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From Population Control to Reproductive Rights: Understanding Normative Change in Global Population Policy (1965-1994)

2004; Taylor & Francis; Volume: 18; Issue: 2 Linguagem: Inglês

10.1080/1360082042000207483

1469-798X

Paige Whaley Eager,

Global Peace and Security Dynamics

Abstract This article examines the process of normative change and nascent norm emergence in areas of global policy making through the convening of UN global conferences. Specifically, the article is a case study of how the norms and discourse undergirding and legitimising global population policy have changed from population control to reproductive rights through the passing decades. The United Nations, as a main site of discursive and normative contestation, provides opportunities for global social movements to lodge oppositional claims against states and other actors in world politics. A constructivist approach is used to identify five processes integral to understanding mutually constitutive and fluid agent-structure processes of normative change and nascent norm emergence in global population policy. This research contributes to the extant constructivist literature on the process of norm emergence by suggesting one processual model that can illuminate other cases of norm formation, maintenance, and change regarding other transnational issues. Notes The population control movement included the United States, as the main state actor, research universities, foundations such as the Rockefeller Foundation, and an epistemic community of demographers, largely based in the United States. Defined broadly, population control policies rest on three basic assumptions: rapid population growth is a primary cause of the Third World or developing world's development problems or, in other words, the developing world was not modernising and developing as it should since population growth was outstripping economic growth. A second assumption of population control is that people must be persuaded, or forced if necessary, to have fewer children without fundamentally improving the conditions in which they live. With this assumption often came draconian population control policies where women and sometimes men would be forcibly coerced through the use of incentives and disincentives to have fewer children than otherwise they might desire. A third assumption was that birth control techniques could be delivered to women in the developing world on a massive scale which would help to solve what had been termed "the population problem or explosion" in the Third World. Reproductive rights can be defined broadly in terms of power and resources: the power to make informed decisions about one's fertility, childbearing, gynaecological health, and sexual activity, as well as the resources to carry out such decisions effectively and safely. A norm is defined as shared expectations of appropriate behaviour for an actor with a given identity. Acceptor was one of the generic labels used by those advocating macro-level population control programmes. An acceptor was a woman who began using a modern birth control method including diaphragms, oral contraceptives, and IUDs. The term acceptor is an indication of how the early population control movement viewed women as objects who needed to accept passively, for their own good, Western-directed family planning measures. See, for example, the World Population Plan of Action (1974) from the Bucharest conference on Population and the Mexico City Declaration on Population and Development (1984) from the Mexico City Conference on Population. Bearing in mind that constructivism is not a theory of politics per se but rather a social theory on which constructivist theories of international politics are based, a constructivist approach to international relations, or more broadly world politics, focuses on understanding how intersubjective agreement is reached by both state and non-state actors regarding appropriate forms of behaviour. Constructivists in general often study ideas, interests, norms, and identity puzzles. Emanuel Adler, "Seizing the Middle Ground: Constructivism in World Politics", European Journal of International Relations, Vol. 3, No. 3 (1997), pp. 319–363. Martha Finnemore and Kathryn Sikkink, "International Norm Dynamics and Political Change", International Organisation, Vol. 52, No. 4 (1998), pp. 887–917. Finnemore and Sikkink have identified our lack of knowledge regarding norm emergence as lacunae in the constructivist-inspired norms literature. For a similar analysis, see Paul Kowert and Jeffrey Legro, "Norms, Identity, and their Limits: A Theoretical Reprise", in R. Jepperson, A. Wendt and P. Katzenstein (eds.), The Culture of National