[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2367 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 2367

To amend the Foreign Assistance Act of 1961 to authorize assistance to 
  provide contraceptives in developing countries in order to prevent 
  unintended pregnancies, abortions, and the transmission of sexually 
              transmitted infections, including HIV/AIDS.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 17, 2007

Mr. Carnahan (for himself, Ms. Lee, Mr. Ryan of Ohio, Mr. Crowley, Mr. 
 Moore of Kansas, Ms. McCollum of Minnesota, Mr. Shays, Mr. Oberstar, 
Mr. Michaud, and Mr. McGovern) introduced the following bill; which was 
              referred to the Committee on Foreign Affairs

_______________________________________________________________________

                                 A BILL


 
To amend the Foreign Assistance Act of 1961 to authorize assistance to 
  provide contraceptives in developing countries in order to prevent 
  unintended pregnancies, abortions, and the transmission of sexually 
              transmitted infections, including HIV/AIDS.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Access to Contraceptives 
Act of 2007''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) A deepening crisis in developing countries with respect 
        to the availability of contraceptives needed for family 
        planning, safe motherhood services, HIV/AIDS prevention, and 
        other vital reproductive health care threatens the health and 
        lives of millions of people.
            (2) In the next ten to fifteen years, the largest-ever 
        generation of young people will enter their reproductive years. 
        For example, the number of women of reproductive age is 
        projected to double in Nigeria in the next 25 years. This 
        demographic shift, combined with increased demand for modern 
        methods of family planning, will increase worldwide the number 
        of people who desire to use contraception by 40 percent.
            (3) The gap between the need for contraceptives and funding 
        for such contraceptives is projected to reach hundreds of 
        millions of United States dollars annually by 2015.
            (4) According to estimates based on national surveys, more 
        than 200 million women in developing countries wish to delay or 
        end childbearing but do not have access to modern 
        contraceptives.
            (5) An estimated 40 percent of married couples in Haiti, 36 
        percent of married couples in Ethiopia, and 32 percent of 
        married couples in Pakistan do not have access to 
        contraceptives. In each of these countries, average birth rates 
        among women are two to three times average birth rates in the 
        United States.
            (6) Access to family planning and contraceptives is 
        essential in reducing unintended pregnancies and, as a result, 
        reducing rates of abortion.
            (7) The provision of modern contraceptives to the more than 
        200 million women in developing countries who desire such 
        contraceptives would avert approximately 52 million pregnancies 
        each year, and as a result, would prevent an estimated 23 
        million unplanned births, 22 million induced abortions, 7 
        million spontaneous abortions, 1.4 million infant deaths, 
        142,000 pregnancy-related deaths, and 505,000 children from 
        losing their mothers.
            (8) In January 2001, the White House reaffirmed President 
        George W. Bush's commitment to United States family planning 
        assistance efforts, stating that ``[the President] knows that 
        one of the best ways to prevent abortion is by providing 
        quality voluntary family planning services''.
            (9) Experiences in a number of countries in recent years 
        indicate that when long-term, effective family planning methods 
        are available, abortion rates decline, sometimes drastically. 
        For example, between 1988 and 2001, the use of modern 
        contraceptives increased in Russia by 74 percent, while the 
        abortion rate declined by 61 percent. Similar experiences in 
        Bangladesh, Bulgaria, Chile, Estonia, Hungary, Latvia, and 
        Romania have shown that increased use of contraceptives is 
        accompanied by a decline in abortion rates.
            (10) In addition to reducing unintended pregnancies and 
        abortions, condoms are a vital component in limiting the spread 
        of HIV/AIDS. Consequently, the HIV/AIDS pandemic is 
        contributing to an increased demand for reproductive health 
        supplies.
            (11) The vast majority of HIV infections are sexually 
        transmitted and condoms are currently the only contraceptive 
        that can protect against this form of HIV transmission. Condoms 
        remain an important intervention in multisectoral approaches to 
        HIV/AIDS prevention, along with programs that promote 
        abstinence and monogamy.
            (12) In sub-Saharan Africa, where HIV prevalence rates can 
        reach 40 percent of the adult population and women constitute 
        60 percent of people living with HIV/AIDS, donors provide an 
        average of only 5.5 condoms per adult male annually.
            (13) Not only does contraceptive use prevent unintended 
        pregnancies among HIV-positive women, it does so at a lower 
        cost than the use of the nevirapine alone. In fact, adding 
        family planning services to Prevention of Mother to Child 
        Transmission (PMTCT) programs can achieve the same effect as 
        increasing drug coverage but at a lower cost. For the same 
        cost, family planning services can avert nearly 30 percent more 
        HIV-positive births than antiretroviral drugs.
            (14) In addition to reducing rates of abortion and HIV/
        AIDS, access to contraceptives and other reproductive health 
        care services saves the lives of mothers and children by 
        helping women avoid high risk pregnancies. An increase in the 
        use of contraceptives, which allow women to space the births of 
        their children over safe intervals, have been proven to reduce 
        maternal and child mortality.
            (15) Complications resulting from pregnancy and childbirth 
        are the leading causes of death and disability for women in 
        developing countries, resulting in more than 500,000 deaths 
        each year. Almost one-third of maternal deaths and illnesses 
        related to pregnancy could be avoided if women in developing 
        countries had access to modern, safe, and effective 
        contraceptives and other reproductive health care services.
            (16) Access to contraceptives and other reproductive health 
        care services are also needed to help ease growing population 
        pressures on cropland, freshwater, and other finite natural 
        resources. In many biologically rich areas, there is little or 
        no access to the health services that allow women and couples 
        to space or limit births. Consequently, the population in these 
        ecologically sensitive areas is growing nearly 40 percent 
        faster than that of the world as a whole.
            (17) The shortfall in reproductive health care services is 
        chronic and growing. The cost of contraceptives needed for 
        family planning and condoms for HIV/AIDS prevention in 
        developing countries is projected to increase from $1.3 billion 
        in 2005 to $1.8 billion in 2015. In spite of this upward trend, 
        donor support for contraceptives in 2005, $213 million, was 
        only 16 percent of overall funding needs.
            (18) The consequences of the shortfall in reproductive 
        health care services are devastating. For every shortfall of $1 
        million in funding for contraceptives, an estimated 360,000 
        additional unintended pregnancies, 150,000 additional induced 
        abortions, 800 additional maternal deaths, and 11,000 
        additional infant deaths occur.
            (19) Although the United States should be commended for its 
        leadership role with respect to the availability of 
        reproductive health services in developing countries, United 
        States support for such services, including funding, has not 
        kept pace with the increase in demand for contraceptives, which 
        has resulted from the large number of youth entering 
        reproductive age and the HIV/AIDS pandemic. Since 1995, United 
        States bilateral assistance for international family planning 
        programs has decreased by 41 percent (adjusted for inflation) 
        despite an increase of more than 275 million women of 
        reproductive age worldwide.
            (20) In addition to the shortfall in funding by the United 
        States for reproductive health care services, United States 
        policy restrictions have reduced donations of contraceptives 
        for developing countries.
            (21) Widely shared goals of reducing the need for abortion 
        and reducing the spread of HIV/AIDS are unlikely to be achieved 
        when United States-donated contraceptives are subject to policy 
        restrictions, such as the Mexico City Policy, that limit access 
        to such contraceptives.
            (22) The Mexico City Policy, which was reinstated in 2001, 
        limits access to contraceptives by prohibiting United States 
        family planning assistance to foreign nongovernmental 
        organizations that use funding from any source to provide 
        abortion services, counseling, or referral or to lobby to make 
        abortion legal or more available in their own country.
            (23) The Mexico City Policy has exacerbated the existing 
        shortage of contraceptives by ending shipments of United 
        States-donated contraceptives to 20 developing countries in 
        Africa, Asia, and the Middle East.
            (24) As an example, the Mexico City Policy has forced eight 
        family planning clinics serving thousands of poor women in 
        Kenya to close. Consequently, women's access to contraceptives, 
        gynecologic and obstetric care, screening, and treatment for 
        sexually transmitted infections, and voluntary counseling and 
        testing for HIV/AIDS in Kenya has been severely disrupted.
    (b) Purpose.--The purpose of this Act is to authorize assistance to 
provide contraceptives in developing countries in order to prevent 
unintended pregnancies, abortions, and the transmission of sexually 
transmitted infections, including HIV/AIDS.

