For months, $9.7 million worth of birth control meant for women in low-income countries has sat stranded in a Belgian warehouse — apparently destined for destruction — as a result of the Trump administration's freeze on foreign aid.
The State Department said in July that it would spend $167,000 in taxpayer money to incinerate the contraceptives at the end of the month, despite the fact that they are paid for and unexpired. That drew outrage from humanitarian organizations around the world, who offered to buy and distribute the productives themselves.
"Nobody benefits by this product being burned," Sarah Shaw, associate director of advocacy at MSI, told NPR. "It's an environmental disaster, it's a human rights disaster, it's just a catastrophe on every single level. So it's like, why not just hand it over quietly, hand it over to a third party and let them deal with it?"
But the administration's July deadline came and went, without official confirmation of the stockpile's destruction — creating confusion about the status of the contraceptives and cautious optimism about their survival.
Humanitarians' hopes were seemingly dashed last week, when the New York Times, citing a statement from USAID, reported that the contraceptives had been destroyed. But the next day, it later reported, Belgian authorities entered the warehouse and confirmed the contraceptives were still there.
Belgium's foreign ministry referred NPR's questions to the Flemish Minister of Environment and Agriculture, which has not yet responded to questions about the status of the contraceptives. In another sign of the products' survival, the Flemish sexual health organization Sensoa is holding a protest "against the planned incineration of contraceptives stored in Geel and the refusal to sell them to Belgium" outside the American Embassy in Brussels on Thursday.
One nonprofit, PAI, said in a Friday statement that "we hear one thing from one source and another from a different source," blaming the U.S. government for creating "confusion among civil society and the general public."
But aid groups have welcomed the ambiguity, hoping there is still a chance the birth control pills, implants and injectables — with expiration dates ranging from 2027 to 2031 — can make it to their intended recipients.
According to the International Planned Parenthood Federation (IPPF), 77% of the products were earmarked for five African nations — the Democratic Republic of the Congo (DRC), Kenya, Tanzania, Zambia and Mali — many of which are already facing contraceptive shortages in light of the Trump administration's dismantling of USAID.
The destruction of this single stockpile could lead to 362,000 unintended pregnancies, 161,000 unplanned births, 110,000 unsafe abortions and 718 preventable maternal deaths, according to the Reproductive Health Supplies Coalition (RHSC).
Over 70 U.S.-based and international organizations sent a letter to Secretary of State Marco Rubio on Friday, urging him to scrap the destruction plans and "do everything you can to ensure lifesaving commodities, including contraception, reach people in need."
"Right now, women and girls around the world are desperately seeking out contraception and facing empty shelves," they wrote. "Meanwhile, this administration is choosing to spend taxpayer dollars to destroy effective health and medical supplies that are wanted and needed and that could save and transform lives."
They added that despite the administration's claims otherwise, the fact that the products have not yet been destroyed means "it is not too late to do the right thing."
NPR sent two emails to the State Department asking for comment, on Monday and again on Tuesday morning, but did not hear back in time for publication.
The contraceptives can still save lives
In their letter to Rubio, the humanitarian groups criticized the U.S. government for rejecting "numerous offers to buy or ship the supplies all while spreading deliberate misinformation about contraception."
They are particularly concerned about the State Department's characterization of the birth control products — which prevent pregnancy from happening in the first place — as "abortifacients," which cause the termination of a pregnancy. There are no methods of abortion included in the stockpile, according to humanitarian groups and an inventory list obtained by NPR.
"If this contraception is destroyed under the blatantly false pretense that they are abortifacients, it would be an outrageous act of cruelty," said Beth Schlachter, MSI Reproductive Choices' director of U.S. External Relations. "It would cost lives, derail progress in global health, and strip millions of people of the basic tools they need to plan their families and protect their health."
The U.S. government has "many responsible options available to them" to prevent the supplies from being destroyed, says Rachel Milkovitch, a global health policy specialist with the humanitarian medical aid group Médecins Sans Frontières USA, or Doctors Without Borders. They could sell them to one or more of the NGOs offering to distribute the products, potentially with help from another European government, or even donate them to African countries' ministries of health directly.
"There is $10 million worth of product that has already been paid for that could just be moved out to countries," says MSI's Shaw. "And local health systems will use this product, it will go to good use."
Shaw says getting the stocks — which she described as the equivalent of ten truckloads — from Belgium to other countries, particularly in Africa, could take as many as six months, considering the logistics of shipping and customs, plus distribution within the country.
And she notes that many of these countries have a policy where they will only accept medicines at least two-years before their sell-by date — which could raise questions about the contraceptives set to expire in 2027. But Shaw also notes that it is possible — and in this case, probable — that they would secure waivers to get around that rule.
"Given the extreme shortages that [health] ministries are experiencing, I imagine that they would be very happy to issue waivers because they know that the product is going to get used," she added.
The stranded stockpile is only part of the problem
The U.S. has long been the largest bilateral donor to family planning — it contributed $600 million each year, making up almost half of global donor funding, according to the RHSC.
But that has changed with the second Trump administration. When the State Department froze foreign aid in January, it specifically halted family planning services because it did not consider them "life-saving" — despite vast evidence showing that these services reduce maternal and newborn deaths.
That freeze, and the administration's dismantling of USAID, has left a huge gap in global family planning resources. Humanitarian groups say that's already causing shortages in many sub-Saharan African countries, which the destruction of the $9.7 million stockpile would severely exacerbate.
One group, International Planned Parenthood Federation (IPPF), says that in Kenya — where unsafe abortions are among the five leading causes of maternal deaths — the U.S. funding freeze has left facilities with less than five months' supply of contraceptives, instead of the required 15 months.
IPPF also warned of a shortage of contraceptives, particularly implants, in Tanzania, which has "directly impacted clients' choices regarding family planning uptake." It says the products in the now-stranded stockpile represent "a terrifying 28% of the total annual need of the country."
Shaw, of MSI, says its teams on the ground will have to start turning women away — which will be "life changing" for those women.
"It means girls are going to drop out of school. Women are going to have unsafe abortions. Women are going to die in childbirth," she says. "I mean, this is really a whole generation of women and girls that the trajectory of their life has been changed very quickly because of this."
While aid groups say the contraceptives being held in Belgium are desperately needed, they also acknowledge that their distribution wouldn't fill in the gaping hole left by the U.S.' withdrawal from this space.
The group PAI has said there is an estimated $40 million worth of contraceptives held up at various points in the global supply chain. One example, according to RHSC, is a stockpile worth $1.5 million being held in Dubai.
Milkovitch, of MSF-USA, says it's worth asking questions about all of the contraceptives that are held up — whether in transit, warehouses or elsewhere — and not just the $9.7 million stock in question.
"If we save these supplies, if we prevent their destruction, it doesn't sort of start or end with this," she says. "There's still going to be contraceptive stockouts in the places that previously benefitted from U.S.-supposed family planning and reproductive health programs."
Copyright 2025 NPR