Security: Norms and Identity in World Politics (New York: Columbia University Press, 1996). See Gary Goertz and Paul F. Diehl, "Toward a Theory of International Norms: Some Conceptual and Measurement Issues", Journal of Conflict Resolution, Vol. 36, No. 4 (1992), pp. 634–664. Goertz and Diehl study the norm of decolonisation. See also Audie Klotz, "Norms Reconstituting Interests: Global Racial Equality and U. S. Sanctions against South Africa", International Organisation, Vol. 49, No. 3 (1995), pp. 451–478; and Thomas Risse, Stephen Ropp and Kathryn Sikkink (eds.), The Power of Human Rights: International Norms and Domestic Change (Cambridge, MA: Cambridge University Press, 1999) on international human rights norms. For reviews on constructivism, see Adler, op. cit.; Karin Fierke and Knud Erik Jorgensen (eds.), Constructing International Relations (New York: M. E. Sharpe, 2001); and Steven Bernstein, "Ideas, Social Structures, and the Compromise of Liberal Environmentalism", European Journal of International Relations, Vol. 6, No. 4 (2000). Klotz, op. cit.; Richard Price, "Reversing the Gun Sights: Transnational Civil Society Targets Land Mines", International Organisation, Vol. 52, No. 3 (1998), pp. 613–644; and Finnemore and Sikkink, op. cit. A regime is voluntarily agreed upon sets of principles, norms, rules, and procedures around which actor expectations converge in a given area. Stephen Krasner, International Regimes (Ithaca, NY: Cornell University Press, 1983), p. 1. There were two previous conferences on population held in 1954 (Rome) and 1965 (Belgrade). Both of these conferences, however, were largely attended by demography experts. Few governments sent official delegations, and representation from women's health and rights NGOs was not apparent. At the 1965 gathering, UN Secretary-General U Thant relayed a message from US President Lyndon Johnson. It read: "It is my fervent hope that your great assemblage of population experts will contribute significantly to the knowledge necessary to solve this transcendent problem. Second only to the search for peace, it is humanity's greatest challenge." Marshall Green, "The Evolution of US International Population Policy, 1965–92: A Chronological Account", Population and Development Review, Vol. 19, No. 2 (1993), p. 306. Most reviews agree that constructivism does not constitute a theory of international relations per se in the same sense that realism, neoliberalism, or Marxism does. In fact, many critics have suggested that constructivism is theoretically empty. However, regardless of whether one looks at norms, discourses, rules, representations, or other labels for intersubjective understandings, constructivists do embrace a common core set of research concerns and seek to understand how certain ideas get taken for granted (i.e. population growth needs to be controlled in the developing world) while others remain unspoken or marginalised (i.e. women do not have a right to reproductive autonomy). William Sewell, "A Theory of Structure: Duality, Agency, and Transformation", American Journal of Sociology, Vol. 98, No. 1 (1992), pp. 1–29. Sewell characterises the problems we face when using the language of structure. First, structuralist arguments tend to assume a far too rigid causal determinism in social life so that we lose sight of agency or the efficacy of human action. Second, it is difficult to deal with change when talking about structure because the metaphor of structure implies stability. Third, structures need to be regarded as a process and not a steady state. It is difficult not to reify in international relations. Reification is giving a concrete reality to what is in fact an abstract concept of analysis. For example, some critics claim that realists have reified the state, attributing to it human characteristics such as rationality or treating the state as if it operated in the international system like an actual human being. Dale Copeland, "The Constructivist Challenge to Structural Realism", International Security, Vol. 25, No. 2 (2000), pp. 189–191. Consistent with constructivist methodology, this single case study utilises the following methods of data collection: interviews, primary document analysis, and secondary resources. Through data source triangulation, a single case study researched well can illuminate questions of broader theoretical relevance and significance. A case study is appropriate when the form of the research question is how or why, in a situation in which there is no control over behavioural events, and when there is a focus on contemporary events. See Robert K. Yin, Case Study Research: Design and Methods, 2nd edn (Thousand Oaks, CA: Sage, 1994). Case studies are able to address a variety of evidence