"I think a lot of people don’t realize the U.S. is the largest donor to global health and one of the largest international family planning donors," says Chloe Cooney, director of global advocacy at Planned Parenthood Federation of America . "You can’t overstate how important the funding is. It really is the difference between life or death for so many people." But as many countries have liberalized their abortion laws over the past 20 years, U.S. still refuses to support any health programs that incorporate abortion care — and in some areas, care funded by the United States Agency for International Development (which oversees a $20 billion budget and counts five African countries among its top 10 aid recipients ) is the only care available."There are districts that wholly depend on USAID funding to run their reproductive health programs," says Joachim Osur, PhD, technical director of reproductive and child health for Kenya-based Amref Health Africa . "If you go to a hospital fully supported by USAID, women in those places will not get [abortion care]... As a health worker, I have come across a number of women who have suffered injuries, some have died, some have lost their uteruses at a very early age because of unsafe abortion." (Young women are particularly vulnerable to sexual violence and then unsafe abortion: In Kenya, for example, 32% of women experience sexual violence before age 18, and an estimated third of girls who are raped will become pregnant as a result.)"The interpretation is that women living in the U.S. are more of human beings than women living elsewhere in the world," he continues. "It is an injustice when we know what to do to save life and we can’t do it."