Trump Administration’s Contraceptive Standoff: How Millions in Birth Control Are Being Held Hostage, Jeopardizing Aid to African Nations

The Trump administration is holding $9.7 million worth of US-purchased contraceptives in warehouses in Belgium, prompting concerns from aid organizations that the supplies may be intentionally delayed until their expiration dates. These commodities, initially procured by the US Agency for International Development (USAID) during the Biden administration for donation to various African nations, are now in limbo following the Trump administration’s dismantling of numerous foreign assistance programs and its initial, thwarted plan to incinerate the birth control.

Background on the Standoff

The contraceptives, once destined for countries including Tanzania, Mali, and Kenya, have been indefinitely stored in Belgium. The Trump administration began dismantling USAID in January, impacting international aid budgets for family planning, malaria, HIV, and child hunger. A preliminary decision by the US State Department to destroy the contraceptives at a cost of $167,000 for incineration was blocked by regulations in Flanders, Belgium, which prohibit the burning of reusable medical devices.

The stored supplies primarily consist of long-lasting birth control methods, such as intrauterine devices (IUDs), rod implants, birth control injections, and various tablets. A list of nearly 5 million items indicates that most products are set to expire in 2028 or 2029, with the earliest expiration date recorded as April 2027.

Aid Workers Raise Alarms

Since the plan for destruction became public, aid workers have advocated for the Trump administration to either deliver the contraceptives to their intended recipients or sell them to a non-governmental organization. Organizations such as the United Nations Population Fund (UNFPA), the International Planned Parenthood Federation (IPPF), and MSI Reproductive Choices have reported that their offers to purchase the birth control were either ignored or denied by the US government.

Aid workers have warned that the undelivered contraceptives, coupled with broader cuts to family planning programs, risk increasing maternal deaths, unsafe abortions, and economic strain from unplanned pregnancies. There is growing concern that the US government may be deliberately holding the supplies in Belgian warehouses until they pass their expiration dates or fall below import thresholds, thereby justifying their destruction under regulatory compliance.

Marcel Van Valen, IPPF’s head of supply chain, highlighted that many destination countries, including Tanzania, apply importation rules that limit entry to medicines with a specific percentage of remaining shelf life. For instance, Tanzania requires a minimum of 60% of total shelf life remaining for such products.

Impact on Recipient Nations

Dr. Bakari Omary, project coordinator at Umati, IPPF’s member organization in Tanzania, emphasized the urgency of receiving these resources before they become ineligible for import. Dr. Omary stated that the contraceptives being held represent 28% of Tanzania’s total annual need, and their absence is already affecting clients’ reproductive health and family planning freedoms.

The challenges in accessing birth control are further exacerbated by significant cuts to USAID programs supporting family planning services in Tanzania. Dr. Omary noted that some programs have been reduced in scale, leading to healthcare workers being removed from communities, which he fears will result in a rise in unplanned pregnancies and unsafe abortions.

Ideological Stance on Birth Control

A US State Department spokesperson previously characterized some of the contraceptives held in Belgium as “certain abortifacient birth control commodities from terminated Biden-era USAID contracts.” This description aligns with an ongoing ideological debate in the US regarding the nature of certain contraceptives and the moment life begins.

However, the American College of Obstetricians and Gynecologists (ACOG) disputes this classification, stating there is “no such thing as an abortifacient contraceptive.” ACOG clarified that by definition, contraceptives prevent pregnancy and do not end an existing one, and that IUDs and other forms of birth control do not cause abortion.

International Efforts and Stalled Negotiations

The Belgian government continues to enforce its ban on incinerating the commodities and has indicated efforts to find a diplomatic solution to the situation. The UNFPA reiterated in August its willingness and ability to purchase and distribute the supplies, having been approached by Chemonics, the contractor managing the USAID Global Health Supply Chain Program, in February. However, discussions between Chemonics and UNFPA reportedly ceased after several weeks.

UNFPA has underscored the life-saving potential of contraceptives, estimating that fulfilling the unmet global need for family planning could reduce maternal deaths by approximately 25 percent. Around 250 million women worldwide desire to avoid pregnancy but lack access to family planning resources.

The fate of the $9.7 million in contraceptives remains uncertain as diplomatic efforts continue and expiration dates draw closer. The ongoing standoff highlights the broader implications of policy shifts on international aid and global health, with aid organizations continuing to press for the release of these vital supplies to prevent humanitarian consequences.