Introduction

The U.N. Population Fund (UNFPA) is the world's largest provider of sexual and reproductive health programs and the principal U.N. entity addressing global population issues.¹ In 2020, the organization provided services in over 150 countries and territories, with expenses totaling $1.29 billion, drawn from voluntary contributions from over 170 entities, including governments, organizations, and individuals.²

Members of Congress have long debated to what extent, if any, the United States should fund UNFPA. Since the mid-1980s, some lawmakers have been concerned that UNFPA's country program in the People's Republic of China (PRC) has engaged in or provided funding for abortion or coercive family planning programs. To address these concerns, Congress enacted the "Kemp-Kasten" amendment in annual Department of State, Foreign Operations, and Related Programs (SFOPS) appropriations laws beginning in FY1985. The amendment states that no funds may be made available to any organization or program that, as determined by the President, supports or participates in the management of a program of coercive abortion or involuntary sterilization. Since the mid-1990s, Congress has also required that no U.S. funding to UNFPA may be used for abortions or its program in the PRC.

Administration determinations over whether to fund UNFPA pursuant to the Kemp-Kasten amendment have generally fallen along party lines, with Republicans opposing UNFPA funding and Democrats supporting it. During the past decade, the Obama Administration funded UNFPA, while President Trump declared UNFPA ineligible. President Biden announced in January 2021 that he would restore funding to the organization. Congress appropriated $32.5 million to UNFPA for FY2021 and $32.5 million for FY2022, subject to legislative funding restrictions regarding abortion and UNFPA's China program. For FY2023, President Biden requested $56 million for UNFPA.

This report provides an overview of UNFPA activities and U.S. funding debates. It does not aim to assess the role or status of family planning and reproductive health activities at the global level or in China. For more information on U.S. international family planning efforts and restrictions, see the following CRS reports:

• CRS Report R46215, U.S. Bilateral International Family Planning and Reproductive Health Programs: Background and Selected Issues, by Sara M. Tharakan.
• CRS Report R41360, Abortion and Family Planning-Related Provisions in U.S. Foreign Assistance Law and Policy, by Luisa Blanchfield.

For a brief overview of China's family planning policies, see Appendix A.

UNFPA Overview³

UNFPA is the primary U.N. entity that addresses sexual and reproductive health issues. Since its establishment in 1969, the organization transitioned from focusing mainly on statistical collection and population analysis to providing maternal health and family planning assistance, communication and education, and policy assistance. UNFPA's work is guided by the International Conference on Population and Development (ICPD) Program of Action, which was agreed to by 179 governments, including the United States, in 1994 in Cairo, Egypt. The ICPD represents a notable departure from previous international approaches to population assistance, which often focused on achieving demographic goals and targets. Specifically, the Program of Action recognizes reproductive health and rights, as well as women's empowerment and gender equality, as "cornerstones" of global population and development programs. It also emphasizes that individuals and couples are at the heart of development and have the "basic right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so." The Program of Action further notes that "in no case should abortion be promoted as a method of family planning."⁴ (See the text box below for more information.)

Operations and Governance

UNFPA is headquartered in New York City and supports six regional offices, two subregional offices, and over 100 country offices worldwide. It has more than 3,000 staff and operates in over 150 countries and territories. UNFPA's programs and activities focus on achieving three broad goals by 2030:

• addressing unmet need for family planning by promoting universal access to quality, integrated sexual and reproductive health services (including contraceptive distribution, maternal health services, and sexual and reproductive health education);
• preventing maternal death by strengthening health systems, training health workers, and improving access to reproductive health; and
• reducing gender-based violence by working with policymakers, justice systems, health and humanitarian partners, and men and boys.⁸

UNFPA is a subsidiary organ of the U.N. General Assembly and receives policy guidance from both the U.N. General Assembly and the U.N. Economic and Social Council (ECOSOC).⁹ It is governed by a 36-member Executive Board, which addresses administrative, financial, and program-related issues. Board members are elected by ECOSOC based on geographic representation; the United States serves as an Executive Board member.¹⁰ UNFPA is also guided by an Executive Director, currently Dr. Natalia Kanem, who is appointed for a four-year term by the U.N. Secretary-General, in consultation with the Executive Board.

