Fighting world poverty: count the U.S. out.

Now that the United States has taken some steps to repair its wrecker image at the United Nations--patiently negotiating one resolution giving Security Council backing to international intervention in Iraq and gracefully withdrawing a more contentious one that would have extended U.S. immunity from the International Criminal Court--this is a good time to look at the bigger picture of U.S.-U.N. relations. It's not a pretty one.

It's possible that long after disputes over Iraq fade into history, the damage that Washington has continued to inflict on some of the world body's most crucial work will still be in need of repair. Millions of lives will have been negatively affected.

U.N. member nations--191 countries including the United States--have a decade to make some dramatic improvements in the lives of several billion people if the world hopes to achieve, even partially, any of the ambitious Millennium Development Goals agreed on in 2000. Most of those goals involve big changes in social policy (along with more genuine political commitment) among the governments of poor nations. This isn't just a question of money.

Reducing poverty requires cutting population growth in many places. No, the world doesn't have too few babies; it still has far too many, and in the poorest places. The U.N. Population Division estimates that by the end of this century something like 98 percent of new births will be in the poorest countries.

Progress also involves facing the reality of the abysmal level of the status of women in much of the developing world--not only Muslim or Arab countries, but in gigantic nations like India and Nigeria.

It is in both these goals--reducing population growth and promoting not just women's rights on paper but a sea change in society's view of women and their absolutely central role in development--that poor and rich nations need to work together for the future of the planet's resources, among other things.

The approaching tenth anniversary of the groundbreaking International Conference on Population and Development, held in Cairo in September 1994, is bringing into clear focus how hard the Bush administration and a host of like-minded conservative supporters, Catholic and Protestant, are working to undercut both the message and the long-term success of the Cairo agreements. In Cairo--and with the enthusiastic support of many Egyptians who surprised other delegations with the boldness of their commitment to change--the world decided to stop focusing on numbers and to put people, especially women, at the heart of population policies instead.

In meetings around the world leading up to this anniversary, Washington's emissaries have been sharpening their attacks on the Cairo consensus and trying hard to water down any and all documents that support its concepts.

What is going on when the United States, home to a lot of the freest, most powerful women on earth, is represented by people who quail at words like "reproductive health" and want to excise unambiguous language that gives a woman control of her own body? Millions of American women (and not a few men) are outraged that this should be the image of Americans being broadcast around the developing world.

This state of affairs is most alarming, however, not because of what Americans think but because of what these rollback techniques are doing to poor women and their families everywhere. No longer is the United States content merely to deprive the U.N. Population Fund of all U.S. contributions-nearly $60 million so far if Congress doesn't act very soon on the latest budget request. Washington is also taking aim at organizations-other U.N. agencies and nongovernmental organizations--that work in coordination with UNFPA. At this point in history, do we really want to hurt UNICEF? The World Health Organization? The High Commissioner for Refugees?

I recently returned from a trip sponsored by a group of population organizations and independent foundations that took me to Latin America, Africa, Southeast Asia, and Cairo, where the momentum is still going strong and a new generation of NGOs owes its existence to the 1994 conference. My function was to assess where some developing nations stand ten years after Cairo. Did that conference, or what it stood for, make a difference?

Everywhere, amid many varied impressions, two common themes were clear. A lot more governments that we hear or read about in the U.S. media have taken enormous legal, medical and political steps to tackle not only family planning deficiencies but also the tragedy of female genital mutilation or other harmful cultural practices, domestic violence and bad attitudes toward women in general. In places as dramatically different as Brazil, Ghana and Laos, people talked about behavior change.

Medical officials and women's rights advocates agree that the threat of AIDS helped galvanize public action in some countries, where open discussions of sexuality and behavior would normally be taboo. Admittedly, this epidemic has given a boost to those trying to spread the messages of the Cairo conference. As UNFPA has discovered, the tools of family planning are now medical necessities in many places.

The second impression made in too many places is that people are counting Americans out. The only way to get condoms for any use other than strictly AIDS-related programs, for example, is to jump through hoops of promises to preach abstention and condemn abortion for whatever cause. Raped by a guerrilla army? Too bad. In danger of death in pregnancy from severe anemia, high blood pressure, or uncontrolled diabetes? Better luck next time.

Between the constraints imposed by an ideologically based international family planning policy and congressional micromanagement of how aid is often delivered, many struggling local organizations trying to lay the groundwork for poverty reduction through smaller families and fewer teenage pregnancies can't hope for U.S. help. Yet this country led the world in family planning in the 1960s.

I'll give the last word to Fred Sai, a public health expert, founder of the Planned Parenthood Association of Ghana and a former adviser to the World Bank.

"The American Christian right is either confused or are confusing the masses" he said in a conversation in his home in Accra, the Ghanaian capital. "I can't understand how people who want to forbid contraception, forbid abortion, and at the same time--knowing what is happening in our country--claim to be pro-children and pro-family. I don't say they shouldn't be moral. That's not an issue. Let people follow society's morality by all means. But don't mix it with public health."

"It almost looks as it they feel there should always be beggars around," he said.

Barbara Crossette is a writer on foreign affairs and a columnist for U.N. Wire, from which this article has been reprinted with permission.