I 
109TH CONGRESS 
2D SESSION 
H. R. 4736 
To amend the Foreign Assistance Act of 1961 to authorize assistance to 
provide contraceptives in developing countries in order to prevent unin-
tended pregnancies, abortions, and the transmission of sexually trans-
mitted infections, including HIV/AIDS. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 8, 2006 
Mr. SIMMONS (for himself, Mr. MOORE of Kansas, Mrs. BIGGERT, Mr. KIRK, 
Mr. OBERSTAR, Mr. RYAN of Ohio, Mr. MICHAUD, and Mr. SNYDER) in-
troduced the following bill; which was referred to the Committee on Inter-
national Relations 
A BILL 
To amend the Foreign Assistance Act of 1961 to authorize 
assistance to provide contraceptives in developing coun-
tries in order to prevent unintended pregnancies, abor-
tions, and the transmission of sexually transmitted infec-
tions, including HIV/AIDS. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ensuring Access to 
Contraceptives Act of 2006’’.
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) A deepening crisis in developing countries 
with respect to the availability of contraceptives 
needed for family planning, safe motherhood serv-
ices, HIV/AIDS prevention, and other vital repro-
ductive health care threatens the health and lives of 
millions of people. 
(2) In the next ten to fifteen years, the largest- 
ever generation of young people will enter their re-
productive years. For example, the number of 
women of reproductive age is projected to double in 
Nigeria in the next 25 years. This demographic 
shift, combined with increased demand for modern 
methods of family planning, will increase worldwide 
the number of people who desire to use contracep-
tion by 40 percent. 
(3) The gap between the need for contracep-
tives and funding for such contraceptives is pro-
jected to reach hundreds of millions of United States 
dollars annually by 2015. 
(4) According to estimates based on national 
surveys, more than 200 million women in developing 
countries wish to delay or end childbearing but do 
not have access to modern contraceptives.
(5) An estimated 40 percent of married couples 
in Haiti, 36 percent of married couples in Ethiopia, 
and 32 percent of married couples in Pakistan do 
not have access to contraceptives. In each of these 
countries, average birth rates among women are two 
to three times average birth rates in the United 
States. 
(6) Access to family planning and contracep-
tives is essential in reducing unintended pregnancies 
and, as a result, reducing rates of abortion. 
(7) The provision of modern contraceptives to 
the more than 200 million women in developing 
countries who desire such contraceptives would avert 
approximately 52 million pregnancies each year, and 
as a result, would prevent an estimated 23 million 
unplanned births, 22 million induced abortions, 7 
million spontaneous abortions, 1.4 million infant 
deaths, 142,000 pregnancy-related deaths, and 
505,000 children from losing their mothers. 
(8) In January 2001, the White House re-
affirmed President George W. Bush’s commitment 
to United States family planning assistance efforts, 
stating that ‘‘[the President] knows that one of the 
best ways to prevent abortion is by providing quality 
voluntary family planning services’’.
(9) Experiences in a number of countries in re-
cent years indicate that when long-term, effective 
family planning methods are available, abortion 
rates decline, sometimes drastically. For example, 
between 1988 and 2001, the use of modern contra-
ceptives increased in Russia by 74 percent, while the 
abortion rate declined by 61 percent. Similar experi-
ences in Bangladesh, Bulgaria, Chile, Estonia, Hun-
gary, Latvia, and Romania have shown that in-
creased use of contraceptives is accompanied by a 
decline in abortion rates. 
(10) In addition to reducing unintended preg-
nancies and abortions, condoms are a vital compo-
nent in limiting the spread of HIV/AIDS. Con-
sequently, the HIV/AIDS pandemic is contributing 
to an increased demand for reproductive health sup-
plies. 
(11) The vast majority of HIV infections are 
sexually transmitted and condoms are currently the 
only contraceptive that can protect against this form 
of HIV transmission. Condoms remain an important 
intervention in multisectoral approaches to HIV/ 
AIDS prevention, along with programs that promote 
abstinence and monogamy.
(12) In sub-Saharan Africa, where HIV preva-
lence rates can reach 40 percent of the adult popu-
lation and women constitute 60 percent of people liv-
ing with HIV/AIDS, donors provide an average of 
only 4.6 condoms per adult male annually. 
(13) Family planning services, reinforced by de-
pendable supplies of contraceptives, are also a cru-
cial tool in reducing HIV infections transmitted be-
tween infected pregnant women and their infants, a 
number that reached 800,000 in 2002. The provi-
sion of family planning services, information, and 
counseling can reduce the number of infants infected 
with HIV by 35 to 45 percent. 
(14) In addition to reducing rates of abortion 
and HIV/AIDS, access to contraceptives and other 
reproductive health care services saves the lives of 
mothers and children by helping women avoid high 
risk pregnancies. An increase in the use of contra-
ceptives, which allow women to space the births of 
their children over safe intervals, have been proven 
to reduce maternal and child mortality. 
(15) Complications resulting from pregnancy 
and childbirth are the leading causes of death and 
disability for women in developing countries, result-
ing in more than 500,000 deaths each year. Almost
one-third of maternal deaths and illnesses related to 
pregnancy could be avoided if women in developing 
countries had access to modern, safe, and effective 
contraceptives and other reproductive health care 
services. 
