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Fueling Our
Resilience

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Dear Friends and Supporters,

We write to you at a time of extraordinary upheaval.

In just a few months, the infrastructure that once anchored U.S. global health leadership—including USAID, funding for global health and gender equality, and support for institutions such as the World Health Organization and the United Nations Population Fund (UNFPA)—has been dismantled. Programs that advance health, rights, and equity worldwide are now defunded or defunct. As a result, millions of women and young people face growing barriers to the reproductive health care they need and deserve. Civil society organizations—the backbone of communities—are being forced to scale back, close, or silence their advocacy, while anti-rights actors exploit the moment to push a regressive agenda.

It is a sobering reality. And yet, if our work at PAI advancing sexual and reproductive health and rights (SRHR) has taught us anything, it is this: where there is crisis, there is also resilience.

That resilience fuels us and the global movement for SRHR. Every day, our team and partners show up with clarity and conviction. We train advocates, drive budget accountability, and build coalitions that ensure SRHR remains a pillar of health, equity, and progress. Through political turbulence and global uncertainty, our mission has never wavered.

This report highlights the infrastructure we’ve built together—systems that hold governments accountable, tools that track budgets and commitments, and coalitions that speak with a united voice. Even as political will supporting SRHR recedes, civil society presses forward. From Mexico to Malawi, Bangladesh to Benin, advocates in PAI’s 35 partner countries are securing funding, protecting rights, and defending hard-won progress.

But none of this happens alone.

We are deeply grateful to you, our donors, allies, and champions. Your steadfast partnership has allowed us to act with urgency, turn disruption into determination, and stand firm in our shared belief that reproductive freedom is non-negotiable. This moment demands more of us.

Since the overturning of Roe v. Wade in 2022, Americans have made clear that reproductive freedom is a core value—upholding it in state after state. We must ensure that domestic support is reflected in global action. That means staying engaged with Congress, amplifying youth voices, and boldly confronting disinformation and attacks on health, rights, and dignity.

We cannot wait for policymakers championing SRHR to re-emerge. The time to act is now, and PAI remains at the forefront, leveraging our tools, data, insights, and trusted voice to advance what works and protect what matters most—because in the end, advocacy is not a luxury. It is a lifeline.

With gratitude and resolve,

NABEEHA KAZI HUTCHINS

President and CEO

NEERAJA BHAVARAJU

Chair of the Board of Directors

In June 2024, PAI’s President and CEO, Nabeeha Kazi Hutchins, spoke on the steps of the United States Supreme Court on the second anniversary of the Court’s decision to overturn Roe v. Wade, dismantling the constitutional right to abortion. Her remarks strongly asserted the right of people all over the world to make decisions about their own bodies without interference from any branch of the government.

In 2024, PAI provided more than $2.6M in flexible funding and targeted technical and capacity support to 77 local organizations and coalitions in 35 partner countries. This support deepened and advanced strategic, locally led advocacy, fueling a resilient global movement to advance rights and end sexual and reproductive health injustices.

Countries
0
Youth‑led or youth‑focused organizations
0 %
Independent, Locally Founded
0 %
Partners
0

directly supported with flexible funding, advocacy training and resources

orgANIZATIONS
0
countries
IN 0

PAI’s Extended
Ecosystem Reach

Bénin
Burkina Faso
Cameroon
Central African Republic
Chad
Côte d’Ivoire
Dominican Republic
Democratic Republic of Congo
El Salvador
Ethiopia
Ghana
Guatemala
India
Indonesia
Kenya
Liberia
Madagascar
Malawi
Mali
Mauritania
Mexico
Mozambique
Niger
Nigeria
North Macedonia
Pakistan
Peru
Rwanda
Senegal
Sierra Leone
Tanzania
Uganda
Vietnam
Zambia
Zimbabwe

Afghanistan
Argentina
Azerbaijan
Bangladesh
Bolivia
Botswana
Bulgaria
Burundi
Cambodia
Canada
Colombia
Comoros
Denmark
Djibouti
Dominican
Republic
Finland
Georgia
Germany
Guinea
Haiti
Morocco
Myanmar
Namibia
Nepal
Netherlands
Norway
Somalia
South Africa
South Sudan
Switzerland
Yemen

