The Trump administration has not delivered $9.7 million worth of contraceptives purchased by the United States to women overseas and is storing them in a warehouse in Belgium, but aid workers are raising concerns that the U.S. government is running out of time to expire them.
CNN previously reported that contraceptives that were supposed to be donated to African countries after being procured by the United States Agency for International Development (USAID) during the Biden administration have not been delivered. They are now being stored indefinitely in a Belgian warehouse, as the United States has discontinued many of its foreign aid programs.
The Trump administration began dismantling the now-defunct USAID in January, leaving a gaping 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 made an “interim decision” to destroy the contraceptives in Belgium at a cost of $167,000.
However, this decision is hampered by regulations in the Belgian province of Flanders, which prohibits the incineration of reusable medical equipment.
A U.S. congressional aide told CNN that contraceptives are primarily long-acting contraceptives, such as intrauterine devices (IUDs). A complete list of supplies shared with CNN by a second source familiar with the warehouse’s inventory shows contraceptives include copper IUDs, rod implants, contraceptive injections, levonorgestrel tablets and ethinyl estradiol tablets.
The list, which details about 5 million items, shows most products have an expiration date of 2028 or 2029, with the earliest expiration date being April 2027.
Since the plan to incinerate the supplies became public knowledge, aid workers have called on the Trump administration to either deliver the supplies to women in Tanzania, Mali, Kenya and other countries, or sell them to NGOs that will do so. Aid workers warn that under-delivery of contraceptives and cuts to family planning programs will increase the economic burden of maternal deaths, unsafe abortions and unplanned pregnancies.
According to these groups, the U.S. government ignored or rejected offers from the United Nations Population Fund (UNFPA), the International Planned Parenthood Federation (IPPF), and a group called MSI Reproductive Choices to purchase contraceptives.
Now aid officials say they are concerned that the U.S. government plans to store the supplies in two Belgian warehouses until they expire and can no longer be used or exported.
“Destination countries, including Tanzania (a major recipient country), as well as Malawi, Bangladesh, the Democratic Republic of the Congo and Kenya, have applied import rules that restrict the import of medicines with certain expiry dates remaining,” Marcel Van Valen, head of supply chain at IPPF, said in a statement earlier this month.
For example, in Tanzania, such long shelf life products cannot be imported if less than 60% of their total shelf life remains, he said.
“Unless a practical solution is found soon, the U.S. government could exploit this gap and hold products until they are technically below import limits, using regulatory compliance as an excuse to justify their destruction,” Van Valen added.
The State Department did not respond to CNN’s questions about the administration’s intentions regarding contraceptive products.
“There is an urgent need to receive these resources before they can no longer be imported,” said Dr Bakari O’Malley, project coordinator for NGO Umati, an IPPF affiliate in Tanzania. “Currently stockpiled contraceptives account for 28% of the country’s annual needs, and not having them already impacts customers’ reproductive health and family planning freedoms.”
The challenges posed by contraceptive stockouts are also exacerbated by significant cuts to USAID programs for family planning services in Tanzania.
“After funding cuts, some programs were scaled back and health workers were removed from the community,” O’Malley told CNN, calling conditions on the ground “difficult.” The doctor said she was concerned that her organization would see an increase in unplanned pregnancies and unsafe abortions.
A US State Department spokesperson previously referred to the contraceptives in limbo in Belgium as “certain abortion contraceptives from a terminated Biden-era USAID contract.”
Whether certain contraceptives are described as abortifacients or as causing abortion is a controversial issue in the United States because of the debate over the moment life begins. However, IUDs primarily work by inhibiting the release of the egg or preventing sperm from reaching the egg.
The American College of Obstetricians and Gynecologists (ACOG) told CNN: “There is no such thing as a contraceptive pill that induces an abortion.”
“By definition, contraceptives prevent pregnancy, not terminate it. IUDs and other contraceptive methods do not cause abortion,” ACOG said.
The Belgian government continues to enforce a ban on the incineration of goods and said it is working to find a diplomatic solution to prevent it.
UNFPA said in August that it “remains capable and willing to purchase and distribute these supplies.” The U.N. agency said it was approached by Chemonix, the contractor that manages the USAID Global Health Supply Chain Program, in February to announce that it might purchase the contraceptives, “but after several weeks of consultation, Chemonix stopped responding to UNFPA.” At the time, a Chemonix spokesperson referred CNN’s questions to USAID.
“Contraceptives save lives. There are more than 250 million women around the world who want to avoid pregnancy but do not have access to family planning,” UNFPA added in a statement.
“UNFPA and its partners estimate that meeting this unmet need for family planning could reduce maternal deaths by approximately 25 percent.”