and serve five main purposes: testing theories, creating theories, identifying antecedent conditions, testing the importance of antecedent conditions, and explaining cases of intrinsic importance. See Stephen Van Evera, Guides to Methods for Students in Political Science (Ithaca, NY: Cornell University Press, 1997), p. 67. Although this research is an examination of one detailed case study, informed observations will offer insights on the process through which norms change and emerge in issue areas of global policy making. Using an inductive method, this case study is consistent with process tracing. In process tracing, the investigator explores the chain of events or the decision-making process by which initial case conditions are translated into outcomes. By invariant model there is no attempt to posit causality or covering laws. This is not to argue that if an actor (individually or collectively) wants to change an existing norm or propagate a new norm, it/they must do X, Y, and Z in order to "succeed" in effecting normative change. Instead, small-t truth claims are made. "They [constructivists] arrive at logical and empirically plausible interpretations of actions, events, or processes about the subjects they have investigated." See Richard Price and Christian Reus-Smit, "Dangerous Liaisons? Critical International Theory and Constructivism", European Journal of International Relations, Vol. 4, No. 3 (1998), p. 272. Most secondary resources on this topic refer to the emergence of an international women's health movement (IWHM) in the 1970s. However, referring solely to women's health groups is too narrow a conceptualisation. The GWHRM is best conceptualised as a global advocacy movement. There is no one organisation that encapsulates everything this movement is trying to accomplish. NGOs such as the International Women's Health Coalition, Women's Environment and Development Organization, Development Alternatives with Women for a New Era, International Planned Parenthood Federation, and Women's Global Network for Reproductive Rights are just a few of the organisations which can be situated within the GWHRM. A global advocacy movement is a loosely connected aggregation of individuals, organisations, governmental actors, and private actors, who may become densely connected at certain points in time, such as when a UN global conference is approaching. Dense exchanges of information and hyper-connectivity may or may not be maintained after the conference has concluded. The term global, as opposed to international, is consciously chosen because international, at least within the traditional international relations literature, implies the study of relations among states. Obviously, relations between states do not alone define this movement. See Richard Price, The Chemical Weapons Taboo (Ithaca, NY: Cornell University Press, 1997). How and why overpopulation became defined as a solvable problem is an important question. For the best explanation, see Peter Donaldson, Nature against Us: The United States and the World Population Crisis: 1965–1980 (North Carolina: University of North Carolina Press, 1990). Donaldson, ibid., p. 2, provides an excellent explanation of demographic transition theory. Ibid., p. 4. Thomas Malthus, in his Essay on the Principle of Population (1798), was reacting against mercantilist philosophy, which pervaded 18th-century European thought. Mercantilism emphasised the value of a large and increasing population for economic growth and prosperity. Malthus, however, observed that increases in food production increase arithmetically while increases in population growth do so geometrically. Today, the neo-Malthusian perspective continues to emphasise the problem of unchecked population growth as the primary obstacle to sustaining the ecological balance of the planet by leading to natural resource depletion, pollution, and a loss of biodiversity. It must be noted that Malthus did not foresee independent fertility control. Instead, Malthus relied upon natural checks on population growth including famine, disease, and war. Green, op. cit., p. 303. Donaldson, op. cit., p. 38. See, for example, the following books on coercive population control programmes: Donald P. Warrick, Bitter Pills: Population Policies and Implementation in Eight Developing Countries (Cambridge, MA: Cambridge University Press, 1982); Donaldson, op. cit.; and Betsy Hartmann, Reproductive Rights and Wrongs: The Global Politics of Population Control (Boston: South End Press, 1995). Rosalind Petchesky, Abortion and Women's Choice: The State, Sexuality, and Reproductive Freedom (Boston: Northeastern University Press, 1990), p. 25. C. Alison McIntosh and Jason L. Finkle, "The Cairo Conference on Population and