Background Briefing with Senior State Department Officials on Protecting Life in Global Health Assistance

Special Briefing
Senior State Department Officials
Via Teleconference
February 7, 2018


MODERATOR: Thank you, sir. And thank you, everyone, for joining us for today’s call. This will be an on-background conference call on Protecting Life in Global Health Assistance. I’ll introduce our participants shortly, but just as a reminder, for attribution, they will be senior administration officials, and the rules of this call will be on background. We will also embargo this until the end of the call.

Today we are joined by [Senior Administration Official], [Senior Administration Official], [Senior Administration Official], [Senior Administration Official], and finally, [Senior Administration Official].

Again, as a reminder, this will be embargoed until the conclusion of the call, but I’ll start by turning it over to our first speaker, [Senior Administration Official One]. Sir, go right ahead.

SENIOR ADMINISTRATION OFFICIAL: Thank you, [Moderator], and thank you all for joining us today. On January 23rd, 2017, President Trump issued a memorandum that reinstated the Mexico City policy for family planning assistance awarded by the U.S. Agency for International Development, and directed the Secretary of State, in coordination with the Secretary of Health and Human Services, to implement a plan to extend the requirements of the reinstated memorandum to global health assistance furnished by all departments and agencies to the extent allowable by law. The Secretary approved an implementation plan on May 9th, and part of that plan was to conduct a review of the effectiveness and impact of the policy’s application, to identify implementation issues, and any other new information that might affect implementation going forward.

The review is the product of an extensive interagency process that solicited input from field offices, embassies and missions, implementing partners, and other interested stakeholders. The State Department, including the Office of U.S. Foreign Assistance Resources, the Bureau of Population, Refugees, and Migration, and the Office of Global AIDS Coordinator, USAID, HHS, and DOD participated in the review. The review summarizes the effort of the U.S. Government agencies and departments’ efforts to implement the Protecting Life in Global Health Assistance policy and identified implementation challenges that have arisen, along with actions to address them.

We are aware of the interest in the policy, and I have several colleagues who can help answer questions, but first I want to provide you with a few bullet points of summary of the report. For implementation to date, the review gathered information from the affected departments and agencies about agreements subject to the policy and activities undertaken for ensuring compliance. The full report will be available later today, and I’ll give you a few highlights here, in each case through September 30th, 2017.

Of the nearly 1,300 total grants and cooperative agreements with global health assistance funding across the U.S. Government, 729 received new funding since the policy’s launch and are subject to the Protecting Life in Global Health Assistance policy. At all affected departments and agencies, nearly all prime partners that have had the opportunity to accept the policy conditions have done so. Prime partners declined to agree to the conditions of the policy in only four instances out of the 733 awards. Many agreements had not yet received global health assistance funding by September 30th, 2017, which means those agreements had not yet received the standard provision during the period of review.

State, USAID, HHS, and DOD have mounted a concerted training effort. Our live and e-learning training efforts reached 5,357 U.S. Government employees, implementing partners, and other stakeholders. Based on internal and external input provided during the review process, affected agencies and departments considered implementation areas that required clarification or further guidance to develop a series of actions we plan to undertake to improve the implementation of the policy.

In addition to input from departments and agencies, we also drew on input from stakeholders, who noted that increased clarity would be beneficial. Several actions relate to the need for additional guidance and steps to ensure a better understanding of the policy and compliance with it across the U.S. Government and our partners.

In addition, in a few areas, the standard provision for grants and cooperative agreements will be changed a bit to better carry out the policy. We also recognize that the initial review has taken place early in the policy’s implementation, and a result, we plan to conduct a further review of the policy by the end of 2018.

We have representatives on hand to provide further details on any agency-specific questions. Thank you.

MODERATOR: Does anyone else have any remarks that they’d like to make? Okay. We can open it up to our first question. Our first question comes from – Moderator?

OPERATOR: Ladies and gentlemen, again, if you’d like to ask a question, please press * then 1 on your touchtone phone. And if you are using the speakerphone, please pick up the handset before pressing the numbers. Again, *1 if you’d like to ask a question. And our first question comes from Matthew Lee from the Associated Press. Please, go ahead.

QUESTION: Hi, thanks for taking my question. I actually have two. One is a logistical one. Can I just ask: Why is this call on background? It seems to me that you – if this policy is a grand success and the previous administrations have been doing it all wrong, that you guys would want to shout from the rooftops or the mountaintops how great this is. So I’d just like to make a plea to have something on the record here.

