
TEXT:
Attached are HHS accomplishments documents from '93-'99, except for '95.
I'm
trying to track that one down. I'm also waiting on an electronic version
of
the memorandum to John Podesta with our accomplishments for '99 and our
goals
for '00.
1993.12.22 : Year-End Accomplishment Fact Sheet
December 22, 1993
UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES NEWS
1993 -- A YEAR OF ACCOMPLISHMENTS
"1993 has been an incredibly productive year for the
people here at HHS and for those whom it serves. President Clinton
has charted an ambitious course for the federal government to 'put
people first,' and that's just what we have done and look forward
to doing in 1994.
"During our 11 months in office, we have achieved enactment
of a sweeping childhood immunization initiative that will guarantee
free inoculation to all low-income children in the United States
and substantially improve the nation's immunization delivery
system; increased funding for such priorities as Head Start, the
Ryan White AIDS services program, and programs to address women's
health concerns; renewed our effort to control and eventually cure
AIDS; processed a record number of Social Security old age,
survivors, and disability benefit payments; and approved a dozen
State applications for experimentation in health care and welfare.
We have also begun a continuous improvement process that will
streamline and improve how we manage our programs and deliver
quality services to the public.
"The Clinton Administration also developed the most
comprehensive health reform proposal in our nation's history. The
President's Health Security Act will guarantee all Americans health
care coverage that is affordable, portable, and permanent. And it
will finally get a handle on runaway health care costs that have
sapped the budgets of American families, business, and government.
"We look forward to the year ahead. It promises to be an
exciting one, dominated by debate and enactment of the Health
Security Act and introduction of the President's welfare reform
proposal. We plan to build on our successes of 1993 as we move our
nation forward toward the new century."
-- Donna E. Shalala
Highlights of 1993 include:
Health Reform. During his first week in office, the President
appointed the White House Task Force on Health Reform, chaired by
First Lady Hillary Rodham Clinton. The group conducted an
exhaustive public review of the problems facing the American health
care system and the people it serves. On September 22, the
President outlined his proposals to achieve health security for all
Americans. On November 20, the Health Security Act was introduced
in both houses of Congress with the largest number of cosponsors of
any reform plan now before Congress.
Childhood Immunization. The President proposed and Congress
enacted the Vaccines for Children program, which guarantees low-
income children access to free immunization against preventable
diseases and vastly improves the nation's immunization delivery
system. The National Outreach Campaign will improve public
education as well as training of health care professionals who
deliver vaccines. HHS also worked with the Office of Personnel
Management to improve immunization coverage under the Federal
Employees Health Benefits Program.
Children. HHS spending for children's programs has increased by
more than $5 billion from $55.3 billion in fiscal year 1993 to
$60.7 billion for fiscal year 1994. This includes an expansion of
Head Start, child care, lead poisoning prevention, and Healthy
Start (a demonstration program aimed at reducing infant mortality).
Head Start. The Clinton Administration has made expanding and
improving Head Start a top priority. Congress approved a $550
million increase in the program's appropriation for fiscal year
1994. HHS established an Advisory Committee on Head Start Quality
and Expansion to ensure that the program's quality is improved as
it is expanded. The Committee's recommendations are expected early
in 1994.
Deficit Reduction. HHS contributed substantially to the largest
deficit reduction effort in the nation's history. As part of a
five-year $504 billion package of deficit reduction, growth in
Medicare spending was reduced by $56 billion and growth in the
federal portion of Medicaid spending was reduced by $7 billion. In
addition, discretionary domestic spending was effectively frozen
for five years.
Reproductive Rights. Immediately upon taking office, the President
signed Executive Orders lifting the bans on abortion counseling by
Title X (family planning) program grantees and on funding by the
National Institutes of Health of biomedical research utilizing
fetal tissue. The Administration also has restored funding to
international family planning organizations and worked successfully
toward a relaxation of restrictions on federally-funded abortions.
Waivers. HHS moved aggressively to speed the consideration of
State proposals to test innovative approaches to health care and
welfare. In its first 11 months in office, the Clinton
Administration approved waivers allowing five States to conduct
statewide health reform experiments (Oregon, Hawaii, Rhode Island,
Tennessee, and Kentucky). Similarly, the Department has approved
State requests for welfare demonstrations from Georgia, Illinois,
lowa, Vermont, Virginia, Wisconsin, and Wyoming.
Welfare Reform. A White House Working Group on Welfare Reform,
Family Support, and Independence was appointed and has spent the
past year considering methods to encourage independence and work
and eliminate dependence on welfare programs. A comprehensive
proposal will be forthcoming in 1994.
AIDS. Twelve years into the AIDS epidemic, the federal effort to
find a cure to HIV disease and treatment for the effects of the
AIDS virus was galvanized with a new influx of federal funding
(including an 18 percent increase in research funds and a 66
percent rise in funding for Ryan White AIDS services) and the first
top-level commitment to fighting this deadly disease. The latter
was evidenced by the appointment of a National AIDS Policy
Coordinator as a member of the White House Staff and direct
Presidential participation in World AIDS Day commemorations. HHS
also has created a new task force to identify and eliminate
impediments to AIDS drug development.
Biomedical Research. Breaking a five-year impasse, Congress
reauthorized programs under the National Institutes of Health. The
new statute eliminates the ban on funding of fetal tissue research
and establishes safeguards against imposition of such policies in
the future. It also establishes requirements for the inclusion of
women and minorities in federally funded research studies and
strengthens the role of the Office of AIDS Research.
Women's Health. Federal efforts to confront and conquer health
problems affecting women were redoubled. Federal funding for
fiscal year 1994 in this area was increased by $203 million over
fiscal year 1993; a permanent Office of Women's Health Research was
created at the National Institutes of Health; a national conference
on breast cancer was convened by the Secretary; and women's health
concerns are at the center of the disease prevention package of
benefits included in the President's Health Security Act.
Family Preservation and Support. The President proposed and the
Congress enacted the Family Preservation and Support Act, which
provides $1 billion over five years to states. Family support
programs, such as family resource centers or home visiting
programs, work with families before a crisis occurs. The Family
Preservation Programs provide services to families experiencing
crises to help keep families and children intact.
Social Security. Faced with a 41 percent increase in applications
for disability claims in the past three years, the Social Security
Administration (SSA) released a $198 million contingency fund and
was able to process approximately 300,000 more cases than
anticipated. Efforts continue to re-engineer the disability
process to make it easier for the customer and more efficient for
the Agency. Nearly 7.5 million old age, survivors, disability, and
Supplemental Security Income claims were processed. SSA handled a
record 46 million telephone calls through its toll-free services.
Older Americans. The Commissioner on Aging was elevated to the
level of Assistant Secretary and the White House Conference on
Aging was put on track for May 1995. In addition, the
Administration on Aging is preparing to unveil plans for four
strategic initiatives in 1994. These are: a blueprint for future
retirees; a long term care initiative focused on development of
home and community-based care systems; an initiative on older
women; and an initiative focusing on malnutrition and nutrition.
Management Improvement. Throughout HHS, modern management
techniques have been introduced or enhanced to ensure that our
products and services are delivered in a caring, effective, and
efficient manner. Through the use of such tools as total quality
management techniques, re-engineering, strategic planning, and
outreach to our partners we have initiated a culture of combining
meaningful public policy with proactive management processes.
HHS Appointments. Sixteen Presidential appointments have been made
and confirmed by the Senate, including eight women and eight men.
In addition, the nomination for Director of the Indian Health
Service is pending before the Senate. The appointees are
distinguished experts in their field, including the first Nobel
laureate to lead the National Institutes of Health. The personal
backgrounds of these individuals represent a broad array of ethnic,
social, and practical experiences.
Contact: HHS Press Office
(202) 690-6343
- accomplishments98.wpd - accomplishments97.wpd - accomplishments96.wpd - accomplishments94.wpd -
accomplishments99.wpd
ATTACHMENT
1
ATT CREATION TIME/DATE: 0 00:00:00.00
TEXT:
Unable to convert ARMS_EXT:[ATTACH.D56JARMS24882414H.046 to ASCII,
The following is a HEX DUsMP:
END ATTACHMENT 5
HHS FACT SHEET
December 31, 1998
Contact: HHS Press Office
(202) 690-6343
HHS Achievements in 1998 Build a Healthier America
In 1998, the Department of Health and Human Services continued to make important progress in
improving the health and welfare of all Americans. We made major investments to ensure the
health of our nation's children, took steps to reduce the major disparities in health that exist
between whites and racial and ethnic minorities, and we made significant strides in our fight
against disease, including cancer and AIDS. Infant mortality reached an all-time low and the
average life span for Americans reached an all-time high. The levels of immunizations for
preschool children of all racial and ethnic groups reached nearly equal levels, wiping out a 26
percentage point difference a generation ago.
Protecting the health of our children has been a top priority of HHS, and in 1998, we approved
48 states and territorial plans under the Child Health Insurance Program, which together will
provide health insurance for more than 2.5 million children in low-income families within the
next three years. We also strengthened our Head Start program, initiated new regulations that
require drug labels to include specific information about drug safety for children, and redoubled
our efforts to reduce tobacco sales to minors.
In response to President Clinton's goal of eliminating major health disparities between whites
and racial and ethnic minorities by 2010, HHS took important steps to meet these new national
health objectives. We added an additional $156 million in our FY 1999 budget targeted to
reducing the disproportionate burden of HIV/AIDS among racial and ethnic minority
communities and awarded grants to promote diabetes prevention activities among American
Indian populations.
This past year brought news of significant gains in biomedical research and in our efforts to
prevent disease and promote health. We announced that for the first time in 20 years, cancer
death rates declined, and AIDS dropped out of the top ten causes of death. HHS-supported
researchers for the first time deciphered the entire genetic code of a multicelled organism, which
holds tremendous promise for improving our understanding of a wealth of human genetic
diseases. We secured a record level of. funding for the National Institutes of Health, and
President Clinton announced an historic increase in funding at the NIH to prevent and treat
HIV-AIDS around the world, including a 33 percent increase over last year's funding to search
for an AIDS vaccine. Overall, HHS will spend nearly $7.7 billion in 1999 for HIV/AIDS
prevention activities.
With all of our appointees now confirmed, we will continue to build on our successes and
accomplishments as we prepare for the new millennium. Improving health care access and
quality, increasing food safety, enhancing our efforts to prevent and manage chronic disease,
and reducing tobacco use are just a few of the priorities that we will address in the coming year.
Donna E. Shalala
PROTECTING THE HEALTH OF OUR CHILDREN AND YOUTH
In 1998, we made significant progress in improving the health of America's children by
implementing the Children's Health Insurance Program, increasing immunization rates,
decreasing tobacco and drug use, and implementing pediatric drug labeling regulations.
Improving Health Care for Children. In 1998, HHS worked diligently with the states to
develop and implement plans to extend health care coverage to millions of uninsured children.
Automated Records Management System
Hex-Dump Conversion
The Children's Health Insurance Program (CHIP), which was passed in the Balanced Budget Act
of 1997, provides $24 billion in set-aside funds for health insurance for low-income children. To
date 48 state and territorial plans have been approved under CHIP. These CHIP plans estimate
that they will cover more than 2.5 million children within the next three years.
Making Child Care More Affordable and Accessible. In January 1998, President Clinton
announced his historic proposal to enhance the affordability, accessibility and quality of child
care for America's working families. The $21.7 billion initiative would increase subsidies and tax
credits for low to middle income families, provide new resources to states to improve the quality
of child care and choices for parents and expand after school programs. In the FY 1999 budget
agreement, the President secured a down payment on the proposal with $200 million for the 21st
Century Learning Center program and $180 million for states to improve child care quality.
Head Start Reauthorized, Strengthened, and Expanded. On October 27, 1998, President
Clinton signed bipartisan legislation that reauthorized Head Start for four more years and
strengthens and expands it to better serve America's families into the 21st century. The renewal
also includes the President's goal of doubling the number of infants and toddlers served in the
Early Head Start program by the year 2002. Under the Clinton Administration, funding for Head
Start has increased by 68 percent and enrollment has increased by over 200,000 children,
reaching 830,000 children this past fiscal year. With an increase of $313 million for FY
1999 -- the amount the President requested in his budget proposal -- Head Start will continue to
expand toward the goal of serving one million children by 2002.
Making Prescription Drugs Safer for Children. HHS marked an important milestone in the
Administration's effort to make drugs safer and more effective for children by requiring that drug
labeling have specific information on the use of new drugs and biologics in children. Without
adequate information, physicians may be reluctant to prescribe certain drugs for their pediatric
patients, or they may prescribe them inappropriately. The new requirements make it more likely
that children will receive improved treatment because doctors will have more complete
information on how drugs affect children.
Reducing Tobacco Sales to Children. In February 1998, HHS launched a major national
education campaign designed to help reduce illegal sales of tobacco products to children. The
campaign, an important part of the administration's comprehensive strategy to prevent youth
tobacco use, informs retailers and customers that it is a federal violation to sell cigarettes or spit
tobacco to anyone younger than age 18 and requires retailers to ask for photo identification from
anyone younger than 27. In addition, HHS made progress in implementing the Synar
Amendment, legislation that requires states to monitor retailer compliance to ensure they prohibit
tobacco sales to children. SAMHSA announced that more than 60,000 retail establishments have
been inspected since the final Synar regulation was enacted in 1996. Four states -- Florida,
Maine, New Hampshire and Washington -- have already met the retailer compliance
requirements set by the law. FDA launched an educational campaign featuring radio, print, and
billboard advertisements, as well as materials for retailers to display in their stores. The
campaign is designed to remind retailers, clerks and customers about the law and the retailer's
risk of fines.
Improving the Chances for Children at Risk for a Permanent, Safe Home. Under the
expanded authority of the Adoption and Safe Families Act signed by President Clinton in 1997,
HHS approved demonstration projects in eight states this year to test new ways to protect
children at risk and secure permanent homes for those in foster care. We issued new proposed
Automated Records Management System
Hex-Dump Conversion
child welfare regulations that will emphasize safety for children, improved well-being of
children, and more accountability for children reaching permanent homes quicker. Finally, along
with President and Mrs. Clinton, we announced our intent to develop a plan for expanding the
use of the Internet. By putting the photos of children who are legally available for adoption on a
national Internet service, the time that a child waits to find an adoptive family could be
shortened.
Reducing Teen Pregnancy. In April 1998, HHS announced that the teen birth rate fell an
estimated 3 percent in 1997, continuing a six-year downward trend. In addition, the teen birth
rate for white, black, American Indian, Asian or Pacific Islander and Hispanic women ages 15-19
declined substantially nationwide from 1991 to 1997. In particular, the rate for black teens - until
recently the highest -experienced the largest decline, down 23 percent from 1991 to 1997 to reach
the lowest rate ever reported for blacks. In December 1998, we released a first-time report
showing the rate of second births for teens was down by 21 percent between 1991 and 1996.
Teen Drug Use Levels Off, Declines in Some Groups. In December 1998, we released the 24th
annual Monitoring the Future Survey, which showed that illicit drug use among teenagers
remained stable for the second year in a row, and in some cases even decreased. The survey
found general stability among the proportion of 12th graders using most illicit drugs in the past
year or past month, including the most frequently used drug, marijuana. Past year use of illicit
drugs among 10th graders decreased from 38.5 percent in 1997 to 35.0 percent in 1998. Past year
use among 8th graders decreased from 23.6 percent in 1996 to 21.0 percent in 1998. This year's
study also reported an increase in perceived risk of harm in using marijuana, which generally is
predictive of a decline in marijuana use. This report is the first to find an increase in the
perceived risk of marijuana use among 8th graders since 1991.
Over the past two years, HHS has re-engineered and expanded our substance abuse prevention
programs, to include State Incentive Grants for Community-based Action, awarded to 19
governors to coordinate and fund local prevention efforts and Targeted Capacity Expansion
Grants, awarded to 41 municipal, county, state, and tribal government substance abuse programs
to help fill gaps in treatment for serious, emerging drug problems at the earliest possible stages.
FOCUSING ON WOMEN'S HEALTH
Preventing Disease in Women. Medicare expanded coverage of mammograms, pap smears,
colorectal cancer screening, bone mass measurement for beneficiaries at risk for osteoporosis and
other bone abnormalities, and diabetes self-management benefits. This emphasis on early
detection and management of disease was a result of the President and Congress working
together to expand the preventive benefits available to all Medicare beneficiaries in the Balanced
Budget Act. During Breast Cancer Awareness Month in October 1998, Secretary Shalala
announced new efforts to encourage mammography screening among special populations,
especially to older, low income, and minority women, who tend to have the highest breast cancer
mortality rates. The Health Care Financing Administration (HCFA) and the National Cancer
Institute (NCI) joined in this breast cancer outreach effort. Also in 1998, the Mammography
Quality Standards Act (MQSA) was reauthorized, meaning that approximately 10,000
mammography facilities in the United States have been accredited and women can have
confidence that they meet uniform federal standards for mammography.
Improving Access to Health Information and Care. On November 16, 1998, HHS formally
launched the National Women's Health Information Center, a combination Web site
(http://www.4woman.gov) and toll-free hotline (1-800-994-WOMAN), which serves as a
Automated Records Management System
Hex-Dump Conversion
"one-stop shopping" resource for comprehensive information on women's health. Because the
service is available through the Internet or via a toll-free number, women in every corner of
America will now have access to accurate and timely health information. Also in 1998, we
established six new National Centers of Excellence in Women's Health, specifically to focus on
serving minority populations. This brings to 18 the number of centers that unite women's health
research, medical training, clinical care, public health education, community outreach, and the
promotion of women in academic medicine.
Joint U.S.-Israeli Conference on Women's Health. In December 1998, the Department
convened the first Bi-National Israel-U.S. Conference on Women's Health to discuss and
exchange information on a range of global health topics that cover the life span of women.
