Written by Emily Douglas for RH Reality Check – Information, commentary and community for reproductive health and justice.

The FDA was dragging its feet on approving emergency contraception – medication that ceases to be effective if its use is delayed – for over-the-counter pharmacy access. She held up a Senate confirmation until the FDA approved. The Department of Health and Human Services threatens to promulgate regulations that would broaden provider conscience protections, enabling providers to refuse to prescribe or even refuse to refer patients for care they find "morally objectionable" – including contraception. She introduced legislation that would prevent finalization or implementation of the regulation. She has co-sponsored legislation to repeal the global gag rule, to end funding for abstinence-only education and fund comprehensive sexuality education, to expand contraceptive access, and to codify Roe v. Wade in federal law. At the Fourth UN World Conference on Women in Beijing she said proudly, "Women’s rights are human rights," attending the major international conference over the objections of Congress.

Now women’s rights champion Senator Hillary Clinton, who The New York Times is reporting will accept President-Elect Barack Obama’s offer to take on the top diplomatic post in his administration, will have the opportunity to act as an ambassador for women’s rights. For women and girls worldwide, it’s a coup, say advocates of international women’s health.

How can the Secretary of State put pressure on governments – including our own – to recognize that women’s health is a prerequisite for economic development?

Adrienne Germain, president of the International Women’s Health Coalition, says that President-Elect Obama doesn’t need help realizing that sexual and reproductive health must be addressed as a cornerstone of social and economic development.

"In this administration, we don’t have to put much pressure," she says.

But as Secretary of State, women’s rights champion Sen. Clinton can keep him focused, say advocates. While Obama has committed to foreign assistance reform and the Millennium Development Goals, a Secretary of State who keeps those issues on the front-burner means they’re less likely to get lost even as economic issues and Iraq demand resident-Elect Obama’s attention. In fact, realigning US policy to address realities facing women and girls in large part does not require additional spending – rather, non-ideological allocations of funds.

"Without spending a penny more, the new administration can do an enormous amount just by standing strong for the human rights of women and for the kinds of actions that are not simply needed but that countries time and time again – since Universal Declaration on Human Rights – have agreed to," says Germain.

A major priority for women’s health leaders is to align U.S. foreign assistance with the principles espoused by in the 1994 International Conference of Population and Development in Cairo and the UN Millennium Development Goals, articulated by world leaders in 2000. In 1965, the foreign assistance bill was revised to include support for family planning programs, but it does so in a context of population control, not of human rights.

"The rights approach has not been reflected in policy," says Jamila Taylor, from the Center for Health and Gender Equity. "Do it from a human rights perspective, not even just a reproductive rights perspective. Human rights runs the gamut of issues – access to education, income generation – all the things that make women vulnerable or empowered around the world."

In Beijing, Sen. Clinton included in her speech a statement that’s still radical today: "What we are learning around the world is that if women are healthy and educated, their families will flourish. If women are free from violence, their families will flourish. If women have a chance to work and earn as full and equal partners in society, their families will flourish. And when families flourish, communities and nations do as well."

As currently written, the US Foreign Assistance Bill has budget categories that make it difficult to deliver comprehensive sexual and reproductive health care, including separate budget lines for population, maternal and child health, HIV/AIDS, and other reproductive health needs. Health systems need to be strengthened overall to deliver care to those most in need, says Germain.

The Secretary of State can also set administration policy when it comes to HIV/AIDS. As Secretary of State, Sen. Clinton could encourage the President to address administratively PEPFAR’s weaknesses in curbing infections among women and girls. "The President has the final say, but the Secretary can push him along," says Taylor. And the Office of the Coordinator on AIDS is situated in the State Department, meaning the Secretary of State could push the office to make gender concerns a priority in PEPFAR funding.

Germain, one of the lead negotiators on the Cairo Programme of Action, worked closely with Sen. Clinton when she was First Lady. In key global conferences held in those years, the US government led the world in making vital changes in support of women’s health and equality. "We had not had that kind of opportunity before in my 40 years of professional work," says Germain, "and it was made much more of an opportunity because of Hillary’s willingness and ability to weigh in and make a difference in the administration." Though the US was a leader on the Cairo Programme, it has always ignored the Millennium Development Goals, which are based in large part on Cairo.

With Clinton at the helm of the State Department, the US has an opportunity to retake its role as international leader on human rights and women’s rights.

What will happen to the Senate when it loses its women’s rights champion? It’s an opportunity for advocates to reach out to a new generation of lawmakers, says Taylor. "We have to get in there and get to know new members," she says. Advocates have to gauge "what their temperament is in terms of being outspoken on these issues."