Population, Reproductive and Sexual Health
Section Newsletter
Fall 2004


Section Chair Dr. Claire Brindis, Institute for Health Policy Studies, 3333 California St. Suite 265, San Francisco, CA 94143
Phone: (415) 476-5255
E-mail: brindis@itsa.ucsf.edu

Dear Colleagues:

By the time we see each other next, our country will have undergone a historical election. As evidenced by the last presidential election, every vote will be important in helping to determine the course of our nation for many years to come. Hopefully, during these months, each of you has been involved in assuring that new and old voters exercise this most basic right. Clearly, there will are many implications of the election for the field of reproductive health, as well as health professionals and advocates so committed to this cause. Over the past nearly four years, reproductive health policies, funding, programs, and research both domestically and internationally have been heavily impacted by a series of actions and decisions made at the highest levels of government. Clearly reproductive health issues -- global family planning, comprehensive sex education, safe and legal abortion, birth control options, and access to health care -- are crucial parts of the national political dialogue and will help to mobilize many to the most fundamental of democratic political actions in 2004 – voting.

As someone who first became involved in the field of reproductive health in the early 1970s -- when the birth control pill was made readily available to both married and unmarried women, access to safe abortion was assured, a network of subsidized family planning services were established through the Title X program, and the U.S. saw itself playing an important role in supporting family planning internationally -- it continues to be rather remarkable to me to see how controversial our field has become. Scarcely a day passes by without international, national, and state headlines related to a wide variety of topics that deeply impact our field. The daily Kaiser Family Foundation Reproductive Report (<www.kaisernetwork.org/daily_reports/rep_repro.cfm>) is an excellent source of information on the multiple efforts, both large and small, across the country to either dismantle or to support one of the most basic of civil liberties in our age—-the inalienable right to control our own personhood without governmental intervention. That right entails the ability of both men and women to decide whether they are to be parents, and when and how many children they wish to bear. Part of that right also relates to assuring that both men and women have access to health care coverage for their reproductive health services, including screening and treatment for sexually transmitted infections and HIV/AIDS, thus protecting their health, including the capacity to bear children.

During the past year, a number of new, as well as old, issues continue to call for our attention and the need for constant vigilance. Woven throughout these controversies is the necessity of assuring the integrity of science and the use of evidence-based practice—-and when such evidence has not been established, for opportunities to pursue this knowledge. It is not difficult to see how the battle lines have been drawn pertaining to abstinence education, Emergency Contraception, and stem cell research. Concurrently, attempts to muffle the voices of national organizations (such as Advocates for Youth, SEICUS, and Planned Parenthood, for example) through repeated audits and diminished funding from long-established government funders for both domestic and international programs that advocate for comprehensive approaches, are increasingly being documented. Internationally, the “chilling effect” has severely impacted the availability of international family planning funds, as well as efforts to limit the “ABC” strategy in Africa to one that primarily focuses on the A, rather that the comprehensive A-Z strategies that are needed to deal with the scourge of AIDS (A refers to abstinence, B refers to “be faithful” and C refers to condom use, while the remaining alphabet letters refers to economic development, education, and improving the role of women that is so crucial to decreasing the incidence of the infection).

This past year also saw the chilling efforts “spill over” into the academic world. Attempts to limit NIH-funded university research in what are perceived to be controversial topics related to sexual practices and HIV/AIDS intervention studies, among others, were brought to light on a right-wing “hit list” attempt to stop further funding of both these researchers, as well as their research questions. A different type of “chilling” example was illustrated in the President’s National Advisory Committee on Stem-Cell Research, where two members were eliminated from the committee for speaking up for their beliefs in the importance of stem cell research. It is ironic that this specific issue has drawn somewhat different political lines than other controversial topics in our field, as evidenced by the efforts of the Reagan family to advocate for the expansion of this research, as well as many others concerned with finding solutions for diabetes, Alzheimer’s, Parkinson’s, multiple sclerosis, and other diseases. This election will also provide the opportunity to see whether voters in California decide to support the Stem Cell Research and Cure Initiative (Proposition 71). If successful, the Initiative would support nearly $300 million dollars in state funds (over 10 years) to conduct embryonic stem cell research, and it would represent the largest state-driven effort in this arena.

In addition to the aforementioned “chilling effect,” more insidious attempts at limiting the types of information made available to young people in reproductive health matters occur every day throughout this country in countless classrooms. Despite sound evidence that indicates that abstinence education is not sufficient to protect adolescents from unintended pregnancies and sexually transmitted infections, teachers across the country must advocate for abstinence until marriage and may not mention contraception except to point out the failure rates of various methods. In this fiscal year, federal funding for abstinence education continues at $140 million, with President Bush seeking $273 million for fiscal year 2005. Over half a billion tax dollars have been spent on this program since the implementation of the Welfare Reform Act of 1996 and the push for abstinence-only education began in 1998. This funding is maintained in spite of ready evidence that comprehensive sex education programs, which promote abstinence but also provide information on the benefits of contraception for those who not remain abstinent, do delay the start of sexual activity. Such programs also reduce the incidence of teenage pregnancies and STDs. Other research points to the vulnerable position we place our young people when we don’t readily provide them with the tools they need. Teenagers who are given no information about birth control, or only negative information, are less likely to use any method of protection and thus place themselves at higher risk for unintended pregnancy and STDs. While there are endless debates regarding what has contributed the most to the substantial reductions in teenage childbearing (e.g., whether it is abstinence education or the availability of contraceptives), it appears that adolescents are able to deal successfully with the dual message of abstinence and protection. Furthermore, while abstinence-only advocates would like to take substantial credit for the decline in teenage pregnancy and childbearing, it is worth noting that the incidence of teenage childbearing peaked eight years before abstinence-only education was implemented, and it has been declining steadily ever since. Clearly, even with the dramatic declines, our country has a long way to go in assuring that we provide adolescents –- including each new wave that enters their ranks on a yearly basis -– with the tools they need to delay having sex, as well as supporting their use of the most effective contraceptive methods when they are sexually active.

In the area of emergency contraception (EC), the FDA’s ruling to prevent over-the-counter access to women of all ages represents yet another recent example of politics triumphing over science. The FDA decision appeared to be based upon political beliefs, rather than scientific merit. The safety of ECs as an over-the-counter product data has been shown repeatedly -- side effects are mild to moderate, overdosing is unlikely to cause adverse events, and EC presents a low risk for incorrect use. In spite of evidence from European countries showing that when adolescents have easy access to EC, they do not increase their sexual activity, do not abuse EC by using it frequently, and do not alter their patterns of using condoms, adolescents were clearly a lighting rod for the FDA decision. While two separate FDA expert panels, the Nonprescription Drugs and Reproductive Health Drugs Advisory Committees, recommended by an overwhelmingly vote (of 23-4) that ECs be made available over-the-counter, the acting director of the Center for Drug Evaluation and Research, Dr. Steven Galson, overruled the agency’s independent advisory committees, as well as his own staff scientists, in denying the request.

The denial focused on a lack of data on adolescent use and safety for teenagers under the age of 16, a factor that has clearly restricted the rights of women of all other ages and once again demonstrates the “dis-ease” with which our country relates to adolescent sexual behavior. United States Reps. Louise Slaughter (D-N.Y.) and Henry Waxman (D-Calif.) led Members of Congress in writing to the Government Accountability Office to ask that the office look into the allegations that politics superseded science in the FDA’s decision. In response to the FDA ruling and in an attempt to identify a viable alternative, the pharmaceutical company is proposing that ECs be allowed to be marketed as an over-the-counter drug for women 16 years and older, while requiring a prescription for women 15 years and younger. While this approach may eventually be accepted by the FDA, this compromise clearly contributes to an added burden for a vulnerable group. While the FDA continues to be the focus at the national level, state level strategies are also being pursued with a focus on a “pharmacy access” strategy. In this approach, trained pharmacists can dispense ECs to patients, although adopting a “behind-the-counter” approach as the woman must be counseled regarding the drug’s use before obtaining ECs. There are currently six states with laws that allow women to have direct pharmacy access to EC: Alaska, California, Hawaii, Maine, New Mexico and Washington, and several states have similar legislation pending. Thus, it will be important to maintain both a state and national focus towards assuring access to ECs for women of all ages.