Development: A New Paradigm?", Population and Development Review, Vol. 21, No. 2 (1995), p. 9. See Donaldson, op. cit., p. 39. Dennis Hodgson and Susan Cotts Watkins, "Feminists and Neo-Malthusians: Past and Present Alliances", Population and Development Review, Vol. 23, No. 3 (1997), p. 487. Stanley P. Johnson, World Population and the United Nations: Challenge and Response (New York: Cambridge University Press, 1987), p. 80. Hodgson and Watkins, op. cit., p. 489. Donaldson, op. cit., p. 124. Hodgson and Watkins, op. cit., p. 489. The Global South has become a popular term in the post-Cold War context to refer to developing countries or Third World countries. Clearly, there are countries within the Global South which would be considered developed countries (i.e. New Zealand and Australia); however, the Global South is a short-hand label used to refer to countries that share the characteristics, in general, of low socio-economic development as compared to countries like the United States, Japan, and the European Union. Often, the Global South/Global North divide is used to discuss the disparities between the haves and have-nots. I would like to thank an anonymous reviewer for this important insight. An important point is to consider how the term reproductive rights has changed to mean a great deal more than simply abortion rights. Most of the pro-life movement does not accept this argument and claims that reproductive rights are simply a euphemism for abortion and nothing more. Members of the GWHRM, interviewed for this research, argue that reproductive rights and health may encompass the right to seek an abortion, depending on a country's laws, but more basically include the right of access to family planning information, to utilise voluntary family planning services free of coercion, discrimination, and violence, and to seek medical treatment for all aspects of reproductive healthcare over the entire life of a woman. Johnson, op. cit., p. 116. Incentives and disincentives may be used by a government to promote pro-natalist or anti-natalist social policies. A pro-natalist social policy encourages women to have more children whereas an anti-natalist agenda encourages a decreased fertility rate per woman, which may decrease population growth. Incentives may include monetary payments to women and husbands to have more children (pro-natalist) or to have only one child (anti-natalist). Incentives may include extended maternity leave for women who have more than two children (pro-natalist) or eliminating paid maternity leave for women who have more than two children (anti-natalist). Jyoti Shankar Singh, World Population Policies (New York: Praeger, 1979), p. 32. To access the verbatim text of NSSM 200, consult the Population Research Institute's Web site online at Executive Summary NSSM 200, p. 4. Retrieved online at on 3 May 2002. Ibid., p. 40. Author interview with Dr Barbara Crane conducted by telephone on 22 May 2002. Hodgson and Watkins, op. cit., p. 492. Petchesky, op. cit., p. 392. Sonia Correa and Rosalind Petchesky, "Reproductive and Sexual Rights: A Feminist Perspective", in G. Sen, A. Germain and L. Chen (eds.), Population Policies Reconsidered: Health, Empowerment, and Rights (Cambridge, MA: Harvard University Press, 1994), p. 52. Claudia Garcia-Moreno and Amparo Claro, "Challenges from the Women's Health Movement: Women's Rights versus Population Control", in Gita Sen et al. (eds.), op. cit., p. 49. Green, op. cit., p. 313. For more detailed analysis of Bucharest and the NIEO, see Jason Finkle and Barbara Crane, "The Politics of Bucharest: Population, Development, and the New International Economic Order", Population and Development Review, Vol. 1, No. 1 (1975), pp. 87–114. Johnson, op. cit., p. 225. Green, op. cit., p. 314. Johnson, op. cit., p. 255. Clearly, a great deal more could be included about China's anti-natalist policy. The Chinese government has been criticised by the United States and other countries for its draconian population control policies. Subsequently, many have used the Chinese case as a prime example of why a government should not be involved in population policy. On the other hand, China has responded by arguing that it is exercising its sovereign right to control its population. Over the years, the policy has become somewhat less stringent depending on where one lives in China. For example, if a couple has a girl the first time, they are often permitted to try again for a boy. Moreover, wealthy families can afford to pay the fines levied by the central government for having more children. A significant number of US Congressional hearings have been held on China's one child policy, and it is still an issue regarding US contributions to UNFPA. UNFPA claims that