And then secondly, the – about the policy aspect of it: When you said of the 1,300 total grants, 729 received new funding and are subject to the new rules, what does that say about the other, what, 500 and – 500-odd grants? Do they – I mean, you said that only four grantees declined to agree to the new rules, so I’m just trying to figure out how that – how that – how you – how to juxtapose those two.

SENIOR ADMINISTRATION OFFICIAL: Sure. So as you mentioned, 733 had – we had – 729 of the 733 had accepted the conditions of the policy. Many agreements, however, had not received global health assistance funding by September 30th, 2017, so they were spending down funding from previous contracts, so they actually haven’t been asked whether – they haven’t been asked to comply with the policy as of September 30th.

QUESTION: Okay. That’s 730, so 733 did not need to agree to the new rules and --

SENIOR ADMINISTRATION OFFICIAL: No, I’m sorry, 733 – 733 were up and were asked to agree to the new policy, 729 agreed --

QUESTION: I gotcha.

SENIOR ADMINISTRATION OFFICIAL: -- (inaudible) policy and then the remaining balance between 1,300 and 733 – about 1,300 and 733, so somewhere in the 600-range have – did not – were not asked yet because their funding was not up yet.

QUESTION: Okay. And how much money are we talking about here? Because there were all sorts of – I mean, and the Kaiser Family Foundation said about 2.2 billion in global health funding that goes to 1,275 foreign NGOs could be affected. Do you – do you have – is that an accurate number? Hello?

SENIOR ADMINISTRATION OFFICIAL: We’ll have to get back to you on the specifics of that question.

QUESTION: Okay. But how much money is affected? Can --

SENIOR ADMINISTRATION OFFICIAL: It’s approximately $8 billion in global health assistance and --

QUESTION: No, no, no, I mean in the four instances of grantees not – declining to sign, the ones that were not – funding – that didn’t get funding renewed, how much money is that?

MODERATOR: Hold on, we’re trying to figure out who has the answer here, if someone does.

QUESTION: Okay.

MODERATOR: Okay. Matt, we’ll have to get back with – this is [Moderator]. We’ll have to get back with you on that. We’ll take a look at the numbers.

And if I could just address the other question in terms of why is this call on background, last year when we rolled out this policy, it was also on background, so it’s just in keeping with that. That’s all.

QUESTION: Okay. Well, you would think that the administration would want to tout its success, if this is a success, with some on-the-record comment, but anyway, that’s – I’m done.

MODERATOR: And as you well know, when we do backgrounder calls, they’re on background, so we’re in keeping with that typical way we handle things anyway. But let’s move on to our next question so we can try to get as many in as possible. (Inaudible) the next question.

OPERATOR: And that comes from the line of Carol Morello from The Washington Post. Please, go ahead.

QUESTION: Hi, would you name the four NGOs that declined to agree to the new rules? And could you give us any sense, are there any other donors or donor nations that are stepping in to provide services that now are not going to be provided as a result of the new rule?

SENIOR ADMINISTRATION OFFICIAL: Yes. We do know that four have declined to sign. Two of those grantees have actually made public statements about that the reason for declining was related to PLGHA policy. One of the other prime grantees, or cooperative agreement recipients, is actually with the Department of Defense, and we have not – we do not have specific information on them.

The other is also with global health; however, we are not – we cannot speak to the reasons for their decision to decline funding, and because they have not made public statements. As you know --

QUESTION: What are their names?

SENIOR ADMINISTRATION OFFICIAL: -- both Marie Stopes and International Planned Parenthood Foundation have made public comments. Consequently, those are obviously on record already.

MODERATOR: Okay. That’d provide some information on that. I think we’re ready to take our next question.

OPERATOR: Thank you. And that comes from the line of Nurith Aizenman from NPR. Please, go ahead.

QUESTION: Hi. Two questions. The first is: As you’re looking for the funding, I just want to clarify, I think, what we’re all hoping to get the answer to is, both for the 729 who have agreed how much funding is involved for them, and then for the four that declined, how much funding was on the line that they have – that they declined to take? Those are the figures, I think, it’d be helpful to have.

