Just a month before the 2015 earthquake, the Nepal Government made a commitment to increase the family planning budget allocation by 7% annually. It partnered with international and private organisations to meet the target, but most of these partners are likely to lose a chunk of their funding.
“Our government already lacks resource to meet the commitment. With the US pulling out, the gap is only going to widen,” says an official working in family planning.
A US Embassy spokesperson said the United States remained committed to helping the welfare of women and children in developing countries: “The Protecting Life in Global Assistance policy has not reduced funding for women and children’s health by one dollar. USAID works together with the Government of Nepal and other external development partners, including multilateral partners, to coordinate interventions, synergise, and reduce gaps. USAID has strong working relationships with both UNFPA and WHO in Nepal.”
Although family planning is a small component of the aid budget for maternal health, the cuts are biting. The EU and Nordic countries have stepped in, but their contribution does not meet the shortfall.
At the recent World Health Assembly in Geneva, the United States wanted to dilute a routine agreement on breastfeeding, amidst a global outcry.
The United States delegation wanted to water down the resolution by removing a call on governments to ‘protect, promote and support breast-feeding’ and another clause calling for restrictions on the promotion of baby foods.
“What happened was tantamount to blackmail, with the US holding the world hostage and trying to overturn nearly 40 years of consensus on the best way to protect infant and young child health,” Patti Rundall of the British advocacy group Baby Milk Action was quoted by the New York Times as saying.
The uproar set off alarm bells in Nepal, where donor support has been critical in trying to meet the target of getting 80% of mothers to breastfeed by 2022.
The US Embassy clarified that improving nutrition among mothers, infants, and young children was still an important public health priority for the United States, and it remained committed to working with WHO and other stakeholders to improve health and nutrition through “cost-effective and evidence-based” measures.
But, the spokesperson added: “While the United States recognises that breastfeeding and provision of breast milk is best for all babies, we recognise not all women are able to breastfeed for a variety of reasons. These women should have access to full and accurate information about breastfeeding, the benefits of breastfeeding, and safe alternatives when breastfeeding is not possible.”
Some experts contend that cuts in funding would not affect the breastfeeding campaign, and Nepal did not need to be dependent on donors anymore.
“Even if the US cuts funding, Nepal is capable of going ahead on its own. Awareness here about breast milk far exceeds any opposition from outside, it’s just that the government has to own it,” says former WHO public health expert Rita Thapa.
Aruna Uprety agrees, but adds that the Americans have played cleverly on a woman’s choice not to breastfeed: “This distracts from the fact that mother’s milk is the healthiest for babies.”
The conclusion is that Nepal is perfectly capable of maintaining its momentum not just on breastfeeding, but also on protecting maternal and infant health with or without outside help.