it does not support coercive population control in China and that its involvement in a pilot programme in 32 provinces in China is directed towards moving Beijing away from such a radical policy. On the other hand, groups such as the Population Research Institute and US Congressman Chris Smith (R-NJ) argue that UNFPA is an accomplice in gross human rights violations against Chinese families. In fiscal year 2003, no US funding was allocated to UNFPA because of the China debate. Author interview conducted on 7 February 2002. See the International Women's Health Coalition's Web site at The bracketing of words or phrases in a draft platform or programme of action indicates that consensus has not been reached. Leading up to Cairo, three major prepcom conferences were held with the goal of removing all brackets before the official start of the Cairo conference. This goal was not achieved. Rhonda Copelon and Rosalind Petchesky, "Toward an Interdependent Approach to Reproductive and Sexual Rights as Human Rights: Reflections on the ICPD and Beyond", in M. Shuler (ed.), From Basic Needs to Basic Rights: Women's Claim to Human Rights (Washington, DC: Women, Law, and Development International, 1995), p. 360. Modernisation theory became popular in the 1950s and 1960s as a way to understand how development should occur in the Third World. The most widely cited source on modernisation theory is Walt Rostow's The Stages of Economic Growth: A Non-Communist Manifesto (London: Cambridge University Press, 1960). According to modernisation theorists, the developing world needed to make progress in economic growth stages to reach the goal of development. The stages were traditional society, pre-conditions for take-off, take-off, the drive to maturity, and the age of mass consumption. The population control movement believed in the stage progression of modernisation theory. Since the developed world had exhibited falling population growth rates, it was assumed that this constituted a necessary condition in order for the developing world to reach development and modernisation. In other words, the developed world or First World was the model that the developing world or Third World needed to follow. Susan Cohen, "The Road to Cairo: Toward a Common Agenda", International Family Planning Perspectives, Vol. 19, No. 2 (1993), pp. 61–66. Other states questioned the United States' motivation in propagating population control, especially at the 1974 Bucharest conference. However, the GWHRM, which included some governmental actors from states supporting reproductive rights and health, was the identifiable actor challenging population control. A norm entrepreneur holds valued and principled beliefs and often seeks to convince a critical mass of states to embrace a new norm (Finnemore and Sikkink, op. cit., p. 893). Moreover, norm entrepreneurs participate in international agenda setting and call attention to existing issues or even create new issues that name, interpret, and dramatise questions. Why did the United States act as a norm entrepreneur? First, because it had the structural power to do so after the Second World War. Second, the Soviet Union, as the other superpower during the Cold War, did not involve itself in population control measures in the developing world. Third, the United States was involved in the development and decolonisation debate. As a country coming to imperialism rather late, the United States did not carry with it the same colonial legacy as Western European countries. Fourth, population control also became constructed as part of America's national security strategy in the 1970s. It is important to make a clear distinction between voluntary family planning programmes and population control programmes. With voluntary family planning, women are presented with all available information, given a choice of contraceptive methods (including the option of not using any contraception), and incentives or disincentives are not used to influence a woman's individual decision. With population control programmes, macro-level societal concerns are first and foremost. Here, women may be presented with only one or two options, all information is not presented, especially regarding side-effects, and the government often uses incentives or disincentives to influence decision making and ultimately reproductive behaviour. It is important to note that many pro-life groups have also called attention to draconian population control policies, particularly against indigenous peoples in the developing world. The difference is, however, that most pro-life groups argue that because of past abuses in family planning programmes, all funding should be eliminated and the government has no role whatsoever to play in providing