In Chiapas, Mexico, PAI’s partner Observatorio de Mortalidad Materna (OMM) held a continuing education workshop for young health promoters from across the Chiapas Highlands. In these monthly sessions, youth develop their creativity and communication skills by writing scripts and producing TikTok videos, creating engaging and culturally relevant content that promotes sexual and reproductive rights among upper secondary students.
PAI worked with Youth Initiative for Community Development (YICOD) to strengthen the voices and capacities of Malawi’s sexual, reproductive, maternal, newborn, child, and adolescent health and nutrition (SRMNCAH+N) youth coalition members to influence SRHR decision-makers in policy and budget processes. In the photo, youth delegates at the National Youth-Led Dialogue on and Youth-Friendly Health Services discuss top advocacy priorities. YICOD co-hosted the event, bringing together youth, civil society, and government to strengthen partnerships and advocate directly to government officials.
In Chiapas, Mexico, PAI's partner Observatorio de Mortalidad Materna (OMM) held a continuing education workshop for young health promoters from across the Chiapas Highlands. In these monthly sessions, youth develop their creativity and communication skills by writing scripts and producing TikTok videos, creating engaging and culturally relevant content that promotes sexual and reproductive rights among upper secondary students.

Securing SRHR Through Advocacy and Policy

Advocacy is at the core of PAI’s work. With this fundamental value, we partner with civil society organizations worldwide to share our nearly 60 years of expertise in advocacy, helping them advance policy priorities and implement change in their communities. There is no one-size-fits-all approach—each partnership is tailored to the moment, the partner, and the local context.

We also recognize that advocacy is a long-term effort, and victories are often incremental in nature. PAI and our partners have secured key policy and budget victories that expanded access to critical healthcare over the past year. These accomplishments, along with many others, are not isolated. They contribute to a global movement, which PAI has led for decades, committed to maintaining progress, proactively advancing SRHR, and ensuring that women everywhere have control over their futures.

PAI worked with Youth Initiative for Community Development (YICOD) to strengthen the voices and capacities of Malawi’s sexual, reproductive, maternal, newborn, child, and adolescent health and nutrition (SRMNCAH+N) youth coalition members to influence decision-makers in policy and budget processes. In the photo, youth delegates at the National Youth-Led Dialogue on SRHR and Youth-Friendly Health Services discuss top advocacy priorities. YICOD co-hosted the event, bringing together youth, civil society, and government to strengthen partnerships and advocate directly to government officials.

PAI and our partners achieved over 100 policy wins in 2024.

  • Mexico’s National Population Council (CONAPO) has officially adopted a comprehensive sexual education toolkit developed by PAI and our partner to advance SRHR education.
  • Zambia’s domestic funding for reproductive health commodities was 15 times greater than the previous year, a key milestone in ensuring sustainable access to safe abortion and other reproductive health services.
  • In Uganda, we helped secure a 7.5 billion Ugandan Shilling allocation, in partnership with a civil society coalition, to purchase reproductive health commodities and address logistical challenges.
  • In the Democratic Republic of the Congo, we helped mobilize policymakers from 17 provinces to sign Declarations of Commitment to finance the health sector with up to 15% of provincial budgets.
  • In Malawi, PAI advised and supported a grassroots coalition in successfully advocating for the Ministry of Finance to increase funding for the health sector, increasing health spending from 8% to 12.2% of the government’s budget.

Leading Boldly

In 2024, PAI showed what it means to lead with both policy precision and unapologetic purpose. Amid escalating political threats to reproductive rights, we were not just holding the line—we were building momentum and reshaping the narrative.

One of the year’s defining moments was the 30th anniversary of the International Conference on Population and Development—a milestone that reaffirmed the global consensus that reproductive rights are human rights. PAI worked both behind the scenes and at center stage, helping shape Congressional resolutions, advising senior administration officials, and catalyzing a White House statement that pledged renewed action to advance global reproductive health. But the work didn’t stop there. We turned the moment into a movement—briefing allies, engaging civil society, and sustaining policy momentum long after the celebrations ended.