Hundreds of women's health leaders from the two nations discussed common issues such as
breast cancer, heart disease, working women's health, and prevention strategies for adolescent
risky behaviors. The Secretary opened the conference by affirming HHS' commitment to advance
the health of women at home and around the world and to strengthen the bond of friendship we
already feel for the women of Israel.
Helping Women Use Medicines Wisely. HHS launched in March 1998 a nationwide campaign
to educate women about the importance of properly using medicines. Women often are the
primary caregivers for their children and, increasingly, their own parents. Frequently their own
health is overlooked in the process, so by taking time to learn to use medicines wisely, women
will be able to take better care of themselves and their families. The grassroots campaign,
"Women's Health: Take Time to Care, Use Medicines Wisely" is primarily directed at women
over 45, particularly those who are underserved. In developing the campaign HHS partnered with
the National Association of Chain Drug Stores and a broad network of organizations, including
the League of Women Voters, American Heart Association, National Black Nurses Association,
and American Association for Retired Persons.
CONTINUING THE FIGHT AGAINST HIV/AIDS
AIDS Falls From Top Ten Causes of Death. In October 1998, the Centers for Disease Control
and Prevention reported that AIDS fell from the top ten causes of death in the U.S., declining an
unprecedented 47 percent from 1996 to 1997 to an age-adjusted HIV death rate of 5.9 deaths per
100,000, the lowest it has been since 1987. The decline in AIDS deaths is primarily due to the
continuing impact of highly active antiretroviral therapy in helping people with HIV live longer
and healthier lives.
Preventing AIDS Through Medical and Behavioral Approaches. President Clinton
announced an historic increase in funding to search for an AIDS vaccine. NIH plans to spend
$200 million on AIDS vaccine efforts in FY 1999, up 33 percent from FY 1998. As of June
1998, NIH-supported researchers had evaluated 23 vaccine candidates and 10 adjuvants
(substances incorporated into a vaccine that boost specific immune responses to the vaccine) in
3,200 volunteers in 49 phase I/II clinical trials. On June 3, 1998, the Food and Drug
Administration granted permission to VaxGen Inc. for the nation's first phase III clinical trial for
an AIDS prevention vaccine. The three-year trial of the vaccine, called AIDSVAX, will include
5,000 U.S. volunteers and 2,500 volunteers in Thailand. In April, HHS determined that needle
exchange programs can be an effective part of a comprehensive strategy to reduce the incidence
of HIV transmission without encouraging the use of illegal drugs.
Increasing Access to AIDS Care. In 1998, HHS also increased by 70 percent the funds
earmarked for the AIDS Drug Assistance Programs (ADAP), ensuring that more than 100,000
Automated Records Management System
Hex-Dump Conversion
low income individuals living with HIV/AIDS receive life-saving and -sustaining drug therapies.
On December 18, 1998, HHS committed $479 million to fund primary health care and support
services for low-income individuals in 50 eligible metropolitan areas. Part of these funds are
targeted to cities with high numbers of affected African American and Hispanic populations
under a special Clinton administration initiative with the Congressional Black Caucus.
CLOSING THE GAP IN HEALTH FOR RACIAL AND ETHNIC MINORITY
POPULATIONS
Initiative to Eliminate Racial and Ethnic Disparities in Health. Launched by President
Clinton in a White House Radio Address on February 21, 1998, the racial disparities initiative
sets a national goal of eliminating major health disparities between whites and racial and ethnic
minorities by the year 2010. The initiative focuses on drawing together public and private
efforts - including local communities -to eliminate the health disparities in these key areas: infant
mortality, diabetes, cardiovascular disease, HIV/AIDS, cancer and adult and childhood
immunizations. The President is asking Congress for $400 million over five years to develop
new approaches and to build on existing strategies to address these disparities, and Congress has
appropriated $65 million for the first year, Fiscal Year 1999. The announcement has been
followed up by a major community outreach campaign headed by Dr. Satcher. In October 1998,
Secretary Shalala announced the formation of a broad, new Departmental Minority Initiatives
Steering Committee, designed to provide guidance for a number of related HHS minority health
initiatives. These include the Hispanic Agenda for Action and the Asian-American and Pacific
Islander Action Agenda, as well as the White House's Historically Black Colleges and
Universities Initiative and the White House Initiative on Tribal Colleges and Universities.
Diabetes. In 1998 HHS' Indian Health Service awarded 286 grants to Indian communities in
urban areas and on or near reservations for programs focused on primary prevention of
diabetes and promoting healthy lifestyle choices. The programs will reach more than 100,000
American Indians and Alaska Natives suffering with diabetes as well as another
30,000-50,000 who are at risk or have undiagnosed cases. In addition, HHS' Health Resources
and Services Administration (HRSA) launched an intensive effort to help its community
health centers prevent, diagnose, and treat diabetes. HRSA's community health centers are the
health care provider of choice for 10 million Americans, 65 percent of them racial and ethnic
minorities.
HIV/AIDS. In response to the severe and ongoing crisis regarding HIV/AIDS in racial and
ethnic minority communities, the Department joined President Clinton and the Congressional
Black Caucus in announcing a special package of initiatives aimed at reducing the
disproportionate burden of HIV/AIDS on racial and ethnic minorities, especially
African-Americans and Hispanics. Final Fiscal Year 1999 appropriations included an
additional $156 million to enhance the federal response to HIV/AIDS in racial and ethnic
minorities. The funding will be used for making available Crisis Response Teams to a number
of highly-impacted areas; enhancing HIV/AIDS prevention efforts in racial and ethnic
minority communities; and reducing disparities in treatment and health outcomes for
minorities with HIV/AIDS.
Infant Mortality. The overall infant mortality rate reached a new low of 7.1 deaths per 1,000
live births. Mortality from Sudden Infant Death Syndrome (SIDS) continued to decline, and
Automated Records Management System
Hex-Dump Conversion
more Americans learned the importance of placing infants on their backs to sleep, in order to
prevent SIDS. Timely prenatal care also reached record levels in 1997 as an estimated 82.5
percent of women received care in their first trimester of pregnancy. Low birth weight babies
accounted for 7.5 percent of all births, compared to 7.4 percent in 1996. Unfortunately, this
increase was confined to non-Hispanic white and Hispanic women. Low birth weight
remained unchanged for births to black women.
Immunizations. This year, HHS reported that immunization rates for the complete series of
childhood immunizations has reached a record high of 78 percent, and that rates for the most
critical vaccines are nearly the same for children of all racial and ethnic groups -- closing a
gap that was as wide as 26 points a generation ago. In addition, the number of cases of vaccine
preventable disease reached record lows, including the lowest confirmed number of measles
cases since 1912. Increasing childhood immunizations has been a priority of the Clinton
Administration since 1993, and our FY 1999 budget includes $656 million for vaccine
purchases and $316 million for immunization program activities. In the coming years, we will
be devoting increased attention to reaching minority children. While 79 percent of white
children have received the complete series of vaccinations by age two, only 74 percent of
black children and 71 percent of Hispanic children are fully vaccinated.
Cancer. On March 12, 1998, CDC and NIH announced that the incidence and death rates for
all cancers combined and for most of the top 10 types of cancer declined between 1990 and
1995, reversing an almost 20-year trend of increasing cancer cases and death in the U.S. The
report showed that incidence rates declined for most age groups, for both men and women,
and for most racial and ethnic groups. During Breast Cancer Awareness Month in October
1998, Secretary Shalala announced new efforts to encourage mammography screening among
special populations, especially to older, low income, and minority women, who tend to have
the highest breast cancer mortality rates. HCFA and the National Cancer Institute joined
together in an education campaign to increase awareness of the new annual Medicare
mammography benefit and the importance of regularly-scheduled screening mammograms.
The new efforts focus on high concentration areas of older women. In addition, HCFA offered
mammogram screenings to older African-American and Hispanic-American women in
Atlanta, Chicago, Cleveland, Los Angeles, Philadelphia, San Antonio, and Washington, D.C.
Cardiovascular Disease. In December 1998, HHS released a landmark study showing that
total cholesterol levels for Americans decreased in men and women in all racial groups.
However, the study showed that black adolescents experienced a smaller decline compared to
non-Hispanic whites and Mexican Americans. Of all the groups, black females continued to
have the highest total cholesterol and experienced the smallest decrease over time. The finding
of higher total cholesterol levels in black adolescents differs from the pattern in adults, in
whom blacks have lower total cholesterol than whites. This will be an area of continued
research at NIH.
BETTER HEALTH AND CARE FOR OLDER AMERICANS
Medicare Project to Promote Healthy Aging. In October 1998, HHS announced the Healthy
Aging Project, a five-year project designed to find improved ways to slow or prevent physical
disabilities in our nation's elderly. With the number of seniors expected to increase to 68 million
Automated Records Management System
Hex-Dump Conversion
by 2030, it is essential to identify the strategies that have been most successful in promoting a
healthy aging experience. With this project, HCFA will rigorously evaluate or test some of the
many programs that claim to improve health and reduce chronic disease.
Preventing Elder Abuse. According to a recent report to Congress, more than half a million
older Americans suffered some form of abuse and neglect in 1996. In cases where a perpetrator
of abuse and neglect is known, the perpetrator is found to be a family member in 90 percent of
cases, and two-thirds of these perpetrators are adult children or spouses. On October 8, 1998,
HHS announced the establishment of a new National Center on Elder Abuse designed to promote
understanding among state and local networks of community workers, physicians, elderly
volunteers, and others working to prevent elder abuse. The center is funded by a $1 million HHS
grant and is led by the National Association of State Units on Aging. Operating as a partnership
between several service and legal organizations, the center will especially expand its support of
training activities, aiming at helping "senior sentinels" persons who work with older persons
on a regular basis -- as well as medical and social service professionals to identify and respond
appropriately to possible cases of elder abuse and neglect.
Improving Nursing Home Quality. On July 21, 1998, HCFA unveiled a nursing home initiative
to enhance protections for nursing home residents, including tougher enforcement of nursing
home rules and strengthened oversight of states nursing home quality and safety responsibilities.
HCFA has implemented a new monitoring system and given new instructions to states on how to
handle problem nursing homes and nursing home chains.
Lifestyle Changes May Help Elderly Eliminate Need for Blood Pressure Medication. On
March 18, 1998, NIH announced that the results of a 30-month study of older Americans with
high blood pressure showed that losing weight and cutting down on salt can lessen and even
eliminate the need for blood pressure-lowering medications in the elderly. By modifying their
own behavior, older Americans can play an important role in treating and managing their high
blood pressure.
Addressing Substance Abuse Among Older Adults. On May 7, 1998, the Substance Abuse
and Mental Health Services Administration (SAMHSA) released a new best practice guideline to
assist the health care community in detecting and treating alcohol and medication abuse among
older patients. By encouraging service providers to understand the effect that alcohol and drug
abuse can have on older people, this report will provide opportunities to help older people who
are in need of substance abuse treatment.
International Year of Older Persons. HHS' Administration on Aging, as head of the Federal
Committee to Celebrate the International Year of Older Persons, launched the International Year
of Older Persons, which began on October 1, 1998 and will last through October 1, 1999. More
than 40 federal departments and agencies are involved in the planning for the International Year.
Activities are planned throughout 1999 at the national, state and local level and include media
roundtables and a two- day conference in June of 1999. A kick-off event featuring the Secretary
was held on October 19.
PREVENTING DISEASE AND IMPROVING THE QUALITY OF HEALTH CARE
Cancer Rates Drop, Overall Quality of Life Improves. On March 12, 1998, CDC and NIH
announced that the incidence and death rates for all cancers combined and for most of the top 10
types of cancer declined between 1990 and 1995, reversing an almost 20-year trend of increasing
cancer cases and death in the U.S. The report showed that incidence rates declined for most age
groups, for both men and women, and for most racial and ethnic groups. In October 1998, CDC
Automated Records Management System
Hex-Dump Conversion
reported improvements in a number of quality of life indicators. The overall infant mortality rate
reached a new low of 7.1 deaths per 1,000 live births. In addition, life expectancy reached a
record high of 76.5 years for those born in 1997. And the preliminary age-adjusted homicide rate
continued to decline, falling 12 percent in 1997.
Improving Food Safety. In May 1998 CDC established PulseNet, a national computer network
of public health laboratories that will help rapidly identify and stop episodes of foodborne illness.
The new system enables epidemiologists to identify serious and wide-spread food contamination
problems up to five times faster than previously possible. In July, HHS issued a new food safety
regulation requiring a warning on packaged fresh fruit and vegetable juices that have not been
processed to prevent, reduce or eliminate illness-causing microbes. Unprocessed juices constitute
only about 2 percent of the total juice sold in the U.S., but they have been linked to increasing
numbers of foodborne disease outbreaks in the past few years. These actions are part of a series
of steps the Clinton administration has taken to improve the safety of foods Americans consume.
National Initiative to Prevent Skin Cancer. In May 1998, CDC launched a national, multi-year
awareness initiative to prevent skin cancer among Americans. Skin cancer appears to be related
to increases in voluntary sun exposure, making skin cancer largely preventable when sun
protective practices and behaviors are consistently followed. The "Choose Your Cover"
campaign educates, encourages and empowers young people to protect themselves from the sun's
ultraviolet rays by practicing sun-safe behaviors.
Bringing Medicare and Medicaid into Compliance With the Consumer Bill of Rights. In
June 1998, HHS established a series of new patient protections for the 39 million beneficiaries of
Medicare to bring Medicare into compliance with the Clinton Administration's Consumer Bill of
Rights. These new protections include access to emergency services when and where the need
arises, patient participation in treatment decisions, and access to specialists. In addition, the 38
million Medicaid beneficiaries also are being assured essential protections in the Consumer Bill
of Rights. In September 1998, HCFA published a Notice of Proposed Rulemaking adding new
patient protections such as access to specialists and an expedited independent appeals process to
bring the program in compliance with the patients' bill of rights, where possible.
HHS Releases Consumer Survey to Empower Medicare Beneficiaries to Make Informed
Choices. On February 20, HHS launched a nationwide effort to help patients rate their health
plans and to help consumers choose among plans. The effort is built on a new survey tool, the
Consumer Assessment of Health Plans (CAHPS), developed by the Agency for Health Care
Policy and Research, that provides a consumers-eye view of the care and service they receive
from health plans. The survey asks how easily beneficiaries can access specialists and emergency
care services and seeks information on the general level of consumer satisfaction. In 1998,
CAHPS was adopted by the Office of Personnel Management for use by the Federal Employees
Health Benefits Program to survey federal employees and report back the findings of the survey
to them to help in the selection of health plans during the federal open season. CAHPS also was
merged with another health care quality tool, the HEDIS Member Satisfaction Survey and will be
used by the National Committee for Quality Assurance to evaluate and accredit commercial
managed care plans. In 1998, HCFA used a specially developed version of CAHPS to survey
Medicare enrollees in managed care plans to assess their experiences. The survey results, which
will provide extensive information about Medicare managed care plans currently available, will
be sent to every Medicare beneficiary in early 1999, helping them make better informed choices
about their health plan options.
Automated Records Management System
Hex-Dump Conversion
FIGHTING HEALTH CARE FRAUD, WASTE AND ABUSE
Redoubling Our Commitment. With leadership from HHS' inspector general, the
Department-wide initiative against waste, abuse and fraud continued to make progress. On
December 7, 1998, President Clinton unveiled a new legislative package as part of his FY 2000
budget that will save Medicare more than $2 billion by combating fraud, waste and abuse. The
President's proposals, which will give HCFA more tools to root out fraud in the Medicare
system, focus on eliminating excessive Medicare reimbursement for drugs, preventing abuse of
Medicare's Partial Hospitalization Benefit, ensuring Medicare does not pay for claims owed by
private insurers, empowering Medicare to purchase cost-effective high-quality health care, and
requesting new authority to enhance contractor performance.
Ensuring Access to Care in Community Mental Health Centers. In September 1998, HHS
took action to ensure that Medicare beneficiaries with acute mental illness get quality treatment
in community mental health centers and that Medicare pays appropriately for those services.
HCFA now has the authority to begin termination actions against centers that appear unable to
provide Medicare's legally required core services, and will require others to come quickly into
compliance. HCFA also can demand repayment of money paid inappropriately for non-covered
services or ineligible beneficiaries.
Medicare Hires Special Fraud Fighters, Enlists Citizens to Report Fraud. On September
15, 1998, HHS announced that for the first time, Medicare will hire special outside contractors,
or "fraud fighters," to carry out audits, conduct medical reviews and conduct programs that will
expand the Clinton administration's fight against waste, fraud and abuse. These special fraud
fighters will work with the Medicare Integrity Program to end criminal activities by fraudulent
health care providers, ensure that Medicare pays only for medically necessary services, and
identify honest errors that lead to improper payments. As a further incentive to weed out fraud
and abuse, HHS announced that beginning in January 1999, it will give rewards up to $1,000 to
Medicare beneficiaries and others who report fraud and abuse in the Medicare program and if
their information leads directly to the recovery of Medicare money.
Fighting Fraud and Abuse Among Durable Medical Equipment Suppliers. Suppliers of
durable medical equipment, such as wheelchairs, canes and other medical supplies have been an
area of special vulnerability to fraud and abuse. As a result of a regulation issued by HHS in
January 1998, such suppliers are now required to obtain surety bonds of at least $50,000, to
assure that those who sell durable medical equipment for Medicare beneficiaries are legitimate
and responsible businesses, not fly-by-night companies, inexperienced individuals without
adequate resources, or even criminals who will defraud and abuse the Medicare program."
