UNITED STATES INTERNATIONAL POPULATION POLICY, ASSISTANCE, AND ORGANIZATION

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP85M00364R001803520042-0
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 20
• Document Creation Date: December 22, 2016
• Document Release Date: September 10, 2010
• Sequence Number: 42
• Publication Date: March 28, 1983
• Content Type: MEMO

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STAT
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Washington, D.C. 20520
March 28, 1983
TXCb".S,,TF I ED
with CONFTUMN AI, Attachment)
MEMORANDUM FOR MR. WILLIAM P. CLARK
THE WHITE HOUSE
SUBJECT: United States International Population Policy?
Assistance, and Organization
Attached please find the report requested in your memorandum
of June 1, 1982. This is a joint State-AID report.
r i s ill
Yf~'
C e s
eExecutive Secretary
cc: OVP
/CIA
Defense
HHS
OMB
OPD
OSTP
Treasury
VJV f ll..V
United States Department of State
- COL John Stanford
- Miss Mary Frances Lowe
- Mr. Alton Keel
- Mr. Edwin Harper
- Dr. George Keyworth
- Mr. David Pickford
UNCLAS 9 T X? r
(With C6ENTIAL Attachment)
STAT
! an L? A
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1. "What assumptions underlie U.S. policy and assistance, and
what are the bases for these assumptions?"
Answer: one must begin with the demographic realities. Even
with birth rates on the decline, the world's
population will probably rise by nearly two billion
people in the last two decades of the 20th
century--the equivalent of adding 40 new countries of
the current size of Egypt. Ninety percent of this
growth will occur in the world's low-income
countries. In most of these countries, the annual
increments to population size are growing larger.
Areas of strategic and economic importance, including
Central America and the Caribbean, Egypt, Turkey,
Nigeria, Kenya, Indonesia, the Philippines,. Pakistan
and India, face a potential doubling of population in
the next 20-30 years. Unless birth rates can decline
more rapidly, many already crowded countries will
triple their populations within the next three
generations.
Underlying U.S. policy is the recognition that these
unprecedented demographic changes have important
political, economic, security, and human
implications. Assistance to friendly countries in
addressing population growth problems has been an
important. element of U.S. foreign policy for two
decades. The Foreign Assistance Act (section 104)
states: "The Congress recognizes that poor health
conditions and uncontrolled population growth can
vitiate otherwise successful development efforts,"
and that "...voluntary population planning programs
can make a substantial contribution to economic
development, higher living standards, and improved
health and nutrition."
At Economic Summit meetings, the President joined the
leaders of other major industrialized nations in
declaring that, "We are deeply concerned about: the
implications of world population growth....We
recognize the importance of these issues and will
place greater emphasis on international efforts in
these areas" (Ottawa, 1981); and "We will give
special encouragement to...programmes to address the
implications of population growth" (Versailles,
1982). In a December 1982 personal message to a
conference of Western Hemisphere parliamentarians in
Brasilia, the President expressed "concern over rapid
population growth and its effects on the process of
economic development."
CON El DENTIAL
OADR: GDS
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Secretary Shultz, in February 1983 testimony to
Congress, stressed the importance of U.S. population
assistance, noting that "rampant population growth
underlies the Third World's poverty and poses a major
long-term threat to political stability and our
planet's resource base." In a recent telegram to.all
Ambassadors and AID Mission Directors, AID
Administrator McPherson stated: "Family planning
programs are an essential element of the U.S.
development assistance strategy, and this
Administration has reaffirmed a 20-year U.S.
commitment to voluntary family planning efforts."
Behind these policy statements is a substantial body
of analysis on the effects of modern population
growth in the Third World and on the utility of-
voluntary family planning programs in reducing
fertility and improving the health of mothers. and
children. These conclusions are based on empirical
evidence gathered in numerous developing countries,
on both family and macroeconomic levels, by analysts
of many nationalities, as well as by such insti-
tutions as the World Bank, United Nations agencies,
and the National Academy of Sciences.
CONFIDENTiAL
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2. "What are the objectives of U.S. international population
policy and programs and their relationship to the U.S.
security, foreign policy, and other interests?"
