Trump foreign aid freeze deals heavy blow to family planning efforts abroad

The Trump administration’s 90-day freeze on foreign aid has impacted family planning resources used by hundreds of thousands of women, girls and couples abroad, causing a number of health clinics to shut down and hindering the supply chain for contraception.

In the first week after President Trump signed the executive order directing the pause on his first day in office, it caused more than 912,000 women and girls to be denied family planning care throughout the dozens of countries that receive U.S. aid, according to one analysis from the Guttmacher Institute, an abortion-rights research group.

That analysis also projected that at least 8,340 pregnant people would die as a result of the pause by the end of the 90-day period in April.

In many countries, the pause has caused clinics to reduce staff, according to reproductive rights advocacy group Population Action International, and has frozen a number of remaining aid workers in place amid the chaos and uncertainty that have surrounded the order.

The freeze has also caused kinks in family planning supply chains, according to Rachel Clement, the group's senior director of U.S. government affairs, in part because future procurements have been paused.

Contraception supplies purchased before the freeze are sitting unused because there aren’t enough workers on the ground to distribute them or because remaining workers are unsure what they can legally do with them, Clement said.

Zambia, for example, receives a large amount of aid funds from the U.S. In 2023, the U.S. sent nearly $600 million in aid to the country, $10 million of which was used for family planning purposes, according to a federal data breakdown from the Guttmacher Institute shared with The Hill.

Now, piles of U.S-provided condoms are lying in warehouses unused, causing shortages in clinics around the country, according to Rachel Moynihan, an advocacy and communications specialist at the United Nations Population Fund. The Zambian government has stepped up and made a twentyfold increase in their own commitment to family planning products to help fill the gap from U.S. supplies. But in many other countries receiving aid, the gap left by the freeze remains unfilled.

“It’s really the whole system that is being gunked up by this,” Clement said. “And it's having a trickle-down effect where people are trying to make these tough decisions in a funding environment where there isn’t a replacement.”

“There isn’t another global donor that is able to step in at the level the U.S. government was funding these things at.”

The U.S. doles out tens of billions of dollars in congressionally approved foreign assistance each year, including spending by the U.S. Agency for International Development (USAID), the State Department and other programs. It gave out $72 billion in total in 2023.

That funding included a budget of $607.5 million for USAID's designated family planning and reproductive health program, which the agency launched in 1965. In 2023, the program delivered 137.7 million male condoms to the countries it services, along with 29 million oral contraceptive pills and 19.2 million injectable contraceptives, according to agency data.

That year alone, the program helped provide 24.2 million women and couples with contraceptives and prevent 8.1 million accidental pregnancies across 41 countries, according to the agency, and to prevent 14,000 maternal deaths.

Some of the ways family planning helps prevent such fatalities, according to the agency, are by reducing the spread of HIV and AIDS through the use of condoms; decreasing unsafe abortion rates; and decreasing pregnancy and postpartum issues by enabling women to space out when they have children, which allows their bodies to fully recover from each pregnancy.

Family planning and reproductive health advocacy groups worry the number of people the program reaches is likely to drop significantly due to the pause and the Trump administration's efforts to put thousands of USAID workers on leave — if not cut the vast majority of the agency's workers or shut it down entirely.

Secretary of State Marco Rubio said late last month that “life-saving humanitarian assistance” would be exempt from the pause.

Aid workers on the ground have been working in “good faith” to understand what the waiver covers and what it does not, according to Moynihan of the United Nations Population Fund.

“In our mind, of course, family planning is life-saving, it’s life changing,” said Moynihan. “It allows people to be healthier when they can space out pregnancies.”

The Hill has reached out to the State Department for comment and more information.

Multiple federal judges have also ruled to block the administration's moves on foreign assistance funding and USAID.

Judge Amir H. Ali of the Federal District Court in Washington ordered that the freeze temporarily be lifted in a Thursday night ruling, writing that administration officials "have not offered any explanation for why a blanket suspension of all congressionally appropriated foreign aid, which set off a shock wave and upended reliance interests for thousands of agreements with businesses, nonprofits and organizations around the country, was a rational precursor to reviewing programs."

Other judges have blocked the Trump administration’s plan to place thousands of USAID employees on leave while weighing whether a further pause is warranted and ordered the government to temporarily cease efforts to terminate foreign aid contracts and grants that were in place before Trump's inauguration.

A number of Democratic attorneys general and grant recipients have said the administration is not complying with court rulings blocking the administration's separate freeze on federal grants, however.

And, advocates say, the pause on foreign assistance has already caused potentially life-threatening damage to some.

“Even if we were able to switch that assistance back on, these are needs that you can’t just pause,” said Clement of Population Action International. “People who are pregnant can’t pause their pregnancies.”

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