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While trying to make the case that the United States remains committed to global health programs, the Trump administration has issued orders to nongovernmental organizations and others working in women’s health that could cripple some of their international operations by demanding contractual compliance with US anti-abortion policies.
The new rules have been written under the blatant title, Protecting Life in Global Health Assistance. They apply to all porgrams funded by the US State and Defense Departments, except for humanitarian work.
“In his campaign to stifle women’s autonomy, Trump’s expanded Global Gag Rule will cause unspeakable damage to integrated care efforts across all health sectors,” Suzanne Ehlers, chief executive of PAI (formerly Population Action International) said in a statement. “It will cost many around the world their lives — especially women. Despite the Trump administration’s ludicrous rebranding of the policy, the Global Gag Rule is unmistakably deadlier than ever.”
The gag order, arising from the Mexico City policy announced in that city by the administration of President Ronald Reagan in 1984, during a United Nations population conference, prohibits US government aid not only to NGOs or local clinics that perform abortions but also to any group that advises or counsels on abortion. Much of the local delivery of family planning assistance will be undercut in the expanded version of the gag rule, specialists in the field say. Leaders of programs abroad will be forced to choose between dropping services or renouncing US support.
The expansion of anti-abortion policies into global health programs moves the restrictions on federal funds in the US ordered under the 1976 Hyde Amendment to the world at large.
The policy details announced by the State Department on May 15 claim to exclude public international organizations and other multilateral bodies. However, the Trump administration, bowing to an American anti-abortion movement led by American Catholic bishops, some evangelical Protestant leaders and social conservatives in Congress, has already cut off all US funds to the UN Population Fund, UNFPA, by executive order. The UN fund is the world’s largest provider of family planning and maternal health care, especially in developing countries.
President Trump, who has flip-flopped over the years about abortion and the rights of women to choose, may be seeking mostly to cement his conservative base, now in jeopardy on health care generally. But he has a stalwart anti-abortion crusader in Vice President Mike Pence. Pence, who earned an archconservative reputation as governor of Indiana, where he tried to set back both women’s and LGBT rights. He broke with White House tradition on Jan. 27 to speak at a rally against abortion in Washington, D.C., where he crowed that “life is winning!”
That claim now requires a big question mark, given which American political lobbies that will benefit from such actions.
In a statement from Catholics for Choice in Washington, its president, Jon O’Brien, said, “With this action, President Trump continues to provide political payback to antiabortion groups. This action will shut out qualified, experienced aid groups which refuse to toe this administration’s ideological line against women’s rights. . . .
The Trump administration’s action turns US foreign assistance into a slush fund for ultraconservative culture warriors bent on exporting their anti-women’s rights agenda to parts of the world where the health and welfare of the world’s poorest women are most in jeopardy.”
O’Brien added that the orders just promulgated “will severely impact the Global South and other areas where not having access to condoms, contraception and safe abortion can kill, destroying families and devastating communities. . . . With a dangerous policy like this attached, US foreign aid should come with a warning label.”
The statement from PAI said the results of the now-codified restrictions “threaten to exclude some of the most effective — and in some cases, only — local health providers in 60 low- and middle-income countries. Without funding, these organizations will be unable to provide integrated maternal health care with contraceptive services, HIV prevention, care and treatment services, or counsel women on their potential risks of Zika infection, among many other services, leaving communities and entire health systems devastated.”
Human Rights Watch called the restrictions on health work abroad “draconian.”
Amanda Klasing, a senior researcher on women’s rights at the organization, said in a statement on May 15: “The Trump administration today made a mockery of its own ‘Women’s Health Week’ by releasing the details of President Donald Trump’s dramatically expanded version of the Mexico City Policy.”
“Instead of relying on evidence on what works to reduce abortions and to stop women and girls from dying during pregnancy and childbirth, this US policy will do the opposite,” she said. “As the largest global donor on health, the US is making pernicious use of US foreign assistance to make organizations choose between providing lifesaving services and maintaining enough funding to keep their programs afloat.”
The policy restrictions announced by the State Department, Human Rights Watch noted, impose “onerous and expensive reporting requirements that will burden with red tape the organizations providing critical services such as HIV, malaria, TB prevention and treatment, vaccinations, and newborn health programs. It will silence doctors and advocates from speaking out in support of laws that protect women’s and girls’ health.”