by Beth Fredrick, Executive Vice President

Originally published by the Global Health Magazine.

All eyes will be on Barack Obama as he makes his inaugural address and in the early days of his administration. With foreign policy and women's issues front and center during election season, women around the world will be listening carefully to hear what commitments the new president will propose. Since they know the impact of U.S. policy firsthand, they will also be paying close attention to the reaction from Congress.

Since the 1980s, presidents have used the early days of their administration to volley restrictions on funding for family planning back and forth - rescinding and reimposing the Global Gag Rule. This time, women will be asking for more: a bold agenda to protect human rights and a new form of "emergency relief" to keep women alive and healthy.

Money may be tight, but wise investments in women are overdue. Death and injury resulting from pregnancy, including from unsafe abortion, can be eliminated without expensive new technologies or drugs. In proposing a spending plan for the billions of dollars already allocated to AIDS relief, the president can empower women and girls against HIV. By speaking out forcefully from his first day in office forward, violence against women can become a thing of the past; never condoned, and always prosecuted as a criminal act.

One of the first items on deck for the administration and Congress will be an overhaul of U.S. foreign aid. Many proposals to alleviate global poverty are ready and waiting to be considered in a development assistance makeover. All focus on the poorest of the poor, yet few acknowledge that 70% of those living on less than $1 a day are women. To achieve the stated goals of the U.S. foreign assistance program, any reform effort needs to expand and strengthen protections for the human rights of women and girls everywhere, especially in the poorest countries where doing so will help to fight poverty.

Then the new president, working with Congress and national governments, can ensure that women have access to the health information and services they need. They can also take steps to enable women and girls to marry by choice, not force; have the legal right to start their own businesses; own land; or take men to court when they rape or beat them, including in their own homes.

Equally urgent is the need to keep the 1.3 billion women of reproductive age (15-44 years old) living in poor countries alive and healthy by fully funding the provision of sexual and reproductive health information and services. In the poorest countries in the world, women go without the most basic health care because these services are considered nonessential or controversial. According to the World Health Organization, sexual and reproductive ill health accounts for one-third of the global burden of disease among women of reproductive age and close to 20% of the overall burden of disease.

Simple interventions - for example, access to treatments for common problems resulting from pregnancy, childbirth, unsafe abortion and sexually transmitted infections - can expand on existing and trusted family planning services and save millions of lives. There is every good reason to resume funding of the United Nations Population Fund, a leader in providing such services. The United States can help countries to train health workers, keep buildings and equipment in good condition, or provide strong management to ensure quality of care. The next administration and Congress can chart a course for effectively supporting women faced with unwanted pregnancies and ditch antiquated policies such as those promoting sexual abstinence, which have been proven to be ineffective and waste ever more precious tax dollars.

Finally, U.S. policymakers can work with other donor governments to bring HIV/AIDS funding together with sexual and reproductive health programs. With 85% of new HIV infections occurring through sexual transmission and new infections outpacing the number of those put on treatment, world leaders are calling for a "long-term" strategy to end the pandemic. This means a holistic approach to sexual and reproductive health for women and men, and addressing the underlying factors that make women - especially girls and young women - so vulnerable to ill-health.

On my first trip to Africa in 1997, I was struck by how closely people there follow politics in the United States. They are not alone. For better or worse, when the United States makes a foreign policy decision, lives change. Mr. President, members of Congress, be the change you professed and reshape the future for millions of girls and women and the world. The reward - in lives saved and in sealing the United States' reputation as a global leader for social justice - will be incalculable.

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