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FOIA Number: 2012-0769-F FOIA MARKER This is not a textual record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. Collection/Record Group: Clinton Presidential Records Subgroup/Office of Origin: Council on Environmental Quality Series/Staff Member: Kathleen (Katie) McGinty Subseries: OA/ID Number: 4299 FolderID: Folder Title: Population Stack: Row: Section: Shelf: Position: S 61 7 1 3 Briefing Paper on Population July 1992 I. The Problem The 1990's represent the most critical decade in the history of population growth since it is what we do in the very near term, including the U.S. government's response, which will largely determine whether world population stabilizes at slightly less than double the current 5.4 billion or eventually triples. (For many of the world's poorest countries, this latter scenario implies a six-fold increase in population over the next century.) The two scenarios have important implications for broad U.S. national interests, including efforts to alleviate world poverty, promote peaceful democratic change, and protect the global environment. Of the 25 largest countries which account for over 80 percent of world population growth, the United States is virtually the only country without a national population policy. Because of high U.S. consumption levels, continued U.S. population growth has substantial impact on the global environment. Because of inadequate birth control information and services, half of all pregnancies in the United States are unplanned. II. History Fortunately, after some 25 years of experience in domestic and international family planning programs we now know how to bring about the transition to smaller families quickly and cost-effectively. The problems are not essentially technical, they are political. Although it is generally recognized that many factors can indirectly influence family size omost particularly the role and status of women, better health care and the availability of economic opportunities for the poor Orecent experience demonstrates that good quality subsidized family planning programs, by themselves, can produce very rapid changes in reproductive behavior. This is because they give low-income women and their partners in the United States, as well as overseas, the same reproductive choices that have been available to middle and upper-income women since the 1960's revolution in birth control technology. Over the last 25 years, almost 30 developing countries have reduced average family size by half or more In most parts of the world, young women today say they only want two or three children. This is true even in very poor countries, like Bangladesh, where the status of women is very low. In response to concerns about population growth, and growing grassroots demand for smaller families, over 120 governments now subsidize family planning services. III. Recent Developments The major political obstacles to early world population stabilization are no longer in the developing world, but rather in Washington, D.C., where Presidents Reagan and Bush have sacrificed long-standing U.S. leadership on population and family planning efforts to domestic abortion politics. In August 1984, at the International Conference on Population in Mexico City, an American delegation led by anti-abortion activist James Buckley announced, in essence, that the U.S. government no longer considered population growth an important world problem, and that the U.S. government found abortion so abhorrent that Americans would no longer support family planning programs in which abortion played any part. Repeated attempts by the Reagan and Bush administrations to abolish categorical funding for domestic and international family planning programs have been foiled by Congress. But since 1980, funding for the domestic family planning program (Title X of the Public Health Services Act) has declined by two-thirds in inflation- adjusted dollars. Funding for international family planning programs through the foreign aid program is, in real dollar terms, below levels provided 20 years ago. Moreover, family planning programs have been seriously hampered by additional abortion restrictions, such as the "gag rule," and important organizations targeted by the anti-abortion rights lobby have been defunded. In December 1984, the Reagan administration ended 17 years of U.S. support for the International Planned Parenthood Federation (IPPF), the largest non-governmental organization in the world after the Red Cross. IPPF refused to defund its national affiliates involved in abortion services or counseling as required by the administration's new Mexico City policy. In early 1986, the Reagan administration also withdrew $36 million in U.S. support for the United Nations Population Fund, allegedly over the Fund's support of family planning projects in the People's Republic of China. In November 1989, President Bush vetoed the entire $14 billion foreign aid appropriation over a $15 million congressional earmark for the U.N. Population Fund. IV. Major Predictable Events The House of Representatives has already passed a foreign aid appropriation for fiscal year 1993, which contains a $20 