Competition for women's health funding in Colombia

Editor’s Note: Around the world, women’s health care providers and those they serve are bracing for the impact of the “global gag rule.” But what does the policy look like on the ground from the perspective of those running soon-to-be cut programs? And how will the women who count on such programs get by? To find out, Devex spent a week with the rural teams of Profamilia, Colombia’s largest family planning provider. This is the third of a three-part series. Read part one and part two.

BOGOTÁ, Colombia — Profamilia is currently facing a culture of competition, rather than collaboration, with other groups involved in women’s reproductive health and rights in Colombia, according to the organization’s president Marta Royo.

Colombia, a nation of 48 million people, boasts a liberal abortion law compared with most of its neighbors.

Since 2006, the country has allowed abortion in cases of threat to a woman’s life or health, fetal abnormality and rape or incest — though many doctors retain the right to deny abortion as they see fit, especially to young women. As a result, there are still an estimated 400,000 illegal abortions every year, according to a 2011 study by the United States-based Guttmacher Institute

Complying with U.S. President Donald Trump’s reinstated “global gag rule” in January, then, was never an option for Profamilia, Colombia’s biggest nongovernmental family planning services and safe abortion provider.

“We provide so much more than abortions, it’s just a small part of what we do,” Royo said. “We are known as a safe haven for women, as a source of education. We won’t turn our back on them.”

The Mexico City Policy, reinstated by Trump during his first full day in office, prevents all non-U.S. NGOs that provide services or information related to abortion from receiving U.S. government funding for any of their programming.

For Profamilia, which serves 600,000 people a year, this translates to a loss of $1.2 million in U.S. Agency for International Development funding for community strengthening and reproductive health programs for vulnerable populations in 11 municipalities. This has set them on a difficult, competitive road to source alternate funding.

After mourning the passage of the expanded policy — which impacts about 15 times more U.S. funding than past iterations, including Profamilia’s $300,000 Zika education project that won’t get off the ground — the Profamilia fundraising team jumped into action. They began searching for support to compensate what will be lost when programs are forced to close at the end of the year, a full 12 months earlier than planned.

They haven’t gotten very far, Royo said.  

“Everybody, the Colombian government, international organizations like the United Nations Population Fund and NGOs like us are all searching for resources at the same time,” she told Devex. “Groups will be able to find resources for things like the environment or housing [for displaced persons], but for sexual and reproductive rights, it’s really hard.”

Women’s health is “definitely not a priority for the government,” Royo added.

As for the U.N.’s reproductive health-focused agency in Colombia: “It is the mission of the UNFPA, but they’re facing their own economic problems,” Royo said, referring to the Kemp-Kasten amendment, which prohibits foreign aid to any organization involved in coercive abortion or involuntary sterilization.

Trump cited Kemp-Kasten in April in order to cut all future funding to UNFPA based on claims that the agency is involved in such coercive work in China.

It’s an “erroneous claim that UNFPA ‘supports, or participates in the management of a program of coercive abortion or involuntary sterilization’ in China,” UNFPA later said in a statement. But Kemp-Kasten will cost the agency its second largest supporter and donor — and upwards of $69 million each year.

UNFPA Colombia works with an annual budget of about $750,000, though the country office is unaware of what portion of that could be U.S funding. It remains to be seen, UNFPA Colombia representative Jorge Parra told Devex, whether the agency will feel the effects of Kemp-Kasten in the South American country.

And even if it does, UNFPA headquarters can look to the “She Decides” fund for family planning, some of which will be directly channeled to the agency for distribution to country offices and programs. Already, countries including Sweden, Belgium, Canada, the Netherlands, Finland, Denmark, Australia, Norway and Luxembourg have pledged more than $110 million between them.

In the case of Colombia, UNFPA also has its eyes on the Multi-Donor Trust Fund of the United Nations for Post-Conflict, a new initiative to support national stabilization and confidence building efforts as well as early implementation of Colombia’s peace agreement.

“We are proposing many projects [to the trust fund] to get specific support for our activities here in Colombia,” Parra said, listing a project to prevent gender-based violence in conflict areas, one focused on reproductive health and preventing adolescent pregnancy, as well as a youth-focused project.  

Parra doesn’t consider UNFPA to be in competition with other family planning or reproductive health institutions, considering the agency works to support public policy and provide technical assistance rather than deliver direct health services, as Profamilia does.

“I think we have complimentary work,” he said, citing a recent example of the two institutions partnering on a research project.

But Royo, who thinks Profamilia can’t compete with UNFPA when it comes to She Decides and peace agreement funding, feels differently.

As the third-largest provider of contraceptive products in Colombia, Profamilia sells contraceptives to distributors as a principle means of earning money to support their services, and they’ll continue to do so, Royo said.

“We lose money every year, but it is a loss that so far we have been able to control,” she added. “What we cannot afford is to lose our mission.”

It’s their apolitical willingness to address all needs of women in the country that is irreplaceable, Royo said, especially since organizations such as UNFPA must be cautious due to political limitations and global work.  

“The Canadian government has stepped up, and the She Decides initiative is important, but again, everybody is trying to reach for the same thing,” Royo said. “We work with UNFPA, but when it comes to funding, we are now competitors.”

Read more international development news online, and subscribe to The Development Newswire to receive the latest from the world’s leading donors and decision-makers — emailed to you free every business day.