Answer: Objectives of U.S. Population Policy and Programs
As with other forms of development aid, the general
objective of U.S. population assistance is to promote
economic development and political stability by
improving the human condition in friendly countries
which ask for our assistance. Population programs
are designed as a necessary complement to other
humanitarian development efforts aimed at reduction
of poverty and improvement in the quality of life.
The U.S. and other donor countries cannot indef-
initely provide the growing resources needed to feed,
train, and create jobs for continually rising numbers
of poor in the Third World. Thus, failure to help in
reducing the pressure of population growth risks
undercutting U.S. development and security assis-
tance. Relatively small outlays for population
programs at this time may save us much larger sums
for emergency food assistance and/or military peace-
keeping assistance in the future.
The specific objective of U.S. international popu-
lation assistance is to aid countries requesting such
help in the development and implementation of humane
population policies and voluntary family planning
programs. U.S. aid is directed at strengthening
local institutions, including the private sector;
training health, demographic, and other personnel;
providing medically approved methods of family
planning; assisting in demographic data collection
and policy analysis; and supporting population-
related biomedical and social science research.
Relationship to U.S. Security and Foreign Policy
Interests
The historically unprecedented growth of population
in many parts of the Third world represents a poten-
tially destabilizing phenomenon. The proportion of
industrialized countries' population in the world's
total, which was one-third in 1950, will probably
decline to only one-fifth by the year 2000. The
number of young adults (ages 20-39) will increase in
the North by 20 million between 1980 and 2000--in the
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South, by 600 million. (This is not a "projection,"
as these individuals are already born.) Within
developing countries, there is a widening income gap
between the rich, elite classes (who generaly prac-
tice family planning) and the poor (who generally do
not).
Population factors--including rapid urbanization and
differential.growth rates among a country's ethnic or
social groups--complicate solutions to a range of
other problems and can limit a government's ability
to meet changing social and economic demands. These
demographic changes affect the prospects for economic
development, diverting resources from investment to
consumption, and exacerbating problems of mal
nutrition, overcrowded cities, unemployment among
socially volatile young adults, deforestation and
environmental degradation. Recent CIA studies of,
several key countries indicate related potential
dangers of political instability, extremism, urban
crime, mass migration, and possible conflicts over
scarce resources.
Our interests in many of these countries include--in
addition to our traditional concern for human welfare
and dignity--such geopolitical factors as strategic
location, military bases, supply of oil or other
critical raw materials, and markets for U.S. exports
and safety of U.S. investments.
In the Middle East, for example, the four most
populous nations--Turkey, Egypt, Iran, and
Pakistan--are experiencing in varying degrees the
complex effects of rapid population growth. In each
of these countries, dependence on food imports and
unemployment/underemployment are already serious
concerns, and the labor pool is growing at an
alarming pace. Political instability in this region
would imperil vital U.S. interests, weakening the
southern flank of NATO and our Indian ocean
capability.
Other countries affected by demographic pressures
include such key suppliers of U.S. petroleum imports
as Indonesia, Mexico, and Nigeria--already heavily
populated nations with high rates of population
growth. They also include countries like Bolivia,
Brazil, Morocco, the Philippines, Zimbabwe, and
Thailand, which supply essential U.S. imports of
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minerals for defense production. Problems of
unemployment/underemployment-and wage differentials,
aggravated by high population growth, also contribute
to pressures for migration to the United States from
Mexico, Central America, and the Caribbean.
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3. "What major factors affect population growth and to what
extent? Assuming economic growth is a major factor in
affecting population growth, what kinds of trade-offs or
considerations should be weighed in allocating financial
assistance between such programs with other countries?"
Answer: Rapid population growth in the Third World is a
post-World War II development directly attributable
to substantial declines in death rates, resulting
from widespread improvements in nutrition and health,
while birth rates remained at traditionally high
levels.
High fertility in less developed countries reflects
such factors as economic benefits from larger fami-
lies, cultural and religious mores, low status of
women, and unavailability and/or ignorance of effec-
tive means of contraception. Traditionally, many
societies have prevented unwanted children through
such practices as infanticide, abortion, and
abandonment.