million earmark for the U.N. Population Fund and an $80 million increase in the line item budget for U.S. population assistance. The Senate Appropriations Committee is expected to include identical provisions in its version of the bill, to be marked-up in September. In addition, Senator Lautenberg will offer an amendment in committee to reverse the Mexico City policy. Similar provisions have passed both the Senate and the House in recent years. It is thus probable that President Bush will again this fall face the prospect of vetoing another foreign aid bill over provisions relating to international population programs. For current status, contact Sharon Camp, Population Crisis Committee (202) 659-1833. Over the next several months, Congress will consider more than a half dozen bills dealing in whole or in part with domestic family planning or abortion issues. They include: The Freedom of Choice Act, to codify Roe V. Wade; the re-authorization for domestic Title X family planning programs, which will include a reversal of the "gag rule;" the re-authorization for NIH which deals with the controversial fetal tissue research issue; the Labor/HHS appropriation which will involve a Medicaid abortion fight and may become another vehicle for gag rule provisions; and abortion provisions in the Defense, District of Colombia and State/Justice/Commerce (Legal Aid) appropriations. President Bush has vetoed or threatened to veto all these bills. Veto override efforts are expected to fail. For current status, contact Bill Hamilton, Planned Parenthood (202) 785-3351. V. Key Issues 1. Funding for International Population Programs: A broad coalition of public interest groups is urging Congress to earmark $650 million for population assistance in FY 1993. The increase represents the appropriate U. S. share of additional funds needed from donor countries to provide family planning services to the estimated 125 million couples whom surveys indicate want help to have smaller families, but have no access to modern contraception. The Bush administration has requested last year's level of $250 million, not including possible allocations from other accounts, but has also again asked Congress to eliminate any specific earmark for population programs. 2. Funding for Domestic (Title X) Family Planning and Contraceptive Research: Family planning organizations believe an appropriation of $320 million is needed to restore programs to their pre- 1980 levels of coverage, double the current $155 million. The administration opposes increased funding and seeks to roll categorical family planning programs into a block health grant to the states. Family planning advocates also seek $200 million for the Center for Population Research at the National Institute for Child Health and Human Development. 3. The Mexico City Policy: Family planning groups seek to overturn the Reagan era 3 policy which makes overseas family planning groups ineligible for U.S. government assistance if they use their own funds to provide abortion services, counseling, or referrals. The Bush administration threatens to veto any legislation overturning the Mexico City policy or refunding the U.N. Population Fund. 4 4. U.S. Participation in the United Nations Population Fund: The U.S. government last contributed to the Fund in 1985, providing $36 million of a $46 million contribution mandated by Congress. The Bush administration claims that the Fund supports a program of coercive abortion in China. Ironically the Bush administration supports Most- Favored-Nation Status for China, despite Congressional concerns about a variety of other human rights abuses. 5. Domestic Abortion Restrictions: Through a series of legislative initiatives (see list above under Major Predictable Events) pro-choice supporters in Congress are seeking to ensure continued access to safe abortion for American women and to modify specific restrictions on federal funding for abortion. The President appears unwilling to seek compromise on any of these legislative initiatives. 6. FDA Ban on the French Mini-Abortion Pill: Advocates of the new French mini-abortion pill have received considerable publicity for their challenge to the FDA's controversial ban on importation of the pill for personal use under medical supervision .oa decision taken under pressure from anti-abortion leaders in Congress. The pill's French manufacturer says the firm has not sought marketing approval in the United States in large part because of the U.S. Government's restrictive stand on abortion. Over 100,000 French and British women have used the mini-abortion pill. The Chinese will soon have an almost identical product on the market, and other products and approvals are in the pipeline around the world. VI. Administration Policy As a congressman in the late 1960s, George Bush was one of the principal sponsors of legislation establishing domestic and international family planning programs. He continued to be supportive until the early 1980's, when intense lobbying of the White House by anti-abortion groups precipitated the first of a series of public battles over population and family planning programs. Although members of the Bush administration occasionally hint that small changes in Reagan era policies might be possible, anti- abortion groups have effectively blocked any compromise. There have also been attempts to draft strong Presidential statements on world population issues, with disappointing results. The administration's official line expresses mild support for family planning as a family health measure and as a means of reducing reliance on abortion for birth control. 