A related question: Do you know – for the 729 that did agree to accept the funding, do you have any kind of analysis about how many of them are going to need to refrain from some activities that they had been doing prior as a result of complying with the policy?

SENIOR ADMINISTRATION OFFICIAL: In terms of how much funding is actually involved, we are going to have to go back and take a look at that closer to be sure that we could provide a more complete answer on that. The main thing that’s really important for you to recognize is that not a dollar of funding has been diverted from our services. Anything that has been declined in terms of accepting funding from the use – entities that have decided not to sign on to PLGHA, 100 percent of the funding is redirected and reprogrammed in the country and at – in the area to provide the comparable services. So that’s in process as we speak.

MODERATOR: Okay. Next question, please.

OPERATOR: Thank you. Again, if you’d like to ask a question, please press * then 1. And we return to the line of Nurith Aizenman from NPR. Please, go ahead.

QUESTION: Another question is: As you know that there’s that Human Rights Watch Report, and one of the things that they have identified as a concern was a lot of confusion around grantees about what – whether they were covered, what sort of activities were covered, could they – could they engage in training, there’s – and they had made note of the fact that there had been training by USAID, in particular, of staff on it. But their finding was that it hadn’t filtered down; there was still a lot of confusion. Would you agree with that finding by Human Rights Watch? Would you disagree? If you do agree, what are you going to be doing additionally to address the confusion issue?

SENIOR ADMINISTRATION OFFICIAL: Sorry, can – the – can you repeat the middle part of your question one more time? The confusion is with the --

QUESTION: With the recipients, with the potential recipients, that there was a lot of – one of the findings that they had in this report that they sent to you a few months ago was that in their surveys, in particular in Uganda and I think it was Kenya, that they had found that a lot of the NGOs – the foreign NGOs were just confused about whether this applied to them, in what way it applied to them, what kinds of activities were – would no longer be permitted, that they were just – there’s a lot of confusion around this topic.

SENIOR ADMINISTRATION OFFICIAL: Actually, I think that part of the reason that this report was produced was to address any confusion related to implementation. As you’re aware, U.S. Government is the largest bilateral donor in global health programs, and we are firmly committed to the health of women and children and families.

Basically, one of the reasons that this report is being released is to identify the implementation questions that arose. We’re also trying to identify what additional clarity needs to be made in the policy so that it’s really obvious where the lines are drawn, and we also want to facilitate our own entities in country as well as in headquarters so that we uniformly apply the policy across the government.

SENIOR ADMINISTRATION OFFICIAL: And let me just add, in addition, in the next several months, one of the things that we found is we will be developing additional training in compliance tools and publicly available FAQs to help facilitate the implementation to address that confusion that is in the field.

MODERATOR: Okay. Next question, please.

OPERATOR: We have no one else in queue.

MODERATOR: Okay. Does anyone have any final remarks that they would like to make? If not, we will wrap it up and end the call.

Nothing? Okay. Anymore questions anyone out there?

OPERATOR: Again, *1 if you’d like to ask a question. And we do have a question from Nurith Aizenman from NPR. Please, go ahead.

QUESTION: So just two final questions: Where will we actually find the report? Are you emailing it to us? Is it going to be made available online, and at what time?

SENIOR ADMINISTRATION OFFICIAL: It will be online and on the State Department website at – I don't have the URL in front of me right now, but it will be on the State Department website.

QUESTION: What – how soon?

MODERATOR: (Inaudible) what section it will be under?

SENIOR ADMINISTRATION OFFICIAL: F side.

MODERATOR: Pardon me?

SENIOR ADMINISTRATION OFFICIAL: F side, it’s on the F – on the F – it’s on the F part of the State website.

MODERATOR: Sorry, what does that mean?

SENIOR ADMINISTRATION OFFICIAL: (Off-mike.)

MODERATOR: Oh, okay, under the – just to – it’s [Moderator] here. Just to clarify, it’s under the Foreign Assistance portion of our website. And to the question of when it will be posted?

SENIOR ADMINISTRATION OFFICIAL: Around 5:15, 5:30 today.

MODERATOR: Okay. It’ll be posted shortly. It’s just before five o’clock here on the East Coast, so it will be posted shortly and you can find it there.

Thanks, everyone, for calling in. Thanks to all our participants for coming in. The embargo on the call has now been lifted, and if you have any additional questions, you know how to find us. Thank you.