We also showed up where it mattered most. On the second anniversary of Roe v. Wade’s reversal, PAI’s President and CEO Nabeeha Kazi Hutchins stood on the steps of the U.S. Supreme Court and issued a call to conscience: “You cannot pretend to be defenders of freedom while denying people the fundamental right to control their bodies.” It was a bold reminder that reproductive freedom is not up for debate.

That same clarity and resolve were front and center at Courageous Conversations, our flagship event, featuring United States Representatives Barbara Lee (D-CA-12) and Sara Jacobs (D-CA-51), Tanzanian youth advocate Innocent Grant, and UNFPA’s Rachel Moynihan. Their dialogue underscored the multigenerational, cross-sectoral strength of the movement—and the global stakes of U.S. policy.

"We can’t get tired; this is a movement to protect our democracy and a movement for freedom to make decisions about our own bodies, whether we’re here in America or abroad."

— U.S. Representative Barbara Lee (D-CA)

Behind the scenes, our advocacy has continued to pay off. We equipped policymakers with the evidence, history, and tools to make informed decisions, enabling urgent actions that improved the health of women and youth worldwide.

From our sought-after Washington Memos covering the appropriations cycle and advocacy resources to the fight against the Global Gag Rule, to our leadership of the International Family Planning Coalition and strategic congressional advocacy, PAI remained at the forefront to help secure a $600M congressional appropriation for international family planning and reproductive health (FP/RH) funding for the 14th straight year. The U.S. is the largest bilateral donor to global FP/RH.

What carried us through wasn’t just expertise.

It was conviction, collaboration—and the unshakable belief that reproductive rights are not negotiable.

Not here.
Not anywhere.

PAI’s Courageous Conversation event with Rep. Barbara Lee and Rep. Sara Jacobs, both vocal proponents of reproductive freedom, elevated the urgency of ensuring SRHR for all people. PAI presented its 2024 Catalyst Award to Rep. Lee for her 26 years of tireless leadership in Congress, championing reproductive rights both in the United States and globally.

Participants are grouped into teams at the Congress on Comprehensive Sexuality Education, the culminating experience of a diploma course for teachers in Mexico called “Pedagogies Against Violence: Comprehensive Sexuality Education and Well Being.” The course and Congress were developed and executed by PAI partner Mano Vuelta. These professionals teach with an intersectional approach in different communities and secondary and high school levels.

In this image, the participants discuss and reflect on pedagogical tools and develop a plan that addresses comprehensive sexuality education in their educational spaces. Each team presented their plan during a plenary session, and received feedback to identify good practices for implementation in their schools.

Cementing Legal Rights

Access to SRHR continues to face growing legal and policy threats. The rollback of protections in the U.S.—including the overturning of Roe v. Wade—has further emboldened legal actions against SRHR globally.

In PAI’s partner country of Uganda, the Constitutional Court cited the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision to justify upholding the 2023 Anti-Homosexuality Act, arguing that national history and tradition can override broader interpretations of individual rights. Despite the dangers they face, PAI’s network of advocates and grassroots organizations in Uganda remains active and vigilant in defending health and rights for all.

To fight back against legal regression, PAI invests in rights literacy. Legal protections—such as the right to contraception or protection from discrimination—only matter if people know about them, and legal wins must be enforceable and accessible to make a difference. By equipping communities with the tools and knowledge to understand and claim their rights, PAI helps translate legal recognition into lived realities. This work strengthens agency, builds accountability, and ensures rights are not just on paper—they are within reach.

By equipping communities with the tools and knowledge to understand and claim their rights, PAI helps translate legal recognition into lived realities.