Economic growth is an important factor in reducing
birth rates. In the now-industrialized countries,
however, the "demographic transition" to lower
fertility occurred over many decades, and under
conditions of smaller population growth rates, higher
income, and greater possibilities for emigration than
is the case for the Third World. Moreover, the
numbers involved today are much greater, and the
youthful age structure--40 to 45 percent of a popu-
lation under 15--means that there will be a dramatic
increase in potential parents in the coming decades.
For example, the number of women of child-bearing age
in Mexico will grow from less than 6 million in 1960
to nearly 25 million by 2000. Even if these future
parents have fewer children, there is a built-in
momentum which prevents a rapid decline in population
growth. Thus, for many developing countries, con-
tinued growth in numbers is itself proving a major
obstacle to the kind of economic development which
might theoretically lead to smaller family size.
Some aspects of the development process--e.g.,,
urbanization, improved income distribution, education
and employment of women--contribute to a desire for
smaller family size. In order, however, for changed
attitudes to be reflected in lower birth rates within
a reasonable time-frame, it is essential that couples
have access to modern methods of family planning.
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Numerous research studies indicate that countries
with improving socioeconomic conditions combined with
family planning programs experience the greatest
decreases in population growth rates. While popu-
lation aid alone will,not solve the problems of
economic development, most observers agree that
lasting progress can only be made when family
planning and population programs are an integral
.element of national development efforts. The sheer
logistics involved in reaching tens of thousands of
rural villages with family planning information,
services, and follow-up, and in training adequate
numbers of medical and paramedical personnel? imply
that most developing countries require some external
support.
Therefore, as has been clearly expressed at many
international meetings in an almost unprecedented
consensus of North and South, an effective develop-
ment strategy should include not only general devel-
opment aid but also population assistance. The
"trade-off" cannot be determined mechanistically: as
with other development sectors, country allocations
will be determined by the need for specific programs,
governmental commitment, absorptive capacity, and
popular interest and participation.
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4. "what are the interests, policies, and activities or
programs in the population area of those governments which
the United States cooperates with or assists?"
Answer: A fundamental rationale for family planning programs
(first enunciated at the 1968 International Con-
ference on Human Rights), was ratified by virtually
every country in the world at the 1974. World Popu-
lation Conference: "All couples and individuals have
the basic right to decide freely and responsibly the
number and spacing of their children and to have the
information, education and means to do so."
Over the past decade, the number of developing
countries with official policies supporting popu-
lation and family planning activities has increased
from 36 to 67. Over 90 percent of the developing
world's people live in countries with some kind of
population policy: 79 percent live in 35 countries
where the official policy is to reduce population
growth, while an additional 14 percent live.in
countries where support for family planning is based
solely on a human rights and health rationale.
Developing countries are also devoting more of their
own resources to this sector. A decade ago more than
half of LDC population activities was financed by
external donors; today, at least 60 percent is
provided by the developing countries themselves.
The need for population policies and programs has
been reiterated in such major expressions of inter-
national consensus as the UN International Devel-
opment Strategy for the 1980's, the Substantial New
Program of Action for the Least Developed Countries
(September 1981), the International Conference of
Parliamentarians on Population and Development
(Colombo 1979), and in regional conferences of
African, Asian, and Western Hemisphere parlia-
mentarians in 1981 and 1982. LDC interest in popu-
lation and family planning . activities is being...
emphasized with increasing frequency and urgency by
Third World leaders in such recent international fora
as the June 1982 session of the UNDP Governing
Council. Within the past two years, such world
leaders as Soeharto of Indonesia, Marcos of the
Philippines, Moi of Kenya, de la Madrid of Mexico,
Bourguiba of Tunisia, Mubarak of Egypt, Ahidjo of
Cameroon, Figueiredo of Brazil, Nyerere of Tanzania,
Senenayake of Sri Lanka, Zia of Pakistan, Gandhi of
India, Bagaza of Burundi, and the King of Nepal, have
publicly called. for increased domestic and inter-
national efforts to address population problems.
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CONFIDENTIAL
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5. "What have U.S. population assistance programs achieved?"
Answer: U.S. population assistance flows through multi-
lateral, bilateral, and private channels to over 110
countries. U.S. programs have played a major role in
about 30 countries and a complementary role in the
remaining 80 countries, through projects of the
United Nations and private. organizations. This
assistance has helped to improve the health and
well-being of millions of individuals and families,
while contributing. to improved prospects for national
economic development.
