Population Services International (PSI) is a left-of-center nonprofit organization that provides and promotes family planning and other health services including abortions in over 60 countries.¹ It uses marketing techniques to change the behavior of women and couples in foreign countries to prevent them from having children. PSI advocates for the use abortion and other family planning services to prevent reproduction.

PSI provides and promotes “family planning” services, which include administering abortions, contraceptives, and birth control. ² PSI cofounder Phillip Harvey has expressed the view that family planning is a method of establishing gender equality and also alleged that an overpopulated world leads to destruction of the environment and a lower quality of life. ³

PSI uses social marketing to persuade women not to have children. PSI focuses on low-income areas across the globe.

To make its health services more accessible, PSI uses a combination of private sector and public sector institutions to make their services more affordable. This includes relying on a flow of donations as well as building a network of self-reliant private clinics.

Background

Population Services International was founded in 1970 by Marie Stopes International founder and contraceptive activist Timothy Black⁴ and Philip Harvey, a lifestyle libertarian businessman best known for founding mail-order erotica retailer Adam and Eve and contraception advocacy funder DKT International. ⁵ PSI focused on making contraception and abortion more accessible through marketing. In 1985, PSI added dehydration as an issue it focused on, and in 1988, PSI began its first HIV prevention project. Then, in the 1990s it added safe water and malaria to its program list. Lastly, PSI included tuberculosis prevention to its programs in 2004. ⁶

People

Philip Harvey

Population Services International cofounder Philip Harvey founded the adult products retailer Adam and Eve and has donated a portion of the profits from his pornography and adult-novelty empire to abortion and contraception advocacy through DKT International. ⁷

In 1999, Harvey published the book Let Every Child Be Wanted: How Social Marketing Is Revolutionizing Contraceptive Use around the World in 1999. In the book, Harvey details how his knowledge of social marketing allows him to promote contraceptives and family planning through social marketing techniques like those used by PSI:

Faced with ever tighter budgets for family planning during the upcoming decades, we must often choose between providing contraceptive services for larger numbers of people and providing more comprehensive health services for smaller numbers. This choice… requires recognition of the very substantial reproductive health benefits of providing contraceptives alone. ⁸

Karl Hoffman

Karl Hoffman is president and CEO of Population Services International. Hoffman has expressed the importance of utilizing the private sector in coordination with public subsidy to have as many people utilize their family planning and health services. ⁹

Spending

From 2008 to 2018, Population Services International had total expenses of $5,260,052,384 and spent $2,740,293,735 on grants. ¹⁰ Over this time, 78.5% of its expenses were spent on foreign programs and 96.8% of its grants were foreign grants. ¹¹

According to PSI’s 2018 tax returns, its programs are broken into three categories. It claims that these programs increase accessibility to family planning services and healthcare in the “developing world.” PSI states that this is accomplished through marketing “affordable products and services.” ¹²

In 2018, PSI spent $271,571,808 on family planning programs across 30 countries and on HIV-prevention programs across 60 countries. The HIV services under this category include targeted communication at vulnerable populations, advertising HIV products and services. ¹³ PSI’s total expenses in 2018 were $527,756,937, making this category 51.5% of its total expenses. ¹⁴

For its second category, PSI spent $132,433,807 or 25.1% of its total expenses. This category consists of providing access to malaria prevention and treatment products to 38 different malaria-endemic countries. In addition to providing malaria treatment and education, PSI has a “strategic behavior change” communications program to increase utilization of its services. ¹⁵

PSI spent $87,138,418 or 16.5% of its total expenses on its third category. This includes focusing on maternal health, child survival, sanitation, “gender-based violence,” non-communicable diseases, and respiratory illnesses. ¹⁶

Programs

Population Services International classifies its programs as “sexual and reproductive health;” “water, sanitation, and hygiene” ; malaria, HIV, and tuberculosis prevention and treatment; noncommunicable diseases; digital health; adolescents and youth; and “safe abortion.” PSI states that it approaches these services with a goal of making them more accessible. ¹⁷

Social Marketing

PSI uses social marketing to influence those they are allegedly trying to help by convincing them to use their services. It targets groups of people that it claims need to use contraceptives and abortion. These groups are typically low-income or live in a culture that rejects the use of family planning.

Between 2016 and 2018, PSI gave IDEO, a left-of-center nonprofit organization, over $3 million in grants to lead its Adolescents 360 program. ¹⁸ The program sought to change people’s perception of contraceptives, increase their use, and “reduce unintended pregnancies” among girls in Nigeria, Ethiopia, and Tanzania. To accomplish this, the program uses “smart start” which includes finding targeted women and couples and telling them they need to use PSI-funded family planning services regardless of what their own desires are. The description of “Smart Start” as a method of outreach to change behaviors demonstrates how PSI uses social marketing to increase the use of their services. ¹⁹

Additionally, the implementation of “Smart Start” also reveals the extent to which PSI utilizes social marketing:

The local navigator role was created to, quite practically, house hunt and identify the young couples in the area, introduce them to Smart Start, and capacitate the HEW to pick up where they left off. Navigators are young female mentors trained to bring warmth and lightness to counselling sessions as they present materials. ²⁰

Funding

From 2008 to 2018, Population Services International reported total revenues of $5,287, 171,649.