Amazonian women from Peru, belonging to the Shipibo-Konibo and Cacataibo Indigenous peoples, participated in the Emergency Contraception to Decide Training Program convened by PAI’s partner Flora Tristan. In the image, the leaders take part in a play-based activity that allowed them to reflect on the importance of listening, trusting, and staying united as a collective. This activity fostered trust, promoted active participation, and reaffirmed Amazonian women’s commitment to defending bodily autonomy and dismantling prejudices against emergency oral contraception in their communities.

In 2024, PAI advanced Afrocentric approaches to legal advocacy, supporting partners across Africa to ground their strategies in local values, histories, and lived experiences. Through legal analysis, litigation, and convenings, partners built a body of jurisprudence that reshapes how justice is defined and delivered. In Malawi and Zambia, this work contributed to legal reforms, increased government funding for reproductive health, and the integration of comprehensive abortion care into national strategies.

In Peru, following a 2023 Supreme Court ruling that mandated free emergency contraception, PAI collaborated with national partners to translate that ruling into access—strengthening supply chains, training providers, reducing stigma, and connecting civil society with health decision-makers to ensure lasting implementation.

By supporting locally led strategies, building legal capacity, and advancing rights literacy, PAI and our partners are closing the gap between what is promised by law and what is delivered in practice.

In the face of rising opposition, this work is essential to protecting hard-won gains and ensuring that all people can exercise their sexual and reproductive health and rights.

Fighting for Policies

In 2024, PAI and our partners championed policy and budget reforms that strengthened SRHR in countries around the world. Amid funding constraints, political instability, and increasing opposition, civil society leaders helped catalyze structural changes that improve access to care and safeguard reproductive rights—laying the groundwork for more resilient health systems.

In Zambia, PAI and our partners provided direct technical input during the national health budgeting process, resulting in a proposed 15-fold increase in funding for reproductive health commodities. This breakthrough followed sustained engagement with the Parliamentary Committee on Health and formal recommendations to increase public financing for essential supplies. Advocates also advanced quality improvement efforts, including the development of a digital platform to capture client feedback and inform provider training and policy dialogue.

In Malawi, we supported youth advocates to build momentum for expanded health services by combining grassroots organizing with strategic government engagement. Their petition for a new facility—complemented by outreach to both district officials and national leaders—increased attention to community health needs. Data-driven strategies also helped improve access to contraception in remote areas, contributing to a documented decline in teenage pregnancies.

In every region where PAI works, community-based advocacy is expanding what’s possible in policy and practice—and making sure progress doesn’t stall when the spotlight fades.

We also enabled meaningful achievements through our Global Financing Facility (GFF)/World Bank partnership that drove measurable policy change across regions. We worked with civil society and youth-led organizations in 28 countries and delivered 175 documented policy breakthroughs and wins throughout the course of the two-year program. In Guatemala, PAI advised local advocates who monitored access to sexual and reproductive health services in rural and Indigenous communities, using the findings to push for improvements at multiple levels of government. In Niger, engagement with municipal officials led to the formal integration of nutrition into local development plans. In Pakistan, our work with civil society and youth leaders contributed to national policy and parliamentary discussions on adolescent health.

Throughout GFF partner countries, community-led monitoring, budget tracking, and coalition-building have become foundational tools for accountability. These strategies helped increase domestic health funding, reinstate family planning budget lines, and ensure youth-friendly services are included in emergency response plans and long-term investment cases.

These collective gains demonstrate the enduring value of civil society leadership. Advocacy isn’t just about changing laws—it’s about embedding rights, responsiveness, and resilience into the DNA of public systems. In every region where PAI works, community-based advocacy is expanding what’s possible in policy and practice—and making sure progress doesn’t stall when the spotlight fades.

By resourcing civil society to lead, and by building networks that transcend projects and political cycles,

PAI continues to fuel resilience—
one policy, one budget,
one system at a time.

By resourcing civil society to lead,
and by building networks that transcend projects and political cycles,

PAI continues to fuel resilience—
one policy, one budget,
one system at a time.

Ahead of the 2024 UN Civil Society Conference in Nairobi, the SRHR Advocacy Accelerator convened civil society leaders to align priorities and advocacy strategies for the Conference and in the lead-up to the September UN Summit of the Future in New York. Co-hosted by PAI, UNFPA, Health NGOs’ Network, and Organisation of African Youth, the Accelerator focused on positioning SRHR as vital to gender equality, youth empowerment, climate resilience, and economic development in the Pact for the Future.

