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The United States has provided around 40% of financial governments contributed to family planning programs in 31 developing countries, some $ 600 million in 2023 last year for which data is available, according to KFF, a health research organization.

US funding has provided contraceptive devices and medical services to deliver them to more than 47 million women and couples, which should have avoided 17.1 million involuntary pregnancies and 5.2 million dangerous abortions, according to an analysis of the Guttmacher Institute, a research organization on sexual health. Without this annual contribution, 34,000 women could die of avoidable maternal deaths each year, concluded the calculation of Guttmacher.

“The extent of the impact is breathtaking,” said Marie Ba, who heads the coordination team for the Ouagadougou partnership, an initiative aimed at accelerating investment and access to family planning in nine West African countries.

The funding was terminated as part of the Trump Administration of the American Agency for International Development. The State Department, in which the skeletal remains of the USAID were absorbed on Friday, did not respond to a request for comments on the decision to stop funding family planning. Secretary of State Marco Rubio described dismissal assistance projects as a waste and not aligned with American strategic interest.

Support for family planning in the poorest and most populated countries in the world has been a constant political priority for democratic and republican administrations for decades, considered a bulwark against political instability. He also lowered the number of women looking for abortions.

Among the countries which will be considerably affected by the decision are Afghanistan, Ethiopia, Bangladesh, Yemen and the Democratic Republic of Congo.

The money to support international family planning programs is appropriate by the congress and has been extended in the last expenditure bill that maintains the government until September. The State Department’s decision to reduce these programs and other aid programs is the subject of multiple prosecution currently in federal courts.

The Trump administration has also dismissed US funding from the United Nations Sexual and Reproductive Health Agency, the UNFPA, which is the largest contraceptive trial in the world. The United States was the largest donor in the organization.

Although the United States is not the only supplier of contraception in a country, the abrupt end of American financing has created chaos in the system and has already caused the handle of the products.

According to warehouses, it is estimated that $ 27 million in family planning products already purchased by USAID, in warehouses – without programs or employees to unload or hand over to governments, according to a former USAID employee who was not authorized to speak to a journalist. A plan proposed by the new management of the USAID in Washington is that the employees remain to destroy them.

The management of the supply chain was a major objective for the USAID, in all areas of health, and the United States paid to move contraceptive supplies such as hormonal implants, for example, manufacturers in Thailand towards the port of Mombasa, in Kenya, where they were led by trucks to East African warehouses, then to local clinics.

“Gathering the pieces will be very difficult,” said Dr. Natalia Kanem, Executive Director of UNFPA “It has already had a catastrophic impact – this literally affects millions of women and families. The poorest countries do not have the resilient stamp. ”

The United States has also paid data and information systems that helped governments follow what was in stock and what they needed to order. None of these systems has worked since the Trump administration sent a work prescription to all programs that have received USAID subsidies.

Bellington Vwalika, professor of obstetrics and gynecology at the University of Zambia, said that the contraceptives had already started running in certain parts of the country, where the United States provided a quarter of the national family planning budget.

“The wealth can buy the goods they want – it is the poor who should think:” Between food and contraception, what should I get? “” He said.

Even before the United States withdraws from family planning programs, surveys found that around 250 million women of procurement wanted to avoid pregnancy but did not have access to a modern contraceptive method.

At the same time, there had been great progress. The contraceptive demand has increased regularly – with long -lasting action methods that offer women greater privacy and secure protection – in Africa, the world with the lowest coverage. The supply improved with better infrastructure that has helped bring products to rural areas. And the “demand creation” projects, of which the United States has been a major donor, used advertisements and social media to inform people of the range of available contraceptive choices and the advantages of spacing or delay in pregnancies. The growing education levels of women have also increased demand.

Thelma Sibanda, a 27-year-old engineering graduate who lives in a low-income community at the forefront of the Zimbabwean capital, Harare, two weeks ago, received a hormonal implant that will prevent pregnancy for five years, in a free pop-up clinic led by the Zimbabwe population services, which has had a subsidy with multiple USAirs to provide free family planning services.

Ms. Sibanda has a 2 year old son and says that she cannot afford more children: she cannot find jobs in the fractured economy of Zimbabwe, and her husband either. They remain on the $ 150 that he earns each month from a vegetable support. She counted on “hope and faith and natural methods” to prevent another pregnancy since the birth of her son, said Ms. Sibanda, and had wished something more reliable, but it was simply not possible in the budget of her family – until the free clinic arrives in her neighborhood.

With its financing from the USAID, the Zimbabwean organization which provided its implant last year was able to buy six robust Toyota vehicles and camping equipment so that an awareness team can travel to the country’s most remote regions, offering vasectomies and IUDs in pop-up clinics. Since the Trump Decree, they had to stop using all this equipment.

The Zimbabwean organization is a branch of non -profit MSI international reproduction choices, which has intervened with temporary funds so that teams can continue to provide free care to women they can reach, such as Ms. Sibanda. MSI can only cover costs until September.

Ms. Sibanda said her priority was to provide her son with the best possible education, and because tuition fees are expensive, this no longer means children. But many African women have no way of making this type of choice. In Uganda, although the national fertility rate is 4.5 children per woman, it is not unusual to meet women in rural areas with a limited education that have eight or 10 children, said Dr. Justine Bukenya, lecturer in community health and behavioral sciences at the University of Makerere in Kampala. These women are pregnant for the first time in adolescence and have little space between pregnancies.

“As they are 30 years old, they could have their 10th pregnancy-and it is the women who will be affected,” she said. “We lose the opportunity to progress with them. The United States did a very strong job here to create a contraceptive request with these women and mobilize young men and women to go for family planning. ”

Some women who have relied on free or low -cost services via public health systems can now try to buy contraceptives on the private market. But the prices of pills, IUDs and other devices will probably increase considerably without guaranteed and large volume purchases in the United States.

“Consequently, women who previously counted on free or affordable options through public health systems can now be forced to turn to private sector sources – at prices that they cannot afford,” said Karen Hong, head of the UnfPA supply chain unit.

The next donors of family planning after the United States are the Netherlands, which provided around 17% of the funding of the Donor Government in 2023, and Great Britain, with 13%. The two countries have recently announced their intention to reduce their aid budgets by a third party or more.

Ms. BA said that the accent in West African countries where she works was to mobilize internal resources and determine how governments can try to reassign money to cover what the United States provided. Philanthropies such as the Gates Foundation and financial institutions such as the World Bank, which are already important contributors to family planning, can offer additional funding to try to advance products in countries.

“We became so optimistic – even with all political instability in our region, we add millions of women using modern methods in recent years,” said Ms. BA. “And now, all this, support in the United States, politicians, everything is completely gone. Gaps are simply too huge to fill.”