SEC. 3. ASSISTANCE TO PROVIDE CONTRACEPTIVES IN DEVELOPING COUNTRIES.

    Section 104 of Foreign Assistance Act of 1961 (22 U.S.C. 2151b) is 
amended--
            (1) by redesignating subsection (g) as subsection (h); and
            (2) by inserting after subsection (f) the following new 
        subsection:
    ``(g) Assistance to Provide Contraceptives in Developing 
Countries.--
            ``(1) Assistance.--The President, acting through the 
        Administrator of the United States Agency for International 
        Development, shall furnish assistance to provide contraceptives 
        in developing countries in order to prevent unintended 
        pregnancies, abortions, and the transmission of sexually 
        transmitted infections, including HIV/AIDS.
            ``(2) Eligibility of nongovernmental organizations.--
        Notwithstanding any other provision of law, regulation, or 
        policy, in determining eligibility for assistance to provide 
        contraceptives in developing countries under this subsection, a 
        nongovernmental organization shall not be subject to 
        requirements relating to the use of non-United States 
        Government funds that are more restrictive than requirements 
        relating to the use of non-United States Government funds that 
        apply to foreign governments with respect to eligibility for 
        assistance under this subsection.
            ``(3) Authorization of appropriations.--
                    ``(A) In general.--There are authorized to be 
                appropriated to the President to carry out this 
                subsection $150,000,000 for each of the fiscal years 
                2008 and 2009.
                    ``(B) Additional authorities.--Amounts appropriated 
                pursuant to the authorization of appropriations under 
                subparagraph (A)--
                            ``(i) may be referred to as the 
                        `Reproductive Health Supplies Fund';
                            ``(ii) are authorized to remain available 
                        until expended; and
                            ``(iii) are in addition to amounts 
                        otherwise available for such purposes.''.
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