A few days into his presidency Donald Trump, like his Republican predecessors before him, reinstated the infamous Global Gag Rule. In its more than 30 years of on-and-off existence, this rule has severely affected organisations working with sexual and reproductive health services in countries all over the world.
It was during the United Nations’ International Conference on Population in Mexico in 1984 that the US delegation – under orders from President Reagan – announced what is now known as the Mexico City Policy. The rule stated that any international NGO’s providing information, advocacy for or access to abortions would be denied US funding. Eventually, this would come to be known as the Global Gag Rule. Ever since, this rule has become a political yo-yo – repeatedly removed by Democratic presidents, and reinstated by their Republican counterparts.
The ideological legacy of the Mexico City Policy can be traced back to the 1973 Helms Amendment. This policy made it impermissible for NGOs to use US funding for abortion services. The gag rule further expands this ban to funding received both from the US and elsewhere. Previously this only applied to NGO’s working with family planning funding, but the Trump administration has extended the policy to cover all global health funding.
The US is the biggest contributor to global health efforts and many international NGOs depend on funding from USAID and the US State Department. The loss of aid from the US has had a major impact on the overall work of international NGOs during the past three decades. This new policy puts these organizations in a difficult spot, forced to make a choice between a significant source of funding and a faithful execution of their mission. The International Planned Parenthood Foundation (IPPF), for instance, has declared that they will not abide by the policy, a decision that will cost them approximately $100 million in financial support.
One of the consequences of the Global Gag Rule as put into practice during the George W. Bush presidency was the closing of several NGOs specialised in sexual and reproductive health around the world. This time around, distribution of contraceptives in Uganda looks likely to be one of the severely affected programs. Ugandan women have limited access to contraceptive methods as is, mainly because family planning is not a government priority. Family planning NGOs have been able to reduce the number of unplanned pregnancies by providing the long-term contraceptive Sayana Press to Ugandan women. Without funding, it is unlikely that they will be able to continue this project.
In India, where homosexuality is illegal, NGOs use US funding to inform about and promote LGBTQ rights. Several HIV and AIDS prevention programs – providing informing about contraceptive methods and making them available to more people in developing countries – may also be affected by the loss of US funding.
The World Health Organisation, (WHO), finds that access to and information about contraceptive methods can decrease the number of unintended pregnancies and unsafe abortions in low- and middle-income countries. According to WHO, more than 20 million women go through unsafe abortions every year, contributing to almost 13 percent of all maternal deaths.
NGOs working with reproductive and sexual health now face the dilemma of choosing whether they will continue to provide family planning care, including abortion services, or abide by the policy. For those who choose to reject the policy, it will be crucial to secure financial aid from other contributors. On March 2 this year, representatives from 50 countries attended the conference She Decides in Brussels to discuss consequences of the Mexico City Policy, and how to support NGOs working with women’s rights. Sweden, for instance, pledged to contribute with $22 million to the continued work with women’s health. Besides ministers from possible donor countries, representatives from countries where NGOs operate and are affected by the policy – Afghanistan and Ethiopia among others – participated to demonstrate the importance of funding for these organisations and how it has been helpful for their missions.
The question that remains is how severe the consequences will be, and whether financial support from other countries will be sufficient to fill the hole caused by reinstating the Global Gag Rule. If not, several NGOs will be prevented from continuing their work in low- and middle-income countries, affecting millions of women worldwide.