Trump’s gag rule endangers the lives of women around the world

President Donald Trump signs an executive order in the Oval Office of the White House, Monday, Jan. 23, 2017, in Washington. (Credit: AP Photo/Evan Vucci)

President Donald Trump signed an executive order to reinstate and dramatically expand the scope of the Global Gag Rule to include all global health assistance provided by the U.S. government – a move women’s health advocates say will threaten the lives of millions of the world’s poorest women and families.

“The gag rule will reverse decades of progress on women’s health by preventing clinicians from providing quality care to the women who depend on them,” Caroline Crosbie, acting CEO of Pathfinder International, said in a statement. “We know what happens when providers are forced to choose between U.S. assistance and providing the care their patients have a right to receive – clinics close and women are denied access to basic health services.”

The Global Gag Rule (GGR), which originally applied only to family planning programs, now freezes funding to any foreign health services NGO if it provides or offers information about abortion services. Even if the organization uses non-U.S. funds for those services. These health-care services include a range of care, including family planning, maternal and child health, nutrition, HIV/AIDS (including PEPFAR), infectious diseases, malaria, tuberculosis and neglected tropical diseases.

The Reagan-era rule was first rescinded by President Bill Clinton, reinstated by President George W. Bush and again repealed by President Barack Obama within his first few days of office. Trump’s executive order goes far beyond the Bush-era interpretation of the gag rule.

“It’s a piece of political football,” Global Justice Center Vice President Akila Radhakrishnan told Humanosphere. “It’s become a part of partisan practice in the United States, a part of partisan practice that plays with the lives of women around the world.”

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The financial implications for all health organizations is enormous. The U.S. spends $9.5 billion on health services aid. All of that money is now subject to the gag rule, according to Trump’s expanded order, according to officials at Population Action International (PAI). Under the original gag rule, only $575 million in spending would have been affected.

The monetary and health implications of the policy are well-recorded. Nongovernmental organizations that tracked the policy’s effects during the Bush administration found that organizations that opted not to comply with the rule were unable to make up the lost funding, harming communities already suffering from poor access to health care.

Under the same policy, the Planned Parenthood Association of Ghana was forced to cut to services, and left some 700,000 clients without access to HIV prevention services – including voluntary counseling and testing, and prevention education. After losing its funding, the organization’s nursing staff was reduced by 40 percent to keep three rural clinics open.

But the most significant impact of the GGR during the Bush administration was on contraceptives – namely condoms. Contraceptive shipments to 16 developing countries in Africa, Asia and the Middle East stopped by 2002. Family planning groups in another 13 countries did not receive contraceptive shipments because they refused to comply with the rule. The affected countries also happened to have some of the world’s highest HIV/AIDS, birth and maternal mortality rates.
The move “made it very clear that he’s a pro-life president,” White House Press Secretary Sean Spicer told reporters yesterday. Trump campaigned as the anti-abortion candidate, and Vice President Mike Pence has a long history as an abortion opponent.

“He wants to stand up for all Americans, including the unborn, and I think the reinstatement of this policy is not just something that echoes that value but respects taxpayer funding as well,” Spicer said.

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After Trump’s reinstatement of the rule, a spokeswoman for International Planned Parenthood Federation told the Guardian that the group stands to lose up to $100 million it receives from the U.S., none of which is used for abortion services. Planned Parenthood is one of more than 130 organizations that oppose the GGR.
“Attempts to stop abortion through restrictive laws – or by withholding family planning aid – will never work, because they do not eliminate women’s need for abortion,” Marjorie Newman-Williams, vice president and director of Marie Stopes International, said in a statement.

Without funds, Marie Stopes International will not be able to provide contraception to 1.5 million women.

“This policy only exacerbates the already significant challenge of ensuring that people in the developing world who want to time and space their children can obtain the contraception they need to do so,” Newman-Williams said. “… and it is women in developing countries who will pay the price.”

Humanosphere reporter Tom Murphy contributed to this report.

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Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com