There's a new twist in the saga of the U.S.-purchased contraceptives intended for sub-Saharan Africa and stuck in Belgium since the Trump administration scaled back foreign aid earlier this year.
This week, questions were raised about whether the stockpile, originally valued at $9.7 million, might be bigger than previously thought. And an official on the ground said some of those products have gone bad.
Authorities in the Flanders region of Belgium confirmed that in addition to the four truckloads' worth of unexpired birth control sitting in a warehouse in the city of Geel, another 20 truckloads of supplies ended up in the village of Kallo but were stored improperly and are therefore unusable — at least as contraceptives.
"The medicines in the 20 relocated shipments, due to non-compliant storage, cannot be brought back into circulation," Jo Brouns, the Flemish minister of the environment, wrote in published responses to a lawmaker's question. "On the other hand, the medical devices in these shipments, such as syringes for injected contraceptives, are still eligible for reuse — provided the other pharmaceutical requirements are met."
Along with the dismantling of the United States Agency for International Development (USAID) earlier this year, the U.S. specifically halted family planning programs — for which it had long been the world's largest bilateral donor — because it did not consider them lifesaving, despite vast evidence showing such services reduce maternal and newborn deaths.
As a result, a shipment of contraceptives that had been earmarked for girls and women in a number of low-income countries — including the Democratic Republic of Congo, Kenya, Mali, Tanzania and Zambia — ended up stranded in Belgium.
Several aid groups tried to buy and redistribute the supply of IUDs, implants and pills, but said the U.S. rejected their offers. The Trump administration has cited a policy that bars foreign organizations from using U.S. funds to provide abortion services, even though the products in the stockpile do not include any abortion methods.
Then, in July, the State Department confirmed that it planned to use taxpayer money to incinerate the products in France by the end of the month, even though they wouldn't expire until 2027 at the earliest.
That sparked an outcry from humanitarian groups worldwide, including the Reproductive Health Supplies Coalition (RHSC), which said the destruction of the single stockpile could result in 362,000 unintended pregnancies, 161,000 unplanned births, 110,000 unsafe abortions and 718 preventable maternal deaths.
The government's late-July deadline came and went without confirmation of the destruction, giving aid groups hope. And in September, after USAID told The New York Times that the stocks had been destroyed, Belgian authorities checked the warehouse and confirmed they were still there.
As Brouns confirmed this week, it turns out those weren't the only contraceptives left in limbo.
What's in those truckloads? The disclosure raises more questions
Brouns said his administration conducted an on-site inspection of the warehouse in mid-August after hearing the products were being shipped to France.
"There appeared to be no planned shipments to France," he wrote. "However, it was determined that 20 of the 24 shipments in total had already been transferred to another storage location in Kallo, which is not specifically equipped for the storage of medicines."
It is not clear exactly what kinds of products were transferred to Kallo or if they were part of the original stockpile. NPR has reached out to the State Department for more information but did not hear back by publication time.
Marcel van Valen, head of supply chain at International Planned Parenthood Federation (IPPF), told NPR over email they believe the 20 truckloads are "additional products at risk of incineration" on top of the $9.7 million in the warehouse.
Aid groups want the rest distributed before it's too late
Brouns, the Flemish minister, stressed that while the contraceptives in Kallo cannot be reused, their medical hardware can. That's in addition to the shipments stored in the Geel warehouse.
Brouns wrote that his administration is in close contact with the minister of foreign affairs, adding that "diplomatic discussions and efforts are indeed crucial for these resources to still be put to (re)use." Reuters reported in October that such talks between the U.S. and Belgium were paused during the government shutdown.
Humanitarian groups are calling on the Trump administration to release the products — either to a nongovernmental organization or a foreign government.
Chiara Cosentino, coordinator for Countdown 2030 Europe — a coalition of European reproductive rights organizations — said in a statement that the administration's "apparent strategy is to let these life-saving supplies expire rather than share them with those who need and want them."
"It is unacceptable that the Trump Administration is holding hostage more than $9.7 million worth of U.S.-funded contraceptives — along with the health and well-being of 1.4 million women and girls in the Global South," she added.
The sub-Saharan African countries where these products are needed — many of which are already experiencing humanitarian crises — are facing worsening contraceptive shortages as a result of the Trump administration's reduction in foreign aid.
"Since the discontinuation of USAID support, it has become much more difficult to continue our services," Dr. Bakari Omary, project coordinator of IPPF's member association in Tanzania, said in a statement. "Previously, anyone who wanted to avoid pregnancy could come to us and choose the contraceptive that suited them. Now women have to switch to whatever is available, or we cannot help them."
Reproductive health advocates say the products stuck in Belgium are only part of the problem and that there are likely more contraceptives held up at other points in the global supply chain. One group, PAI, says the value of contraceptives supplies already purchased by the U.S. government but stuck in limbo at risk of expiration could be as high as $40 million.
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