IMPROVING CUSTOMER SERVICE
Implementing the FDA Modernization Act of 1997. The FDA Modernization Act of 1997,
which became law in November 1997, requires FDA to improve the regulation of food, medical
products and cosmetics. By November 1998, FDA had met nearly all of the deadlines for
carrying out the law's provisions and completed a number of initiatives, including: a final
regulation establishing parameters for distributing sound and balanced information about
"off-label" uses for marketed drugs, biological products, and medical devices; guidance on FDA's
fast track programs, intended to ease the development and evaluation of new drugs and biologics
to treat serious and life-threatening illnesses; and an overall FDA plan for complying with the
terms of the new law, developed through a series of meetings with stakeholders across the U.S.
Online Access to Information. Throughout 1998 HHS made valuable use of the Internet by
Automated Records Management System
Hex-Dump Conversion
developing numerous Web sites to make information more accessible to the public. HCFA
unveiled a new Web site (http://www.medicare.gov) that contains information for Medicare
beneficiaries and others involved in making health care decisions, including Medicare Compare
and preventive benefits information. The AoA launched a limited access interactive Web site
(AgingNet) specifically devoted to the key members of its national aging network, the state and
area agencies on aging. Through this personalized service, customized information and technical
assistance can be quickly disseminated and provided to our partners throughout the country. Both
NIH and AoA unveiled Spanish-language Web sites that provide resource and referral
information and selected Spanish-language publications to those interested in hispanic aging and
health issues.
Assuring Year 2000 Readiness. HHS finished 1998 with Year 2000 (Y2K) preparedness ahead
of schedule. The majority of HHS mission-critical systems were Y2K-compliant at the end of
December, three months prior to the government-wide March 31, 1999 deadline. For the
particularly complex Y2K tasks in Medicare, HCFA ended the year with all internal systems
fully Y2K-compliant, and 95 percent of the renovation of the code for the 78 external mission
critical systems (payment systems operated by Medicare contractors) also compliant. FDA
worked throughout 1998 with medical device manufacturers to gather and post information to
help hospitals, doctors, and researchers ensure that medical and laboratory equipment will be
ready for the date conversion, which takes place on January 1, 2000. During 1999, in addition to
extra testing of computer systems, HHS will accelerate outreach activities to assure that private
sector partners, providers and suppliers, know how to ensure their own Y2K readiness.
CONTINUING PROGRESS ON WELFARE REFORM
Welfare-to-Work Efforts Paying Off. An HHS report sent to Congress in August 1998 found
welfare reform succeeding overall, and state have not cut benefits in "race to the bottom" that
was feared. Almost every state requires personal responsibility contracts, and most states have
adopted a work-first model, with 32 states expecting clients to work within six months. For the
first time, half of all low-income single mothers with children under six-the population most
affected by welfare policy-are working, a dramatic increase from 35 percent in 1992. State
evaluations of welfare programs show employment increases of 8 to 15 percentage points. A
Maryland study found that less than one half of I percent of families leaving welfare placed a
child in foster care, and most of those families had already been under investigation for abuse
and neglect.
Welfare Caseload Continues Unprecedented Decline. As of June 1998, HHS announced that
welfare caseloads have declined to approximately 8.4 million recipients and slightly over 3
million families. Since January 1993, the number of recipients on welfare has dropped by more
than 41 percent, including a decline of more than 30 percent since the enactment of the welfare
reform law on August 22, 1996. There are 5.7 million fewer recipients on the welfare rolls since
President Clinton took office, and 3.8 million fewer welfare recipients since the passage of the
1996 law. The rate of decline remains strong with nearly 2 percent reductions each month, almost
double the rate for the same period in 1997.
Tracking Delinquent Parents. HHS reported that the National Directory of New Hires, a child
support collection system launched in October 1997, marked a year of record achievements in
collections and paternity establishments and found more than 1.2 million delinquent parents. On
June 24, 1998, President Clinton signed into law the Deadbeat Parents Punishment Act of 1998.
The law is based on his 1996 proposal for tougher penalties for parents who repeatedly fail to
Automated Records Management System
Hex-Dump Conversion
support children living in another state or who flee across state lines to avoid supporting them.
On October 1, 1998, HHS started operating the Federal Case Registry, which will contain records
of all parents who owe child support. Combined with the National Directory of New Hires, HHS
now has the strongest child support enforcement resource in the history of the program for
finding parents who are earning money, but not paying child support.
Federal Government Helps to Shrink Welfare Rolls. President Clinton announced in August
1998 that the federal government had hired 5,714 new workers off the welfare rolls, which is
more than half-way to its goal of 10,000 by 2000. Nearly 80 percent of these new workers are
outside the Washington, D.C. metropolitan area. HHS has hired 282 new workers from the
welfare rolls and is well ahead of schedule in reaching its goal of 300 new welfare hires by 2000.
###
Automated Records Management System
Hex-Dump Conversion
Date: Wednesday, December 31, 1997
FACT SHEET
Contact: HHS Press Office (202) 690-6343
1997: HHS CONTINUES PROGRESS TOWARD KEY GOALS
In 1997, HHS made significant strides toward ensuring that Americans have the tools they need
to lead healthy and productive lives. Through targeted investments, we helped continue the
important progress we've made since 1993 toward creating a stronger and healthier nation. And
through better management, we streamlined and strengthened our services.
In particular, we took important steps toward improving health care access and quality. Under
the Balanced Budget Act of 1997, we launched an historic expansion of health care for our
nation's children. We also strengthened the Medicare and Medicaid programs, adding important
new benefits and extending the life of the Medicare Trust Fund without raising premiums.
President Clinton also appointed a new advisory commission to improve health care quality,
which proposed a new Consumer Bill of Rights. And we began implementation of the landmark
Health Insurance Portability and Accountability Act of 1996, which includes important new
protections for an estimated 25 million Americans who move from one job to another, who are
self-employed, or who have pre-existing medical conditions. We also initiated a new effort to
ensure privacy of personal health records, and achieved unprecedented levels of recoveries and
prosecutions under our expanded effort to fight health care fraud and abuse.
In addition, HHS again reported significant gains in key indicators of our nation's health. AIDS
deaths declined for the first time in the history of the epidemic, and teen birth rates declined for
the fifth straight year. Infant mortality rates reached a new record low, and more women than
ever before received prenatal care. Childhood immunization rates reached a record high,
meeting the goals we set in 1993, and rates of vaccine preventable childhood disease fell to
all-time lows.
HHS also announced new signs of progress in combating teen drug use with two comprehensive
studies showing the first leveling off of drug use among young teens since 1992. And we achieved
the largest decline in welfare caseloads in history.
In the coming year, we will continue to build on these accomplishments and prepare HHS -- and
the nation -- for the 21st century. As part of this effort, we will work with Congress to craft
bipartisan legislation to enact the Consumer Bill of Rights for health care, protect the privacy of
health records, and dramatically reduce youth tobacco use.
Guide to HHS Progress Toward Goals
BUILDING STRONG FOUNDATIONS FOR INFANTS AND YOUNG CHILDREN
New Children's Health Insurance Program
Increasing Adoptions
Improving Child Care
Head Start Expansion Initiative
Record Vaccination Levels
Automated Records Management System
Hex-Dump Conversion
Record Progress In Preventing Infant Mortality
Increasing Availability of Pediatric Use Information for Prescription Drugs
ENSURING SAFE PASSAGES TO ADULTHOOD FOR ADOLESCENTS
National Strategy to Prevent Teen Pregnancy
New Signs of Progress in Combating Youth Drug Use
First Provisions of the President's Plan to Reduce Youth Tobacco Use Become
Effective
IMPROVING HEALTH CARE QUALITY
HHS Takes First Steps Toward Implementing Landmark Health Insurance Legislation
Advisory Commission on Consumer Protection and Quality in the Health Care Industry
Consumer Bill of Rights
Ban on Time Limits for Breast Cancer Surgery
New Patient Appeals Rights
Physician Incentive Rules
Standardizing Health Plan Performance Measurement
Medicare Managed Care Marketing Guidelines Released
FIGHTING HEALTH CARE FRAUD, WASTE, AND ABUSE
Record Recoveries and Prosecutions
Expanding Operation Restore Trust
Tightening Standards for Health Care Providers Participating in Medicare and
Medicaid
New Resources for Fraud and Abuse Control
Medicare Fraud Hotline Improved and Expanded
Automated Records Management System
Hex-Dump Conversion
Medicare Secondary Payer Initiatives Produce Significant Savings
PROGRESS IN THE FIGHT AGAINST HIV/AIDS
First Ever Decline in AIDS Deaths
IDS Vaccine Initiative
New Treatment Guidelines
Increased Access to AIDS Drugs
IMPROVING DEPARTMENT MANAGEMENT
Increasing On-Line Access to Health Information
Streamlining and Modernizing the FDA
MOVING FORWARD ON THE PROMISE OF WELFARE REFORM
Largest Caseload Decline in History
Overhauling the Welfare System Nationwide
Record Child Support Enforcement
New Proposal to Improve State Child Support State Incentive Payments
OTHER SIGNIFICANT ACCOMPLISHMENTS
Ensuring Food Safety
Improving Guidance on Mammography
First Biotechnology Product to Treat Cancer
Increasing Organ Donation
BUILDING STRONG FOUNDATIONS FOR INFANTS AND YOUNG
CHILDREN
New Children's Health Insurance Program. At President Clinton's urging, the
Balanced Budget Act of 1997, signed into law by the President on August 5, 1997,
provides the largest increase in funds available for health insurance for low-income
Automated Records Management System
Hex-Dump Conversion
children since the creation of Medicaid in 1965. The $24 billion set-aside for
children, administered by HHS, will allow states to extend health coverage to
millions of uninsured children by expanding their current Medicaid programs or by
creating new health insurance plans.
Increasing Adoptions. On February 14, 1997, HHS submitted to President Clinton
Adoption 2002, a new action plan to help states set and meet urgent new adoption
targets. The report, developed under a Presidential directive signed by President
Clinton in December 1996, takes its name from the President's goal to at least
double by the year 2002 the number of children adopted or permanently placed each
year. Specific recommendations contained in the report included changing federal
law to clarify reasonable efforts to reunite families, offering financial incentives to
states to increase adoptions and permanent placements, and providing technical
assistance to states, courts, and communities to move children more rapidly from
foster care to permanent homes. In November 1997, President Clinton signed into
law the Adoption and Safe Families Act of 1997, enacting a key part of the
President's plan by changing federal law to require that children in foster care
receive permanent placements within 12 months. As part of the President's
initiative, HHS also awarded 40 demonstration grants in October 1997 for programs
aimed at increasing adoptions and reducing the number of children in foster care. In
1997, HHS also awarded child welfare waivers to six states to allow them to test
innovative strategies to improve child welfare systems.
Improving Child Care. On October 23, 1997, President Clinton hosted the
first-ever White House Conference on Child Care to focus the nation's attention on
the importance of addressing the need for safe, affordable, quality child care. This
Conference underscores and builds upon the Clinton Administration's commitment
to strengthening the American family by giving parents the tools they need to fulfill
their responsibilities and giving children the ability to reach their full potential. At
the Conference, HHS proposed a National Child Care Provider Scholarship Fund
that will increase child care providers' incentives to complete child care-related
course work.
Head Start Expansion Initiative. In March 1997, HHS announced a new Head
Start initiative that will expand Head Start services for children while also helping
parents on welfare move to work. Under the new initiative, Head Start expansion
funds are being used for the first time to build partnerships with child care
providers to deliver full-day and full-year Head Start services. Full-day and
full-year services, in turn, can help parents attain full-time work. Through the Head
Start-child care partnerships, Head Start and child care agencies combine staff and
funds to provide high quality services. Children stay in one place all day, rather
than attending Head Start for half a day and then moving to child care for the
remainder of the day. Since taking office, the Clinton Administration has nearly
doubled funding for Head Start, increased the number of children and families
served by approximately 35 percent to about 836,000, and expanded the number of
children age 0-3 in Head Start to over 37,000.
Record Vaccination Levels. In July 1997, HHS announced that childhood
immunization rates reached a new all-time high of 78 percent in 1996 for the
Automated Records Management System
Hex-Dump Conversion
complete series of recommended vaccinations. In addition, HHS announced that the
nation had exceeded its childhood vaccination goals for 1996, with 90 percent or
more of America's toddlers receiving the most critical doses of the most routinely
recommended vaccines for children by age two. Also in 1996, reported levels of
preventable childhood diseases were at near or record lows, and three diseases
reached the elimination targets. The 1996 goals were set in 1993 when President
Clinton launched the comprehensive Childhood Immunization Initiative (CII), led
by the CDC, in response to low vaccination rates among preschool children.
Record Progress In Preventing Infant Mortality. In 1997, HHS announced that
the nation had again reached a record low infant mortality rate. Driving the overall
decline in infant mortality was a 15 percent decline in infant deaths attributed to
Sudden Infant Death Syndrome (SIDS) between 1995 and 1996. This decline is
largely attributed to the increase in awareness produced by the Department's Back
to Sleep campaign, which spreads the message that infant caregivers can reduce the
risk of SIDS by placing babies on their backs to sleep. In addition, HHS announced
in 1997 that a record number of women are receiving prenatal care in their first
trimester of pregnancy. To help build on this progress, HHS in February 1997
announced the nation's first toll-free referral and information service to help women
obtain proper prenatal care throughout their pregnancies. Callers in all 50 states can
now call 1-800-311-BABY (2229) for pregnancy and prenatal care information,
including referral to local clinics and physicians. A separate phone number is
available for Spanish speakers: 1-800-504-7081. The service is supported by
HRSA's Healthy Start program.
Increasing Availability of Pediatric Use Information for Prescription Drugs.
On August 13, 1997, President Clinton unveiled a new FDA regulation that will
protect children by requiring drug manufacturers to study the safety and appropriate
dosage levels of medications for pediatric populations. The regulation also requires
proper labeling of drugs for use by children. Even though many drugs affect
children differently than adults, most drugs have not been tested on pediatric
populations. Under this rule, manufacturers of prescription drugs likely to be used
by children will be required to complete studies and place information on drug
labels to help pediatricians and other health care providers make
scientifically-based treatment decisions when prescribing drugs to children.
ENSURING SAFE PASSAGES TO ADULTHOOD FOR ADOLESCENTS
National Strategy to Prevent Teen Pregnancy. HHS announced in 1997 that the
birth rate for teens aged 15-19 has declined five straight years in row, decreasing by
12 percent between 1991 and 1996. To build on this success, the Clinton
Administration in January 1997 launched a comprehensive effort to prevent teen
pregnancy and encourage adolescents to remain abstinent. The new initiative, led by
HHS, builds on the variety of efforts already underway at HHS and in communities
across the country. The initiative also responds to a call from the President and
Congress for a national strategy to prevent out-of-wedlock teen pregnancies and to
a directive, under the new welfare law, to assure that at least 25 percent of
communities in this country have teen pregnancy prevention programs in place. To
supplement this effort, HRSA in 1997 began awarding $50 million a year in new
Automated Records Management System
Hex-Dump Conversion
funding for state abstinence education activities, provided for under the new
welfare law. And in May 1997, HHS announced the availability of two new $1
million grant programs for communities to develop innovative approaches to
prevent teen pregnancy -- one targeted to girls and the other to boys.
New Signs of Progress in Combating Youth Drug Use. In 1997, HHS released
data showing that illicit drug use among younger teens has leveled off for the first
time since 1992. The data, taken from the 1996 National Household Survey on
Drug Abuse and the 1997 Monitoring the Future Survey, also shows that after
doubling from 1992 to 1995, marijuana use is leveling off among younger teens,
and shows signs of beginning to level off among older teens as well. The surveys
also found signs of improvement in drug-related attitudes, with disapproval of
substance abuse increasing among younger teens. To bolster efforts to prevent
youth substance abuse, HHS in October 1997 awarded a total of $15 million in
grants to Governors' offices in five states to support statewide planning for
coordinated youth substance abuse prevention services. Another $5 million was
awarded to five regional centers, which will help the states implement well
grounded, research-based substance abuse prevention strategies. HHS also released
the first research-based guide to preventing young people from using drugs, and
approved the first non-prescription test system for drugs of abuse.
First Provisions of the President's Plan to Reduce Youth Tobacco Use Become
Effective. On February 27, 1997, the first provisions of the FDA's comprehensive
rule to prevent the sale of tobacco products to children went into effect. In
February, the FDA launched a nationwide outreach effort to educate retailers,
parents and community leaders about the provisions of the FDA rule to protect
children from tobacco products, and on August 1, 1997, the FDA joined with 20
national retailer, consumer and health professional organizations to launch a major
poster campaign to assist retailers in enforcing age and photo ID provisions. In
September 1997, President Clinton called for comprehensive national legislation to
build on the FDA rule and significantly reduce children's use of tobacco products.
IMPROVING HEALTH CARE QUALITY
HHS Takes First Steps Toward Implementing Landmark Health Insurance
Legislation. On April 1, 1997, HHS announced new regulations as the first step in
implementing key provisions of the Health Insurance Portability and Accountability
Act of 1996 (HIPAA), signed into law by President Clinton on August 21, 1996.
The regulations focus on limiting exclusions for pre-existing medical conditions,
prohibiting discrimination against employees and dependents based on their health
status, guaranteeing availability of health insurance to small employers, and
guaranteeing renewability of insurance to all employers regardless of size. In
addition, Secretary Shalala on September 11, 1997 submitted to Congress
recommendations for Federal health record confidentiality legislation as called for
in the Act. The recommended legislation would guarantee rights for patients and
define responsibilities for record keepers, so that there will be clear guidance and
real incentives for confidential, fair, and respectful treatment of personal health
information, and penalties for its misuse. Using these recommendations as a guide,
HHS will work with Congress to enact bipartisan legislation to guarantee these
Automated Records Management System
Hex-Dump Conversion
protections.