UNFPA participates in the U.N. system through a range of interagency and intergovernmental processes. It contributes to General Assembly and ECOSOC debates and is a member of the U.N. Chief Executives Board (the key coordinating mechanisms for the heads of U.N. agencies). It also participates in overarching U.N. initiatives on gender-based violence, implementation of the Sustainable Development Goals, and Coronavirus Disease 2019 (COVID-19), among others. At the field level, it works closely with other U.N. entities as part of U.N. Country Teams.¹¹

Funding and Programs

UNFPA is funded by voluntary contributions from governments, intergovernmental organizations, the private sector, foundations, and individuals. Donors generally provide two types of funding:

• core funding is unrestricted in its use and is generally used to fund key UNFPA activities and programs;
• noncore (or "extrabudgetary") funding is earmarked or restricted to specific activities and purposes, such as UNFPA thematic funds or country or issue-specific programs.¹²

Over the decades, noncore funding has increasingly represented the bulk of UNFPA's overall budget and expenditures. UNFPA maintains that core contributions reduce transaction costs, provide financial stability, and allow the organization focus on programs that support its core mission. At the same time, many donors prefer to provide noncore funding to ensure their contributions focus on their policy priorities.¹³

In 2020 (latest available data), UNFPA's expenses totaled $1.28 billion. The organization's overall revenue was $1.32 billion, with contributions from 96 governments and other donors; of this amount, over 60% ($811.2 million) was noncore funding. The largest core donors were Germany ($78.8 million), Sweden ($65.9 million), and Norway ($55.1 million). The largest noncore donors were the United Kingdom ($111.55 million), the Netherlands ($52.2 million), and the European Commission ($49.9 million).¹⁴

Figure 1. UNFPA Worldwide Program Expenses, 2020

Source: Created by CRS. Data from UNFPA.

UNFPA programs are divided into five primary categories (see Figure 1).¹⁵ Similar to previous years, the majority of funds in 2020 were allocated toward programs related to integrated sexual and reproductive health services ($621 million) and gender equality activities ($240 million).¹⁶ Other key programs include analysis on population dynamics/evidence-based policymaking, improving the overall well-being of adolescents and youth, and enhancing organizational effectiveness.¹⁷

UNFPA supported programs in over 120 countries in 2020, allocating funding to developing regions and states experiencing conflict and humanitarian crises¹⁸ (see Figure B-1 in Appendix B). In 2020, the majority of program funding was spent on global interventions and activities (20%), followed by Arab States (19.2%), East and Southern Africa (18.6%), and West and Central Africa (15.9%).¹⁹ Roughly 20% of UNFPA's 2020 program expenses went to five countries: Yemen ($71.7 million), Bangladesh ($37 million), Turkey ($33.3 million), Syria ($32.9 million), and the Democratic Republic of Congo ($28.4 million). For UNFPA's country program in China, total expenses were $21 million (see the text box below).²⁰

U.S. Policy: Background and Funding Debates

The United States played a key role in the establishment of UNFPA. From the mid-1960s onward, Congress expressed increased concern over the impact of rapid population growth on development in low-income countries. In 1967, for the first time, Congress amended the Foreign Assistance Act of 1961 to specifically authorize and direct funds for population assistance programs, urging the United States to channel family planning resources through the United Nations and other international organizations.²³ Through the late 1970s and early 1980s, the United States remained a strong supporter of UNFPA and was one of the largest donors, with contributions rising from $14.2 million in FY1971 (about 50% of UNFPA's total budget) to $38.2 million in FY1984 (about 28% of the total budget).²⁴ At the same time, reflecting broader domestic debates, U.S. policymakers increasingly placed conditions on U.S. funding related to abortion and family planning activities globally, including the Helms Amendment in 1973 and the Mexico City Policy in 1984.²⁵

In the mid-1980s, U.S. policy toward UNFPA shifted. In August 1984, governments, including the United States, met in Mexico City for the 2^nd U.N. International Conference on Population. At the conference, the Reagan Administration announced that no U.S. funding to UNFPA could be used for abortion and called for UNFPA to provide assurances that it was not engaged in, or providing funds for, abortion or coercive family planning programs.²⁶ The Administration's concerns focused primarily on UNFPA activities related to China's coercive family planning practices (see the "Debate over UNFPA's Activities in China" section for more information).