subsidised or free contraceptives to women. All pro-life groups are opposed to abortion. However, some groups may make exceptions in the case of rape, incest, mother's health, and severe foetal impairment. A few of the more extreme groups are opposed to all types of contraceptives since they prevent conception. The GWHRM, on the other hand, also points out abuses and seeks to transform practices and norms in an effort to call attention to past and present human rights violations of women and men in regard to their reproductive rights, while also maintaining the right to family planning as a human right. Petchesky, op. cit., p. 200. Price and Reus-Smit, op. cit., p. 275. Originally, social movement theory focused on political opportunity structures at the national level. Sidney Tarrow defines political opportunity structures as those consistent, but not necessarily formal or permanent, dimensions of the political environment that provide incentives for people to undertake collective action by affecting their expectations of success and failure. Changes in the political alignments that control the state are often cited as openings or closings for particular social movements. Openings in the political opportunity structure at the national level also include the appearance of rifts within elites, situations where new allies become available, and moments when the state capacity for repression declines. All of these factors can lead to new political actors entering the realm of contentious politics. For example, the domestic political opportunity structure for pro-life and pro-choice movements changed dramatically when President Reagan entered office. Political opportunity structures need to be perceived by organisers and movement participants and then framed in such a way that emphasises expectations of success if collective action is undertaken. Florence Passy, "Supranational Political Opportunities as a Channel of Globalization of Political Conflicts", in D. della Porta, H. Kriesi and D. Rucht (eds.), Social Movements in a Globalizing World (New York: St. Martin's Press, 1999), pp. 148–169. This would make an interesting future comparative case study analysis, examining differences in domestic political opportunity structures for a selection of countries in order to ascertain how receptive governments were to the demands for recognition of reproductive rights and health by domestic social movements. The United Nations declared 1975–1985 the UN Decade for Women, and three global conferences on women were held: Mexico City (1975), Copenhagen (1980), and Nairobi (1985). A fourth global conference on women was held in Beijing (1995). Three global conferences on population and development have been held in Bucharest (1974), Mexico City (1984), and Cairo (1994). Bert Klandermans, The Social Psychology of Protest (Malden, MA: Blackwell, 1997), pp. 91–92. This sense of identity was readily apparent during my interviews with various individuals. Those individuals who supported reproductive rights and health always referred to themselves as we as opposed to they who oppose our agenda. See Thomas Risse, "Let's Argue! Communicative Interaction in World Politics", International Organisation, Vol. 54, No. 1 (2000), pp. 1–39. Here I am referring to the process through which ECOSOC grants certain NGOs consultative status, which enables these NGOs to have a significant impact on conferences, monitoring committees, and other consensus-driven procedures. Most observers note that the 1992 Earth Summit in Rio de Janeiro was a victory for NGOs in general since they collectively had a great deal of influence on the conference preparations, proceedings, and follow-up. David Snow and Robert D. Benford, "Ideology, Frame Resonance, and Participant Mobilization", International Social Movement Research, Vol. 1, No. 1 (1988), pp. 197–217. See, for example, Price, The Chemical Weapons Taboo, op. cit.; Richard Price, "Reversing the Gun Sights: Transnational Civil Society Targets Land Mines", op. cit.; and Thomas Risse, Stephen Ropp and Kathryn Sikkink (eds.), The Power of Human Rights: International Norms and Domestic Change (Cambridge, MA: Cambridge University Press, 1999). Why this is the case is beyond the scope of this inquiry; however, to be perceived and recognised by others in the international community today as a modern, civilised state, a state must uphold some semblance of political and civil rights. Richard Price (1997) makes a similar argument when he addresses how it became institutionalised that states, which resorted to the use of chemical weapons, were viewed by the international community as not part of the civilised world. For an alternative perspective, see Mary Glendon, "Rights Babel: The Universal