March 3, 2003

President George W. Bush
The White House
Washington, DC

Dear Mr. President:

Refugees International (RI) has learned that the Administration is considering expanding the Mexico City Policy to include all reproductive health programs funded by the US Agency for International Development and the Department of State. RI is deeply concerned that this expansion would be detrimental to the safety and health of millions of refugee and displaced women throughout the world.

Applying the Mexico City Policy to these programs would reduce the already limited capacity of health care organizations to provide services to war affected women and subject organizations to lengthy registration and waiver procedures in order to receive funding. These procedures would inhibit the capacity of organizations to respond effectively in emergency situations, when the ability to provide services on short notice is a matter of life or death. Refugee women, already extremely vulnerable, would lose access to quality health care, leading to increased rates of maternal and child mortality. Integrated health care has proven to be critical in addressing the variety of needs for which women make the effort to seek health care. Family planning and reproductive health services are important because they help reduce the demand for abortion and because they help combat the spread of HIV/AIDS.

Over 75 percent of refugees and displaced persons are women and their children. They face incredible hardships. They have been forced to flee their homes and face great risk of gender-based violence. They are often the sole providers for their families, yet they often lack access to basic services such as healthcare. The US government has traditionally been a strong supporter of health programs for refugee and displaced women. These programs save lives. In many cases, health services are already difficult for refugee and displaced women to access. It would be tragic if these limited services were impeded in any way or no longer supported.

We understand that all Department of State funding for organizations providing health services to refugee and displaced women has been delayed pending a final decision on the implementation of the Mexico City Policy. We have heard reports that these delays have also interrupted other emergency programs, such as food delivery. The US government should continue to support the right of refugee and displaced women to access comprehensive health services for themselves and their children.

Details of the proposed change are vague, which is one reason why the proposal is causing confusion. According to some accounts, foreign organizations would be able to receive U.S. funding for separate programs to address HIV/AIDS, even if other programs run by the organization currently violate the Mexico City Policy. If the Mexico City Policy is expanded, this would be an important exception. However, even this carve-out for separate HIV/AIDS programs could cause uncertainty and delay. It would be tragic if an expansion of the Mexico City Policy undermined your administration's aggressive fight against HIV/AIDS.

I urge you not to expand the Mexico City Policy to health programs affecting refugee and displaced populations. Instead, I ask that you support this most vulnerable group of women by preserving the ability of organizations to respond appropriately and effectively to their integrated health needs. I encourage you to reach the decision not to expand the application of the Mexico City Policy as quickly as possible, so that organizations can resume access to much needed funding to continue their lifesaving work.

Sincerely yours,

Kenneth H. Bacon
President

CC: Colin Powell, Secretary of State
Arthur E. Dewey, Assistant Secretary of State, Bureau of Population, Refugees,
and Migration