The Kemp-Kasten Amendment

In 1985, reflecting the Reagan Administration's aforementioned concerns, Congress enacted the Kemp-Kasten amendment as part of the FY1985 Supplemental Appropriations Act.²⁷ The measure, introduced by Senator Bob Kasten and Representative Jack Kemp, stated:

None of the funds made available under this Act nor any unobligated balances from prior appropriations Acts may be made available to any organization or program which, as determined by the President, supports or participates in the management of a program of coercive abortion or involuntary sterilization.²⁸

The amendment was created specifically to address concerns related to UNFPA's country program in China. Presidents have not made determinations regarding other organizations.

Congress did not provide details on the meaning of the phrase, "support or participate in the management of a program" in the legislation. However, in the "additional views" section of the House Appropriations Committee Report 99-142, Representative Kemp stated that management of coercive programs may include providing resources to collect and analyze data necessary to the enforcement of such a program; training of the individuals who plan, manage, and carry out such a program; education and publicity about the programs; assistance to the official bodies of government that are charged with developing and implementing such a program; and other such assistance.²⁹

The amendment has been enacted in subsequent annual SFOPS laws since FY1985. Most recently, it was included in the FY2022 SFOPS Appropriations Act.³⁰ Since FY2019 (and in some previous fiscal years), it has included an additional provision requiring that the President report on how and why the determination was made within a certain time period:

any determination made under the previous proviso must be made not later than 6 months after the date of the enactment of this Act, and must be accompanied by the evidence and criteria utilized to make the determination.³¹

Other Related Legislative Conditions

In addition to Kemp-Kasten restrictions, since FY1994 Congress has periodically enacted funding conditions for UNFPA in SFOPS appropriations acts. Section 7057 of the FY2022 SFOPS act requires that

• funds not made available for UNFPA because of any provision of law shall be transferred to the Global Health Programs account and made available for family planning, maternal, and reproductive health activities;
• none of the funds made available may be used for a country program in China;
• U.S. contributions to UNFPA be kept in an account segregated from other UNFPA accounts and not be commingled with other sums; and
• for UNFPA to receive U.S. funding, it cannot fund abortions.³²

Similar to previous years, the FY2022 SFOPS act requires a report on dollar-for-dollar withholding of funds. Specifically, not later than four months after the enactment of the act, the Secretary of State must submit a report to the committees on appropriations indicating the funds UNFPA is budgeting for a country program in China. If the Secretary's report states that funds will be spent on such a program, then the amount of such funds shall be deducted from the funds made available to UNFPA for the remainder of the fiscal year in which the report is submitted.

Debate over UNFPA's Activities in China

Since Kemp-Kasten was enacted, U.S. policymakers have debated whether or not UNFPA's program in China supports or participates in the management of a program of coercive abortion or involuntary sterilization (see Appendix A for an overview of China's family planning policies). Broadly, opponents of UNFPA funding maintain that the United States should not fund an organization that supports, either directly or indirectly, what they view as the PRC government's restrictive and coercive family planning policies. They suggest that even if UNFPA does not directly or knowingly participate in such activities, its partnership and collaboration with PRC entities that implement China's family planning policies violate the Kemp-Kasten amendment. Opponents further argue that U.S. contributions are fungible; any U.S. funding to UNFPA, even if designated for specific purposes, frees up organizational resources for unrelated (and possibly "objectionable") purposes.³³ Some opponents have also questioned whether UNFPA can adequately monitor whether the funding for its China program is being used for designated programs and activities. Others have criticized past statements of support made by UNFPA leaders regarding China's population programs.³⁴