U.S. Government

Between 2008 and 2018, Population Services International received over $1.8 billion dollars from the U.S. government. The top two programs that granted PSI these funds include the USAID Foreign Assistance for Programs Overseas (67.52%) and the Global AIDS program (12.74%). ²¹

Private Foundations

Between 2008 and 2020, Population Services International received over $700 million dollars in grants from 94 different foundations. Its top two donors, the Warren Buffett-endowed major abortion-advocacy funder The Susan Thompson Buffett Foundation ($416,989,056) and the contraception and population control funder Bill & Melinda Gates Foundation ($273,790,867) made up 98% of those donations. The next biggest donors include the Bill & Melinda Gates Foundation Trust ($28,976,468), The David and Lucile Packard Foundation ($18,200,00), and The William & Flora Hewlett Foundation ($9,740,000). ²²

The Gates Foundation provided nearly $28 million dollar explicitly to support the “private sector” programs offered by PSI. ²³

The Global Fund

The Global Fund is an international partnership that spends $4 billion a year on fighting AIDS, tuberculosis, and malaria. It reports that 93% of its funding comes from world governments. ²⁴ The Global Fund has disbursed nearly $1.3 billion to Population Services International between 2003 and 2020. ²⁵

1. Return of Organization Exempt from Tax Form (990). Population Services International. 2018. Part III.
2. “Thinking Outside of the Gender Toolbox.” PSI, March 20, 2020. https://www.psi.org/2019/08/thinking-outside-of-the-gender-toolbox/.
3. Helzner, Judith F. Studies in Family Planning 31, no. 4 (2000): 346-48. Accessed October 13, 2020. http://www.jstor.org/stable/172243.
4. “Tim Black Obituary,” December 16, 2014. https://www.theguardian.com/society/2014/dec/16/tim-black.
5. “Watch How We’re Moving #50Forward,” July 21, 2020. https://www.psi.org/2020/07/50forward-video/.
6. “Population Services International (PSI),” 2020. https://www.devex.com/organizations/population-services-international-psi-21256.
7. Cheshes, Jay. Hard Core Philanthropist. Mother Jones. December 2002. Accessed January 8, 2020. https://web.archive.org/web/20080306201159/https://www.motherjones.com/commentary/notebook/2002/11/ma_158_01.html
8. Harvey, Philip D. Let Every Child Be Wanted: How Social Marketing Is Revolutionizing Contraceptive Use around the World. Westport, CT: Auburn House, 1999.
9. Santos, Lean Alfred. “PSI CEO on Family Planning’s 3 ‘Exciting New Funding Trends’.” Devex. Devex, January 29, 2016. https://www.devex.com/news/psi-ceo-on-family-planning-s-3-exciting-new-funding-trends-87673.   
10. Return of Organization Exempt from Income Tax (Form 990) (Multiple). Population Services International. 2008-2018. Part I, Line 17.
11. Return of Organization Exempt from Income Tax (From 990) (Multiple). Population Services International. 2008-2018. Part IX, Lines 1-3.
12. Return of Organization Exempt from Income Tax (Form 990). Population Services International. 2018. Part III, Section 1.
13. Return of Organization Exempt from Income Tax (Form 990). Population Services International. 2018. Part III, Section 4a.
14. Return of Organization Exempt from Income Tax (Form 990). Population Services International. 2018. Part I, Line 18.
15. Return of Organization Exempt from Income Tax (Form 990). Population Services International. 2018. Part III, Section 4b.
16. Return of Organization Exempt from Income Tax (Form 990). Populations Services International. 2018. Part III, Section 4c.
17. “Practice Areas Archive.” Accessed October 14, 2020. https://www.psi.org/practice-area/.
18. Return of Organization Exempt from Income Tax (Form 990) (Multiple  years). Population Services International. 2016-2018. Schedule I.
19. “Smart Start: Project.” IDEO.org. IDEO. Accessed October 14, 2020. https://www.ideo.org/project/smart-start.
20. “Smart Start: Project.” IDEO.org. IDEO. Accessed October 14, 2020. https://www.ideo.org/project/smart-start.
21. “Population Service International.” USASpending.gov. Accessed October 10, 2020. https://www.usaspending.gov/recipient/ba876c77-3365-f116-f868-d68c20e4ff21-P/all
22. Information provided by FoundationSearch. Population Services International. www.FoundationSearch.com
23. Information provided by FoundationSearch. Population Services International. www.FoundationSearch.com
24. “Financials,” 2020. https://www.theglobalfund.org/en/financials/.
25. “Population Services International.” data.theglobalfund.org. The Global Fund. Accessed October 14, 2020. https://data.theglobalfund.org/investments/partner/Population Services International.