Legislation that would sharply cut U.S. foreign aid programs and slash support for family planning advanced on Wednesday in the Republican-controlled House, drawing protests from State Department officials and relief agencies.

The bill, approved by a House Appropriations subcommittee, also clamps new restrictions on aid for Pakistan as well as Middle East allies such as Egypt and Yemen, requiring the State Department to first certify that those countries are cooperating in the fight against terrorism.

A Republican-backed provision would cut aid for family planning organizations and also reinstate the so-called “Global Gag Rule,” which prohibits agencies that receive U.S. funds from either performing abortions or providing advice or information about the procedure. The rule was repealed by President Obama in January 2009.

While the bill’s prospects are uncertain—the measure would have to be approved by the Democrat-controlled Senate and signed by Obama—international relief groups attacked some of the proposed aid cuts as irresponsible, saying they would hamper global efforts to reduce poverty and respond to famines and other crises. The measure would cut foreign-aid funding by about 11 percent from current levels.

“They will have a huge impact on the lives of those who are already marginalized in the poorest corners of the earth,” said Samuel Worthington, president of InterAction, an alliance of U.S.-based international non-government organizations.

Republican lawmakers said the bill would prioritize programs that serve U.S. national interests while scaling back overall spending. “In this difficult geopolitical and economic climate, the American people deserve a policy that is based on American principles, looks out for American interests, and wisely invests American dollars,” Rep. Kay Granger (R-Texas), chairwoman of the Appropriations subcommittee on State-Foreign Operations, said Wednesday.

Republicans and Democrats agreed on several key provisions, including an increase in aid for so-called “front-line states”—Pakistan, Afghanistan and Iraq. Granger and the committee’s ranking Democrat, Nita Lowey (D-NY), both favored attaching strings to aid for Pakistan and several Middle Eastern countries, though Lowey decried cuts in disaster relief, health programs and family planning that she said would deny millions of women access to adequate health care.

The committee’s passage of the bill was a setback to Secretary of State Hillary Rodham Clinton, who has been battling simultaneous efforts by two House committees to slash foreign aid. Clinton on Tuesday wrote a letter to members of the House Foreign Affairs Committee warning that she would urge a veto of any legislation that sought to impose strict new requirements on U.S. assistance to critical U.S. allies and countries in transition, such as Egypt and Yemen.

The bill “would be debilitating to my efforts to carry out a considered foreign policy and diplomacy, and to use foreign assistance strategically to that end,” Clinton wrote.

In the letter, obtained from a congressional aide by The Washington Post, Clinton criticized the legislation’s “onerous restrictions” on department operations and foreign aid, and the “severe curtailing” of dues owed to international organizations.

Brad Goehner, a spokesman for Rep. Ileana Ros-Lehtinen (R-Fla.), the committee chairwoman, said in reaction to the letter: “It’s disappointing, particularly given the current debt crisis, that the Obama administration is fighting to keep sending taxpayer money to foreign organizations and governments that undermine U.S. interests.”