Supporters of U.S. funding note that several onsite investigations, including one by the George W. Bush Administration in 2002, found "no evidence that UNFPA knowingly supported or participated in the management of a program of coercive abortion or involuntary sterilization."³⁵ They also contend that UNFPA has continually been subject to U.S. funding conditions that prohibit funding for abortion or require dollar-for-dollar withholdings from UNFPA's China program, emphasizing that UNFPA is the only international organization subject to such restrictions. More broadly, some contend that U.S. cuts to UNFPA funding may force the organization to reduce family planning services that prevent millions of abortions each year through education and contraceptive delivery. Some also suggest that UNFPA's efforts to advance the ICPD Program of Action through its country program in China may play a role in influencing the government to loosen restrictive family planning policies.³⁶

Administration Kemp-Kasten Determinations

Over the decades, Administrations have used different methods and criteria to make Kemp-Kasten determinations, ranging from in-depth investigations in China to broader statements of policy. In general, Administrations appear to agree that UNFPA does not directly engage in coercive abortions or involuntary sterilization as part of its China program; however, there are varying views as to whether UNFPA violates Kemp-Kasten by operating in the country and/or supporting or partnering with Chinese government agencies. Administration determinations have generally fallen along party lines, with Republican Presidents withholding funding under Kemp-Kasten and Democratic Presidents supporting UNFPA funding. The below chronology provides an overview of Presidents' Kemp-Kasten justifications and statements since 1985.

U.S. Funding

When UNFPA is eligible for funding under the Kemp-Kasten amendment, the United States generally provides core and noncore ("extrabudgetary") contributions to the organization.⁴⁸ Congress usually appropriates funding to UNFPA's core budget through a line item in annual SFOPS appropriations bills or in accompanying explanatory statements or reports.⁴⁹ In both FY2021 and FY2022, Congress appropriated $32.5 million in core funding to UNFPA under the International Organizations & Programs (IO&P) account. (In FY2021, UNFPA also received $20 million in IO&P funding through the American Rescue Plan Act [ARPA, P.L. 117-2] for COVID-19 response and recovery efforts.⁵⁰) Similar to in previous years, Congress directed that funds not provided to UNFPA be reprogrammed to other global health activities and that if funding is provided, the amount of the UNFPA China Program must be deducted from the U.S. contribution. President Biden's FY2023 request for UNFPA funding is $56 million. (See Table B-1 in Appendix B for UNFPA IO&P funding since FY1985 and Figure 2 below.)

Figure 2. U.S. Core Funding to UNFPA, IO&P Account: FY1985-FY2022 (in current U.S. dollars)

Source: Adapted by CRS based on congressional budget justifications, SFOPS legislation, and other documents. Notes: Funding levels represent appropriated amounts in the years in which the United States contributed to UNFPA. In some years, Congress appropriated funding to the UNFPA but none was provided due to Kemp-Kasten determinations or actual amounts were lower due to recessions or other withholdings. Figure does not include U.S. extrabudgetary contributions through other SFOPS accounts (see Table 2). *FY2021 IO&P funding level does not include an additional $20 million in IO&P funding to address COVID-19 through ARPA (P.L. 117-2).

During some years, the United States has also provided noncore (also referred to as "extrabudgetary") funding for specific UNFPA projects and activities. In general, Congress does not appropriate such funding in legislation; instead, it appropriates a lump sum to specific SFOPS appropriations accounts and the executive branch allocates funding based on U.S. global health, humanitarian, and other foreign policy priorities. For example, U.S. extrabudgetary funding increased during the Obama Administration; from FY2014 through FY2016, the United States obligated over $70 million to UNFPA through the State Department's SFOPS Migration and Refugee Assistance account administered by the Bureau of Population, Refugees and Migration (see Table 2).