Rights Idea at the Dawn of the Third Millennium", Gregorianum, Vol. 79, No. 4 (1998), pp. 611–624. These included the International Covenant on Economic, Social, and Cultural Rights, the International Covenant on Civil and Political Rights, the Universal Declaration of Human Rights, the Convention on the Elimination of All Forms of Discrimination Against Women, and the Vienna Programme of Action. See, for example, Risse, "Let's Talk", op. cit. See Charlotte Bunch and Niamh Reilly, Demanding Accountability: The Global Campaign and Vienna Tribunal for Women's Human Rights (New Jersey: Center for Women's Global Leadership, 1994), for an account of the impact of the Vienna conference on women's claims for recognition of universal reproductive rights. See Hodgson and Watkins, op. cit., for an explanation of why this alliance was strategic and beneficial for both movements. For more on the Mexico City Policy, see Peter Donaldson and Charles Keely, "Population and Family Planning: An International Perspective", Family Planning Perspectives, Vol. 20, No. 6 (1988), p. 309. In its 1973 decision in Roe v. Wade, the US Supreme Court recognised that a woman's right to decide whether to continue was protected under the constitutional provisions of individual autonomy and privacy. Finding a need to balance a woman's right with the state's interest in protecting potential life, the Supreme Court established a trimester framework for evaluating restrictions on abortion. For more information see The policy of empowerment and health for all by the year 2000 was further developed at the International Conference on Primary Health Care in Almaty, Kazakhstan (formerly the USSR) in 1978. Reproductive rights activists have utilised the "right to healthcare" principle in order to lend credence to their arguments that women have a right to reproductive health services. The World Health Organisation estimates that 500,000 women die each year from avoidable pregnancy-related causes. Ninety per cent live in developing countries and 10–20% of these avoidable deaths result from unsafe abortions. Moreover, the maternal mortality rates in many developing countries are up to 200 times higher than those in industrialised countries. These statistics were retrieved online at on 4 May 2002. Specifically, paragraph 7.2 of Chapter VII in the Cairo Programme of Action defines reproductive health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health implies that people are able to have a satisfying and safe sex life, and that they have the capability to reproduce and freedom to decide if, when, and how often to do so." Throughout my research, I interviewed several activists involved in the GWHRM. All of them felt that global conferences were important in achieving broad-level consensus norms. However, they all expressed a great deal of frustration over the hours and days spent negotiating the text as opposed to discussing implementation, overview mechanisms, and financial commitments. For scholarly expositions on this subject, see Jacques Fomerand, "UN Conferences: Media Events or Genuine Diplomacy?", Global Governance, Vol. 2, No. 3 (1996), pp. 361–375; Peter M. Haas, "UN Conferences and Constructivist Governance of the Environment", Global Governance, Vol. 8, No. 1 (2002), pp. 73–91; and Keith Krause, "Multilateral Diplomacy, Norm Building, and UN Conferences: The Case of Small Arms and Light Weapons", Global Governance, Vol. 8, No. 2 (2002), pp. 247–263. Annelise Riles, The Network Inside Out (Michigan: University of Michigan Press, 2000), p. 8. McIntosh and Finkle, op. cit., p. 226. For additional studies assessing the implementation of Cairo and state compliance, see Confounding the Critics: Cairo: Five Years On, Executive Summary by Health, Empowerment, Rights, and Accountability (New York: HERA, 1998); Risks, Rights, and Reforms: A 50-Country Survey Assessing Government Actions Five Years after the ICPD (New York: Women's Environment and Development Organisation, 1999); and From Commitment to Action: Meeting the Challenge of ICPD (New York: Center for Reproductive Rights, 1999). According to many activists, the Bush administration has stated its intention in other UN gatherings, including the UN General Assembly Special Session on HIV/AIDS (June 2001) and the Asian Pacific Population Conference (November 2002), that it would not reaffirm its support for the Cairo Programme of Action unless the terms reproductive health services and reproductive rights are changed or removed. The US delegation, advised by the Vatican's chief negotiator during the 1994 Cairo Conference, argued that these two phrases could be construed as promoting abortion. Haas, op. cit., p. 74. Risse, "Let's Talk", op. cit., p. 23. Haas, op. cit., p. 77.