Advisory Commission on Consumer Protection and Quality in the Health Care
Industry. In March 1997, President Clinton announced the members of the
Advisory Commission on Consumer Protection and Quality in the Health Care
Industry, created through an Executive Order signed by President Clinton to build
on his Administration's commitment to improving the quality of the nation's health
care system. The 32-member Commission will review rapid changes in the health
care financing and delivery systems and make recommendations, where
appropriate, on how best to preserve and improve the quality of the nation's health
care system. Co-chaired by the Secretaries of Health and Human Services and
Labor, the Advisory Commission has broad-based representation from consumers,
businesses, labor, health care providers, insurers, and quality and financing experts.
Consumer Bill of Rights. In November 1997, the Advisory Commission on
Consumer Protection and Quality in the Health Care Industry announced their
recommendation for a "Consumer Bill of Rights" to promote and assure patient
protections and health care quality. The three goals of the Consumer Bill of Rights
are: (1) to strengthen consumer confidence that the health care system is fair and
responsive to consumer needs; (2) to reaffirm the importance of a strong
relationship between patients and their health care providers; and (3) to reaffirm the
critical role consumers play in safeguarding their own health. The President has
asked all federal agencies to develop plans for applying the "Consumer Bill of
Rights" to their workforce, and challenged private health care plans to adopt the
standards. The Clinton Administration will work with Congress in the coming year
to craft bipartisan legislation to enact the Commission's recommendations. The full
text of the Consumer Bill of Rights is available on the Internet at
www.hcqualitycommission.gov
Ban on Time Limits for Breast Cancer Surgery. In February 1997, HHS
announced steps to ensure that Medicare beneficiaries are protected from any
requirements by health plans that would place time limits on hospital stays for
mastectomies. In letters to 350 managed care plans contracting with Medicare, HHS
said outpatient surgery or limitation on hospital stays may not be required by plans
for beneficiaries undergoing surgery for the treatment of breast cancer. Medicare
paid for more than 84,000 mastectomies last year, or about a third of all
mastectomies in the U.S. This action coincides with a call by President Clinton for
bipartisan legislation to guarantee that a woman can stay in the hospital for 48
hours following a mastectomy. New Patient Appeals Rights. Response within 72
hours to appeals of care denials is required for Medicare beneficiaries under
regulations enacted by HHS in April 1997. This regulation covers decisions that
could jeopardize life, health or ability to regain maximum function, and
terminations of care, such as skilled nursing facility discharge.
Physician Incentive Rules. As of January 1997, health plans are required to
disclose financial incentives and pay for stop-loss insurance for physicians so they
can lose no more than 25 percent of their income if the cost of care for their patients
exceeds what they are paid by the plan. The regulations also ban any incentive
arrangements that include payments to doctors to limit or reduce medically
Automated Records Management System
Hex-Dump Conversion
necessary services. These rules are designed to make sure incentives to discourage
unnecessary services do not jeodardize quality patient care.
Standardizing Health Plan Performance Measurement. In January 1997, HCFA
formally launched the Medicare Health Plan Employer Data Information Set
(HEDIS), a partnership with the Kaiser Family Foundation to establish a
performance measurement system that will minimize reporting burdens on managed
care plans serving Medicare beneficiaries. The new measures will help plans to
improve the quality of their care and support efforts to improve the health status of
beneficiaries.
Medicare Managed Care Marketing Guidelines Released. On September 8,
1997, HHS issued marketing guidelines to help Medicare beneficiaries make
informed choices about managed care plans. The guidelines will inform health
plans serving Medicare what is, and is not, allowed under Medicare managed care
regulations on advertising, enrollment, and required notifications to Medicare
beneficiaries. The guidelines will also help expedite review of marketing materials
by the Health Care Financing Administration, which runs the Medicare program.
FIGHTING HEALTH CARE FRAUD, WASTE, AND ABUSE
Record Recoveries and Prosecutions. On September 29, 1997, HHS announced
that the Department's expanded efforts to fight fraud and abuse in health care are
paying off, with unprecedented levels of recoveries and prosecutions. In FY 1997,
HHS identified $1.2 billion for collection in total fines, restitutions, settlements,
and recoveries -- the most ever identified in one year. The FY 1997 total was six
times higher than recoveries for FY 1996, and over three times higher than the
previous best year for recoveries. In addition, criminal and civil prosecutions
totaled 1,340 cases in FY 1997 -- double the number for FY 1996, and more than
five times the total number in FY 1995. Over 2,700 health care providers and
entities were excluded from doing business with Medicare, Medicaid, and other
federal and state health care programs for engaging in fraud or abuse of the
programs -- an 86 percent increase from the 1,400 exclusions in FY 1996. Since
1993, actions affecting HHS programs alone have saved taxpayers more than $20
billion and increased health care fraud convictions by 240 percent.
Expanding Operation Restore Trust. In May 1997, Secretary Shalala announced
a new, nationwide expansion of Operation Restore Trust (ORT), the Department's
comprehensive anti-fraud initiative. ORT was started in 1995 as a two-year, five
state pilot program to test the success of several innovations in fighting fraud and
abuse in the Medicare and Medicaid programs. During the demonstration, ORT
identified $23 in overpayments for every $1 spent looking at the fast-growing areas
of Medicare, including home health care, skilled nursing facilities, and providers of
durable medical equipment.
Tightening Standards for Health Care Providers Participating in Medicare
and Medicaid. On September 15, 1997, President Clinton announced three new
weapons to fight fraud and abuse in the home health care industry, the fastest
growing part of the Medicare program. The President announced: (1) an immediate
moratorium on all new home health providers coming into the Medicare program
while HHS implements new regulations to prevent risky providers from entering
Automated Records Management System
Hex-Dump Conversion
the program; (2) a new renewal process for home health agencies currently in the
program to help weed out fraudulent providers; and (3) a doubling of audits to help
increase detection of fraud and abuse. In addition, the Clinton Administration in
March 1997 proposed a new regulation that would revise the federal standards,
called Conditions of Participation, that health care providers must meet in order to
participate in the Medicare program. The new rule, included at the President's
urging in the Balanced Budget Act of 1997, requires applicants to provide their
social security numbers and employer identification numbers so HCFA can check
for past fraudulent activity, and to conduct criminal background investigations on
the staff they hire. The Balanced Budget Act will further reduce fraud and abuse in
home health care by establishing a prospective payment system for home health
services, tightening eligibility, and developing guidelines for use of home health
services.
New Resources for Fraud and Abuse Control. In FY 1997, the HHS Office of
the Inspector General (OIG) received $70 million from the new Health Care Fraud
and Abuse Control Account created under the Health Insurance Portability and
Accountability Act of 1996. The landmark Act, signed into law by President
Clinton in August 1996, created a stable source of funding for health care fraud
control efforts for the first time. The new funding has enabled the OIG to open six
new field offices to facilitate enforcement actions, increasing from 26 to 31 the
number of states in which the OIG is present. In addition, HHS in August 1997
awarded more than $2.25 million in grants funded by HIPAA through HCFA and
the Administration on Aging for new programs to aid in the fight against health
care fraud and abuse. Provisions under HIPAA will also establish a fraud and abuse
database to identify health care providers who have been the subject of adverse
actions as a result of illegal or abusive practices, and award grants to partner
agencies engaged in investigations, prosecutions, and audits of health care fraud
and abuse.
Medicare Fraud Hotline Improved and Expanded. In July 1997, HHS expanded
the Medicare fraud hotline started in 1995 to report fraud and abuse in Medicare
and Medicaid programs. Over 32,000 complaints that warranted follow-up action
have been received since it began service. The hotline is staffed Monday through
Friday, 8 a.m. to 5:30 p.m. Eastern Standard Time, and assistance is available in
both English and Spanish. The toll-free Hotline number is 1-800-HHS-TIPS
(1-800-447-8477). The TTY number for the hearing impaired is 1-800-377-4950
and the fax number is 1-800-223-8164.
Medicare Secondary Payer Initiatives Produce Significant Savings. In 1997,
HCFA saved more than $1.1 billion because of new initiatives that help Medicare
avoid paying bills that should be paid by other insurers. The Initial Enrollment
Questionnaire and Prospective Data Sharing initiatives are both identifying
Medicare beneficiaries who have other health insurance coverage. Under Medicare
Secondary Payer (MSP) laws, other insurers covering Medicare beneficiaries often
must pay claims before Medicare. This applies, for example, to beneficiaries with
coverage through current employment.
PROGRESS IN THE FIGHT AGAINST HIV/AIDS
Automated Records Management System
Hex-Dump Conversion
First Ever Decline in AIDS Deaths. In September 1997, HHS reported that, for
the first time in the history of the epidemic, the number of Americans diagnosed
with AIDS declined, falling six percent for Americans over age 12 between 1995
and 1996. In addition, HHS reported that HIV/AIDS mortality declined 26 percent
between 1995 and 1996, falling from the leading cause of death among 25-44 year
olds to the second leading cause of death in that age group. The CDC also reported
a slowing in the epidemic overall and a 43 percent decline in perinatally acquired
AIDS cases between 1995 and 1996.
AIDS Vaccine Initiative. On May 18, 1997, President Clinton challenged the
nation to commit itself to the goal of developing an AIDS vaccine within the next
ten years. The President also announced a number of important initiatives to help
fulfill this commitment, including high-level international collaboration, a
dedicated research center for AIDS vaccine research at NIH, and outreach to
scientists, pharmaceutical companies, and patient advocates to maximize the
involvement of both private and public sectors in the development of an AIDS
vaccine. As part of this effort, the National Institute of Allergy and Infectious
Diseases at NIH in September 1997 announced the first grant recipients in its new
program to foster innovative research on AIDS vaccines.
New Treatment Guidelines. In 1997, HHS released draft guidelines for treating
HIV with antiretroviral drugs. The guidelines, developed by panels of AIDS
clinicians and researchers, reflect the current state of knowledge about HIV disease
and antiretroviral drugs, and will help standardize and improve the quality of care
for HIV-infected persons in the United States.
Increased Access to AIDS Drugs. In 1997, HHS dramatically increased funding
for the AIDS Drug Assistance Program, significantly increasing access to promising
treatments for HIV and AIDS. ADAP funding increased by 70 percent, and nearly
80,000 people benefited from the program in 1997. In addition, the FDA approved
four new AIDS drugs and two drugs for AIDS related conditions in 1997. In March
1997, the FDA approved the first protease inhibitor with labeling for use in
children.
IMPROVING DEPARTMENT MANAGEMENT
Increasing On-Line Access to Health Information. In April 1997, HHS
launched Healthfinder, a new government gateway site on the Internet that brings
together under one umbrella the broad range of consumer health information
resources produced by the federal government and its many partners. Its current
resources include hyperlinks to more than 1,000 Web sites and nearly 1,200
selected online documents. The address for Healthfinder is
http://www.healthfinder.gov. To provide better access to research information, the
National Library of Medicine at the NIH in June 1997 launched a new service to
provide all Americans free access to MEDLINE -- the world's most extensive
collection of published medical information -- over the World Wide Web. Prior to
this announcement, users have had to register and pay to search MEDLINE and
other NLM databases. MEDLINE can be accessed at: http://www.nlm.nih.gov. Also
in June 1997, HHS announced a new "Computers for Seniors" program designed to
help give older Americans access to the Internet and help them make better use of
Automated Records Management System
Hex-Dump Conversion
Medicare, Medicaid and other HHS programs.
Streamlining and Modernizing the FDA. In 1997, the FDA made significant
progress in streamlining operations to improve consumer access to drug
information, cut red tape, and speed approval of new medical products and devices.
To date, the agency has cut new drug approval times nearly in half, while the
number of new drugs approved in a year has doubled. In recognition of its
innovations of the U.S. drug approval process, the FDA was named a 1997 winner
of the prestigious Innovations in American Government Awards Program,
sponsored by the Ford Foundation and Harvard University's John F. Kennedy
School of Government. To build on this progress, President Clinton signed into law
the FDA Modernization Act of 1997 on November 21, 1997, improving the
regulation of food, medical products and cosmetics. In 1997, the FDA proposed a
"new use initiative" to speed up the development of new and supplemental uses of
medications; announced new, easier to understand labels for over-the-counter
drugs; and launched an initiative to provide consumers with better, easier to
understand information about prescription drugs. In addition, the FDA announced a
plan to reinvent the regulation of human tissue, the FDA's sixth reinvention effort
as part of the Clinton Administration's Reinventing Government Initiative.
MOVING FORWARD ON THE PROMISE OF WELFARE REFORM
Largest Caseload Decline in History. In 1997, HHS announced that the welfare
caseload fell by 3.4 million recipients, from 14.1 million in January 1993 to 10.7
million in May 1997, a drop of 24 percent since the Clinton Administration took
office. Forty-eight out of fifty states have seen their caseloads decline, with ten
states reducing their rolls by 40 percent or more in the last four years. This is the
largest welfare caseload decline in history and represents the lowest percentage of
the population on welfare since 1970. According to an analysis released in 1997 by
the Council of Economic Advisors (CEA), the reduction in the welfare rolls can be
attributed to the strong economic growth during the Clinton Administration, the
waivers granted to states to test innovative strategies to move people from welfare
to work, and other factors, such as the Administration's expansion of the Earned
Income Tax Credit.
Overhauling the Welfare System Nationwide. On July 1, 1997, the historic
welfare law that the President signed last August went in to effect in every state,
making work and responsibility the law of the land. HHS has certified welfare plans
for each state. In accordance with the welfare law, all plans require and reward
work, impose time limits, and demand personal responsibility. The balanced budget
that the President signed on August 5, 1997 delivered on the President's pledge to
fulfill the promise of welfare reform by investing in moving people from welfare to
work and fixing the provisions in the law that had nothing to do with welfare
reform, including restoring disability and health benefits to legal immigrants who
are currently receiving benefits or become disabled in the future, and continuing
Medicaid coverage for currently disabled children receiving SSI. On November 17,
1997, HHS proposed regulations under the new law which are intended to help all
welfare recipients who can work go to work, and to encourage states to work with
all families.
Automated Records Management System
Hex-Dump Conversion
Record Child Support Enforcement. Due to the President's unprecedented and
sustained campaign to make noncustodial parents pay the child support they owe,
HHS announced in 1997 that it had collected a record $12 billion in child support
in 1996, an increase of 50 percent since 1992. In addition, HHS announced that
paternity establishment almost doubled to nearly 1 million cases in FY 1996, from
516,000 in 1992. And the number of families actually receiving child support rose
to 4 million cases with collections, an increase of 43 percent over 1992. To build on
this progress, the new welfare law includes tough child support measures
long-supported by the President, including: a national new hire reporting system;
streamlined paternity establishment; uniform interstate child support laws;
computerized state-wide collections; and tough new penalties. These measures are
projected to increase child support collections to more than $24 billion in the next
ten years.
New Proposal to Improve State Child Support State Incentive Payments. On
March 13, 1997, Secretary Shalala submitted to Congress a proposal designed to
further improve the performance of state child support enforcement programs by
linking federal incentive payments to states to their performance in five key areas:
establishment of paternities, establishment of child support orders, collections on
current child support owed, collections on previously or past due child support
owed, and cost-effectiveness. The five areas are intended to better measure the
performance of states in fostering parental support for children and family
self-sufficiency. Current law provides for HHS to make incentive payments to
states for their child support enforcement systems, but these payments are based
only on cost-effectiveness. Under the new welfare reform law, HHS was authorized
to prepare an alternative plan. On September 16, 1997, Secretary Shalala joined
Reps. Clay Shaw and Sandy Levin in announcing bipartisan legislation drawn from
the HHS proposal. The legislation would provide incentive funds to states which
deliver real results for children who need child support payments from
non-custodial parents. To reinforce the goal of achieving self-sufficiency, states will
be rewarded for collection in all child support cases, but with a stronger emphasis
on welfare and former welfare cases. The House passed this legislation in 1997, and
action on the bill is pending in the Senate.
OTHER SIGNIFICANT ACCOMPLISHMENTS
Ensuring Food Safety. In 1997, HHS dramatically increased attention on food
safety. In January, President Clinton announced a comprehensive new food safety
initiative to help detect and respond to outbreaks of foodborne illness earlier, and to
give us the data we need to prevent future outbreaks. The CDC and the FDA play a
key role in this new initiative. Key components of the new initiative include:
building a national Early Warning System to identify infectious agents and their
sources and rapidly communicate these findings nationwide; developing new
methods for monitoring the food supply; strengthening intergovernmental
coordination to reduce and improve responses to outbreaks of foodborne illnesses;
and improving awareness of food safety practices. Building on the President's
initiative, the FDA in August 1997 announced new measures to reduce the risk of
illness from disease-causing microbes in unpasteurized fruit and vegetable juices,
Automated Records Management System
Hex-Dump Conversion
and in October announced an initiative to upgrade domestic food safety standards
and to ensure that fruits and vegetables coming from overseas are as safe as those
produced in the United States. In addition, the FDA in December 1997 approved
the irradiation of meat products to control disease_causing micro_organisms.
Improving Guidance on Mammography. In March 1997, NIH issued a
recommendation that women age 40 and over be screened with mammography
every one to two years. In addition, NIH recommended that women at higher risk of
breast cancer get expert medical advice even before the age of 40 about when to
begin screening and about the frequency of their screening. To support this new
recommendation, President Clinton proposed and Congress adopted an expansion
of Medicare coverage which will help pay for annual mammograms for all
Medicare beneficiaries age 40 and over. The new benefit will be available starting
January 1, 1998. In addition, the FDA in October 1997 announced final regulations
that significantly improve the quality and performance of equipment and personnel
at all U.S mammography facilities. The regulations implement the Mammography
Quality Standards Act (MQSA) passed by Congress in 1992. The MQSA requires
that all mammography facilities meet stringent quality standards, be accredited by
an FDA-approved accreditation body, and be inspected annually.
