Behind the Great Wall. (Letters).

IN HER EXCELLENT ARTICLE on China's population policies Barbara Crossette could have given more credit to the UN Population Fund (UNFPA) for its role in helping China perform the u-turn, based on its acceptance of the Cairo Programme of Action of i994, from a coercive to a voluntary approach to family planning.

In spite of the modesty of the program in financial term--some $3.5 million in 2000 for a country of 1.3 billion people--UNFPA played a crucial catalytic role in formulating and pioneering the "two changes"--in thinking and in methodology--in China's family planning work. I heard Dr. Zhao Baige of the State Family Planning Commission argue this in October 2001, and his view was echoed by the US Embassy in Beijing. This was true for the client-oriented, quality-of-care approach initiated in the pilot counties in 1998, which had already resulted in appreciable decreases in abortion, maternal mortality and female sterilization by 2001. (The policy initiated in these counties has since been extended to 1/3 of all counties in China.) It also applied to the drafting of the new Population and Family Planning Law, enacted in 2002, where UNFPA'S assistance was a key factor.

I cannot think of any program anywhere that achieved so much for so little money. I feel UNFPA deserves our acknowledgement of this remarkable success, and our whole-hearted support for its future work.

NICOLAAS BIEGMAN
Former Netherlands
Ambassador to the UN, head of
the International Review Team
on the UNFPA China country
program, October 2001
Skopje, Macedonia

BARBARA CROSSETTE ACCURATELy states that China's population policy is reforming for the better since Cairo, but it is important not to overstate the changes. Positive changes have occurred at the policy level in the last five years, many supported by international donors like the Ford Foundation and UNFPA. Official family planning policy now includes language promoting informed choice of contraceptives and meeting the needs of clients. But it will take time for these policy changes to alter the reality of China's family planning program for countless rural Chinese women.

China's new population law outlaws coercion in implementing the program and is an important step in controlling the authority of local officials to enforce demographic goals, a clear "signal" to them that coercion will not be tolerated. Pressure to implement those goals as the main criteria for job promotion is the reason officials resort to coercion. However, China's weak legal system--especially in rural areas--has limited capacity to enforce the law, so the message is normative rather than enforceable. Coercion will only disappear when officials' performance in implementing the family planning policy is also evaluated by measuring the protection of clients' rights and informed choice. Such work to develop new measures of family planning performance is underway, but is not yet operational beyond pilot projects. Most of the country is still measuring family planning performance by population target achievement, births averted and contraceptive method coverage. That such revised evaluation criteria is being piloted is an important indication that the intention to change the program is real. The Bush administration and the international community should encourage these changes, not punish UNFPA for its China work by withholding its UNFPA contribution.

JOAN KAUFMAN
Lecturer in Social Medicine at
Harvard Medical School
former Ford Foundation
program officer for
reproductive health in China
Harvard, MA

AS A MEMBER OF THE UK delegation to China to investigate accusations of UNFPA involvement in forced abortions, I can only congratulate Barbara Crossette for setting the record straight. The United Kingdom has been among the most supportive countries to the UNFPA and any allegation regarding the possibility that British taxpayer money could be used to support forced abortions deserves our full attention and a thorough investigation.

It is with this in mind that, together with two colleagues of mine from opposition parties, I conducted a joint fact-finding mission to China in April 2002. Our team spent two-and-a-half days being briefed in Beijing, and then four days visiting two counties in Yunnan province, namely Xianping and Dali. We were able to select the houses and the women that we wanted to speak with, in villages that we selected. We spoke to health professionals, administrators and ordinary women in the street, in clinics and in randomly selected homes. By the end of the mission, our delegation concluded that while there are still problems with reproductive rights in some parts of China, the government is moving in the right direction. The transition to a voluntary, client-oriented approach presents a major challenge to the Chinese government, requiring profound changes in management, training and service delivery systems and in monitoring and evaluation. Most importantly, UNFPA'S involvement appears to be encouraging reformers in their efforts to speed up the transition to a client-centered approach.

The UK delegation was convinced that the UNFPA program is a force for good and is moving China away from abuses. It is vitally important that the UNFPA remains involved in China with continued financial support from the UK and other Western governments.

CHRIS MCCAFFERTY, MP
Chair of the UK All-Party
Parliamentary Group on
Population, Development and
Reproductive Health
London, United Kingdom