A growing body of data documents a correspondence
between the practice of family planning and declining
birth rates in a large number of countries receiving
AID population assistance, as shown in the accom-
panying table. Declines have been particularly large
in East/Southeast Asia and in Latin America, where
U.S. aid has been concentrated. In South Korea, for
example, the population of married women of child-
bearing age practicing family planning rose from nine
percent in 1964 (before U.S. assistance) to 55
percent by 1980; in Colombia, from 23 percent in 1969
to 49 percent in 1980; in Thailand, from 15 percent
in 1970 to an estimated 60 percent currently; in
Indonesia, from ten percent in 1973 to an estimated
40 percent currently.
The high standards of U.S. assistance have also
influenced population policies of other donors and
host countries. This U.S. leadership role has
contributed to increasing the LDC share of total
program costs to at least 60 percent; establishing
standards for humane implementation of family
planning programs; strengthening the UN's multi-
lateral efforts through encouraging greater support
from other donors; developing safer, cheaper, and
better methods of family planning; augmenting the
private sector's role in delivery of services;
improving program management; generating better
demographic and population data; and upgrading.. the
quality of medical and paramedical personnel engaged
in maternal/child health and family planning programs.
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6. "What are the present and prospective assistance programs
with other countries and contributions to private and
United Nations organizations in the population area?"
Answer: Current annual expenditures from all sources for
population and family planning programs in the
developing world (exclusive of China) are about one
billion dollars annually. Approximately $400 million
of this total comes from external donors, the.
remainder from LDC's themselves.
In FY 1983, the U.S. allocated $211 million for
international population programs, or only two
percent of total economic and security assistance.
Of this, approximately $91 million or 43 percent, is
in bilateral government-to-government agreements,
including $12.4 million for Africa, $15.0 million for
Latin America, $2.1 million for the Near East, and
$61.1
million for Asia; major Asian
programs
include
$24.8
million for Bangladesh, $16.6
million
for
India,
$6.0 million for Indonesia, $6.0 million for
the Philippines, and $5.1 million for Thailand.
Centrally funded projects amount to $120 million, or
57 percent of the total. This includes $33.8 million
to the United Nations Fund for Population Activities
(UNFPA) and $11.5 million to the International
Planned Parenthood Federation (IPPF). The central
budget also funds biomedical and social science
research; policy development and demographic data
projects; and training, education, and service
delivery activities provided by private organizations
to many LDC's, including a large number not covered
under bilateral agreements--such as Mexico, Brazil,
Nigeria.
Support of population programs from other donor
countries has increased considerably, from under
one-third of total population aid in the early 1970's
to about half at present. The U.S. share of UNFPA's
budget has declined, from 35 percent between 1967 and
1970, to 25 percent in FY 1983. Other major donors
to UNFPA include Japan, Germany, Canada, the Nether-
lands, the U.K., and the Scandinavian countries; in
addition, over 40 developing countries add their own
voluntary contributions to the work of this
organization. World Bank loans in this area.amount
to less than one percent of total annual lending, but
President A. W. Clausen has expressed an intention to
.expand the Bank's role in addressing population
growth issues.
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With regard to prospective assistance, LDC's have
greatly increased requests for population aid. There
is now a backlog of over $100 million in requests to
AID which cannot be funded from current budgets.
Substantial additional assistance will be essential
because of an anticipated doubling in the number of
child-bearing women between 1975 and the year 2000,
coupled with a decline in buying power of donor
support. For example, AID's FY 1983 program of $211
million, although $88 million more than the FY 1972
level, is actually $31 million lower in constant
dollars, or a one-quarter reduction in buying power.
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7. "Are these programs and the activities of the organizations
consistent with the U.S. Government's domestic programs,
practices, or approach in population matters, and would
they, in effect, be acceptable or practiced in the United
States? How is such consistency monitored and what: actions
are taken in the event of inconsistency?"