The full level and extent of such FY2021 funding is not yet available; however, the Biden Administration plans to provide extrabudgetary funding for UNFPA programs in the following humanitarian contexts:

• $2.6 million in response to the Rohingya refugee crisis;
• $1.2 million in response to the needs of crisis-affected women who have fled Ethiopia's Tigray region for Sudan;
• $1.5 million in humanitarian assistance to Afghanistan, focused on returnees and internally displaced persons (IDPs); and
• $1.3 million in humanitarian assistance in Sudan for a strengthened response to gender-based violence to support IDPs and vulnerable populations.⁵¹

The United States also announced $5 million for UNFPA Supplies, which provides contraceptives and maternal health medicines to adolescent girls and women.⁵²

Issues for Congress

Congressional perspectives on UNFPA funding are mixed and, similar to the executive branch, often fall along party lines. Over the years, some Members have considered legislation making various changes to the Kemp-Kasten amendment or removing the provision from law altogether. Other proposed legislation has expressed support for or opposition to UNFPA more broadly.⁵³ During the 117^th Congress, Members may consider the following recurring issues.

Timing and Justification of Administration Determinations

In recent years, some policymakers and observers have expressed concern that Administration determinations under the Kemp-Kasten amendment are delayed and/or lack sufficient justification for the determination.⁵⁴ In an effort to address these issues, since FY2020 annual SFOPS Acts have required that a determination be made within three months and that the executive branch provide the "evidence and criteria" used to make the determination in its justification.⁵⁵ Members may continue to monitor if such requirements are proving effective and adequate for addressing congressional concerns.

Impact of U.S. Withholdings on UNFPA Operations

Some experts and policymakers have expressed concern regarding the impact of U.S. withholdings on UNFPA field operations. In 2017, UNFPA officials stated that the impact of U.S. funding cuts are "direct," and that work is often scaled back across countries where UNFPA operates, not just the China programs targeted by the withholding policy.⁵⁶ Countries with smaller budgets (such as those in Latin America and Eastern Europe) are particularly vulnerable, as are programs that are traditionally supported by the United States (including those in Middle Eastern countries responding to refugee crises).⁵⁷ Recognizing the possibility of ongoing U.S. cuts, UNFPA expanded its advocacy and outreach efforts to governments and other donors in 2019 and was able to maintain its core budget level despite the U.S. withholding (while also falling short of other funding targets).⁵⁸ More recently, UNFPA faced additional budget shortages from the United Kingdom's April 2021 decision to cut 85% of its UNFPA funding as part of broader reductions in foreign aid.⁵⁹

Bilateral Versus Multilateral Population Assistance Funding

Congressional debates regarding UNFPA often occur against the backdrop of broader discussions regarding the role of multilateral and bilateral funding in U.S. foreign assistance. Some experts contend that U.S. funding to multilateral organizations such as UNFPA are a particularly effective use of family planning and reproductive health resources. They argue that such cooperation allows the U.S. government to share related costs with other governments and organizations, as well as to benefit from the convening power and perception of neutrality that U.N. entities such as UNFPA often enjoy.⁶⁰ On the other hand, some argue that the United States should focus on bilateral family planning and reproductive health activities (see the text box below), emphasizing that bilateral approaches may allow for better oversight and alignment with U.S. priorities.⁶¹

Looking Ahead

When assessing U.S. policy and funding for UNFPA in FY2023 and beyond, some Members of Congress might also consider the following issues.

• U.S. membership on the UNFPA Executive Board. The United States currently serves as a member of the UNFPA Executive Board, which approves the organization's policies and budgets. Congress may monitor executive branch priorities in this role related to strategic planning, approval of the UNFPA budget, UNFPA's country program in China, and other issues as they arise.
• UNFPA and the COVID-19 pandemic. COVID-19 prompted UNFPA to reassess and adjust its activities to meet pandemic-related challenges, including disruptions to family planning and reproductive health services and the secondary impacts on women and girls (such as increased rates of gender-based violence and COVID-related disruption to health care, education, and other social services). Congress may consider tracking UNFPA's efforts to incorporate COVID-19 interventions into its activities and its role in broader U.N. system-wide initiatives to mitigate the short and long-term effects of the pandemic.⁶²
• UNFPA and U.N. reform. Congress has long demonstrated an interest in ensuring that U.N. entities operate as efficiently and effectively as possible. Accordingly, some Members may seek to track UNFPA's role in implementing U.N. system-wide development reforms adopted by the U.N. General Assembly in 2019.⁶³ Congress may also monitor UNFPA-specific reform activities, such as efforts to improve programming processes, strengthen results-based management, and improve human resources through enhanced staff mobility and recruiting.⁶⁴

