Barred from burning $9.7 million in birth control, the Trump administration may now be running down the clock

By Lauren Kent, CNN

(CNN) — The Trump administration is holding $9.7 million worth of US-purchased contraceptives in warehouses in Belgium rather than delivering them to women overseas, as aid workers voice concerns that the US government is running down the clock until the commodities expire.

CNN previously reported on the undelivered contraceptives – once slated for donation to various African nations after being procured by the US Agency for International Development (USAID) during the Biden administration. They are now being held indefinitely in warehouses in Belgium as the United States has discontinued many of its foreign assistance programs.

The Trump administration began dismantling the now-defunct USAID in January, leaving a massive hole in international aid budgets for family planning, as well as malaria, HIV, child hunger and other pressing issues.

The US State Department previously said in a statement that it had taken a “preliminary decision” to destroy the contraceptives in Belgium, at a cost of $167,000 for incineration.

But that decision has been thwarted by regulations in Flanders, Belgium, which has a ban on incinerating reusable medical devices.

The contraceptives are mostly long-lasting types of birth control, such as intrauterine devices (IUDs), a US congressional aide told CNN. A full list of the supplies, shared with CNN by a second source with knowledge of the warehouse stock, shows that the contraceptives include copper IUDs, rod implants, birth control injections, and levonorgestrel and ethinyl estradiol tablets.

Most of the products expire in 2028 or 2029, with the earliest expiration date among the products in April 2027, according to the list that detailed the nearly 5 million items.

Since the plan to incinerate the commodities became public knowledge, aid workers have campaigned for the Trump administration to deliver the items to women in Tanzania, Mali, Kenya and elsewhere, or to sell them to an NGO that would. Aid workers have warned that the undelivered contraceptives and cuts to family planning programs will increase maternal deaths, unsafe abortions and economic strain from unplanned pregnancies.

The US government ignored or denied offers for the birth control to be purchased by the United Nations Population Fund (UNFPA), the International Planned Parenthood Federation (IPPF) and an organization called MSI Reproductive Choices, according to those organizations.

Now, aid workers say they fear the US government is planning to hold the supplies in the two Belgian warehouses until their expiration dates render them unusable or unable to be exported.

Lack of contraceptives already impacting women

“Destination countries, including Tanzania (the main recipient), as well as others such as Malawi, Bangladesh, DR Congo, Kenya, apply importation rules that limit entry to medicines with a specific percentage of remaining shelf life,” IPPF’s head of supply chain Marcel Van Valen said in a statement earlier this month.

For example, in Tanzania, these types of long-shelf-life products can’t be imported if less than 60% of the total shelf life remains, he said.

“Unless a practical solution is found urgently, the US government may exploit this gap, allowing the products to sit until they technically fall below import thresholds and then justifying their destruction under the pretext of regulatory compliance,” Van Valen added.

The State Department did not respond to CNN’s questions about the administration’s intentions for the birth control commodities.

“It’s urgent that we receive these resources before they become ineligible for import,” said Dr. Bakari Omary, the project coordinator at the NGO Umati, which is IPPF’s member organization in Tanzania. “The contraceptives being held represent 28% of the country’s total annual need, and not having them is already impacting clients’ reproductive health and family planning freedoms.”

The challenges posed by out-of-stock birth control commodities are also being compounded by broader cuts to USAID programs for family planning services in Tanzania.

“After funding cuts, some of the programs were reduced in scale; their healthcare workers were removed from the communities,” Omary told CNN, describing the situation on the ground as “difficult.” The doctor said he feared his organization would witness a rise in unplanned pregnancies and unsafe abortions.

Ideological debate on birth control

A US State Department spokesperson previously referred to the contraceptives held in limbo in Belgium as “certain abortifacient birth control commodities from terminated Biden-era USAID contracts.”

Whether to describe certain contraceptives as abortifacient, or causing abortion, is a controversial question in the US due to the debate over the moment life begins. However, IUDs primarily work by suppressing the release of eggs, or by preventing sperm from reaching an egg.

The American College of Obstetricians and Gynecologists (ACOG) told CNN that there is “no such thing as an abortifacient contraceptive.”

“By definition, contraceptives prevent pregnancy – not end a pregnancy. IUDs and other forms of birth control do not cause abortion,” ACOG said.

The Belgium government continues to enforce the ban on incinerating the commodities and said it had been working to find a diplomatic solution to prevent that happening.

The UNFPA said in August that it “remains able and willing to purchase and distribute these supplies.” The UN agency said it could purchase the birth control after being approached in February by Chemonics, the contractor managing the USAID Global Health Supply Chain Program, “but Chemonics stopped replying to UNFPA after several weeks of discussions.” At the time, a spokesperson for Chemonics referred CNN’s questions to USAID.

“Contraceptives save lives. Around the world, there are over 250 million women who want to avoid pregnancy but are not able to access family planning,” UNFPA added in a statement.

“UNFPA and its partners estimate that filling this unmet need for family planning could reduce maternal deaths by approximately 25 per cent.”

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