Answer: U.S. international population assistance operates
under the same principles as domestic family planning
programs. These include voluntary participation,
provision of high-quality services, and offering of a
wide variety of family planning methods, including
natural family planning, in order to maximize indi-
vidual choice. AID regulations on such specific
matters as ensuring informed consent for sterili-
zation, and the prohibition of abortion-related
activities, are incorporated into all grant and
contract documents.. It is also AID's general
practice to provide to other countries only those
contraceptives which have U.S. Food and Drug
Administration approval for use in the U.S. After a
grant or contract is awarded, it is closely monitored
by AID through administrative review and post-audit,
to ensure full compliance with policies. AID will
not support programs where these standards are not
followed.
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8. "More specifically, are U.S. funds contributed to countries
or to private or international organizations that finance
or encourage coercive-measures or abortion? If so, what is
the rationale for such programs or contributions?"
The U.S. does not support programs where there is any
coercive element or compulsion to accept a particular
method of family planning. Recognizing that a given
contraceptive method may not be suitable for every
couple under every circumstance, AID-supported
programs are required to provide information to
prospective clients on various methods of family
planning, and to refer them if necessary to other
organizations in order to ensure a free and informed
choice.
AID policy, in pursuance of Section 104(f) of the
Foreign Assistance Act, prohibits support for abor-
tion or abortion-related activities, including
research on methods of abortion, procurement or
distribution of abortion-related equipment, payment
of fees or training of individuals to perform
abortion, and support for information or communi-
cation programs which promote abortion as a method of
family planning.
All AID-funded population contracts and grant agree-
ments with private and voluntary organizations
(PVO's) and with host governments incorporate
language to prohibit use of AID funds for abortion-
related activities; PVO subgrant agreements also
incorporate such prohibitions. In the few instances
where private organizations directly or indirectly
support abortion-related programs with other donor
funding, AID contractual agreements, administrative
reviews, and audit procedures ensure that no U.S.
funds are utilized for prohibited purposes. In the
case of UN organizations, it is clearly understood by
these organizations that no U.S. funds will ever be
used for activities prohibited under U.S. law, and in
1982, UNFPA assured the U.S. Government that it was
not then supporting abortion activities, nor did it
plan to in the future.
At least 98 percent of the total program of these
organizations is devoted to health and family
planning activities; the United States supports this
element of their programs because it represents the
primary objective of our international population
assistance program. Furthermore, evidence from
several developing countries shows that abortion
rates generally decline when effective methods of
family planning are provided as an alternative to
couples who desire to limit family size.
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9. "Are U.S. cooperative or assistance programs entirely
voluntary on the part of the foreign government? Does the
U.S. in any way condition or link other forms of assistance
to acceptance of assistance or programs in the population
area? What expenditures does the U.S. have for promoting
population programs in other countries, and should we have
expenditures for promotion?"
What expenditures/programs does the U.S. have for analyzing
the implications of population growth?"
Answer: Acceptance of population programs by a host govern-
ment is not a precondition for AID development
assistance. U.S. population assistance is subject to
conditions similar to those applied to other sectors
of development--namely, needs and desire for
assistance, voluntarism, sociocultural acceptability,
and absorptive capacity.
The U.S. does not promote programs contrary to the
policies of sovereign countries. AID has worked with
LDC government agencies, universities, research
institutes, and private organizations, at their
request, to study and analyze development problems,
to explore factors that contribute to these problems,
and to assist in developing appropriate responses.
Activities supported include provision of population
information and access to scholarly work on popu-
lation, research, training, and computer models. AID
also supports social science research, demographic
data collection, vital registration, censuses, and
sample surveys--all necessary for the analysis of
implications of population growth, the study of
social and economic determinants of fertility, and
the evaluation of.family planning and development
projects.
In FY 1983, about $30 million, or 14 percent of the
AID population budget,. is allocated for demographic,
social science, and operations research and
population policy analysis, while $17 million, or 8
percent, goes for information and education
activities.
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10. "What policy and program changes have been made since
January 1981, and what principles guide U.S. population
assistance programs and contributions? How have the
policy, programs, and principles been articulated by
Administration officials to date?"
Answer: The Administration has, in various fora detailed on
page 1 of this response, reaffirmed the U.S. commit-
ment to support humane population policies and volun-
tary family planning programs in friendly countries
requesting such aid, as an essential element of U.S.
development assistance strategy in addressing the
implications of continuing rapid population growth in
the Third World.
