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1 1 (October 4, 2021)

handle is hein.crs/goveglc0001 and id is 1 raw text is: Updated October 4, 2021 U.S. Global Family Planning and Reproductive Health Programs: Funding Trends and Issues for Congress The United States is the largest global donor of international family planning and reproductive health (FP/RH) assistance, supporting programs in 40 countries. In recent years, Congress has appropriated approximately $575 million annually in funds for bilateral FP/RH as sistance. Key is sues for the 117th Congress include debate over the merits of U.S. support for these activities, funding levels, statutory limitations of FP/RH assistance, and emerging global challenges that may affect access to FP/RH services. Background Some U.S. international family planning activities originated prior to 1965. Following enactment of the Foreign Assistance Act of 1961 (FAA), Congress authorized research on family planning is sues, among other topics. Beginning in 1965, the U.S. Agency for International Development (USAID) started contraceptive distribution programs. Theseprograms evolved over time to also address reproductive health is sues, including female genital mutilation/cutting (FGM/C) and obstetric fistula prevention and care. U.S. global FP/RH programs are authorized in Section 104 of the FAA, as amended (22 U.S.C. 2151b). USAID administers the majority of FP/RH funding, which Congress appropriates primarily through the Global Health Programs (GHP) accountin annual State, Foreign Operations, and Related Programs (SFOPS) appropriations. FP/RH funding has been subject to severalrestrictions enactedby Congress sincethe 1970s, most notably the Helms Amendment, which prohibits the useofU.S. funds to performabortions or to coerce individuals to practice abortions. (For more information, see CRS Report R41360, Abortion and Family Planning-RelatedPro visions in US. ForeignAssistance Law and Policy, by Luis a Blanchfield.) Bilateral FPIRH Assistance The GHP account funds more than 90% ofbilateralFP/RH assistance. Some funding is also providedthrough other accounts, including the Economic Support Fund (ESF), which funds select countries considered to be politically and strategically important. Forexample, Pakistan and Jordan have received ESF funds for FP/RH activities in recent years. USAID's FP/RH programs are administered through the Office of Population and Reproductive Health (PRH) within the Global Health Bureau. PRH is responsible for setting technical and programmatic direction. USAID dis tributes FP/RH commodities (such as contraceptives) and related services (such as fistula prevention and efforts to end FGM/C) primarily through contracts and grant agreements with nongovernmental org anizations. The agency's technical and administrative staff oversee and monitor the work of implementing partners. (For more information on USAID FP/RH programs, see CRS Report R46215, U.S. Bilateral InternationalFamily Planning and Reproductive HealthPrograms: Backgro undandSelected Issues, by Sara M. Tharakan.) The President's budgetrequest for FY2022 includes $550 million for bilateral FP/RH programs. This amount is 132% higher than the Administration's FY2021 request, and 4.4% lower than FY2021-enacted amounts (seeFigure 1). Figure 1. FP/RH Bilateral Aid Funding, FY20 1 5-FY2022 Requested vs. Enacted Amounts (millions) Requested -e-Enacted SSOOm S400mn Source: State Department Congressional Budgetjustifications, 2016- 2021, and annual SFOPS appropriations. Notes: Fundingamounts includethose requestedandenacted in the GHP and ESF accounts only. The House-passed SFOPS bill (H.R. 4373) for FY2022 includes $760 million for bilateral FP/RH programs. On September 30,2021, the President signed into law the Extending Government Funding and Delivering Emergency Assistance Act (P.L. 117-43), which included short-term FY2022 appropriations through December 3, 2021, forthe continuation of federalprojects and activities conducted in FY2021. Multilateral FPIRH Ass stance The United States has historically providedmultilateral FP/RH assistance through contributions to the U.N. Population Fund (UNFPA), the primary U.N. entity addressing population is sues. Since FY1985, the United States has periodically withheldUNFPA funding under the Kemp-Kasten Amendment in annual SFOPS bills. The Kemp -Kas ten Amendment prohibits funding to any organization orprogramthat, as determinedby the President, supports orparticipates in the management of a programof coercive abortion or involuntary sterilization. nat Hesearu

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