On November 25, civil society organization Flora Tristan and the community in Pucallpa, Peru came together to mark the International Day for the Elimination of Violence Against Women. In this photo, Edilberta Amasifuen, Indigenous leader of the Shipibo-Konibo people, prepares to march by using Kené art. During the march, community members took to the streets to demonstrate their presence and the collective power of Indigenous women against multiple forms of violence.

Their participation highlights the resistance and struggles with violence against women that native women sustain in their territories. For these women, taking to the streets is an act of demand, of memory, and of defending the right to a life free of violence in a society that still carries sexist and patriarchal norms. Edilberta’s voice, like that of so many other women, calls on the State and society to recognize and guarantee their rights from an intercultural perspective and with gender justice.

Standing Strong

Disinformation and misinformation are powerful tools used by anti-rights actors to spread false narratives and undermine human rights. Around the world, these tactics are weaponized to erode public trust, limit access to reproductive health services, and dismantle protections for SRHR.

The critical question is: How do we stop it? PAI believes the answer lies with those who push back and demand evidence-based information—community leaders, educators, advocates, and civil society. These trusted voices are well-positioned to counter false narratives with the truth, ensuring that communities can access accurate information and resources to maintain their health and protect their rights.

At PAI, we adopt a proactive approach to counter disinformation and enhance resilience.

We collaborate with frontline community members and organizations, aiding them in remaining vigilant against deceptive messaging and shifts in language that threaten SRHR. We strengthen the backbone of the collective effort to combat disinformation by equipping partners with the necessary tools for swift action and mobilization.

On the sidelines of the 79th UN General Assembly, PAI and Devex partnered to host a live-stage event featuring Dr. Ayman Abdelmohsen, Chief of the SRHR Branch at UNFPA, in conversation with Devex’s Kate Warren in September 2024. Dr. Abdelmohsin emphasized the critical role of civil society in multilateralism and its power to drive accountability, advocacy, and trust-building—advancing innovation and demand for family planning and contraceptive commodities and achieving the full promise of sexual and reproductive health and rights and global health equity.

In the United States, PAI ensured that key stakeholders—including the media, lawmakers, and allies—received accurate information about pivotal moments such as the Roe v. Wade anniversary and court cases concerning access to mifepristone, one of many essential drugs needed to provide comprehensive reproductive health care.

In Malawi, we advanced a community-centered advocacy strategy to increase awareness of and drive dialogue on safe abortion access. Through community radio panels, media engagement, and outreach, our partner Banja La Mtsogolo (BLM) reached an estimated 40,000 people with accurate information about abortion laws, the dangers of unsafe abortion, and available services. Their efforts also strengthened local media capacity and led to more balanced, informed reporting on SRHR.

In Mexico, PAI supported local partners in Chiapas and Oaxaca to proactively counter harmful narratives by equipping teachers, school administrators, and students with science-backed information, particularly in conservative communities where our partners recognized that disinformation was spreading. Not only did these efforts create intentional spaces where students felt comfortable asking questions, but they also enabled teachers to speak out about reproductive health misinformation that was being spread in their communities.

Across the six social accountability hubs that PAI supports in Asia, Africa, and Latin America and the Caribbean, PAI strengthened grassroots advocates’ strategic and technical capacity to counter misinformation and push back against efforts to undermine SRHR progress.

Disinformation remains a persistent threat. However, through strategic actions and unwavering commitment, PAI and our partners stand firm, amplifying the truth and defending the movement's future.

We are so grateful to you, our supporters and champions, for continuing to stand with PAI.

Your belief in PAI enables our fight to end preventable maternal deaths, support women to choose if and when to become pregnant, and end gender-based violence in our lifetime.

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At Mano Vuelta’s Congress on Comprehensive Sexuality Education, teachers who educate at various levels in Mexico collaborate to share key considerations for teaching comprehensive sexuality education to individuals with disabilities and the actions required to move toward a more inclusive approach.