In October 1982, AID issued a "Population Assistance
Policy" paper, similar to those approved for other
development sectors, which sets.forth the current
.policy emphases. This Administration places partic-
ular value, in its population assistance, on prin-
ciples of voluntarism and informed choice, and on
support for programs which are consistent with human
dignity, local religious and cultural values, and
stability of the family.
New program emphases articulated in the Policy Paper,
in regulations and program guidance, in Congressional
testimony, and in messages to overseas missions,
include the following:
-- Since 1981, the major focus of U.S. population
programs has been'defined as delivery of voluntary
family planning services, fully integrated into gen-
eral U.S. development assistance.
-- Concerning voluntarism and informed choice, AID
will not support programs in which there-is any
element of coercion to practice family planning or to
accept any particular method of contraception. In
fact, AID-supported programs must. include a descrip-
tion of the effectiveness and risks of all major
methods of family planning and an agreement either to
provide other family planning methods if requested or
to refer couples to programs offering other methods
-- In consonance with Section 104(d) of the Foreign
Assistance Act, AID has reemphasized efforts.-to
integrate or coordinate development programs and
policies in various sectors, including population, so
as to maximize their combined impact.
r--'o t% 1 '- I n -` I T I A
L! tEI Iu . \I-UiL
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-- In January 1981, AID discontinued funding of
research on methods of abortion as a means of family
planning. AID continues to gather epidemiological
data to assess the incidence, extent, or adverse
consequences of abortion. All U.S.-funded population
contracts and grant agreements with private organi-
zations and with host governments incorporate
language to prohibit AID funding for abortion-related
activities.
-- New policy guidance to all missions emphasizes the
importance of integrating natural family planning
training and services into population programs.
-- Relatively greater program emphasis is being
placed on transfer of technology through private
sector research into safer and better methods of
fertility regulation.
-- The Agency-wide emphasis on policy dialogue with
governments will include population and demographic
issues where appropriate.
-- AID has reaffirmed its policy of supplying other
countries only those contraceptives approved by the
Food and Drug Administration for use in the united
States.
-- In February 1981, additional AID program guid-
ance concerning voluntary sterilization was II Lssued,
further clarifying the requirements for informed and
voluntary consent by acceptors of such services.
-- AID does not advocate any specific population
growth rate or size for countries it assists.
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11. "Should National Security Decision Memorandum 314 of
November 25, 1975, and Mr. Brzezinski's memorandum of May
17, 1977, on this subject be revised and/or updated? What
guidelines or alternatives for United states policy and
assistance programs and other contributions in this area
may be desirable or merit further consideration? How
should the U.S. Government be organized for population
matters, and where should prime responsibility for inter-
national population affairs reside?"
Answer: NSSM-200, "Implications of Worldwide Population
Growth for U.S. Security and Overseas Interests,"
submitted in December 1974, and NSDM-314 were
developed under Presidents Nixon and Ford and
reviewed and reaffirmed in May 1977. The fundamental
findings and policy determinations of these documents
have proven a workable basis for U.S. policy. The
growing population problems in many key countries,
combined with the strengths and experience of., U.S.
programs, have led this Administration to maintain
U.S. leadership in this field. We believe that it
would be appropriate and useful to have updated and
revised policy guidance, based upon existing
statements on this subject by the President,
Secretary Shultz, AID Administrator McPherson and
other Administration spokesmen, as well as the
material presented in these responses.
Concerning the organizational framework for inter-
national population matters, the currently shared
primary responsibility of the Department of State and
the Agency for International Development, with the
collaboration as appropriate of such other agencies
as NIH, CIA, and Census Bureau, has proven effective
over many years. Solution of population problems is
an essential part of the development process;
therefore, responsibility for program implementation
should continue to reside primarily in the Agency for
International Development.. There are, however,
foreign policy and national security implications
connected with implementation of population strategy,
as well as various diplomatic activities which can
enhance the effectiveness of U.S. and international
efforts. For these reasons, the Department of
State's role in population policy development and
coordination, diplomatic activities, and represen-
tation remains appropriate.
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