First Biotechnology Product to Treat Cancer. On November 26, FDA approved
Rituxan, the first biotechnology product to treat cancer. The drug is used to treat a
type of non_Hodgkin's lymphoma. Rituxan targets and destroys white blood cells
involved in the disease. Because specific cells are targeted, rather than all
fast-growing cells, as is the case for most chemotherapy, tumor shrinkage is
accomplished with fewer toxic side effects than other cancer treatments.
Increasing Organ Donation. In December 1997, HHS launched a National Organ
and Tissue Donation Initiative aimed at increasing the number of organ donations
and reducing the number of Americans who die each year while waiting for organ
transplantation. The initiative builds on more than a decade of experience gained
from government, private, and volunteer efforts. Focusing on known barriers to
donation, it will: (1) create a broad partnership of public, private, and volunteer
organizations to encourage Americans to agree to organ and tissue donation; (2)
emphasize the need to share personal decisions on organ donation with one's
family; (3) work with health care providers, consumers, and physicians to ensure
that deaths are reported to organ procurement organizations whenever there is
potential for donation; and (4) learn more about what works to bring about
donation, through research and evaluation, including an HHS conference on best
practices next spring.
###
Automated Records Management System
Hex-Dump Conversion
Date: Tuesday, Dec. 31, 1996
FACT SHEET
Contact: HHS Press Office, (202) 690-6343
1996: YEAR OF ACHIEVEMENT, RENEWED COMMITMENT
Over the past four years, the Department of Health and Human Services has made important
commitments to the American people. We made a commitment to protect our nation's
children, and to pay special attention to the needs of our adolescents. We enhanced our
long-term commitments to improving the health and enhancing the independence of all
Americans. And we made new commitments to tough management at HHS, finding new ways
to do business and get results.
Today, those commitments are paying off. Childhood immunization rates are at their highest
levels ever in this country, and infant mortality is at an all-time low. There are 2 million fewer
people on welfare, and teen pregnancy rates are going down. We're making work pay with
more child care, better child support enforcement, an expanded Medicaid program, and a
reformed welfare system.
We launched an historic children's tobacco initiative to take power back from the cigarette
companies and put it in the hands of parents. We demanded quality from every Head Start
program. And we dramatically reduced drug approval time at the FDA, allowing new
advances in AIDS and other pharmaceuticals to reach Americans faster, while preserving
high standards for safety and effectiveness.
Under our "zero tolerance" policy for fraud and abuse, our Operation Restore Trust program
is saving $10 in health care costs for every anti-fraud dollar we spend. And we're protecting
Medicare for seniors and the disabled, giving beneficiaries enhanced benefits and greater
choice in their medical care.
Over the next four years, we must complete the job in many of these areas - and prepare to
meet the goals of the 21st century. We must reduce the ranks of the uninsured, especially
among our children. We must ensure that the quality of health care in America remains
among the best in the world. We must continue to aim at independence for all Americans,
while providing a safety net when help is needed. We must aggressively address the problem of
teen drug and alcohol abuse. We must extend our crusade against waste, fraud and abuse.
And we must assure the solvency of the Medicare program in both the near- and long-term,
for all Americans young and old.
These are tough challenges. But in an America where the doors of opportunity are wide open
and the keys of responsibility are in every person's hands, we can achieve them. Donna E.
Shalala
Children
Record Childhood Immunization Levels. In April 1996, HHS announced that the national
infant immunization rate is at an all-time high and vaccine-preventable childhood diseases
are at historic all-time lows. According to CDC's most recent National Immunization
Survey, which surveys parents of preschoolers nationwide, 75 percent of two-year-olds in
the United States received their full series of shots as recommended. On December 9, 1996,
Secretary Shalala launched a new nationwide public service campaign to encourage
Automated Records Management System
Hex-Dump Conversion
parents to make sure their children are adequately immunized.
Revised Head Start Performance Standards. In November 1996, HHS published revised
Head Start Program Performance Standards, developed with the consultation of thousands
in the Head Start field, that improve on the program's existing quality standards. These
revised, more user-friendly standards remove rigid and prescriptive requirements,
integrate infants and toddlers into the Head Start program, promote collaboration with
other community programs, and draw on medical expertise. In the spirit of the
Administration's reinvention goals, the revised Head Start Program Performance
Standards were developed based on communication with Head Start and early childhood
program practitioners. This new version focuses on quality services for children, including
infants and toddlers, and their families. It was published as a final rule in the Federal
Register on November 5, 1996.
New Early Head Start Grants. On September 10, 1996, Secretary Shalala announced new
"Early Head Start" grants for programs that will provide comprehensive support and
services to low-income families with children under three and pregnant women. For FY
1996, HHS awarded 74 new Early Head Start grants. At a funding level of $40 million, this
expansion will serve nearly 6,000 more children and their families. Combined with last
year's grants, Early Head Start now totals 142 programs across the country. The programs
will provide a range and variety of services to children and their families. Using the
successful Head Start model, Early Head Start will offer a basic early education, nutrition,
health and family development approach. Yet to meet the unique requirements of very
young children, the programs will test new services as well, including special health needs
for newborns, a three-generational model with grandparents, parents and children, and
strong parent-child interaction models. Also, some programs will target families with
particular needs, such as teen parents and families with histories of substance abuse.
Preventing Birth Defects. U.S. food manufacturers will add the nutrient folic acid to most
enriched breads, flours, corn meals, pastas, rice and other grain products to reduce the risk
of neural tube birth defects in newborns, as a result of action taken in February 1996 by
the Department of Health and Human Services and the Food and Drug Administration.
Folic acid, or folate, reduces the risk of neural tube birth defects such as spina bifida when
consumed in adequate amounts by women before and during early pregnancy.
Adolescents
President Clinton's Initiative to Prevent Youth Tobacco Use. On August 23, 1996, President
Clinton announced the nation's first comprehensive program to prevent children and
adolescents from smoking cigarettes or using smokeless tobacco and beginning a lifetime of
nicotine addiction. The President's initiative to protect children is based on the final FDA
rule, published in August 1996, that will make it harder for young people to buy cigarettes
and smokeless tobacco and will reduce the appeal of tobacco products to children under 18.
The rule is based on the Agency's finding that cigarettes and smokeless tobacco products
are delivery devices for nicotine, an addictive drug. In addition to the rule, the FDA will
propose to require tobacco companies to educate children and adolescents about the health
risks of tobacco use as part of the President's initiative. This national mass media campaign
would be monitored for its effectiveness. FDA intends to begin consultations about this
campaign with the nation's six tobacco companies with a significant share of sales to
children.
Automated Records Management System
Hex-Dump Conversion
Preventing Teen Pregnancy. The Administration's strategy to prevent teen pregnancy is
based on five principles that research and experience tell us are key to promising
community efforts: parental and adult involvement; strong messages of abstinence and
personal responsibility; clear strategies for young people's futures; involvement by all
facets of the community; and a sustained commitment to young people. Beginning in FY
1996, as part of President Clinton's teen pregnancy prevention strategy, HHS funded 17
grants totaling $5 million to innovative and comprehensive demonstration programs to
prevent early teen sexual activity, reduce teen pregnancies, and develop and implement
innovative comprehensive programs for pregnant and parenting teens. HHS also
implemented the CDC Teen Pregnancy Prevention Program with grants to 13
community-wide coalitions in communities with high rates of teen pregnancy. In addition,
at President Clinton's insistence, the new welfare law includes provisions requiring teen
mothers to live at home, stay in school, and turn their lives around. The Department will
build on our work in this area in launching a national strategy to reduce out-of-wedlock
teen pregnancy and assure that at least 25 percent of communities have teen pregnancy
programs in place.
Reality Check Anti-Marijuana Campaign. On June 24, 1996, Secretary Shalala launched
Reality Check, a national public education campaign designed to counter recent increases in
marijuana use by youth. The campaign is targeted in particular at improving information
and communications about marijuana. Keeping Youth Drug Free: A Guide for Parents,
Grandparents, Elders, Mentors and other Caregivers, the key ingredient of the Reality Check
campaign, endorsed by the National PTA, is designed to help parents talk with their
children about drug issues. The PTA will work with HHS toward the goal of distributing
the guide to some 14 million parents. The campaign also includes: a Reality Check
Community Kit, with ready to use local campaign materials; "Tips for Teens About
Marijuana" and other materials targeted for youth; poster displays in hundreds of malls
and grocery stores throughout the country, which will carry the slogan, "Marijuana is a
drug. Help your kids understand;" and a Reality Check marijuana web site on the National
Clearinghouse for Alcohol and Drug Information (NCADI) homepage
(http://www.health.org/reality).
Girl Power! Launched in November 1996, "Girl Power!" is a multi-phase, national public
education campaign sponsored by the Department of Health and Human Services (HHS) to
help encourage and empower 9- to 14-year-old girls to make the most of their lives. Studies
show that girls tend to lose self confidence and self worth during this pivotal age, becoming
less physically active, performing less well in school, and neglecting their own interests and
aspirations. It's during these years that girls become more vulnerable to negative outside
influences and to mixed messages about risky behaviors. Girl Power! is designed to
combine strong "no-use" messages about tobacco, alcohol, and illicit drugs with an
emphasis on providing opportunities for girls to build skills and self-confidence in
academics, arts, sports, and other endeavors.
Welfare Reform
Declining Welfare Rolls. Due in part to both the Clinton Administration's early emphasis
on state welfare reform demonstrations and its policies to strengthen the economy, welfare
rolls are down by 2.1 million since President Clinton took office in January 1993. The
number of AFDC recipients has fallen from 14.1 million in January 1993 to 12 million in
Automated Records Management System
Hex-Dump Conversion
September 1996, a decline of 15 percent. While working toward the passage of
comprehensive welfare reform legislation, the Clinton Administration approved 79
welfare-to-work programs in 43 states -- more than all previous administrations combined.
Record Child Support Enforcement. Since taking office, the Clinton Administration's
partnership with states has yielded unprecedented financial support for children. In 1996,
the federal-state child support enforcement system collected a record $11.8 billion from
non-custodial parents, up from $8 billion in FY 1992. The Federal government also
collected a record of over $1 billion in delinquent child support by intercepting income tax
refunds of non-paying parents for tax year 1995. Preliminary data for paternity
establishment show an estimated 800,000 in FY 1996, up from 515,857 in FY 1992. Under
President Clinton's comprehensive child support enforcement plan -- included at the
Administration's urging in the new welfare law -- child support collections could increase
by $24 billion over the next 10 years. In addition, while working toward comprehensive
improvement of child support enforcement, President Clinton used his executive authority
to increase child support collections. In 1996, President Clinton directed the Treasury
Department to activate a centralized, streamlined Federal system to offset child support
debts against most Federal payments; ordered Federal agencies to take necessary steps to
deny loans, loan guarantees, or loan insurance to any individual who is delinquent on child
support debt; and issued an executive order to make the federal government a model
employer in the area of child support enforcement.
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996. On August
22, President Clinton signed into law "The Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (P.L. 104-193)," a comprehensive bipartisan welfare reform
plan that will dramatically change the nation's welfare system into one that requires work
in exchange for time-limited assistance. The law contains strong work requirements, a
performance bonus to reward states for moving welfare recipients into jobs, state
maintenance of effort requirements, comprehensive child support enforcement, and
supports for families moving from welfare to work -- including increased funding for child
care and guaranteed medical coverage.
Gains in Health Indicators
National Health Statistics. On October 4, 1996, HHS Secretary Donna E. Shalala released
annual preliminary vital statistics findings for 1995, showing broad gains in national health
indicators. The report, "Births and Deaths for 1995," prepared by the National Center for
Health Statistics, part of HHS' Centers for Disease Control and Prevention, contains the
latest preliminary U.S. natality and mortality statistics. According to the report, the U.S.
last year achieved: an historic low infant mortality rate; continued increase in the number
of women obtaining early pre-natal care; the first decline in the birth rate for unmarried
women in almost 20 years; continued decline in the teen birth rate; a dramatic decline in
homicide rates; a leveling in the HIV/AIDS death rate, for the first time since the epidemic
took hold; and continued increase in life expectancy.
Cancer Death Rate Declined for the First Time Ever in the 1990s. The National Cancer
Institute (NCI) announced on November 14, 1996 that the cancer death rate in the United
States fell by nearly 3 percent between 1991 and 1995, the first sustained decline since
national record-keeping was instituted in the 1930s. The rates reported by NCI are based
on mortality data collected by the National Center for Health Statistics of the Centers for
Automated Records Management System
Hex-Dump Conversion
Disease Control and Prevention.
Reducing SIDS Mortality. On October 9, 1996, Secretary Shalala announced that deaths
due to Sudden Infant Death Syndrome (SIDS) fell 30 percent between 1992 and 1995. This
includes a 12 percent drop in 1994 and an 18.5 percent drop in 1995, the largest annual
declines ever observed in the U.S. and the only large declines observed in two consecutive
years. Secretary Shalala credited the public-private 'Back to Sleep' campaign, which
recommends that babies be placed on their backs to sleep to reduce the risk of SIDS, with
bringing about the improvement in SIDS mortality. This recommendation, made by the
American Academy of Pediatrics in 1992, is the backbone of the HHS campaign, initiated
in 1994 by the National Institute of Child Health and Human Development, one of the
National Institutes of Health.
Health Care
The Health Insurance Portability and Accountability Act of 1996. On August 21, 1996,
President Clinton signed into law the Health Insurance Portability and Accountability Act
of 1996, which includes important new protections for an estimated 25 million Americans
(approximately 1 in 10) who move from one job to another, who are self-employed, or who
have pre-existing medical conditions. The legislation, which was jointly sponsored by Sen.
Edward Kennedy (D-Mass.) and Sen. Nancy Kassebaum (R-Kan.), was approved virtually
unanimously by the House and Senate. It is designed to improve the availability of health
insurance to working families and their children.
Growth in Managed Care Enrollment. As of November 1, 1996, approximately 4.7 million
Medicare beneficiaries were enrolled in managed care plans, accounting for 12 percent of
the total Medicare population. That represents an 87 percent increase in managed care
enrollment since 1993. In 1995, an average 80,000 Medicare beneficiaries voluntarily
enrolled in risk-bearing HMOs each month. Enrollment in Medicaid managed care plans
has also increased significantly. Since Jan. 1, 1993, enrollment in Medicaid managed care
plans has increased by more than 140 percent, including a 51 percent increase in 1995
alone. As of June 30, 1995, 11.6 million Medicaid beneficiaries were enrolled in managed
care plans, representing 32 percent of total beneficiaries.
State Medicaid Demonstrations. Since January 1993, HHS has approved 15 comprehensive
health care reform demonstration projects, and the framework of one additional
demonstration. In addition, 19 states have received Medicaid waivers since January 1993,
as part of larger welfare reform projects. These complementary Medicaid waivers enable
states to continue providing essential health care services while encouraging independence
from welfare. Finally, 25 sub-state Medicaid demonstration projects have been approved,
affecting smaller components of state Medicaid programs.
Increasing Access to New Therapies. In FY 1996, the FDA approved a record 46 new drugs
(new molecular entities). Among the therapies approved were six for AIDS and nine for
cancer. New agents were also approved for difficult to treat conditions such as Lou
Gehrig's disease and Alzheimer's disease. FDA also approved six new vaccines. In addition,
on March 29, 1996, President Clinton announced a major initiative to make promising new
cancer therapies available sooner to American cancer patients. Also, on September 26,
1996, FDA announced final rules to make it easier for promising experimental drugs and
devices to be studied in persons who are in life-threatening situations and unable to give
consent for their use.
Automated Records Management System
Hex-Dump Conversion
Office of Cancer Survivorship. On October 27, 1996, President Clinton unveiled the new
Office of Cancer Survivorship at the National Cancer Institute. Recent success of cancer
prevention, early detection, and treatment efforts has created a new need: research into the
physical, psychological, and economic well-being of the growing number of cancer
survivors. The Office of Cancer Survivorship will support research covering the range of
issues facing survivors of cancer, including: long term medical and psychological effects;
factors that predispose survivors to second malignancies; reproductive problems following
cancer treatment; and their unique insurance and employment issues.
Surgeon General's Report on Physical Fitness. Regular physical activity offers substantial
benefits in health and well-being for the vast majority of Americans who are not physically
active, according to the first-ever Surgeon General's Report on Physical Activity and
Health released on July 11, 1996. The report, which was commissioned by Secretary
Shalala, also concludes that regular moderate physical activity can reduce the risk of
developing or dying from heart disease, diabetes, colon cancer, and high blood pressure.
Attacking Waste, Fraud, and Abuse
Operation Restore Trust. On May 13, 1996, Secretary Shalala marked the first-year
anniversary of HHS' anti-fraud initiative, Operation Restore Trust, saying new approaches
in the pilot program have already produced $42.3 million in recoveries. This constitutes a
return of $10 in recoveries for every $1 spent on the project. The pilot project is operating
in five states, and the Clinton Administration has proposed expanding it to all 50 states in
the coming fiscal year. With first-year targeted demonstration project funds of $4.09
million, Operation Restore Trust has produced $42.3 million in restitutions, fines,
settlements and recovery of overpayments. This includes $24.5 million returning to the
Medicare Trust Fund from criminal restitutions, fines and recoveries; $14.1 million
returning to the Trust Fund as a result of civil judgments, settlements and penalties; and
$3.7 million returned to the Treasury as a result of services inappropriately billed or
medically unnecessary services rendered.
Women's Health
Centers of Excellence in Women's Health. On October 1, 1996, HHS announced the
establishment of six National Centers of Excellence in Women's Health to serve as national
models for improving the health care of American women. The six centers, located at
academic institutions in different areas of the country, will serve as demonstrations and
models which can be evaluated and duplicated throughout the nation. The centers will
integrate health care services, research programs, public education, and health care
professional training, and will forge links with health care services in the community.