Financials

This annual report offers a chance to show how donor support fuels our work and drives impact. At PAI, we’re committed to transparency and accountability—we deeply value the trust our donors place in us and work every day to honor that commitment by making the most of every contribution.

To see the PAI 2024 Audited Financial Statements, please visit pai.org/about/financials.

Board and Leadership

Board of Directors

Neeraja Bhavaraju

Chair

Tammy Palmer​

(Through JUNE 2024)

James Siegal, J.D.

Vice Chair
(SINCE JUNE 2024)

Barbara Sapin, J.D.

Secretary

Luis Guardia

Treasurer

Nabeeha Kazi Hutchins

President and CEO

Karla Berdichevsky Feldman, M.D., MPH

Angela Bruce-Raeburn

Barbara Camens, J.D.

Patricia Fairfield, Ph.D.

Vineeta Gupta, M.D., J.D., LL.M

Sujata Lamba

Emeritus Members

Pouru Bhiwandi, M.D.

Sharon L. Camp, Ph.D.

The Honorable William H. Draper III

Thomas E. Lovejoy, Ph.D.

(deceased)

Phyllis Tilson Piotrow, Ph.D.

Nafis Sadik, M.D.

(deceased)

Vicki Sant

(deceased)

Department Leadership

Nabeeha Kazi Hutchins

President and CEO

Mustafa Kudrati

Senior Vice President, Program Strategy and Growth

Kadeem Brown

Vice President, Finance

Christine Meehan

Senior Director, Individual Giving

Katie Unthank

Director, Strategic Communications

powering activism

On May 2, 2022, news of the leaked Dobbs decision overturning Roe v. Wade sent shockwaves that reverberated across the United States and around the world. PAI responded within hours, joining thousands of protestors on the steps of the U.S. Supreme Court. We spoke out on social media, provided context on the global impacts of the ruling for the media and stood in solidarity with our fellow champions fighting for reproductive rights domestically.

Speaking truth to Power Power In Washington D.C.

By the time the Dobbs decision became official on June 24, PAI already had spent weeks refining our strategy and messaging to continue advancing our agenda in a post-Roe political climate.

Key to our ability to take quick action was our long-standing leadership of the International Family Planning Coalition (IFPC) — an alliance of more than 70 members representing rights-focused groups and international humanitarian, development and faith-based organizations.

The collective advocacy of PAI and our coalition partners led to significant gains on Capitol Hill in 2022. Together, we secured record support — over 200 co-sponsors — for the Global Health, Empowerment and Rights (Global HER) Act, which would permanently repeal the Global Gag Rule. We also worked with our champions in the Senate to introduce the Abortion is Health Care Everywhere Act, which would eliminate the Helms amendment.

We succeeded at avoiding funding cuts for international family planning and reproductive health programs and the United Nations Population Fund (UNFPA) — no small feat, given the emboldened opposition in Congress.

While our focus is on the international sphere, we were not simply bystanders to what was happening in the United States. We stood with our fellow advocates working in the domestic space, including supporting the Title X domestic family planning program and endorsing the Women’s Health Protection Act to re-establish a federal right to abortion care.

We do all this as part of a vocal, unified sexual and reproductive health and rights movement — a movement that we will continue to strengthen, both at home and abroad.

In addition to hundreds of engagements with congressional staff, PAI’s advocacy in Washington, D.C., included:

letters signed to U.S. policymakers
0
pieces of legislation endorsed
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policy briefs and analyses published
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Nabeeha Kazi Hutchins, head of PAI, an international reproductive rights group, added in a statement that the “decision would bolster the anti-abortion movement around the world, derail the progress toward universal access to sexual and reproductive health and rights and violate the agency, autonomy and aspirations of communities across the United States.
Abortion is essential health care, and access to abortion is a fundamental human right. Together we stand in solidarity, not only here in the U.S., but with our sisters, our brothers and communities all around the world.
Nabeeha Kazi HutchinsPresident and CEO