5 VII. Questions and Answers 1. Q. In recent years, the United States government has provided over 40 percent of foreign aid for family planning worldwide. Doesn't this prove the Bush administration strongly supports international population and family planning efforts? A. No. Congress, not the Bush administration deserves the credit for current levels of U.S. population assistance. Congress has had to "force feed" the administration to ensure continued support for these programs. Congress has annually earmarked population program funds, usually over the administration's objections. The administration has consistently sought to reduce the budget for U.S. population aid. 2. Q. The U.S. government does more than its share. Isn't it time other donor governments did their share? A. A number of other countries are already doing more than the United States, relative to their size and wealth. Norway gives over $10 per person to world population efforts, compared to just over $1 per person from the United States. Canada, Denmark, Finland, the Netherlands, and Sweden also give more per capita. The United States used to be near the top of this list. 3. Q. Since abortion is illegal in most countries which receive U.S. foreign aid, how can the administration's Mexico City policy be a real problem? Some 300 foreign organizations have willingly accepted the abortion restrictions as a condition of U.S. assistance. We need to separate abortion from family planning. A. Over 67 countries eligible for U.S. foreign aid allow abortion for medical or other conditions not permitted under the Mexico City policy. Most family planning groups would like the policy overturned, including those who have complied, in order to keep the doors of their family planning clinics open. Family planning services for millions of very poor women are at stake. Five of the most important agencies took the government to court in a failed attempt to block the policy's implementation. 4. Q. Has the administration's policy had any real impact? There is no evidence that the policy has reduced the number of abortions around the world, only that it has made abortion more dangerous. The policy has undermined the quality of health care for women, including medical treatment for women with botched illegal abortions and post-abortion contraceptive 6 counseling. By defunding important family planning agencies, the Reagan and Bush administrations have also slowed the spread of family planning services worldwide. Given the rising world demand for smaller families, the net result has surely been more not less abortions. 5. Q. Doesn't China's population program rely on coerced abortion and sterilization to enforce a one-child policy? Isn't the administration justified in defunding the U.N. population program for continuing to support such abuses? A. The United Nations Population Fund supports projects in about 140 countries, including China, which is an important member of the United Nations. The fund does not support abortion services or coercive practices in any country. Its projects in China are designed to expand maternal and child health care in 300 of China's poorest countries and to support the local manufacture of safer, more effective western-style contraceptives. These efforts are reducing reliance on abortion. U.S. concerns about human rights abuses in China are best dealt with directly in the context of U.S.-China relations, not by denying U.S. support to United Nations population programs around the world. 6. Q. Why should Americans spend money on family planning services overseas, when we have so many pressing needs at home? A. Few global problems affect American interests as broadly as uncontrolled world population growth. Virtually all of the developing countries in which the United States has some vital economic, environmental, or security interest suffer from unmanageable population pressures: e.g., Mexico, Panama, Brazil, Nigeria, Kenya, Egypt, Pakistan, Indonesia, and the Philippines. Population growth undermines efforts to alleviate world poverty and expand international markets for U.S. products. It increases dependence on U.S. humanitarian aid and contributes to rising pressures on U.S. borders from political and economic refugees. Perhaps most importantly, human population growth aggravates a wide range of environmental problems, such as deforestation, global climate change, the loss of plant and animal species, soil erosion, water scarcity, and air and water pollution. A doubling of world population over the next 50 to 100 years will make it difficult to solve most of these problems even with major efforts at conservation. A tripling of human population othe probable result of currently inadequate efforts to deal with rapid population growth Owould be an environmental disaster. 7