National Action Plan on Breast Cancer Web Site. On Oct. 27, 1996, President Clinton
launched a new Internet Web site for the National Action Plan on Breast Cancer. The Web
site, developed by a public/private partnership and coordinated by HHS' Office on
Women's Health, is designed to serve as a gateway to information on breast cancer
research, treatment and prevention. The Web site provides answers on frequently asked
questions about breast cancer, as well as information on the Action Plan, breast cancer
clinical trials and research, breast cancer organizations and advocacy groups, educational
conferences, publications, and government and private resources. The web site address is
http://www.napbe.org.
Automated Records Management System
Hex-Dump Conversion
Breast Cancer Gene Research. This discovery may lead to new treatment and prevention
strategies. On October 27, 1996, President Clinton announced $30 million in new funding
for research into the genetic basis of breast cancer.
Promoting Breast and Cervical Cancer Early Detection. The CDC's National Breast and
Cervical Cancer Early Detection Program builds an infrastructure in states and
communities to reduce deaths from breast and cervical cancers among all women through
public and provider education, quality assurance, evaluation, and partnerships. The
program also provides affordable screening services for underserved women, particularly
low income, elderly, and minority women. On October 1, 1996, Secretary Shalala
announced the expansion of the program to all 50 states, with over 1 million women having
already received these life-saving services.
Imaging Technology. HHS is working with other federal agencies, including NASA, the
Defense Department and the CIA, as well as private companies, to adapt high-tech imaging
technology to improve the early detection of cancer in women. In September 1996, HHS, in
collaboration with the CIA, awarded $1.98 million to the University of Pennsylvania to
conduct a series of clinical trials of imaging technology from the intelligence
community -- originally intended for missile guidance and target recognition -- to improve
the early detection of breast cancer.
Preventing Violence Against Women. In February 1996, President Clinton announced the
opening of a 24-hour, toll-free hot-line to provide crisis assistance and local shelter
referrals to victims of domestic violence throughout the country. Since its opening, the
hotline has received over 72,000 calls. Phone number: 1-800-799-SAFE. In October 1996,
the Advisory Council on Violence Against Women distributed a Community Checklist,
which includes steps that every facet of a community can take to prevent domestic violence.
The Council, created in July 1995, is co-chaired by the Attorney General and HHS
Secretary and consists of 47 experts -- representatives from law enforcement, media,
business, health and social services, victim advocacy and survivors -- helping to steer new
efforts to prevent violence against women.
HIV/AIDS
FDA approves new advances. In 1996, the FDA approved a new class of AIDS drugs called
protease inhibitors. Indinavir, the third of these drugs to be approved by the FDA, received
full approval for people with advanced HIV disease in 42 days. On May 14, 1996, the FDA
approved the first HIV test system that includes collection of blood samples at home. The
new testing system is comprised of three integrated components: an over-the-counter home
blood collection kit, HIV-1 antibody testing at a certified lab, and a test result center that
provides test results, counseling and referral anonymously.
Death Rates improve. In October 1996, HHS reported that in 1995, for the first time since
the epidemic took hold, the HIV/AIDS death rate did not increase from the previous year
and in November, the Centers for Disease Control and Prevention reported a sharp decline
in the number of infants born HIV-infected. The number of reported cases of perinatally
acquired (mother-to-infant) AIDS declined by 27 percent between 1992 and 1995,
according to information released by the Centers for Disease Control and Prevention
(CDC). Increased use of perinatal zidovudine (AZT) therapy by HIV-infected pregnant
women and their newborns is the most likely factor leading to this reduction, CDC said.
Increased Funding for the Ryan White CARE Act. Funding for the Act has increased by
Automated Records Management System
Hex-Dump Conversion
158 percent since President Clinton took office. On May 20, 1996, President Clinton signed
a five-year reauthorization of this program, guaranteeing assistance until the year 2001.
Funding for AIDS drug assistance has increased by 221 percent.
HHS Funds Innovative Aids Programs Under the Ryan White CARE Act. On September
26, 1996, Secretary Shalala announced the award of $7.1 million in federal funds to 19
innovative community-based AIDS service programs. The programs are designed to
improve the delivery of care to HIV-positive and/or at-risk individuals, including homeless
persons, those with mental illness or substance abuse problems, women and children,
adolescents, Native Americans, and former prisoners. Two grants were awarded through a
new collaboration between HHS and the Department of Housing and Urban Development
(HUD). On December 13, 1996, Secretary Shalala announced the award of $227.7 million to
20 states, the District of Columbia, and Puerto Rico to provide care to Americans living
with AIDS and HIV. On December 13, Secretary Shalala also announced $3.35 million in
2-year continuation awards for nine projects in six states to evaluate and disseminate
health care and support services delivery models for HIV-infected and at-risk adolescents.
Microbicide Initiative. At the Eleventh International Conference on AIDS this year,
Secretary Shalala announced a new effort to develop safe and effective topical microbicides
to help women protect themselves against HIV infection. The initiative includes a $100
million commitment to research and development.
###
Automated Records Management System
Hex-Dump Conversion
FOIA Number: 2013-0365-F
Clinton Presidential Records
Automated Records Management
System [EMAIL]
This is not a presidential record. This is used as an
administrative marker by the William J. Clinton Presidential
Librarv Staff.
Hex Dump file is not in a recognizable format, has been incorrectly
decoded or is damaged.
File Name: p_g4142883_who_html_5.doc
Attachment Number: [ATTACH.D56JARMS21982414L.046
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: "Morton, Julie (OD)" <[email protected]> ( "Morton, Julie (OD)" <[email protected]> [
UNKNOWN
CREATION DATE/TIME: 2-AUG-2000 13:10:33.00
SUBJECT: FEDERAL FUNDS SUPPORT EXPANSION OF RESEARCH IN WOMEN'S HEALTH
TO: [email protected] ( [email protected] [ UNKNOWN
READ:UNKNOWN
Sarah S. Knight ( CN=Sarah S. Knight/OU=WHO/O=EOP [ WHO ])
READ:UNKNOWN
TEXT:
NATIONAL INSTITUTES OF HEALTH
National Institute of Child Health and Human Development
NIH NEWS RELEASE
FOR IMMEDIATE RELEASE
Wednesday, August 2, 2000
Contact:
Robert Bock
(301) 496-5133
FEDERAL FUNDS SUPPORT EXPANSION OF RESEARCH IN WOMEN'S
HEALTH
In a major new effort to stimulate women's health research
across a variety of disciplines, the National Institutes of
Health announced it will fund 11 awards to support
development of new research in women's health. The program,
Building Interdisciplinary Research Careers in Women's
Health (BIRCWH), seeks to increase the number of researchers
working on women's health issues and to mentor junior
researchers in an interdisciplinary scientific setting by
pairing them with senior investigators.
The Office of Research on Women's Health (ORWH) at the
National Institutes of Health (NIH) leads the BIRCWH
initiative, which will award a total of $5.5 million to 11
universities.* In addition to ORWH, nine NIH Institutes**
and the Agency for Healthcare Research and Quality (AHRQ)
will co-sponsor this program.
"The BIRCWH program offers a tremendous opportunity to
advance women's health research," said Vivian Pinn, M.D.,
and Director of the ORWH. "This program will encourage
researchers from a variety of areas - basic, clinical,
behavioral, health services and public health research - to
approach a scientific question from different perspectives."
Junior faculty members, selected as Interdisciplinary
Women's Health Research (IWHR) Scholars, will have the
opportunity to augment their research skills in these
interdisciplinary career development programs. They will be
matched with a seasoned senior investigator, who will mentor
them for a period of two to five years.
Dr. Pinn added that the new initiative will allow the
participating cosponsors to support interdisciplinary
efforts that may not fit neatly into their research domains.
For example, the National Institute of Aging is typically
concerned with the phase of women's lives that follows
menopause. The National Institute of Child Health and Human
Development (NICHD) tends to focus its research on the
events prior to menopause. The new initiative, however, will
support research spanning the phases before, during and
after menopause and serve as a model for reducing
fragmentation of women's health care.
The BIRCWH program was modeled after an existing program,
the Women's Reproductive Health Research Career Development
Centers, supported by the NICHD, the National Cancer
Institute (NCI) and the ORWH.
"This initiative is a commitment to women's health research
- training today the scientists of tomorrow," said Duane
Alexander, M.D., Director of the NICHD. "As a co-sponsor of
the BIRCWH initiative, the NICHD will continue the important
work of fostering career development in women's health."
Along with the NICHD, eight other NIH institutes will
support biomedical and behavioral research and the AHRQ will
support health services research.
*The 11 universities participating in the new program are:
-Baylor College of Medicine - Baylor BIRCWH Program
University of Alabama at Birmingham - UAB Women's Health
Research Scholars' Program
University of California, Los Angeles - Building
Interdisciplinary Research Careers in Women's Health
(BIRCWH) Center
-University of California at San Francisco - UCSF - Kaiser
Women's Health Interdisciplinary Scholarship
-University of Connecticut Health Center - UConn Center for
Interdisciplinary Research in Women's Health
-University of Kentucky Research Foundation -
Interdisciplinary Research Careers in Women's Health
--University of Medicine and Dentistry of New Jersey -
Career Center in Interdisciplinary Women's Health Research
-University of North Carolina at Chapel Hill - UNC BIRCWH
Career Development Program
Virginia Commonwealth University - Building Research
Careers in Women's Health
Washington University in St. Louis - Building
Interdisciplinary Research Careers in Women's Health
-- Yale University School of Medicine - BIRCWH Career
Development Programs
**The nine NIH institutes supporting the BIRCWH program are:
--National Institute on Aging
--National Institute on Alcohol Abuse and Alcoholism
--National Institute of Allergy and Infectious Diseases
--National Institute of Arthritis and Musculoskeletal and
Skin Diseases
--National Cancer Institute
--National Institute of Child Health and Human Development
--National Institute on Drug Abuse
--National Institute of Environmental Health Sciences
--National Institute of Mental Health
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Alexander N. Gertsen ( CN=Alexander N. Gertsen/OU=WHO/O=EOP [ WHO
)
CREATION DATE/TIME:11-AUG-2000 20:53:26.00
SUBJECT: Then & Now DPC Final
TO: Jenni@13102034046@fax Jenni@13102034046@fax UNKNOWN
READ:UNKNOWN
TEXT:
FOR INTERNAL USE ONLY
THE CLINTON-GORE DOMESTIC RECORD:
WHAT A DIFFERENCE SEVEN YEARS MAKES
August 11, 2000
Achieving the Longest Consecutive Decline in Crime on Record
� 1981-1992. Under the Reagan and Bush Administrations, the nation,
S overall crime rate remained at historically high levels, with the crime
rate increasing steadily starting in the mid-1980,s.
i¿½ Today. The overall crime rate has dropped for 8 years in a row
) the longest continuous drop on record ) and is now at a 25 year-low.
And, as a result of the Clinton-Gore Administration,s historic 1994 Crime
Bill, over 100,000 additional community police officers have been funded
for our nation,s communities.
Turning Back the Tide on Three Decades of Escalating Violent Crime
i¿½ 1992. The violent crime rate in America had more than quadrupled
during the previous three decades, with the violent crime rate in 1992 at
nearly an all-time high in over 30 years.
i¿½ Today. The violent crime rate has dropped every year since
President Clinton took office ) a remarkable 25 percent decline since
1992.
The Lowest Murder Rate in Over 30 Years
i¿½ 1981-1992. The nation,s homicide rate was nearly the same in
1981 when President Reagan took office as it was in 1992 when President
Bush left office ) and at a historically high level.
i¿½ Today. The murder rate has dropped by more than one-third since
President Clinton took office in 1993. The murder rate is now at its
lowest point in 31 years.
Gun Violence Cut By Over One-Third
� 1992. When President Bush left office, the total number of gun
crimes in America had reached its highest point in 20 years.
i¿½ Today. Since 1992, the total number of gun crimes has declined
by 35 percent. In 1993 President Clinton signed the Brady Law, which has
helped deny more than half a million felons, fugitives and stalkers from
buying guns as a result of Brady background checks.
Welfare Rolls Cut More Than Half: Lowest Since 1968 and the Longest
Decline in History
i¿½ 1981-1992. The number of welfare recipients increased by almost
2.5 million (a 22 percent increase) to 13.6 million people.
i¿½ Today. Between January 1993 and September 1999, the number of
welfare recipients dropped by 7.5 million (a 53 percent decline) to 6.6
million the lowest level since 1968.
From Welfare To Work
i¿½ 1992. Seven percent of welfare recipients were working.
ïᵢ½ Today. By 1998, 27 percent of welfare recipients were working,
nearly quadruple the level in 1992, and every state met the work
requirements implemented in the welfare reform law the President signed in
1996.
i¿½ 1992. Twenty percent of people on welfare in 1991 were working
in 1992.
i¿½ Today. The percent of people on welfare in 1998 who were working
in 1999 increased to 36 percent ) an 82 percent increase from 1992.
[Background: Census Bureau data reflects the percent of people receiving
welfare at any point in Year 1 who were working in March of Year 2,
whether receiving welfare or not.]
Child Support Collections More Than Doubled
i¿½ 1992. Child support collections totaled $8 billion, and only
500,000 fathers that year legally established paternity.
� Today. Child support collections doubled to nearly $16 billion
by 1999, and the number of fathers taking responsibility for their
children by establishing paternity has tripled to a record 1.5 million.
Lowest Teen Birth Rate On Record
ïᵢ½ 1992. The teen birth rate for 15-19 year-olds was 60.7 per 1,000
teens.
i¿½ Today. The teen birth rate has declined nearly 20 percent since
1992 to the lowest level since record keeping began 60 years ago.
Improved Access to Affordable Quality Child Care and After-School
Programming
ïᵢ½ 1992. Child care for working families was severely underfunded
and there was no federal funding to help support after-school
opportunities.
� Today. Federal funding for child care has more than doubled,
helping parents pay for the care of about 1.5 million children in 1998,
and the 1996 welfare reform law increased child care funding by $4 billion
over six years to provide child care assistance to families moving from
welfare to work. The Administration has also helped provide after-school
opportunities to approximately 850,000 children so that more parents can
go to work knowing that their children are in safe learning environment
during the after-school hours.
Educational Achievement: Scores Are Up, Gaps Are Narrowing
ïᵢ½ 1992. The average reading score on the National Assessment of
Educational Progress (NAEP) for nine-year-olds was 180; and the gap
between nine-year-olds in high-poverty and all nine-year-olds was 29
points. 388,000 students were taking Advanced Placement exams and about 38
percent of high school seniors were taking a core curriculum of four years
of English and 3 years each of Math, Science and Social Studies
ïᵢ½ Today. Since 1992, reading and math scores on the National
Assessment of Educational Progress (NAEP) have increased for fourth,
eighth, and twelfth graders, including those students in the highest
poverty schools. Reading and math scores for nine year-olds in our
highest poverty schools have improved by nearly one grade level since
1992. In 1996, average NAEP reading scores for nine year-olds increased
eight points, and the gap between nine year-olds in high-poverty schools
and all nine year-olds decreased to 22 points. The number of students
taking AP exams has increased by two-thirds, to more than 581,000 in 1997,
and the fraction of graduating seniors taking a core curriculum has grown
to 55 percent.
Educational Accountability: Nearly All States Have Implemented Standards
� 1992. At the start of the Administration, only 19 States had
academic standards, or clear definitions of what students should know and
be able to achieve.
i¿½ Today. As a result of the President,s initiatives Goals 2000 and
Improving America,s Schools Act (IASA), 49 states have adopted rigorous
standards for core curriculum subjects as well as standards-based
assessments, and these initiatives have provided assistance to states to
develop challenging standards for all students.
Public School Choice: Substantially More Charter Schools
� 1993. There was only one charter school in the entire nation,
and only one state with a charter school law.
i¿½ Today. There are over 1,700 charter schools, serving 250,000
children. Charter school laws are now in place in 36 states, Puerto Rico
and the District of Columbia.
Educational Technology: Almost All Schools Are Connected To The Internet
i¿½ 1993. In 1993, only 3 percent of classrooms had access to the
Internet, and in 1994 only 35 percent of school were connected to the
Internet.
i¿½ Today. Through the aggressive E-rate program, more than 65
percent of classrooms have Internet access, and by the end of this year,
100 percent of schools will likely be connected to the Internet. Ninety
percent of high-poverty schools are connected to the Internet, compared to
19 percent in 1994.
Higher Education Access is Up: Largest Investment
i¿½ 1992. In 1992, 62 percent of high school graduates enrolled in
college. Only 14 percent of black 25-29 year-olds had a bachelor,s degree
or higher, as did only 28 percent of women.
i¿½ Today. Since 1993, high school graduate enrollment has increased
to 67 percent ) an all time high. The fraction of blacks and women with a
bachelor,s degree or higher have each increased by more than 4 percent,
and student aid has doubled to nearly $60 billion ) the largest investment
in higher education since the G.I. Bill. The Administration has
significantly expanded college opportunity by providing over $7 billion
per year in tax credits to 13 million students and families for
postsecondary education and training, increasing the maximum Pell grant
award from $2,300 to $3,300 (which updated the average increase in tuition
and fees during the same period), decreasing student loan costs by
billions of dollars through interest rate formula and origination fee
reductions, and helping nearly 30 percent more students pay for college
through work-study opportunities.
Improving Public Health
i¿½ 1993. Immunization rates were too low, infant mortality rates
were too high, and funding for biomedical research and mental health
services were inadequate.
i¿½ Today. Immunization rates are at an all-time high ) 90 percent
for toddlers and infant mortality has declined by 14 percent since
1993. NIH funding has increased by $7.3 billion (an increase of 58
percent since 1993) and funding for mental health prevention and treatment
has increased by 65 percent.