Appendix A. China's Family Planning Policies⁶⁵

China's family planning policies are guided by a national law, the Population and Family Planning Law of the People's Republic of China, which first went into effect in 2002 and has been amended twice, in 2015 and 2021.⁶⁶ The law has never explicitly condoned nor prohibited coercive sterilization and abortion, and has referred to contraception as the main means of family planning.⁶⁷ Article 20 states, "Couples of childbearing age independently choose family planning, contraception and birth control measures to prevent and reduce unwanted pregnancies."⁶⁸ Due to the vagueness of the law's provisions and to variations in regulations at the subnational level, its implementation has varied widely across the country. The law has led to many abuses by local officials attempting to enforce its limitations on births, including forced contraceptive use, sterilizations, and abortions, in some cases late-term abortions.⁶⁹ Furthermore, the law has authorized other penalties for violators of the policy, including heavy fines ("social compensation fees") and job-related sanctions, as well as the denial of public health and education benefits to offspring beyond the number of children permitted by the law.⁷⁰

Between 1980 and 2015, the PRC government imposed what became known outside China as a "One-Child Policy," mostly in urban districts, to curb population growth. Many couples in rural areas were allowed to have two children, and ethnic minorities, including ethnic Uyghurs, often were allowed to have two children per couple in urban districts and three in rural areas. The policy led to many human rights abuses, as well as demographic and related problems, especially among the Han Chinese majority,⁷¹ including sex-selective abortions, a skewed gender ratio (more boys than girls),⁷² and an accelerated aging of the total population.⁷³ In response to demographic trends and popular pressure, in 2015, China's National People's Congress (NPC) amended the Population and Family Planning Law to allow all married couples to have two children.⁷⁴

Despite the general relaxation of population control measures since 2016, birth rates in China have continued to decline, as many couples prefer to have one child, largely for economic reasons.⁷⁵ In 2021, the NPC amended the Population and Family Planning Law for a third time, allowing all married couples to have up to three children, and abolishing the social compensation fees or fines assessed on couples having children beyond the legal limit. As in the past, the law leaves the details of implementation to subnational governments.⁷⁶ Overall, coercive family planning practices in China have declined in recent years, although forced terminations of pregnancies still were reported in some PRC provinces in 2021.⁷⁷

In 2017, the PRC government ordered a crackdown on ethnic Uyghur Muslims in the Xinjiang Uyghur Autonomous Region who had violated China's family planning guidelines, which had been not always been strictly enforced in the region. The government detained many Uyghur and other Muslim minority women in "reeducation centers" for violating family planning laws, calling the violations a sign of religious extremism.⁷⁸ PRC official documents from 2019 reportedly revealed plans for a campaign of mass sterilization of women in rural Xinjiang aimed primarily at Uyghur women with three or more children, as well as some with two children. Xinjiang authorities reportedly also have carried out forced abortions among Uyghurs.⁷⁹ The Department of State included coercive sterilizations and abortions performed on Uyghur women in its January 2021 determination that China is committing genocide.⁸⁰

Appendix B. Additional Information

Figure B-1 illustrates UNFPA country programs by location in 2020. Counties with darker values have higher expenses (the highest is Yemen at $71.7 million), while those with lighter values have lower expenses (the lowest is Chile at $200,000).

Figure B-1. UNFPA Country Program Locations and Expenses, 2020

Source: UNFPA Data Transparency Portal.

Table B-1 lists UNFPA appropriations and executive branch determinations since FY1985, the first year Kemp-Kasten first became law. In some years, executive branch determinations were made in the middle of the fiscal year (for example in January when a new President took office). This affected actual UNFPA funding amounts if funds had already been obligated under the previous Administration.