Donald P. Warwick

Contraceptives in the Third World

A move is afoot to liberalize the distribution and augment the testing of contraceptives in the less developed countries. The most active proponents of lowered restriction on distribution have been the United States Agency for International Development and the World Health Organization (WHO). WHO has recently launched a program to establish a network of 20 clinical research centers around the world. The difficulties involved in obtaining genuine informed consent and otherwise protecting the poor research subject are numerous. Another problem is how much testing should be done before a drug is distributed and how much medical supervision is needed. What is needed is an impartial international interdisciplinary and properly qualified private body to analyze the questions of ethics and contraceptives in depth and make recommendations.

Foreign Aid for Abortion

One of the most sensitive subjects in the field of non military foreign assistance is aid for abortion. Consequently, it is very difficult to gather data. Information from interviews was combined with scattered fragments of existing data in the effort to construct a composite picture of the international abortion scene. Apart from any outside intervention, induced abortion is a common practice in developing countries. Abortion is frequent and is a prominent cause of death and illness among women of childbearing age. Foreign aid is a small proportion of the total aid for population activities, and, with the exception of the United Nations agencies, most organizations supplying funds for abortion operate on a clandestine and usually illegal basis. The most common type of foreign aid involves the technique known as uterine aspiration, which goes under various code phases. Abortion can be a profit-making proposition in developing countries. In the United States the politics of abortion have had an overwhelming impact on foreign aid for abortion. As of 1979 only a handful of international donors were involved in direct support of abortion activities in the developing countries; others provided indirect assistance for research, meetings, and information activities. The Agency for International Development (AID) was an ardent supporter of abortion until it was brought to a standstill by the Helms Amendment of 1973. AID was forced to withdraw from most abortion activities. The only agencies operating openly in this field are the World Bank and the United Nations Fund for Population Activities. The International Planned Parenthood Federation has been the most outspoken advocate of legal abortion services in developing countries.

Sensitive Questions about Foreign Aid for Abortion

that is because lay people have never had such an opportunity. They have to learn that they have a legitimate, important role as active partners in establishing the contract (covenant) between the professional and the rest of us. The current AMA principles, as sound as they are, can be no more than a private agreement among AMA members unless the rest of us participate in drawing up the agreement.