Improving And Expanding Health Insurance Coverage
i¿½ 1993. Millions of children could not access affordable and
meaningful health insurance, people with disabilities who wanted to work
could not for fear of losing their health insurance, and young people
leaving foster care could not retain the critical health insurance they
needed to make a healthy start as adults. Unlike many other American
workers, self-employed Americans received absolutely no tax assistance in
purchasing health care insurance.
i¿½ Today. Up to five million children are expected to have health
insurance as a result of the enactment of the historic Children,s Health
Insurance Program in 1997) the largest expansion of health insurance for
children since the creation of the Medicaid program. The President has
also enacted historic expansion coverage expansions for people with
disabilities who wish to return to work and for foster care children aging
out of Medicaid eligibility, including legislation to assure that
self-employed Americans receive the same tax benefits as workers who have
job-based health coverage.
Reforming The Health Insurance Market
i¿½ 1993. There were no federal protections ensuring that Americans
who left their jobs wouldn,t lose access to health insurance. Individuals
with mental health needs were often faced with discriminatory insurance
benefits; new mothers and women recovering from mastectomies were
discharged from the hospital before it was medically prudent; and the
scientific progress made in identifying the genetic causes of disease was
in danger of being used to discriminate against Americans purchasing
health insurance or applying for jobs.
i¿½ Today. The President,s enactment of the bipartisan Health
Insurance Portability and Accountability Act ensures that Americans now
have insurance portability protections when they switch or lose jobs. The
President has also enacted legislation that assures that: annual and
lifetime coverage limits can be no different for mental health coverage
than other benefits; new mothers can stay in the hospital; drive-through
mastectomies are eliminated; and genetic discrimination against many
Americans purchasing health insurance is prohibited. In addition, through
executive action, the Clinton Administration applied patient protections
to 85 million Americans in Federal health plans, and prohibited genetic
discrimination in Federal hiring and employment actions.
Modernizing and Strengthening Medicare
i¿½ 1993. At the beginning of the Clinton Administration, the
Medicare Trust Fund was projected to become insolvent in 1999, and the
program,s benefit package excluded important preventive services,
including annual mammograms, colon, cervical, and prostate cancer
screenings, diabetes management services, and coverage for the routine
care costs associated with clinical trials. And the Medicare program,s
management was vulnerable to fraud and abuse.
ïᵢ½ Today. The life of the Medicare Trust Fund has been extended by
26 years and offers premiums that are nearly 20 percent lower today than
projected in 1993. And, the President,s concerted effort to fight fraud,
waste, and abuse in the Medicare program has resulted in savings of more
than 50 billion to the American taxpayers. The program also now covers
annual mammograms, colon, cervical, and prostate cancer screenings,
diabetes self-management services, and the routine care costs associated
with clinical trials.
Helping Families Balance Their Responsibilities at Home and At Work
i¿½ 1992. Workers could not take leave for family or medical reasons
without fear of losing their job, and the previous Administration had
vetoed twice a proposal to allow employees to take unpaid family or
medical leave.
ïᵢ½ Today. In 1993, President Clinton signed the Family and Medical
Leave Act (FMLA) the first bill he signed into law ) mandating that public
and private employers with at least 50 workers provide their employees
with 12 weeks of unpaid leave without risking their jobs, which provides
protected leave to 90.7 million American workers, about 71 percent of the
American workforce.
Ensuring a Head Start for More of America,s Children
� 1992. Head Start ) the national program that provides
comprehensive development
services for America,s low-income, pre-school children ages three to five
) was severely underfunded and only able to serve just over 700,000
children.
i¿½ Today. President Clinton increased funding for the Head Start
program by 90 percent and this year the program will serve approximately
880,000 children ) well on the way to meeting the President,s goal of
serving one million children by the year 2002.
Helping Children Most in Need by Reforming Foster Care and Adoption
ïᵢ½ 1992. Children in the foster care system often languished for
months without being
reunited with their parents or placed in a permanent loving home with
adopted parents.
ïᵢ½ Today. Between 1996 and 1998, adoptions rose 29 percent
nationwide from 28,000 to 36,000, which puts us on track to meeting the
President's goal of 56,000 adoptions in 2002. In 1997, the President
signed the Adoption and Safe Families Act, which expedited permanent
placement decisions for children, ensured health insurance coverage for
all special-needs children in subsidized adoptions, and created an
incentive program for states to increase adoptions, and has also fought
hard to remove racial and ethnic barriers to adoption.
New Tools in the Fight Against Domestic Violence
iᵢ½ 1992. There was no coordinated Federal response to violence
against women, in the home, workplace, or on campus.
i¿½ Today. In 1994 President Clinton signed the Violence Against
Women Act (VAWA) and the number of women experiencing violence at the
hands of an intimate partner declined 21 percent from 1993 to 1998. In
addition, in 1996, 1997, and 1998, intimate partners committed fewer
murders than in any year since 1976.
Protecting Reproductive Rights and Promoting Reproductive Health
i¿½ 1992. Science was held hostage to politics and women,s health
suffered as a result. The &gag rule8 prevented women from receiving
information about all their medical options at family planning clinics.
Women and medical professionals were subject to violence and harassment at
reproductive health clinics. A woman,s basic right to choose was in
jeopardy.
i¿½ Today. The fundamental right to choose has been protected and
women have expanded
access to family planning services. The gag rule was reversed and women
are able to receive medical advice and referrals on all their medical
options. Science is no longer held hostage to politics: the ban on
importation of RU-486 was reversed, and the ban on federal funding for
fetal tissue research was lifted, opening the way for potentially
lifesaving biomedical research. Thanks to the Freedom of Access to Clinic
Entrances Act (FACE), championed by the President, women and medical
professionals have federal protection from violence and harassment at
reproductive health clinics. Over one million federal employees have
contraceptive coverage.
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: Angela C. Mizeur ( CN=Angela C. Mizeur/OU=WHO/O=EOP [ WHO ])
CREATION DATE/TIME:25-SEP-2000 16:58:55.00
SUBJECT: Re: interesting artice
TO: David S. Spielfogel ( CN=David S. Spielfogel/OU=CEQ/O=EOP@EOP [ CEQ 1)
READ:UNKNOWN
TEXT:
thanks David-being the dork that I am, I'm still interested in the details
of that. But that does clarify
David S. Spielfogel
09/25/2000 03:27:06 PM
Record Type: Record
To:
Angela C. Mizeur/WHO/EOP@EOP
cc:
bcc:
Subject:
Re: interesting artice
from the human geneticist in my family:
>Quick answer after quick perusal it would absolutely not be possible to
>put sperm DNA into the oocyte nucleus and fertilize with sperm!!
>Explanation is more than I have time for but it is well proven that this
is
>impossible. On the other hand, I don't think there is any reason to think
>that the Dolly type of cloning could not be done with a male cell to
>produce an exact clone of the male parent (if anyone would want to do
>this). However, the ethical guidelines are such that even attempting this
>is not in the realm of possibility in the near future!!
Angela C. Mizeur
09/25/2000 12:20:23 PM
Record Type: Record
To:
See the distribution list at the bottom of this message
cc:
Subject:
interesting artice
Anyone who understands this cloning technique feel free to chime in the
details.
Seems to me that the XX can be made from the 2 guys with early development
of cells induced
in vitro conditions, and then you're set b/c you are creating Barr Bodies,
cell specialization, etc.
Slippery slope for sure.
September 25 2000
BRITAIN
Male couples could have own
babies
BY MARK HENDERSON, SCIENCE CORRESPONDENT
Links
MALE homosexual couples could conceive children
without a mother using the genetic techniques pioneered
by Dolly the Sheep, a leading British biotechnology expert
has claimed.
Dr Calum MacKellar, a lecturer in bioethics and
biochemistry at the University of Edinburgh, believes that
research into cloning procedures to treat infertility and
metabolic disease could yield technology that would allow
a male homosexual couple to produce a child using only
their own DNA, with no need for a third, female, party to
act as mother.
Dr MacKellar, who runs the European Bioethical
Research charity, said that the cell nuclear replacement
technique, which was used to create Dolly, the cloned
sheep, could be developed to create so-called "male
eggs", which could then be fertilised by sperm from the
other partner.
The "male egg" would be created by removing the nucleus
from a donor egg and replacing it with the nucleus from a
sperm cell. The new egg would then have male DNA and
could be fertilised in-vitro by another sperm to give the
embryo two genetic fathers. It would then be implanted in
the womb of a surrogate mother.
However, Dr MacKellar said that new government
guidelines on human cloning have ignored the ethical issues
raised by the technique, which would allow the birth of a
child with two genetic fathers.
At present, embryos conceived in such ways in animal
tests on mammals have so far failed to develop. As
science stands, a mammal embryo created solely from
paternal DNA lacks certain imprinted maternal genes that
allow it to grow normally. Reptiles and birds do not face
this obstacle.
Dr MacKellar, however, said the advance of genetics was
proceeding at such a rate that this difficulty could soon be
overcome. "Because researchers are now beginning to
find techniques of stripping imprints from certain
chromosomes, a successful outcome for the male egg may
not be far away," he said.
"Not long ago, everybody thought the cloning techniques
used to create Dolly the sheep were science fiction. Now
they are very real, and the legislation is having to catch up.
It would be a mistake not to consider the male egg issue
at the same time."
The ethical problems that such a development would raise
were not addressed in last month's report into cloning by
the Chief Medical Officer, Sir Liam Donaldson, which will
form the basis of a new Bill to be placed before MPs later
this year.
As a result, public debate has overlooked one of the most
controversial areas in which cloning might one day be
applied, Dr MacKellar said.
"This is something of an oversight," he said. "The ethical,
philosophical and theological issues surrounding the
creation of children with two genetic fathers and a
surrogate mother are extensive, and they need to be
thoroughly thought through before any legislation is
considered in parliament.
"If the Government does not take careful notice of the
issues surrounding the male egg, another report will need
to be written by another Chief Medical Officer just
because no-one believed this could happen."
The cell nuclear replacement technique that could be used
to create male eggs is considered by the Donaldson
report, but only as a way to treat infertility and metabolic
disorders caused by mitochondrial disease - in which a
mother's cells have defective mitochondria, the DNA
structures that create energy.
By placing the nucleus from one of a mother's eggs into a
donor egg with healthy mitochondria, the embryo formed
would inherit maternal nuclear DNA without inheriting the
mitochondrial disorder. The Donaldson report
recommends that research into such techniques be allowed
Message Sent
To:
Alon J. Kupferman/WHO/EOP@EOP
Bobby D. Conner/WHO/EOP@EOP
Hildy Kuryk/WHO/EOP@EOP
Lauren K. Gillespie/WHO/EOP@EOP
Rebecca Hunter/WHO/EOP@EOP
Brian S. Mason/WHO/EOP@EOP
Jared Powell/WHO/EOP@EOP
Fern Mechlowitz/WHO/EOP@EOP
Anne W. Bovaird/WHO/EOP@EOP
Dawn V. Woollen/WHO/EOP@EOP
Bridget T. Leininger/WHO/EOP@EOP
Ann Marie Wallace/WHO/EOP@EOP
Tanya L. Lombard/WHO/EOP@EOP
Nancy Marlow/CEQ/EOP@EOP
David S. Spielfogel/CEQ/EOP@EOP
Debra Reed/CEQ/EOP@EOP
Janet Anderson/WHCCTF/EOP@EOP
Shelley N. Fidler/WHCCTF/EOP@EOP
Julie M. Anderson/WHO/EOP@EOP
Lisa M. Kountoupes/WHO/EOP@EOP
Cara E. Walsh/WHO/EOP@EOP
[email protected] @inet
[email protected] @ inet
[email protected]
Jaimme A. Collins/WHO/EOP@EOP
Scott Beale/WHO/EOP@EOP
[email protected]
Brooke B. Livingston/OMB/EOP@EOP
Rachael F. Goldfarb/WHO/EOP@EOP
Lauren A. Skryzowski/WHO/EOP@EOP
Danielle G. Valentino/WHO/EOP@EOP
[email protected]
[email protected]
[email protected]
[email protected]
Debra Boylan/WHO/EOP@EOP
Lindsay R. Drewel/OVP/EOP@EOP
[email protected]
RECORD TYPE: PRESIDENTIAL (NOTES MAIL)
CREATOR: [email protected] ( [email protected] [ UNKNOWN D
CREATION DATE/TIME:27-SEP-2000 10:41:28.00
SUBJECT: KAISER DAILY REPRODUCTIVE HEALTH REPORT
TO: [email protected] ( [email protected] [ UNKNOWN 1)
READ:UNKNOWN
Ann Marie Wallace ( CN=Ann Marie Wallace/OU=WHO/O=EOP [ WHO I)
READ:UNKNOWN
TEXT:
KAISER DAILY REPRODUCTIVE HEALTH REPORT
A service of the Kaiser Health Information Network
http://report.kff.org/repro/
Wednesday, September 27, 2000
CAMPAIGN 2000
#1 AL GORE: Vice President Responds to Questions on Abortion
on MTV
#2 NARAL: Targets 'Worst Choice' Candidates for Defeat in
November
ABORTION NEWS
#3 BORN ALIVE PROTECTION ACT: House Passes Bill 380-15
#4 JUDICIAL BYPASS: Granting of Waivers Differs By State
MEDIA & SOCIETY
#5 SEX ED: Abstinence-Only Education On the Rise
#6 PRIESTS FOR LIFE: Cable Ads Target Abortion-Rights
Supporters
REPRODUCTIVE HEALTH SERVICES
#7 MIFEPRISTONE: Planned Parenthood Head Predicts FDA Approval
This Week
PUBLIC HEALTH & EDUCATION
#8 TEXAS: Foundation Launches Teen Pregnancy Prevention
Campaign
BIOETHICS & SCIENCE
#9 CONCEPTION: 'Male Couples' Could Be a Possibility
OPINION
#10 BIRTH CONTROL: Women Do Not Carry Unfair Burden
CORRECTION: In our coverage of Nat Hentoff's Washington Times
column yesterday, Rep. Jerrold Nadler (D-N.Y.) was incorrectly
called "antiabortion." Nadler is an abortion-rights proponent
and in fact, Hentoff quotes Nadler as describing himself as being
"as pro-choice as anybody else."
CAMPAIGN 2000
#1 AL GORE: VICE PRESIDENT RESPONDS TO QUESTIONS ON ABORTION
ON MTV
Hoping to gain exposure among the twenty-something crowd,
Vice President Al Gore made an appearance on MTV's "Choose or
Lose" show last night, where he fielded questions on abortion and
other politically charged issues, the AP/Baltimore Sun reports.
During the 90-minute questioning that was broadcast to an
estimated one million viewers, Gore defended his support for
abortion rights and said that young women need "access to
appropriate sex education, family planning and programs including
abstinence but all the range of options" to make important sexual
decisions (AP/Baltimore Sun, 9/27). He stated, "I think that
[abortion] is an individual choice. I think actually the pro-
life and pro-choice forces in this country have more in common
than either side is willing to acknowledge. Both sides would
like to see a reduction in the number of abortions and the way to
do that in my opinion is to reduce the number of situations where
women feel like they have to make that choice.
I
think
that
if we tried to heal some of those divisions, we could sharply
reduce the number of abortions." Gore also answered a question
regarding mifepristone, or RU-486, saying, "I think that [the
drug] ought to be available, provided of course that it is safe
and I think what's wrong is to hold it off the market for some
kind of political reason" ("Choose or Lose," MTV, 9/26). Gore's
MTV appearance follows his guest appearances on the Oprah
Winfrey, Jay Leno and David Letterman shows, where he also tried
to "mobilize young voters in the battle against Republican rival
George W. Bush." A Kaiser Family Foundation and MTV survey
released this week found that less than 50% of people under 25
years of age "absolutely" intend to vote this November
(AP/Baltimore Sun, 9/27).
#2 NARAL: TARGETS 'WORST CHOICE' CANDIDATES FOR DEFEAT IN
NOVEMBER
The National Abortion and Reproductive Rights Action League
yesterday unveiled a new $5 million, 15-state campaign, urging
independent and abortion-rights Republicans to vote against Texas
Gov. George W. Bush (R) and congressional candidates appearing on
the group's "Worst Choice List," the Washington Post reports.
