The battle to stop the US from destroying contraceptives for Africa is being fought in Belgium and France.

The first alarm bells rang in late July: several humanitarian and family planning NGOs denounced the Trump administration's intention to imminently destroy a large shipment of contraceptives. USAID, the US aid agency, was storing them in Belgium, awaiting distribution to humanitarian missions, primarily in Africa. This operation, along with the contraceptives, was left in limbo when the US government decided to dismantle its renowned state development agency, which, according to the scientific journal The Lancet, could lead to up to 14 million preventable deaths by 2030.

Washington's order was for the pills, intrauterine devices, and hormonal implants stored in Belgium, estimated to cost nearly $10 million (€8.4 million), to be incinerated in neighboring France. The uproar sparked by civil society in some European countries and the United States appears to have halted, for the time being, a measure that, international organizations warn, puts the health of up to 1.4 million women and girls at risk.

A month later, the shipment, which was supposed to be destroyed in early August, is apparently still stored in the Belgian town of Geel, near Antwerp. Or so NGOs suspect, as the US State Department, which took over after the closure of USAID, refuses to explicitly confirm its status.

"We understand that the stocks are still in Belgium; we don't have definitive confirmation, but the indirect information we've received is that they're still here," says Federico Dessi, director of Médecins du Monde Belgium.

The Belgian government assures us that it is not sitting idly by. "As soon as we learned of the possible destruction of the contraceptive stockpile stored in a warehouse in Geel, the Ministry of Foreign Affairs initiated diplomatic efforts with the US Embassy in Brussels," a spokesperson responded to this newspaper via email. "All possible avenues are being explored to prevent the destruction, including their temporary relocation," she asserts, although she declines to provide details on the status of the negotiations "so as not to affect their outcome."

This decision is an affront to the fundamental principles of solidarity, public health, and sexual and reproductive rights that France defends.

Marine Tondelier, French environmental leader

Pressure is also mounting in France, where the Green Party has called on President Emmanuel Macron to intervene: "This decision is an affront to the fundamental principles of solidarity, public health, and sexual and reproductive rights that France defends," said Green Party leader Marine Tondelier in a letter to Macron. A citizen petition has also been sent to the National Assembly urging "the government to be questioned on this issue and to do everything possible to prevent this incineration on French and European soil."

The Ministry of Health stated that France, "unfortunately, has no legal means to requisition the stockpile , as these are not medicines of major therapeutic interest," and "does not have a supply problem" with this type of product.

Even so, NGOs believe that governments can intervene to prevent contraceptives from being incinerated, a measure they warn makes no sense given their cost, $167,000. "That's more than what it would cost to distribute them," emphasizes Sarah Shaw, director of London-based MSI Reproductive Choices.

It was Biden

In response to a query from EL PAÍS, a State Department spokesperson simply confirmed this week, without clarifying a timeframe, that "a preliminary decision has been made to destroy certain abortive contraceptive products from terminated Biden-era USAID contracts," which do not include "HIV medications or condoms."

Washington, according to the official explanation, is merely complying with the so-called "Mexico City Rule," also known as the Global Gag Rule , which, since its establishment in 1984 by the Ronald Reagan administration, has restricted U.S. foreign aid to organizations that provide, advise on, or promote legal abortion services, regardless of local laws or whether these activities are not funded by U.S. funds. Just days after returning to the White House, Trump reinstated this rule, traditionally upheld by Republican administrations and rescinded by Democrats.

The US government's decision is an intentionally reckless and harmful act against women and girls around the world.

Doctors Without Borders

Despite Washington's silence, social and political organizations in Belgium and France have not lost hope and are taking advantage of this hiatus to redouble pressure on their governments to try to stop the destruction of contraceptives in good condition and with a shelf life of several years. Several NGOs have offered to purchase them, at no cost to the US, or to handle the logistics to ensure they reach their destination.

"The US government's decision is an intentionally reckless and harmful act against women and girls around the world," denounces Médecins Sans Frontières (MSF), which urges the US "to stop the destruction of these contraceptives and deliver them to the ministries of health in the countries that need them most," for which it is offering "technical support," as it has done in the past. "It is unacceptable to think that these medical products would be burned when global demand is so high," emphasizes Rachel Milkovich, MSF's sexual health specialist in the US.

Unwanted pregnancies

According to MSI Reproductive Choices, the products targeted for destruction could prevent an estimated 362,000 unwanted pregnancies , 110,000 unsafe abortions, and 718 maternal deaths. Seventy-seven percent of these contraceptives were to be sent to countries like Kenya, Tanzania, Zambia, and Mali. "Behind these statistics are women and girls who will no longer be able to control whether or when they become pregnant," laments Sarah Shaw, director of the reproductive health group at this London-based NGO.

Already at the beginning of the month, along with about fifteen other civil society organizations in the country, the Belgian branch of Médecins du Monde sent a letter to the Belgian Ministries of Foreign Affairs and Development through lawyers, demanding that they seize the medicines stored on Belgian soil to "prevent their destruction." They never received an official response, Federico Dessi notes, so they are now evaluating further action, including the possibility of sending a letter of formal notice that would legally compel the authorities to explain the steps they are taking.

"We want to encourage ministers to take action and find a way to save these stockpiles, ideally through diplomatic means, so they can be used to meet the needs of vulnerable people who require contraceptives for family planning and the prevention of infectious and communicable diseases," he explains.

Trump has also reinstated the Kemp-Kasten Amendment, which prohibits assistance to "any organization or program that supports or participates in the operation of coercive abortion or involuntary sterilization programs." This, the State Department adds, "includes non-abortive contraceptives provided as assistance to entities that do not make the commitment required by this policy."

The abortifacient argument is “completely false,” Shaw counters, insisting that the US administration “rejected all offers to purchase them.”

“These are not abortion-related items, but contraceptives. And as far as we know, even the current US government policy isn't necessarily against contraceptives,” Dessi notes. “We sincerely believe there's no contradiction between these items and what US policy could be, since destroying them actually undermines public health and, in some ways, contributes to the spread of sexually transmitted diseases in different countries.” Despite the few positive signs, she says they won't throw in the towel: “We hope the governments will reach an agreement.”