This year has and will likely continue to be a “roller coaster” of controversies and challenges in the field of reproductive health. The March for Women’s Lives was clearly a shining moment, giving inspiration to many of us to renew our vows to fight for reproductive rights. I have been honored to serve as the Chair of our Section this year. As I bid you farewell in this capacity, I wish upon each of you the strength and the integrity to continue to contribute on both the large, as well as the small ways, to that most basic of rights. What could be more moral than assuring that every child is a wanted child, and that we strive to protect the sexual and reproductive health of both men and women?

A special word of thanks……

I wanted to thank Tim Williams, Program Chair, for his incredible contributions to this year’s Annual Meeting. He has carried his responsibilities with a great deal of professional competence and this year’s program promises to be outstanding. I also want to thank each of you who submitted abstracts to our Section. While increasingly competitive to be chosen to present results to your peers, the breadth and depth of the abstracts submitted speak well to the tremendous variety of program, research, and policy efforts under the broad umbrella of reproductive health and family planning. If your abstract was not selected for this year’s program, please do not feel discouraged, but continue to consider our Section as a place for future submissions.

I also would like to thank Cynthia Green, previous Section Chair, for her continued good counsel this year, as well as her capable job in helping to chair the Awards Committee. Among many of her efforts this year, Cynthia also provided great assistance in assuring that three graduate students in schools of public health were provided with the opportunity to receive their membership dues paid for by APHA.

I would also like to thank Lois Uttley for her continued efforts on our behalf in developing reproductive health-related fact sheets that are available on the main APHA Web site. The most recent fact sheet on emergency contraception will soon be available. Access to reproductive health is clearly mirrored in APHA’s mission, and providing with members throughout the organization with information on reproductive health matters assures that “our” topics will be championed by the broader community of public health professionals outside of our own Section. This is especially crucial as APHA sponsored a series of political forums in Washington, D.C., in September for public health leaders living in the area with senior staff from both campaigns. The forum focused on their views of public health, including reproductive health. If you have any questions regarding advocacy, please contact Lakitia Mayo at <Lakitia.Mayo@apha.org>.

Finally, I would also like to express my appreciation of the mammoth work by Susanna Binzen, Section Editor. She has done an outstanding job for multiple years and it has greatly contributed to capturing our Section’s comings and goings. We are very much in your debt. The challenge is to consider additional ways that we can let our Section members know about the availability of the Section Newsletter. Before the age of technology, APHA would print and distribute the Newsletter as a Member benefit. Now, the newsletter is available on the Web, but we find that only a small proportion of our Section is reading the Newsletter. We need to explore both with our members and APHA whether we should invest our limited resources in assuring that each member receive a copy. Currently, APHA sends an e-mail message to each member regarding the availability of the Newsletter. However, given the e-mail traffic many of us have, this often gets lost in the shuffle. If you have any thoughts regarding how to get the word out to our members regarding the Newsletter availability, please let Susanna (<SBinzen@CDC.GOV>) or myself know (<brindis@itsa.ucsf.edu>).

New Technologies Available for Annual Meeting Presentations

APHA is expanding the educational experience of both presenters and attendees at the APHA Annual Meeting by investing in LCD projectors, computers and new Web-based technology for all scientific sessions. This new technology will enable voice and PowerPoint presentations to be recorded and uploaded to the APHA Web site following the meeting, thus extending the life of the meeting and providing access to hundreds of actual scientific session presentations that Annual Meeting registrants may have missed while attending other sessions.

Annual Meeting attendees can receive full access to these expanded sessions by registering for E-ssentialLearning on the Annual Meeting registration form. Special introductory discounted fees are $25 for Annual Meeting session presenters, $50 for APHA members (who are not session presenters), and $100 for non-members and are in effect for anyone registering for the full APHA Annual Meeting by the Oct. 1 pre-registration deadline. These fees will increase substantially for anyone registering on-site at the Annual Meeting in Washington.

Log-in information and password access to these E-ssentialLearning sessions will be provided to registrants immediately following the Annual Meeting.

LCD projectors and computers are now included as part of the standard audiovisual package in each session room. This new technology will enable presenters to upload their PowerPoint presentations in advance of the meeting and have them pre-loaded on the APHA session computers. Individual presentations then begin with a click of the mouse. The cost and inconvenience of bringing a computer to the Annual Meeting has been eliminated for presenters, allowing them to take advantage of new technologies and be a part of the E-ssentialLearning experience.

Nominations Comittee Report

Chair Cynthia Green, Director of Monitoring and Evaluation, Centre for Development and Population Activities, 1400 16th St. N.W., Suite 100, Washington, DC 20036
Phone: (202) 939-2690
Fax: (202) 332-4496
E-mail: cgreen@cedpa.org

Congratulations to our newly elected members of the PFPRH Section Council! They will take office at the end of the November 2004 APHA meeting.

Chair-Elect: Young-Mi Kim, EdD

Secretary-Elect: Erica Fishman, MSW, MPH

Section Council: Lourdes Rivera, JD; Diana Romero, PhD; Sheryl Thorburn, PhD, MPH

Governing Council: Kay Armstrong, MS; Lisa Maldonado, MPH; Sharon Rudy, MEd, EDS, PhD

Thanks to all the other candidates who ran for office. Don’t feel bad; if you think about it, half of all candidates lose elections. I really appreciate your volunteering for these jobs, and I hope you’ll consider running for office again.

Resolutions Committee

Policy statements express the Association's stance and recommendations on a given issue affecting the health of the public. They direct APHA in pronouncements, testimony and other activities. These statements are in the form of resolutions and position papers. A resolution is a concise statement (500 words or less) of the Association's stance on a particular issue affecting the health of the public. Whereas any member of APHA can propose resolutions, individuals are urged to submit proposed resolutions through their sections. Position papers, however, must be submitted by sections, special primary interest groups or caucuses. A position paper is a longer exposition (3,000 words or less) on a broad issue affecting the public's health with a fuller explanation of Association policy on the matter.

At last year's Annual Meeting, APHA's Governing Council established the following priorities for APHA's legislative agenda in 2004: Public Health Infrastructure; Access to Care; and Health Disparities. In addition, APHA identified important gaps in existing policy for which they would like to see policy developed: asbestos disease compensation; the role of public health in universal health coverage; Medicaid and State Children's Health Insurance Program (SCHIP); Clean Water Act; Smart growth/transportation policy; Medicare reform; state of the public health workforce; right to mid- and late-term abortion; and comprehensive national policy on catastrophic acute and long-term health care. At the Annual Meeting this November, the APHA’s Governing Council will review and adopt policy statements that express the Association's stance on these issues and others that affect the health of the public.

Although the deadline for the submission of proposed 2004 Policy Statements has passed, individual members and the Section as a whole are urged to submit resolutions in the future which address policy issues relevant to reproductive health and family planning. These statements are our voice and an important avenue for promoting political action on critical issues.

For more information about APHA's public policy development process or the PFPRH Resolutions Committee, please contact me at the address and phone number below. I hope to see you in November!

Co-Chairs S. Marie Harvey, Associate Professor of Public Health & Director of the Research Program on Women’s Health, Center for the Study of Women in Society, University of Oregon, Eugene, OR 97403
Phone: (541) 346-4120
Fax: (541) 346-5096
E-mail: mharvey@oregon.uoregon.edu
Paula Tavrow, Deputy Research Director, Quality Assurance Project, University Research Company, LCC, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814
Phone: (626) 796-1890
Fax: (301) 941-8427
E-mail: ptavrow@urc-chs.com.

Membership Report

Chair, Erica Fishman, Director of Community Outreach, University of Minnesota, SPH, MCH Program, Division of Epidemiology, 1300 So. 2nd St., Suite 300, Minneapolis, MN 55454
Phone: (612) 625-4891
E-mail: erica.fishman@epi.umn.edu

As of June 30, 2004, our Section has 790 individuals for whom this is their primary section. This number is lower than last year; however, we continue to have new members joining each month.

Please tell your colleagues of all the great benefits of being a member of our Section, including an informative newsletter. For those people who attend APHA, the Section is an invaluable resource for information regarding population, family planning and reproductive health related sessions. It also provides an opportunity to meet informally with people who do similar work domestically and internationally. For more information, please contact Erica Fishman at (612) 625-4891 or <erica.fishman@epi.umn.edu>.

More on the March for Women's Lives

Section member (and former Section Chair) Richard Grossman, MD, attended the March for Women’s Lives (as did a number of other Section members; see the Spring 2004 newsletter). He subsequently wrote this piece, which appeared in the Durango (Colorado) Herald.

Walk Humbly

Do justice, love mercy, walk humbly.
--Micah 6:8

"What do we want? CHOICE!" The crowd around me was moving slowly, but shouting enthusiastically. One guy with a megaphone started the chant and it took off, repeated, then echoed through the thousands of voices immediately surrounding me.

I was one of perhaps a million people walking on the Mall in our nation's capital. There were many others from southwest Colorado, too. This was the March to Save Women's Lives, April 25. People from all over the country were there to insist the administration change its reproductive health policies.

President Bush's record on reproductive health issues has been poor. For instance, he cut aid for international family planning. Contraception is the best way to prevent unplanned pregnancies. Bush’s action will result in more abortions, not fewer. At home his regime blocked making emergency contraceptive pills available without prescription. This is one of the best ways of preventing unplanned pregnancies, since they are so safe and effective.

In addition, many laws have been passed to decrease access to abortion. People across the country are concerned that, if Bush is reelected, women’s ability to have safe and legal abortions will be further curtailed—-or abolished. If that happens, abortions will not stop. Desperate women will go to back-alley providers, or try to abort themselves. We will return to the tragedies doctors saw before abortion became legal 31 years ago. Women suffered humiliation, extortion, infertility, and sometimes even death. This explains the name of the march; women will die if abortion becomes illegal again.

Despite the huge numbers of people, the crowd was well behaved. There were grandmothers and babies in strollers. There were delegations from every state, a good number of political groups and many major religions. My favorite was marching belly dancers, followed by drums. This group danced its way through the afternoon. There was always a knot of spectators ahead, taking pictures.

Security was thick. A helicopter circled overhead while police lined the route. One of the cops reminded me of the risks. He pointed to a bicycle wheeled by a young man and pointed out that the little pack suspended under its seat could contain a “device”—-a bomb.

There were a gratifying number of young people. Most pro-choice activists are old, as are most doctors who perform abortions. We remember the horrors that occurred before abortion became legal. Although the majority of the marchers were women, there was a good percentage of men. Most people carried a sign or wore a pro-choice button. My favorite was: “If men got pregnant, abortion would be a sacrament.”

I wandered among the large Medical Students for Choice contingent. These young people took time away from their studies to march for what they believe is important. With over 7,000 members, MS4C showed up in force. Among them are the brave providers of abortion services of the future.

I stopped to talk with two antiabortion men who were standing quietly alongside the March. Each held a rosary. One, Joshua, was a law student at a D.C. school. He spoke unemotionally and was very sure of his beliefs; I admire him for his willingness to enter this lions' den. We talked for half an hour, neither of us changing our minds, but each exploring common ground.

My concern is that Joshua, like many other antiabortion people, is too idealistic. He feels that it is wrong to compensate for human frailty by allowing, say, the use of condoms to prevent transmission of HIV. I am sure that Joshua will abstain until married. I hope that he won't be too disappointed by life as he discovers its realities.

The last national pro-choice march in Washington, D.C., was a dozen years ago. Afterwards I read Amy Mallick's inspiring report in the Herald, and felt guilty that I hadn't attended. The demonstration last month was much larger than any prior pro-choice rally. In fact, it may be the largest demonstration D.C. has ever seen!

My favorite T-shirt had the Biblical quotation that started this article, except that the last phrase was crossed out and replaced with "march proudly." A million people did march proudly that day. I hope that the president will heed our message.

From the Hill

Terri Bartlett, Vice President, Public Policy and Craig Lasher, Senior Policy Analyst, Population Action International, 1120 19th Street, NW, Suite 550, Washington, DC 20036
Phone: (202) 659-1833
E-mail: <tlb@popact.org> (Terri) and <clasher@popact.org> (Craig)

Congress returned after Labor Day from its long summer recess with a number of contentious international family planning and reproductive health (FP/RH) issues yet to be resolved. How Congress will go about completing all of its unfinished work-—most notably 12 of 13 mandatory appropriations bills—-and when it will adjourn for the year remain open questions. The answers are seriously complicated by the charged partisan atmosphere on Capitol Hill.

Exacerbated by mounting budget deficit projections, the process of appropriating funds for government programs—-one of the few tasks that Congress must do each year—-is in disarray, and stopgap funding measures for significant portions of the federal budget may be necessary if Congress is to leave town to campaign by its target adjournment date of Oct. 1. The possibility of a “lame duck” session after the November election is a subject of widespread speculation.

Not surprisingly, electoral politics will play a central role in debates over these unresolved family planning and reproductive health issues. In addition, it can be asserted without exaggeration that the outcome of this year’s presidential race will have profound implications for the future of U.S. involvement in international family planning and reproductive health programs.

Since the last Section newsletter, a number of important legislative and policy developments have occurred in Washington-—most notably the Bush administration’s decision to withhold the fiscal year (FY) 2004 contribution to the United Nations Population Fund UNFPA, and passage of the FY 2005 foreign operations appropriations bill by the House of Representatives.


On July 16, the State Department announced that the Bush administration was withholding the U.S. contribution to UNFPA—-the lead multilateral organization in the population field—-for the third year in a row based on still-unproven charges of UNFPA complicity in human rights abuses associated with the Chinese government's "one-child" policy. Invoking the Kemp-Kasten restriction that prohibits funding to organizations that "support or participate in the management of a program of coercive abortion or involuntary sterilization," Secretary of State Powell withdrew the $34 million appropriated by Congress for FY 2004. (See the State Department press release on the decision at <www.state.gov/r/pa/prs/ps/2004/34433.htm> and the reaction of UNFPA Executive Director Thoraya Obaid at <www.unfpa.org/news/news.cfm?ID=476>).

Although the State Department release does not mention it, the Bush administration intends to reprogram $25 million of the withheld FY 2004 UNFPA contribution to programs to combat trafficking in persons as they did the FY 2003 UNFPA contribution. At an anti-trafficking conference in Florida the same morning, President Bush stated that the State Department had conveniently just "identified" $25 million in funding for anti-trafficking efforts.

Notwithstanding the announcements of the President and the State Department, congressional supporters of UNFPA and of family planning are expected to place "holds" on the reprogramming of the UNFPA funds to trafficking rather than to family planning activities as Congress intended. The effect of this hold would be to block the Bush administration from spending the $25 million. To date, no reprogramming request for the withheld UNFPA contribution has been sent to Capitol Hill for approval.

In addition, during House floor debate of the FY 2005 foreign operations appropriations bill (H.R. 4818) on the day before the decision was announced, Foreign Operations Subcommittee Chair Jim Kolbe (R-Ariz.) and Ranking Member Nita Lowey (D-N.Y.) did a colloquy (a scripted dialogue that explains the intent of Congress) on the expected reprogramming of the FY 2004 UNFPA contribution. Chairman Kolbe agreed to work in the House-Senate conference to ensure that UNFPA funds are spent on U.S. Agency for International Development (USAID) bilateral family planning and not lost to non-family planning activities like trafficking.

A few days earlier, on July 9, an amendment intended to help insure funding for UNFPA was narrowly defeated during consideration by the House Appropriations Committee of H.R. 4818. The amendment, offered by Rep. Lowey, lost on a vote of 26 to 32. The amendment sought to create a politically viable solution to this contentious issue by requiring that UNFPA spend U.S. funds only in six countries important to U.S. national security interests and with pressing women's health problems while maintaining longstanding guarantees that no U.S. funds are used in China or for abortion.

The unsuccessful Lowey amendment included the following provisions:

  • earmarked a U.S. contribution to UNFPA of not less than $25 million;

  • maintained the Kemp-Kasten restrictions in their original form;

  • designated that funding be provided only to UNFPA programs in six specified countries of strategic importance to U.S. national security--Iraq, Afghanistan, Jordan, Pakistan, Kenya, and Tanzania;

  • prohibited funding for any individual UNFPA country program that has been cited for violating Kemp-Kasten restrictions (China); and

  • reduced the amount of U.S. funding available for these six countries dollar-for-dollar by the amount spent by UNFPA in a country in which the UNFPA program has been cited for violating Kemp-Kasten (China).

Two Republicans—-Reps. Mark Kirk (R-Ill.) and Rodney Frelinghuysen (R-N.J.)—-joined 24 Democrats in support of the amendment, and two Democrats—-Reps. Alan Mollohan (D-W.Va.) and Marion Berry (D-Ark.)—-joined 30 Republicans in opposition. Absent committee members included: Reps. Culberson (R-Texas), Fattah (D-Penn.), Hinchey (D-N.Y.), LaHood (R-Ill.), Murtha (D-Penn.), Sweeney (R-N.Y.), and Taylor (R-N.C.).

During the committee debate on the amendment, UNFPA’s defenders, most notably Reps. Lowey and Kirk, gave clear and compelling arguments in support of the life-saving work of UNFPA and of the amendment. Foreign Operations Subcommittee Chair Kolbe (R-Ariz.) expressed his "reluctant" opposition to the amendment citing potential complications to enactment of the bill posed by the attachment of a controversial amendment. Kolbe's opposition combined with the strong lobbying by the White House and the House Republican leadership of "swing" Republicans on the committee doomed the amendment.

The defeat of the Lowey amendment in the Appropriations Committee in the House effectively ended most hopes for a legislative solution for FY 2005 to the continued defunding of UNFPA. The Senate is expected to include pro-UNFPA language in its version of the foreign aid bill, including a rewrite of the Kemp-Kasten language. However, the chances of pro-UNFPA provisions emerging from House-Senate negotiations on the final bill are remote, particularly in light of the ongoing deadlock in the Senate over the appropriations process.


On a slightly more positive note, when the House of Representatives adopted its version of the FY 2005 foreign operations appropriations bill (H.R. 4818) on July 15 on a vote of 365 to 41, it included a number of provisions important to family planning supporters in the following areas:

  • report language specifies $432 million for family planning/reproductive health (FP/RH) from all USAID bilateral accounts, of which $375.5 million is from the Child Survival and Health Programs Fund (both are the same as current year appropriated levels and higher than the President's budget request).

  • $25 million contribution subject to a Kemp-Kasten determination;

  • existing restrictions requiring UNFPA to maintain U.S. funds in a segregated account, none of which may be spent in China or for abortion; and

  • existing restriction requiring dollar-for-dollar reduction to U.S. contribution for any amount UNFPA spends in China.

Global Gag Rule/Mexico City Policy
  • no language on the Global Gag Rule (see <www.globalgagrule.org>); and

  • continuation of longstanding restrictions related to abortion and informed consent.

Family planning & HIV/AIDS
  • continuation of a directive requiring that any information on condoms furnished by U.S.-supported programs be medically accurate; and

  • inclusion of report language urging the State Department’s Global AIDS Coordinator to "foster greater linkages and coordination between family planning and maternal health programs and Emergency Plan activities," the five-year, $15 billion presidential initiative in 15 of the most AIDS-affected countries.

For the full text of the House-approved bill, go to: <http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=108_cong_bills&docid=f:h4818eh.txt.pdf>

Several amendments of interest to family planning advocates that had been discussed were not offered, including an amendment drafted by Rep. Carolyn Maloney (D-N.Y.) to provide a contribution to UNFPA only for activities to address the problem of obstetric fistula and a rumored amendment by Rep. Todd Akin (R-Mo.) to require all foreign aid recipients to have an official policy opposing prostitution and sex trafficking, which a number of development and humanitarian assistance organizations opposed—-not just those groups receiving HIV/AIDS assistance.

As the House was preparing to debate the foreign aid bill in July, some of the Bush administration’s HIV/AIDS policies were coming under fire from delegates at the XV International AIDS Conference in Bangkok. Critiques were primarily directed at the abstinence and monogamy emphasis in the U.S. prevention strategy and the refusal of the U.S. government to purchase generic drugs for AIDS treatment. Rep. Barbara Lee (D-Calif.), the lone member of Congress in attendance, criticized U.S. policies to fight the pandemic through “abstinence-until-marriage” programs as biased and unproven.

Prior to leaving for Bangkok, the Lee introduced a bill (H.R. 4792) to improve the U.S. approach to HIV prevention by placing the emphasis on the needs of women and girls and by repealing the earmark of one-third of bilateral prevention funds for “abstinence-until-marriage” programs. That earmark is likely to result in a massive infusion of financial resources-—in excess of $100 million annually—-into organizations (primarily faith-based groups) that may be uncomfortable with a comprehensive, multifaceted prevention approach tailored to the specific needs of local communities.

To read a copy of the bill, go to: <http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=108_cong_bills&docid=f:h4792ih.txt.pdf>.

The version of the foreign aid bill that will come out of the Senate Appropriations Committee later this fall is likely to included a number of pro-family planning provisions such as: a repeal of the Global Gag Rule; rewrite of the Kemp-Kasten provision; and efforts to moderate some of more ideologically-driven HIV/AIDS policies described above. If events allow the Senate to debate the foreign operations appropriations bill on the floor, champions of family planning may make efforts to add amendments restoring a U.S. contribution to UNFPA.

However, given the controversies surrounding these issue—-as well as numerous extraneous political, procedural, and schedule obstacles—-advocates are doubtful that many positive FP/RH provisions will make their way into the final appropriations bill that will be approved by Congress and sent to the President for his signature.


How debates over international family planning and reproductive health programs will be resolved remains to be seen. As a constituent, voter, and public health professional, your well-informed opinion on these vital programs has tremendous credibility and carries great weight with your Senators and Representative. Please let them know what you think.

Members of APHA are urged to join the PAI action network to keep up with political developments in Washington. Go to <http://populationaction.org/action/getinvolved.htm> to sign up.

Most importantly, educate yourself and your friends, families, and colleagues on the positions of the candidates for President and the House and Senate, and read the national party platforms of the Republicans and Democrats. It would be difficult to overstate the importance of this election to the future of family planning and reproductive health programs—-both domestic and international. Please exercise your right—-and your solemn duty—-to vote on Nov. 2.


Sexuality Task Force

Co-Chairs Jennifer Hirsch, Associate Professor, Dept. of Sociomedical Sciences,
Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032
Phone: (212) 305-1185
E-mail: jsh2124@columbia.edu

Dina J. Feivelson, 141 E. 33rd St., #9J, New York, NY 10016
Phone: (212) 532-4724
Fax: (212) 305-3702
E-mail: djf64@columbia.edu

With the elections coming up, all we can think about these days is politics, politics, politics. Like-minded souls might be interested in a new report from the International Working Group on Sexuality and Social Policy, “Global Implications of US Domestic and International Policies on Sexuality.. The International Working Group on Sexuality and Social Policy (IWGSSP), which is composed of researchers and activists from a wide range of countries and regions of the world, contributes to sexuality-related global policy debates through strategic policy-oriented research and analysis.

The report, the first-of-its kind analysis of U.S. policies on sexuality and their global impact, explores how the Bush administration’s policies have undermined sexual health at home and abroad. The report, which was released last month in San Juan, Puerto Rico, examines Bush administration policy decisions on a variety of issues, from HIV prevention and sexuality education to marriage and sex trafficking, finding “a focused campaign that reaches far and wide across American policy on health, education, welfare, trade, and foreign assistance.” The report identifies and analyzes actions taken by the Bush administration and its allies in Congress and finds that “the linkage between domestic measures and foreign policy when it comes to policing sexuality is noteworthy…Sexuality is not an afterthought, but a centerpiece of their thinking.”

Moreover, the report illuminates international implications of U.S. policies on sexuality for policymakers, advocates, and service providers within the United States and in other countries at the national and local level and within the United Nations system. The findings were released to coincide with the July meeting of the Economic Commission of Latin America and the Caribbean (ECLAC) meeting in San Juan, Puerto Rico, to mark the 10th anniversary of the 1994 International Conference on Population and Development in Cairo.

Members of the IWGSSP from Brazil, Mexico, and the United States spoke at a news conference releasing the report about the need for a positive approach to sexual and reproductive health and rights to implement the Cairo Programme of Action and the UN’s Millennium Development Goals to promote gender equality and women’s empowerment, to improve maternal and infant health, and to combat HIV/AIDS. They emphasized the leadership role of the United States and the power of its policies and funding.

“We connected the dots between U.S. policies on sexual health, education, and rights and discovered how dangerous and detrimental they are for public health, at home and abroad,” said Richard Parker, co-chair of IWGSSP and a Professor and Chair, Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. “Time and again, when it comes to U.S. positions on sexuality, we see politics trumping science and ideology undermining health and rights.”

David Satcher, Director of the National Center for Primary Care at Morehouse School of Medicine in Atlanta and a member of the IWGSSP, spoke of the 2001 report he released as the 16th U.S. Surgeon General, A" Call to Action to Promote Sexual Health and Responsible Sexual Behavior:"

"Our goal was to describe the public health problems related to human sexuality and sexual health and to move toward a science-based public health approach to solving these problems," Satcher said. "Our concern was that issues related to human sexuality and sexual health were too often dealt with politically or with religious bias, and with too little attention to public health. Programs to combat the spread of sexually transmitted diseases, unintended pregnancies and other sexual health problems should include a balanced agenda of a) abstinence education; b) a focus on a need to be faithful to one partner and (c) failing these two, the use of condoms when appropriate. This has been called the ABC approach. However we feel that in order for the ABC approach to succeed, we must deal with values and attitudes. So we recommend ABC plus HOPE: Environments of poverty, abuse and discrimination rob persons of hope for the future and of the motivation for responsible sexual behavior. On the one hand, we are pleased with the progress that we have been able to make. However, we continue to be frustrated with the politicization of issues related to human sexuality and sexual health."

Sonia Correa, co-chair of IWGSSP and research associate at the Brazilian Association for the Interdisciplinary Study of AIDS, noted the report’s relevance to the ECLAC meeting’s focus on the Cairo Programme of Action and referred to the Brazilian experience.

"We cannot allow U.S. policies on sexuality to sabotage progress being made on the Cairo Programme of Action," Correa said. "Brazil’s reproductive health policies had anticipated the 1994 Cairo conference, but even so Cairo greatly energized our work in Brazil, especially in relation to access to abortion in cases when it is legal. Of real concern is the potential negative impact of U.S. policies on the prevention components of the HIV/AIDS program, since in Brazil, USAID money basically funds prevention work done by non-governmental organizations."

“I have seen the impact of the conservative U.S. position on sexuality at a women’s conference in Mexico just last month,” stated Gloria Careaga, IWGSSP member, social psychologist and Academic Secretary of the Gender Studies Program at the National Autonomous University in Mexico. “The U.S. pressured countries to join them so that national policies had to converge with Bush administration policies.”

“The U.S. is trying to bribe, bully and blackmail other countries to take up its sex policing agenda,” said Rosalind Petchesky, Distinguished Professor of Political Science, Hunter College and the Graduate Center, City University of New York and IWGSSP member. "What is frightening, and dangerous, is how the Bush administration is pursuing its agenda on sexuality so systematically and with such missionary zeal, domestically and internationally, in tandem with its economic and military policies. But the rest of the world is not with the Bush administration when it comes to sexual health, education and rights. At each one in a series of international meetings over the last two years, an overwhelming majority of countries re-affirmed the Cairo Programme of Action, despite ferocious U.S. resistance. The Bush administration’s policies on sexuality weaken its leadership position in the world. A country that could be a powerful force in promoting and protecting sexual health and rights is actually aggressively undermining global health.

Global Implications of US Domestic and International Policies on Sexuality is available at: <www.healthsciences.columbia.edu/dept/sph/cgsh.html>.

The Sexuality Task Force NEEDS YOU. This year our annual meeting at APHA has been scheduled, mercifully, for Sunday afternoon rather than for the 6 a.m. time slot to which we have been assigned in years past. This means that you all should be awake (even the left-coast folks) and ready to talk about sex and public health! If you are interested in joining the Sexuality Task Force, in organizing sexuality-related sessions at APHA, in taking a look at how sexuality policies are affecting public health, or at writing sexuality-related position papers to submit to APHA’s Governing Council, come join us on Sunday afternoon. We would love to see some new faces.

Management/Sustainability Task Force

Co-Chairs Erica Fishman, Director of Community Outreach, MCH Training Program, School of Public Health, University of Minnesota, 1300 So. 2nd St., Suite 300, Minneapolis, MN. 55454
Phone: (612) 625-4891
E-mail: erica.fishman@epi.umn.edu
Lisa A. Hare, Senior Policy Advisor, DELIVER - JSI, 1616 North Fort Myer Dr., 11th Floor, Arlington, VA 22209 Phone: (703) 528-7474
E-mail: lhare@jsi.com

The Task Force serves as a means to increase communication on management and sustainability issues, with a particular focus on sharing experiences between those members working internationally and those working domestically. This year we are pleased to be sponsoring a panel that focuses on managing and sustaining programs in the face of shifting financial and political support. This panel will explore regional and national experiences of donor phase-out in Latin America and the Caribbean, managing programs under a newly decentralized system in the Philippines, and creative approaches to maintaining and improving family planning services in Massachusetts in an environment of decreased funding and political change. Based on comments from the panelists, Erica Fishman, Task Force co-chair, will highlight similarities and differences between programs presented. Please join us for: Session Number: 4309 Title: Managing and Sustaining Family Planning and Reproductive Health Programs in the Face of Change: Funding Shifts, Health Reform, and Political Swings. Date and Time: Tuesday Nov, 9; 4:30-6:00 p.m.

Immediately following this session, please join us for our annual Task Force meeting . At the meeting we will have the opportunity to share experiences and ideas in a small informal setting. We will also review activities from the past year, discuss activities for the coming year and discuss possible sessions for the 2005 Annual Meeting. The Task Force welcomes new and current members to join us. Time and Date: Nov. 9; 6:00-7:30 p.m. Location can be found in the program.

You are invited to submit any suggestions for the Task Force to Erica, and we hope that you will join our meeting in Washington, D.C.

Adolescent Reproductive Health

Co-Chairs Geri Lynn Peak, Two Gems Consulting Services, Baltimore, MD
Phone: (410) 323-7212
E-mail: gpeak@charm.net and

Lindsay Stewart, Senior Advisor on HIV/AIDS and Family Planning, Latin America and Caribbean Bureau, # 5.9-101 RRB, USAID
Phone: (202) 712-4964
Fax: (202) 216-3262
E-mail: lstewart@usaid.gov, and

John Santelli, Professor of Clinical Pediatrics and Clinical Population & Family Health, Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, B-2, New York, New York 10032
Phone:(212) 304-5634
Fax: (212) 305-7024
E-mail: js2637@columbia.edu

The Adolescent Reproductive Health Task Force's discussion of abstinence will continue at the 2004 APHA Annual Meeting in Washington, D.C. While abstinence is clearly a good choice for many teens, abstinence-only programs are unproven and may be unethical as they provide only part of the information that teens need to protect their health. Furthermore, they ignore the fact that in many cases, first sex is not a choice for many young people who are forced into it. Some groups are now suggesting that abstinence-only programs are also a violation of our free speech rights. The internationalization of poorly grounded U.S. policy is also affecting our foreign aid programs.

We will discuss the effect of abstinence-only and abstinence programs on domestic and international adolescent reproductive health programs and will also discuss a draft APHA position statement on this topic. We welcome input on this topic from all who wish to participate in this discussion. If you have done research on this topic and would like to present it at this meeting, please let us know. Check your APHA program schedule for the time and place of the Adolescent Reproductive Health Task Force meeting. As usual, we will also have a dinner on the Sunday night of the APHA Annual Meeting at a place still to be determined. The dinner focus will be "the journal of negative results."

If you wish to be put on the Adolescent Task Force mailing list, or have any other questions or comments, please write ARHTF Co-Chair Lindsay Stewart at <lindsaystewart1@cox.net>. Further information will be sent to all those on the ARHTF prior to the meeting.

Other Committee and Task Force Information


Board Representative Lois Uttley, Education Fund of Family Planning Advocates of NYS, 17 Elk Street, Albany, NY 12207
Phone: (518) 436-8408
Fax: (518) 436-1048
E-mail: Lois@mergerwatch.org


Men and Reproductive Health

Co-Chairs Robert Becker, Associate Vice President of Education and Training, Planned Parenthood of New York City, 26 Bleecker Street, New York, NY 1003
Phone: (212) 274-7336
Fax: (212) 274-7300
E-mail:rob@robertmbecker.com , and

Héctor Sánchez-Flores, Center for Reproductive Health Research and Policy, University of California, San Francisco, Box 0936, San Francisco CA 941143-0936
Phone: (415) 476- 3375
Fax: (415) 476-0705
E-mail: hectors@itsa.ucsf.edu


Chair Joan Healy, Director, International Programs, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516
(919) 967-7052
E-mail: jhealy@ipas.org and

Sally Girvin, Institute for Reproductive Health Access, NARAL/New York, 462 Broadway, Suite 540, New York, NY 10013
Phone: (212) 343-0114
Fax: (212) 343-0119
E-mail: sgirvin@naralny.org

Annual Meeting Program Plans

Chair-Elect Tim Williams,
John Snow Inc., 1616 N Fort Myer Drive, 11th Floor, Arlington, VA 22209
Phone: (703) 528-7480
Fax: (703) 528-7480
E-mail: tim_williams@jsi.com

Many thanks again to all of you who helped make this year’s PFPRH program a strong and exciting one, including those who submitted and reviewed abstracts, provided advice, agreed to moderate sessions, and those who will advance knowledge of the FP/RH field through their presentations in November. We received a tremendous number of quality abstracts that have now found their way into 29 panels, 10 poster sessions, and three roundtable sessions. This may be the largest number of scientific sessions we have had in recent memory, so participants should definitely find something of interest throughout the conference.

Our program this year reflects the breadth of interests and expertise that reside in our Section. In addition to the many expected sessions on youth, abortion, HIV/AIDS prevention, men, gender, policy, etc., this year’s program will also showcase some timely topics that haven’t always received much coverage in our Section, such as reproductive health in emergency/conflict settings, contraceptive advances, partnerships, cloning, and many others. And in keeping with this year’s theme of public health and the environment, we will sponsor two panels on population, reproductive health and the environment.

Please see the table at the bottom of this article for an outline of the PFPRH program, showing each day’s schedule of scientific sessions and business meetings. Also, please visit the link below to our program online at the APHA Web site, where you can read descriptions of each session, view individual abstracts, see sessions in other Sections that PFPRH is co-sponsoring, find links to other Sections’ programs, and learn of other activities taking place at the conference.


Remember as always that APHA is more than a series of panel presentations. The posters and roundtables feature exceptional research materials presented in ways that allow for learning through more in-depth discussion of findings. The roundtables especially are recent additions this year and should definitely be worth attending. For a change of pace, consider attending Task Force meetings on topics of interest, where you can network with leaders in the field, discuss state-of-the-art knowledge and activities of Task Force members, and help influence next year’s program. Note that most of these meetings are on Sunday, Nov. 7 at the beginning of the Annual Meeting. And finally, don’t miss the PFPRH Business Meeting/ Awards Ceremony on Monday at 4:30, followed soon thereafter by our Section’s social hour!

I sincerely hope you will attend this year’s Annual Meeting, and that you will find much of interest in the PFPRH program throughout the event. Safe travels to Washington, and a rewarding meeting to all. See you in D.C. in November!

Related Files:

Call for Highlights from the 2004 Annual Meeting

If you attend the 2004 Annual Meeting in Washington, D.C., please jot down the most interesting of the research findings, new approaches, or other information or developments that you encountered, and send them along to the newsletter to share with your fellow Section members. We can’t all be at every session, of course, but if we share what we learn, it will almost like attending a few more!

The next Annual Meeting promises to have many excellent presentations on topics of great interest. Please send in notes on your favorites to <SBinzen@cdc.gov> for inclusion in next spring’s newsletter.

In Memoriam

Remembering Charlotte Ellerston, by Sheryl Thorburn, PhD, MPH, PFPRH Section Member

It was with great sadness that members of the PFPRH Section learned that Charlotte Ellerston died on March 21, 2004, at the age of 38, after a year-long battle with breast cancer.

Charlotte had a Bachelor’s degree in biological anthropology from Harvard College. She received an MPA (1992) and a PhD (1993) from the Woodrow Wilson School at Princeton. Charlotte served as the Director of Reproductive Health for Latin America and the Caribbean at the Population Council’s regional office in Mexico. Her work at the Population Council included developing research projects and programs on abortion, contraception, STIs, and obstetrics. Subsequently, Charlotte founded Ibis Reproductive Health, a non-profit organization with a mission to produce stronger consumers of reproductive health products, services, and policies, along with more responsive health personnel and systems. Ibis aims to increase the reproductive health choices open to women, and to enhance women’s autonomy in exercising these choices.

Charlotte authored over 100 book chapters, journal articles, and commissioned reports. She served on the boards of the Association of Reproductive Health Professionals, the Reproductive Health Technologies Project, and the U.S. Emergency Contraception Hotline. She was a Fellow at the Harvard School of Public Health’s Center for Population and Development Studies.

Charlotte had an international reputation. Her contributions to reproductive health in the United States and around the world were well known and respected. Those who worked closely with Charlotte found her to be “….a wonderful friend, mentor, and colleague. Her energy and enthusiasm for our work was infectious and she inspired us with her unique insight, hard work and intellect.”

Even though I did not know her personally, like many others I admired her work and her commitment to reproductive health. Her career was truly distinguished. Her early death is a great loss to our profession, and I know her colleagues and friends will sorely miss her.

Remembering Jane Boggess by Claire Brindis

Jane Boggess, PhD, well-known advocate for easily accessible and affordable reproductive health services for men and women, died of a stroke Jan. 18, 2004. She was 57 years old.

Gov. Pete Wilson appointed Dr. Boggess in 1993 as Chief of the California Office of Family Planning, where she served until 1998. During her tenure, she achieved national notoriety in public health circles for her success in launching California’s successful Family P.A.C.T. program, which provides free and low-cost family planning health services to low-income residents. She also began other innovative programs, such as the Male Involvement Program, the nation’s first large-scale effort to specifically reach out to young men as a part of a teenage pregnancy prevention strategy.

As founder and executive director of the Pharmacy Access Partnership, a center of the Public Health Institute, Dr. Boggess led a collaborative effort among pharmacies, government agencies and public health organizations to provide Emergency Contraception (EC) to women at California pharmacies without an advanced prescription from a physician. As a result of efforts by the Pharmacy Access Partnership, California became the first state to specifically adopt legislation to deregulate EC, and now has over 800 pharmacies participating in the EC program. She recently testified at a FDA hearing to consider making EC available over-the-counter, and was widely recognized as one of the country’s leading experts in the issue.

“Jane was a true visionary, and capable of bringing disparate groups together to achieve a common goal,” observed Pauline Daniels, program officer with The California Wellness Foundation. “She had the tenacity and dedication to make good ideas come to life. The entire reproductive health community is very sad about this sudden loss.”

Dr. Boggess began her career working as assistant director of the Health Officers Association of California and later became Director of Women’s Health for San Bernardino County. She has served on the Advisory Committee of The California Wellness Foundation’s $10 Million Teen Pregnancy Prevention Initiative.

Dr. Boggess was born in Upland, California, and earned her BA and PhD in Anthropology from U.C. Berkeley and spent four years studying a population of monkeys in the Himalayas. She developed a professional interest in family planning issues after her daughter was born, observing that she was fortunate to be able to delay motherhood in order to be able to take advantage of educational and career opportunities, something not all women were able to do.

In her personal life, Dr. Boggess was a world traveler, a gourmet cook, and enjoyed horseback riding and gardening.

News From the Population Field

Dr. James F. Phillips, a senior researcher with the Population Council, received the 2004 Marjorie Horn Operations Research Award on Aug. 3, 2004.

Presented by the U.S. Agency for International Development, the award recognizes excellence in conducting and utilizing research . The award is named for the late Dr. Marjorie Horn of USAID, who made a major contribution to the field of operations research in reproductive health.

Jim Phillips was recognized for his pioneering approaches to program-relevant research. During his 35-year career, he has focused on measuring the demographic role of family planning programs and conducting field experiments in reproductive change. His recent work as an advisor to the Ghana Health Service led to the Community-based Health Planning and Services Initiative, which mobilizes volunteers, resources, and organizations to support community-based primary care. He has also worked in Bangladesh, the Philippines and Thailand. Along the way, he has inspired and mentored a large cadre of researchers who continue his application of methodological rigor and cultural sensitivity. He holds a MS in population studies and a PhD in sociology.

Photo Contest

Second Annual International Photoshare Photo Contest!
Sponsored by The INFO Project and Nikon.
Do you have photos of programs in action and the people you serve? Pictures
illustrating the realities of urban and rural life in developing countries?
Snapshots from your personal travels, volunteer service, or work experience?
You may have an award-winning photo!

Participants may submit one photo per category:

- Family Planning and Reproductive Health
- HIV/AIDS Education, Treatment, and Prevention
- Environment
- Agricultural and Economic Development
- Democracy and Governance
- Humanitarian Assistance
- Open Category - Global Health
- Open Category - Human Interest



1st Place/Best of Show:
$300 USD

2nd Place:
$150 USD

3rd Place:
$75 USD

Photoshare Contributor of the Year:
Nikon 3.2Megapixel CoolPix 3700 Digital Camera with a 3X Zoom Lens, USB
Interface, Audio/Video Output, Rechargeable Li-ion Battery, Nikon View
Software, and 16MB SD memory card.

Photoshare Image of the Year:
Matted and framed photo.

All category winners will receive a certificate. Winning photos and photographers will be featured at the INFO booth at the APHA Annual Meeting in Washington, D.C., November 2004. Entries and winners will also be featured on the Photoshare and INFO Web sites, e-list, and promotional materials.


1. Fax (410-659-6280) or mail the ENTRY FORM to:

David Alexander, Photoshare
111 Market Place, Suite 310
Baltimore, MD 21202 USA

2. Submit your photos through the mail, e-mail, FTP, or on CD-ROM. See the Web site for the entry form and more information and further instructions on how to submit your entries.

~ All entries must be submitted by Oct. 1, 2004. Any individual (amateur and professional) or organization is welcome to participate.
~ A completed entry form, including captions, must accompany entries.
~ Original color or black & white prints, slides, negatives, and digital images are acceptable. At a minimum, digital images must be approximately 1280x960 pixels. Photos below the minimum resolution, photos without captions, and photos previously contributed to Photoshare are not eligible.
~ Originals will be returned upon request at Photoshare's expense through UPS or DHL when a street address is provided (no P.O. boxes). Photoshare is not responsible for the loss or damage or photographs. However, in the event that photos are lost or damaged on return, Photoshare will resend digital copies, when available.
~ Photos will be judged on the basis of content (relevance to category) and quality (e.g. lighting, composition, focus).
~ Winners will be notified by phone or e-mail.
~ Entries that violate copyright or the right of privacy of any person or entity are not acceptable.
~ All contest entries are subject to inclusion in Photoshare, a digital photo collection and service of The INFO Project helping international non-profits communicate health and development issues through photography.

David Alexander or Lavina Velasco
Photoshare - A Service of The INFO Project
111 Market Place, Suite 310
Baltimore, MD 21202 USA
E-mail: photoshare@infoforhealth.org
Phone: (410)659-6280
Fax: (410) 659-6266
Web announcement: www.infoforhealth.org/photosharecontest04.shtml

Photoshare is a service of The INFO Project helping non-profit organizations communicate global health and development issues through photography. By facilitating photo sharing among colleagues in international development, Photoshare has become a leading source for editorial development photography. The Photoshare collection, consisting primarily of photos taken by public health professionals in the field, contains more than 7,000 images illustrating the realities of urban and rural life in developing countries, as well as global efforts to improve and save lives. Our popular on-line photo database, available at www.photoshare.org through the Johns Hopkins University Bloomberg School of Public Health/Center for Communication Programs, serves many major government institutions and international NGOs.

The 2004 Photoshare Photo Contest is sponsored in part by Nikon.

Of Interest

Declining HIV Prevalence Gives Hope in Cambodia: A publication by Population Services International (PSI) released in May 2004, examines the decrease in HIV prevalence in Cambodia which the World Health Organization has attributed to the government's 100 percent condom use policy in commercial sex establishments and the work of NGOs who support that policy.

Condom use among brothel-based sex workers is reported to have more than doubled from 1997 to 2002, and the share of new HIV infections resulting from commercial sex has plummeted from 80-90 percent to 21 percent in 2002.

Cambodia has followed the example of Thailand, where HIV prevalence fell dramatically after the government implemented a 100 percent condom use policy in 1989. This certainly does not mark an end of the epidemic in Cambodia but does show that well-targeted social marketing efforts, including the strategic promotion of condoms, can have a significant impact on the epidemic. For more information, visit <www.psi.org/resources.cambodia.html>.

New Resources

EngenderHealth is pleased to announce the release of two new publications in the Quality Improvement Series: COPE® Handbook: A Process for Improving Quality in Health Services, Revised Edition, and COPE® for Reproductive Health Services: A Toolbook to Accompany the COPE® Handbook. COPE (client-oriented, provider-efficient services), a facility-based quality improvement process, was introduced in 1988 and has since been used in 50 countries worldwide, with proven success. The revised COPE® Handbook provides a more comprehensive explanation of the COPE process, more tips for facilitation of the process, and orientation materials for managers to use to support the introduction and sustainability of COPE in their facilities. The COPE® for Reproductive Health Services toolbook is a content-specific resource for providers of reproductive health services. This toolbook represents a useful addition to the wide array of toolbooks EngenderHealth has produced, including COPE® for Maternal Health Services, COPE for Child Health, and Community COPE®. Each toolbook contains Self-Assessment Guides, a Record-Review Checklist, a Client-Interview Guide, Client-Flow Analysis forms, and Action Plan and Follow-Up forms, all related to the specific type of service provided.

To request a copy of these publications, please contact Material Resources at (212) 561-8000 or <materialresources@engenderhealth.org>. The PDF version of COPE® Handbook: A Process for Improving Quality in Health Services, Revised Edition, can be viewed or downloaded at <www.engenderhealth.org/res/offc/qi/cope/handbook/index.html>. The PDF version of COPE® for Reproductive Health Services: A Toolbook to Accompany the COPE® Handbook can be viewed or downloaded at <www.engenderhealth.org/res/offc/qi/cope/toolbook/index.html>.

Ipas announces the publication of Lives worth saving: Abortion care in sub-Saharan Africa since ICPD. A progress report by Karen Otsea. In the decade since the International Conference on Population and Development (ICPD), much has happened in sub-Saharan Africa to bring the topic of unsafe abortion out of the shadows and into the realm of public discussion. This comprehensive report examines the development of abortion-related policies as well as the progress made in expanding and improving access to contraception, safe abortion services, and postabortion care in sub-Saharan Africa since the ICPD, taking into account the broader public-health context and the complex social, economic and political environment of the region.

Download a free copy at: <www.ipas.org/publications/en/ICPDAfricabooksm_en.pdf>,
order a copy from <ipas_publications@ipas.org> or telephone (800) 334-8446 (toll-free in the United States) or (919) 960-6453. Single copies of many of our publications are available at no charge to developing-country nationals; shipping and handling fees apply for requests of multiple copies.

Ipas has also recently published Achieving ICPD commitments for abortion care in Latin America: The unfinished agenda. by Lucia Rayas and Diane Catotti. Relying on results from an extensive survey of key stakeholders in Bolivia, Brazil, Mexico, Nicaragua and Uruguay, this report concludes that political, economic and social forces—-especially conservative religious forces—-in Latin America have significantly impeded the implementation of the holistic reproductive and health rights recommendations that were made at the International Conference on Population and Development (ICPD) in Cairo 10 years ago. It may be viewed at <www.ipas.org/publications/es/ICPD_LAC_book_es.pdf>.

Population Council, India announces a set of three briefs on Non-consensual Sexual Experiences of Young People in Developing Countries. These briefs consolidate the main themes addressed at a global consultative meeting on non-consensual sex among young people in developing countries held in New Delhi in September 2003. The meeting was organized by the Population Council, India, in collaboration with World Health Organisation/Department of Reproductive Health and Research, Switzerland, and Family Health International/YouthNet, United States. The titles for the briefs are: Forced sexual relations among married young women in developing countrie, <www.popcouncil.org/pdfs/popsyn/PopulationSynthesis1.pdf>;
Sexual coercion: Young men's experiences as victims and perpetrators <www.popcouncil.org/pdfs/popsyn/PopulationSynthesis2.pdf>; and The adverse health and social outcomes of sexual coercion: Experiences of young women in developing countries www.popcouncil.org/pdfs/popsyn/PopulationSynthesis3.pdf>.
In addition, FHI/YouthNet has produced a brief from the same meeting, titled Non-consensual Sex among Youth as a YouthLens Brief No:10, available at <www.fhi.org/en/Youth/YouthNet/Publications/YouthLens+English.htm>
(scroll to YouthLens No. 10). Please write to <info@pcindia.org> with your full mailing address for hard copies.

The Alan Guttmacher Institute has recently produced Contraception Counts, a series of downloadable, printable state and district fact sheets with comparative (U.S.) information on: pregnancies and their outcomes; the need for contraceptive services and supplies; how each state or district is working to meet women’s contraceptive needs; the impact of subsidized services; and the key role of the Title X program. It is now available in both HTML and PDF formats at <www.guttmacher.org/pubs/state_data/index.html>.

Additional resources on contraceptive needs and services are available from AGI. For state-by-state and national information on Medicaid funding for family planning services, click <www.guttmacher.org/pubs/medicaid050304.html>. For estimates of women in need and the availability of publicly funded family planning services by U.S. county, click <www.guttmacher.org/pubs/win/index.html>. For policy briefings on the accomplishments of Title X and the challenges the program faces, click <www.guttmacher.org/pubs/ib_1-01.html> and <www.guttmacher.org/pubs/ib_3-01.html>.

UNFPA and EngenderHealth have released two new publications to help meet the desperate need for HIV prevention programs for pregnant and postpartum women. HIV Prevention in Maternal Health Services: Programming Guide and HIV Prevention in Maternal Health Services: Training Guide address a neglected component of comprehensive programs to prevent mother-to-child transmission of HIV (PMTCT). These guides emphasize preventing HIV infection in the 99 percent of pregnant women in the world who are HIV-negative at the time of their pregnancy. Since many women only access health care during pregnancy, maternal health services are a pragmatic starting place for HIV prevention interventions and entry point for referrals to other HIV/AIDS services. Field-tested in Cambodia, Ethiopia, Ghana, and Malawi, the guides are currently being used in three new pilot projects in Ethiopia, Myanmar, and the Ukraine. They can be downloaded at <www.engenderhealth.org>. The guides will also be available in French as of September 2004. The PDF versions of HIV Prevention in Maternal Health Services: Programming Guide and HIV Prevention in Maternal Health Services: Training Guide can be downloaded at <www.engenderhealth.org/res/offc/hiv/prevention/> and at <www.unfpa.org/hiv <http://www.unfpa.org/hiv>

PATH introduces Resources for Emergency Contraceptive Pill Programming: A Toolkit. This publication is designed to help program managers, policy makers, and donors make emergency contraceptive pills (ECPs) widely available to women in developing countries through reproductive health programs. The toolkit provides guidance, technical information, and sample materials developed by PATH and other organizations. The toolkit contains 10 modules, addressing such areas as cost considerations, raising public awareness, regulation, and provider training. The toolkit can be found on the emergency contraception resources page of the PATH Web site at <www.path.org/resources/ec_resecpprog-tookit.htm>. The toolkit is available on CD-ROM in both English and Spanish. To order a copy of the CD-ROM, please send a message to <publications@path.org>.

The Population Reference Bureau announces two new materials dealing with the issues of health and poverty in developing countries. The Wealth Gap in Health, a wall chart, uses recent research and analysis to shed light on how the poorest women and children are faring compared with their better-off peers. Selected health and population indicators are provided for 53 developing countries, including fertility, infant and child mortality, nutrition, and the use of family planning and other health services. To view or download the chart, go to <www.prb.org/pdf04/TheWealthGapinHealth_Eng.pdf> (136KB).

Improving the Health of the World's Poorest People, a four-page policy brief, highlights the extent of the rich-poor health divide, the factors that play a role in health disparities, and approaches for improving the health of the poor. The brief is based on a longer report by PRB. To view or download the policy brief, go to <www.prb.org/pdf04/ImprovingtheHealthbrief_Eng.pdf> (105KB). To view or download the full report, go to <www.prb.org/pdf04/ImprovingtheHealthWorld_Eng.pdf> (438KB). Print copies are available free of charge to those working in developing countries. If you would like to request copies, please contact PRB at <prborders@prb.org>.

Section Web Site

The Population, Family Planning, and Reproductive Health Section Web site can be accessed at <www.pfprh.org> or at <www.apha.org/sections/sectwww.htm>. Thanks to Section Council member Larry Finer, who developed the site.

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Submissions to the Newsletter

Share your news! Let us know about books or papers you have recently published, upcoming conferences you are involved in, or policy or program news that might be of interest to fellow Section members. Perhaps we can abstract an article or include a description of an innovative program. Please send all submissions by Monday, March 28, 2005 to:

Susanna Binzen
Division of Reproductive Health, MS K-35
Centers for Disease Control and Prevention
4770 Buford Highway, NE
Atlanta, GA 30341
Phone: (860) 232-3262
Fax: (860) 232-6648
E-mail: SBinzen@cdc.gov