The list highlights candidates' abortion records in several
Senate and House races. According to NARAL President Kate
Michelman, the "get-out-the-vote" campaign represents "the
largest on-the-ground silent war that we've ever conducted in
NARAL's history." During the campaign, NARAL plans to "pepper"
more than two million voters with telephone calls and direct
mailings in 15 targeted states -- California, Florida, lowa,
Michigan, Missouri, Minnesota, Montana, New Hampshire, New
Mexico, Ohio, Pennsylvania, New Jersey, New York, Washington and
Wisconsin -- hoping to influence results in nine Senate races and
about 24 House contests. "Our job is to educate [voters], to
persuade them and to mobilize them to vote," Michelman said,
noting that when voters compare Bush's and Vice President
Al Gore's abortion records, "they move like lightning to Gore"
(Balz, Washington Post, 9/26). Michelman added in a statement,
"[N]o issue is more vital in the race between Al Gore and George
W. Bush than the makeup of the Supreme Court and the future of a
woman's right to choose." In addition to Bush, NARAL's "Worst
Choice List" features the following Senate candidates:
Sen. Spencer Abraham (R-Mich.): Has voted against abortion
and reproductive rights measures 41 of 43 times and in favor
of overturning Roe V. Wade, sponsored legislation that would
prevent anyone other than a parent from accompanying a minor
across state lines for an abortion, and cosponsored
legislation to ban overseas non-governmental organizations
from receiving U.S. family planning dollars if they use such
funds "to provide legal abortion services or [to] publicly
participate in debates about abortion laws or policies;
Sen. Rod Grams (R-Minn.): Has cast 55 of 55 votes against
abortion and reproductive rights legislation, voted in favor
of overturning Roe v. Wade, backed a measure to make
permanent the Hyde amendment that bans Medicaid coverage for
abortion services except in cases of rape, incest, or life
endangerment, and voted against the Freedom of Access to
Clinic Entrances Act;
Sen. John Ashcroft (R-Mo.): Has cast 42 of 43 antiabortion
votes on abortion and reproductive rights legislation,
cosponsored a bill to overturn Roe V. Wade, and voted to
make permanent the Hyde amendment;
Rep. Rick Lazio (R-N.Y.): Supported a measure that would
ban abortion procedures throughout pregnancy regardless of a
woman's health, voted to recognize an embryo as a person,
voted against the repeal of the Hyde amendment, and voted to
ban privately funded abortions at overseas military
hospitals for U.S. servicewomen and military dependents
except in cases of rape or incest;
Former Virginia Gov. George Allen (R): Has backed a
constitutional amendment to overturn Roe v. Wade, vetoed a
bill to protect doctors, clinic workers and women and their
families from violence and intimidation at reproductive
health care facilities, voted against the Freedom of Choice
Act, which would have codified Roe v. Wade and protected a
woman's right to choose, and voted against the Family and
Medical Leave Act, which allows millions of Americans to
take unpaid leave for illness or to care for a new child or
sick family member.
The "Worst Choice List" also includes incumbent Reps. James Rogan
(R-Calif.), Tom Tancredo (R-Colo.) and Pete Sessions (R-Texas),
as well as House challengers Michigan state Sen. Mike Rogers (R),
Minnesota state Sen. Linda Runbeck (R), former Montana Lt. Gov.
Dennis Rehberg (R), Ohio state Rep. Pat Tiberi (R), New Jersey
Republican Mike Ferguson and Washington state Rep. John Koster
(R) (NARAL release, 9/26).
SBA BLASTS NARAL LIST
The SBA List Candidate Fund, which works to increase the
"percentage of pro-life women in Congress," attacked NARAL's
"Worst Choice List" in a release yesterday. According to
Executive Director Jennifer Bingham, "The NARAL voter contact
campaign does nothing new in targeting races that every other
pro-abortion and pro-life organization targets. NARAL's
success will be measured by how deceptive they are to voters who
largely support a ban on partial-birth abortions [and] more
limits on abortion in general." She also called NARAL's claim
about Bush-appointed justices overturning Roe V. Wade
"deceptive," noting, "an unlikely overturning of Roe would only
mean that forming abortion policy would once again be the
responsibility of voters in the states." The SBA List Candidate
Fund plans to spend about $400,000 nationally on 22 antiabortion
candidates (SBA List Candidate Fund release, 9/26).
ABORTION NEWS
#3 BORN ALIVE PROTECTION ACT: HOUSE PASSES BILL 380-15
The House yesterday overwhelmingly passed the Born-Alive
Infant Protection Act, which guarantees that "babies born alive
during botched abortions cannot be killed or allowed to die
because [they are] unwanted," the Washington Times reports. The
bill, which passed 380 to 15, was sponsored by Rep. Charles
Canady (R-Fla.), who said that the legislation was needed because
"the corrupting influence of a seemingly illimitable right to
abortion has brought' into question the 'settled principle' that
infants born alive are entitled to protections under law." He
added that the act offered a response to recent court rulings,
including the Supreme Court decision in Stenberg V. Carhart, that
struck down bans on "partial-birth" abortions. "The implications
of these decisions are shocking. Under the logic of these
decisions, once a child is marked for abortion, it is wholly
irrelevant whether that child emerges from the womb as a live
baby," Canady said. Democrats, while supporting the measure,
said it was not necessary and "accused" Republicans of offering a
"dishonest bill," according to the Times. Rep. Jerrold Nadler
(D-N.Y.) said, "The purpose of this bill is only to get the pro-
choice members to vote against it so they can slander us and say
we are for infanticide. That's why I voted for it in committee,
and that's why we will vote for it on the floor so we do not step
into this trap" (Hudson, Washington Times, 9/27). The National
Abortion and Reproductive Rights Action League opposed the
measure, saying it "would effectively grant legal personhood to a
pre-viable fetus -- in direct conflict with [Roe v. Wade] -- and
would inappropriately inject prosecutors and lawmakers into the
medical decision-making process," according to the AP/Detroit
Free Press. The Senate is "unlikely" to take up the bill in the
remaining days of this session (Abrams, AP/Detroit Free Press,
9/27).
#4 JUDICIAL BYPASS: GRANTING OF WAIVERS DIFFERS BY STATE
As more states adopt parental notification requirements for
minors seeking an abortion, judicial bypasses are becoming more
common and more controversial, the AP/Washington Times reports.
Thirty-one states now have parental notification laws, which
under Supreme Court guidelines must include an option for teenage
girls to request a waiver from a judge. Whether a teen is
successful in getting such a waiver often depends on the state in
which she lives. In Massachusetts, for instance, "nearly all" of
the 15,000 girls who have sought waivers since 1981 have
succeeded. A network of volunteer lawyers who represent girls on
short notice and "steer" them toward sympathetic judges has been
formed by abortion-rights activists. But in other states, where
judges are more stringent in granting bypasses, girls who do not
wish to tell their parents about their pregnancy must either go
to another state, have an illegal abortion or go to a hearing
"before an unsympathetic judge." The issue of bypasses came to a
head in Texas this year when the state's Supreme Court overturned
a lower court ruling denying a 17-year-old girl a waiver,
prompting the state Republican Party to adopt in its platform the
warning that it will target judges who "nullify the Parental
Notification Law by wantonly granting bypasses." Abortion-rights
opponents believe such laws help reduce teen pregnancies. Doug
Johnson, legislative director of the National Right to Life
Committee, said, "Just the fact that some adult other than the
abortion clinic staff has to be involved tends to put a bit of a
check into the system." But abortion-rights advocates claim that
the judicial bypass procedure is an invasion of privacy.
"There's a terrible sense of apprehension, a sense of
powerlessness. A sense that [the girls'] lives were being given
over to some stranger who had an amazing power over their future
-- a sense of being violated," Boston-based law professor
Shoshanna Ehrlich said. Each year, there are about 900,000 teen
pregnancies nationwide, with about one-third of those ending in
abortion (Crary, AP/Washington Times, 9/25).
MEDIA & SOCIETY
#5 SEX ED: ABSTINENCE-ONLY EDUCATION ON THE RISE
A special September/October 2000 issue of the Alan
Guttmacher Institute's bimonthly journal, Family Planning
Perspectives, is dedicated to sex education issues, featuring two
studies from the AGI and one from the Urban Institute. One AGI
study, titled, "Changing Emphases in Sexuality Education in U.S.
Public Secondary Schools, 1988-1999," reports that "the focus on
abstinence-only instruction increased markedly during the 1990s."
The study, based on 1988 and 1999 nationwide surveys of 7th-12th
grade public school sex ed teachers, indicates that certain
topics, such as HIV and other STDs, condom use and how to handle
peer pressure, "are being taught less often and in later grades
than teachers think they should be." The study also found that
"instruction in all grades is much less likely to cover birth
control, abortion, how to obtain contraceptive and STD services,
and sexual orientation than it was in the late 1980s." Although
40% of teachers cited abstinence as their "most important
message" and 70% think that students who receive abstinence
education are less likely to engage in intercourse, 86% believe
"students who are taught to use contraceptives if they are
sexually active are more likely to do so than are students who do
not receive similar instruction." Moreover, most teachers felt
that sex ed curricula should include information on birth control
(89%), abortion (84%-89%), how to use a condom (82%) and sexual
orientation (78%). Thus, "gaps between teachers' recommendations
and actual coverage of these topics are large 24-30 percentage
points." AGI President Sara Seims said of the findings,
"Teachers on the front line in high schools around the country
recognize that young people need a range of information to
support them in making responsible decisions regarding their
sexuality. Yet this study reveals that teachers are covering far
less, far later than they believe is needed. Our findings are
particularly disheartening, considering that abstinence accounted
for about one-quarter of the recent drop in the U.S. teenage
pregnancy rate, while improved contraceptive use was responsible
for the rest. And the teenage pregnancy rate and adolescent
rates of STDs remain high. Abstinence messages are very
important, but clearly the coverage of contraceptive topics is
also crucial in helping our youth prevent unplanned pregnancy andSTDs." The second AGI study, titled "Sexuality
Education in
Fifth and Sixth Grades in U.S. Public Schools, 1999," finds that
"large proportions of schools are doing little to prepare
students for puberty or for dealing with pressures and decisions
regarding sexual activity," and that "fifth and sixth grade
sexuality education teachers often feel unsupported by the
community, parents or school administrators" (Alan Guttmacher
Institute release, 9/26).
TEENAGE BOYS RECEIVING MORE SEX ED THAN IN THE PAST
The journal also features an Urban Institute study that
looks at sex education specifically among teenage boys. Titled
"Adolescents" Reports of Reproductive Health Education, 1988 and
1995," the study reveals that 98% of teenage boys "report
receiving formal education about sex or HIV, and 70% report
receiving such instruction before ever having intercourse." In
addition, "while nearly all African-American and Hispanic teenage
boys report receiving sex or HIV education at some point, they
are far less likely than their white peers to report receiving
such instruction before ever having sexual intercourse." The
study also found that "teenage boys get less sex education than
teenage girls about certain topics," such as birth control, STDs,
and "how to say no to sex," and teenage boys are less likely to
receive that education before ever having sexual intercourse.
Laura Lindberg, study co-author, said, "These findings come on
the heels of recent trends toward less sexual activity and
increased condom use among teenage boys. They add to a growing
body of evidence that sex education does not necessarily
encourage sexual activity." Lindberg added, "The nation's
educators continue to have an important obligation to provide the
best and safest information and should try to reduce differences
in access to appropriate education by race, gender, and school
attendance" (Urban Institute release, 9/26).
#6 PRIESTS FOR LIFE: CABLE ADS TARGET ABORTION-RIGHTS
SUPPORTERS
Priests For Life, an antiabortion organization of Catholic
priests who work with clergy of all denominations, launched a
television campaign Monday urging people to vote against
politicians who support abortion rights, the Washington Times
reports. The organization's national director, Rev. Frank
Pavone, is featured in the television spot and states: "Hello,
I'm Father Frank Pavone. The United States Catholic Bishops, in
their document 'Living the Gospel of Life,' recently wrote that
no public official can responsibly advocate for abortion. If
those elected to public office can't respect the life of a little
baby, how are they supposed to respect yours?" The ad will air
on cable channels in "heavily Catholic markets," including New
York, Los Angeles, Chicago, Washington, Detroit, Pittsburgh and
Kansas City. With a budget of $250,000 for this first phase of
the television campaign, the group is also planning a mass
mailing to every priest in the country, calling on them to raise
the abortion issue during Mass (Washington Times, 9/27).
REPRODUCTIVE HEALTH SERVICES
#7 MIFEPRISTONE: PLANNED PARENTHOOD HEAD PREDICTS FDA APPROVAL
THIS WEEK
The FDA will likely approve mifepristone, the French
"abortion pill," for consumer use this week, Planned Parenthood
of America President Gloria Feldt predicted Monday, USA Today
reports. "We're just sitting on pins and needles. We cannot see
any possible reason why the FDA would not at this point go ahead
and finalize its approval," Feldt said, adding, "But, until it's
actually done, I'm not celebrating." While the FDA may decide to
delay the decision, Feldt said that she expects "final approval"
before the Sept. 30 deadline. Feldt and other abortion-rights
leaders have also expressed concerns about potential FDA
restrictions on mifepristone, such as limiting its use to doctors
who provide surgical abortions and have admitting privileges at a
hospital within one hour of their offices. According to Feldt,
however, the FDA will probably "not be as restrictive." Laura
Echevarria of the National Right to Life Committee said that the
group will continue to educate women about the dangers of
mifepristone, including excessive bleeding. Pamela Long, a
spokesperson for Danco Laboratories, the firm licensed to
distribute the drug, said that mifepristone would reach the
market about one month after FDA approval. The FDA had no
comment (Rubin, USA Today, 9/26).
PUBLIC HEALTH & EDUCATION
#8 TEXAS: FOUNDATION LAUNCHES TEEN PREGNANCY PREVENTION
CAMPAIGN
Responding to news that Potter County experienced one of
Texas' highest teen pregnancy rates in 1996, the Amarillo Area
Foundation on Aug. 1 launched an extensive teen pregnancy
prevention campaign, complete with television, radio, newspaper
and billboard advertisements, the AP/Ft. Worth Star-Telegram
reports. The ads advise teens to "wait to have sex" and
encourage parents to "start talking to your children -- now."
Gloria Roberts, who teaches a teen parenting program in Amarillo
schools, said, "This is the first time we've had a comprehensive
program to try to prevent teen pregnancy. It's something we've
needed for a long time. We've put a Band-Aid on this situation
too many times." Claudia Stravato, executive director of Planned
Parenthood of Amarillo and Canyon, added, "I think it's very
positive that we're beginning to talk about [sex] in Amarillo.
In a conservative community like this, it's important to get
parents and community institutions comfortable talking about
sexuality and how to deal with it" (AP/Ft. Worth Star-Telegram,
9/24).
BIOETHICS & SCIENCE
#9 CONCEPTION: 'MALE COUPLES' COULD BE A POSSIBILITY
Genetic techniques used to clone Dolly the sheep could help
males conceive a child, according to Dr. Calum MacKellar,
bioethics and biochemistry lecturer at Edinburgh University. BBC
News reports that male couples could use their own DNA to
conceive by using the "nuclear replacement" technique, in which
the nucleus from a human egg is removed and replaced with a sperm
nucleus. The resulting "male egg" could be fertilized by sperm
from another man through in vitro fertilization, and then
implanted in the womb of a surrogate mother, who would bring the
fetus to term. However, MacKellar, who also runs the not-for-
profit organization European Bioethical Research, acknowledges
that there are "significant genetic obstacles" that would need to
be overcome before the technique would work. For example, the
embryo of a mammal created using only paternal DNA would lack
imprinted maternal genes which are essential for normal
development. In addition, an expert panel on genetic cloning led
by England's Chief Medical Officer, Sir Liam Donaldson, has "not
looked into the ethical issues" surrounding male-only conception
(BBC News, 9/25).
OPINION
#10 BIRTH CONTROL: WOMEN DO NOT CARRY UNFAIR BURDEN
In a New York Post column, freelance writer Ira Carnahan
labels Planned Parenthood's arguments that women bear an unfair
burden of health care costs as "dubious." Carnahan is responding
to a recent lawsuit filed by the organization against Bartell
Drug, a Seattle-based chain that does not cover contraceptives in
its health plan. Carnahan states that "women pay more out of
pocket for health care" than men, but cites a 1994 Women's
Research & Education Institute study -- the same study cited by
Planned Parenthood to say that women pay 68% more out of pocket -
- that shows that women spend 67% more on health care than men
overall. For example, Carnahan cites figures from the study that
estimate that the "average annual health expenditure for women
ages 15-44 [is] $2,123" and for men it is $1,272, while out-of-
pocket expenditure averages $573 a year for women and $342 a year
for men. "Thus, while the average woman spends substantially
more each year on health care than the average man, most of that
extra spending is paid for by her private insurance or Medicaid.
This means that it is women (who are also more likely than men to
have health insurance in the first place) who benefit
disproportionately from our health insurance system. The idea
that insurance plans discriminate against them is the opposite of
the truth," Carnahan writes. Carnahan also counters Planned
Parenthood's statement that contraceptives should be covered by
insurance plans, stating that the group's argument "assumes that
some significant percentage of women who hold jobs and have
private insurance get pregnant simply because their health plan
doesn't pay for contraception." But the "biggest problem" with
Planned Parenthood's campaign, Carnahan writes, is that
"requiring contraceptives to be insured subverts the purpose of
insurance, which is to cover unpredictable expenses that would
otherwise cause great hardship." The author argues that "a
monthly bill of $25 or $30 for birth control pills simply doesn't
fit into that category" and that married women already share
contraceptive costs with their husbands. Carnahan also states
that coverage of contraception would lead consumers to become
"less sensitive to price," which would cause the price of birth
control to rise. "There is nothing historic about Planned
Parenthood's birth control lawsuit. Much the opposite: It's
just another in a long line of efforts by people to get something
for nothing," Carnahan concludes (Carnahan, New York Post, 9/26).
The Kaiser Daily Reproductive Health Report is published for The
Kaiser Health Information Network, a free service of The Henry J.
Kaiser Family Foundation by National Journal Group Inc.
Copyright 2000 by National Journal Group Inc. and Kaiser Family
Foundation. All rights reserved.
Daily Report Phone: 202-672-5952, Fax: 202-672-5767
Daily Report E-mail: [email protected]
Daily Report Contacts: Sarah Katz, Alyson Browett and Ingrid
Dries-Daffner
Kaiser Health Information Contacts: Marla Bolotsky, Jacqueline
Koenig, David Shapinsky, and Regina Davis
Kaiser Network E-mail: [email protected]
If at anytime you wish to discontinue e-mail delivery of the
Kaiser Daily Reproductive Health Report or any other Kaiser
E-Mail Alert, please visit the Kaiser Family Foundation
registration page at http://www.kff.org/register/.
Please note: The "Click here" function included at the end of
stories is only accessible from the Web-based version of the
document located on the Kaiser Family Foundation's home page.
You are invited to read the publication on the Web and utilize
the searchable database at:
http://www.kff.org
-30-
: