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The Trump presidency could be a pivotal moment for the world's neediest people. For the last 15 years, the United States has been the biggest funder of an unprecedented effort to fight disease and lift incomes in poor countries. Now aid groups are asking what a Trump administration will mean for that effort. NPR's Nurith Aizenman reports.
NURITH AIZENMAN, BYLINE: Foreign aid has been a rare topic of agreement between President Obama and Republicans in Congress. It probably doesn't hurt that it only accounts for about 1 percent of the federal budget, but there's more to it than that, says Todd Moss of the Center for Global Development, a Washington think tank.
TODD MOSS: Since the end of the Cold War, we've really seen a consensus within the Republican Party. There's pretty broad agreement that we cannot turn our backs on the world's most needy and desperate people, that that will only come back to bite us.
AIZENMAN: This bipartisan consensus has been particularly strong when it comes to funding global health. Beginning with President George W. Bush, the United States massively ramped up programs to get people in poor countries treatments for HIV/AIDS and malaria. And Moss says that spending has been a key piece of a remarkably successful global effort to help the world's neediest.
MOSS: The last decade has been probably the best in the history of mankind in terms of welfare benefits and reductions of poverty.
AIZENMAN: Eighteen million lives have been saved from HIV/AIDS or malaria since 2000. The number of people in poor countries who live in extreme poverty has dropped by half since 1990. And last year, world leaders meeting at the United Nations vowed to completely eliminate extreme poverty by 2030. I ask Moss, will Donald Trump keep that commitment?
MOSS: Well, I actually think we know very little.
AIZENMAN: Trump barely mentioned foreign aid during the campaign except for comments that were pretty general, like last April when then-Fox News anchor Greta Van Susteren asked him what he'd do about countries that have deep needs.
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DONALD TRUMP: We just can't continue to keep giving, giving, giving. Now, there are countries that can do it.
GRETA VAN SUSTEREN: Would you cut out giving some of this humanitarian aid to these countries that are hurting?
TRUMP: I would try so hard to keep some of these countries going, but, Greta, we are a debtor nation.
AIZENMAN: And regardless of whether Trump downgrades the U.S.'s overall foreign aid contribution, advocates worry particular areas of spending could be vulnerable, like reproductive health. Alison Marshall is with International Planned Parenthood Federation which provides health care to millions of women in over 170 countries.
ALISON MARSHALL: It's become a political football.
AIZENMAN: See; U.S. law has long prohibited foreign aid money from paying for abortions overseas. But in 1984, then-President Reagan took that a step further by barring contributions to aid groups that, quote, "actively promote abortion." And that included giving referrals, advice.
MARSHALL: We'd have to stop counseling. We'd have to stop information provision. We'd have to stop telling women and girls when they came into our clinic what their options are, and we can't do that.
AIZENMAN: President Clinton reversed the policy when he came into office. President George W. Bush reinstated it, and President Obama reversed it again. Trump hasn't said he'd re-impose the ban, but his anti-abortion stance on domestic questions has advocates scared. Marshall says the last time around...
MARSHALL: Clinics had to be closed. Staff had to be laid off, and we just weren't able to offer the family planning services to the women and girls who needed them.
AIZENMAN: Advocates also wonder if Trump's more inward focus could mean his administration will step away from the very vigorous role the U.S. has been playing in putting the rights of women and girls on the international agenda. So far, it's not an issue Trump has really spoken about. Nurith Aizenman, NPR News.
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