(16) Access to contraceptives and other repro-
ductive health care services are also needed to help 
ease growing population pressures on cropland, 
freshwater, and other finite natural resources. In 
many biologically rich areas, there is little or no ac-
cess to the health services that allow women and 
couples to space or limit births. Consequently, the 
population in these ecologically sensitive areas is 
growing nearly 40 percent faster than that of the 
world as a whole. 
(17) The shortfall in reproductive health care 
services is chronic and growing. The cost of contra-
ceptives needed for family planning and HIV/AIDS 
prevention in developing countries is projected to in-
crease from $954 million in 2002 to $1.8 billion in 
2015. In spite of this upward trend in the cost of 
contraceptives, donor support for contraceptives in 
2002, $197.5 million, was less than 20 percent of 
current overall funding needs.
(18) The consequences of the shortfall in repro-
ductive health care services are devastating. For 
every shortfall of $1 million in funding for contra-
ceptives, an estimated 360,000 additional unin-
tended pregnancies, 150,000 additional induced 
abortions, 800 additional maternal deaths, and 
11,000 additional infant deaths occur. 
(19) Although the United States should be com-
mended for its leadership role with respect to the 
availability of reproductive health services in devel-
oping countries, United States support for such 
services, including funding, has not kept pace with 
the increase in demand for contraceptives, which has 
resulted from the large number of youth entering re-
productive age and the HIV/AIDS pandemic. Since 
1995, United States bilateral assistance for inter-
national family planning programs has decreased by 
35 percent (adjusted for inflation) despite an in-
crease of more than 225 million women of reproduc-
tive age worldwide. 
(20) In addition to the shortfall in funding by 
the United States for reproductive health care serv-
ices, United States policy restrictions have reduced 
donations of contraceptives for developing countries.
(21) Widely shared goals of reducing the need 
for abortion and reducing the spread of HIV/AIDS 
are unlikely to be achieved when United States-do-
nated contraceptives are subject to policy restric-
tions, such as the Mexico City Policy, that limit ac-
cess to such contraceptives. 
(22) The Mexico City Policy, which was rein-
stated in 2001, limits access to contraceptives by 
prohibiting United States family planning assistance 
to foreign nongovernmental organizations that use 
funding from any source to provide abortion serv-
ices, counseling, or referral or to lobby to make 
abortion legal or more available in their own coun-
try. 
(23) The Mexico City Policy has exacerbated 
the existing shortage of contraceptives by ending 
shipments of United States-donated contraceptives 
to 16 developing countries in Africa, Asia, and the 
Middle East and denying contraceptives to leading 
family planning agencies in another 12 countries. 
(24) As an example, the Mexico City Policy has 
forced eight family planning clinics serving thou-
sands of poor women in Kenya to close. Con-
sequently, 
women’s 
access 
to 
contraceptives, 
gynecologic and obstetric care, screening, and treat-
ment for sexually transmitted infections, and vol-
untary counseling and testing for HIV/AIDS in 
Kenya has been severely disrupted. 
(b) PURPOSE.—The purpose of this Act is to author-
ize assistance to provide contraceptives in developing coun-
tries in order to prevent unintended pregnancies, abor-
tions, and the transmission of sexually transmitted infec-
tions, including HIV/AIDS. 
SEC. 3. ASSISTANCE TO PROVIDE CONTRACEPTIVES IN DE-
VELOPING COUNTRIES. 
Section 104 of Foreign Assistance Act of 1961 (22 
U.S.C. 2151b) is amended— 
(1) by redesignating subsection (g) as sub-
section (h); and 
(2) by inserting after subsection (f) the fol-
lowing new subsection: 
‘‘(g) ASSISTANCE TO PROVIDE CONTRACEPTIVES IN 
DEVELOPING COUNTRIES.— 
‘‘(1) 
ASSISTANCE.—The 
President, 
acting 
through the Administrator of the United States 
Agency for International Development, shall furnish 
assistance to provide contraceptives in developing 
countries in order to prevent unintended preg-
nancies, abortions, and the transmission of sexually 
transmitted infections, including HIV/AIDS.
‘‘(2) ELIGIBILITY OF NONGOVERNMENTAL OR-
GANIZATIONS.—Notwithstanding any other provision 
of law, regulation, or policy, in determining eligi-
bility for assistance to provide contraceptives in de-
veloping countries under this subsection, a non-
governmental organization shall not be subject to re-
quirements relating to the use of non-United States 
Government funds that are more restrictive than re-
quirements relating to the use of non-United States 
Government funds that apply to foreign governments 
with respect to eligibility for assistance under this 
subsection. 
‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(A) IN GENERAL.—There are authorized 
to be appropriated to the President to carry out 
this subsection $150,000,000 for each of the 
fiscal years 2007 and 2008. 
‘‘(B) 
ADDITIONAL
AUTHORITIES.— 
Amounts appropriated pursuant to the author-
ization of appropriations under subparagraph 
(A)— 
‘‘(i) may be referred to as the ‘Repro-
ductive Health Supplies Fund’; 
‘‘(ii) are authorized to remain avail-
able until expended; and
‘‘(iii) are in addition to amounts oth-
erwise available for such purposes.’’. 
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