Less than a year after the Trump administration moved to cut funding for international organizations that provide women’s reproductive health care and abortions, aid groups report they are beginning to see a host of negative impacts.
In Nigeria, health groups found greater difficulty accessing contraception, reduced access to health services, and an increasingly hostile environment for sexual and reproductive health rights.
In Uganda, advocates reported the breakdown of networks between groups that comply with the US policy and those that don’t, affecting the quality and availability of health care. Health groups are also increasingly concerned about the impact on HIV assistance.
The findings are in reports examining the Trump administration radically expanded version of the so-called “Mexico City Policy.” Also known as the Global Gag rule, the policy conditions US funding for global family planning on a commitment from NGOs that they won’t promote or perform abortions using funds from any source.
The Trump White House has expanded the rule to apply not just to funding for family planning, but all global health assistance, including funding for HIV/AIDS, maternal and child health, malaria, nutrition, and other programs. If a foreign group provides or discusses abortions, even using non-US funds, the administration will pull its aid funding for all health programs.
As a result, the rule’s impact has expanded from affecting $575 million in US funding for family planning to impacting an estimated $8.8 billion in global health assistance, according to Human Rights Watch. It’s being enacted even as Secretary of State Rex Tillerson acknowledges the link between women’s health and the success and stability of their countries.
Jamie Vernaelde, a senior research and policy analyst at Population Action International (PAI), which assembled reports on Uganda and Nigeria, said that, “throughout PAI’s history of documenting the impact of the Global Gag Rule, we have seen the policy undermine family planning and reproductive health programs, including procurement and distribution of contraception and other lifesaving commodities.”
“Comparable threats are emerging in Uganda and Nigeria,” Vernaelde said, “and we expect even greater disruptions across health sectors under rollout of the Trump administration’s expanded policy.”
PAI advocates for improved access to family planning and reproductive health care. The global gag rule has been implemented on and off, depending on the administration in power, since 1985.
PAI’s report, released Thursday on International Women’s Day, comes as Tillerson begins a trip to Africa. In a March 1 speech before his departure, Tillerson called for greater resilience and stability on a continent that “will factor more and more into numerous global security and development challenges.”
Tillerson approved a plan to implement the new Mexico City policy on May 15. President Donald Trump issued a memorandum directing the expansion on his first full day in office.
“As we look ahead, this administration seeks to deepen our partnership with Africa, with an aim of making African countries more resilient and more self-sufficient,” Tillerson said in the speech at George Mason University in Fairfax, Virginia, before setting out on a trip to Chad, Djibouti, Ethiopia, Kenya, and Nigeria from March 6th through the 13th.
“That serves our partners, and it serves the United States as well by creating a stable future for all of our children and our grandchildren,” Tillerson said.
While Tillerson calls for bolstering stability in Africa, development experts say the global gag rule will directly undermine those goals, damaging longer-term economic prospects and stability of the world’s poorest countries.
These specialists point to a demonstrated link between women’s ability to control their reproductive lives and their childbearing, and the economic growth, stability and resilience in communities and countries.
Tillerson himself pointed up the crucial role women play in a country’s successful development in a Q&A session after his speech, saying that the way to break “the generational cycle” of poverty is “by really empowering women to fully participate in all aspects of our human life as mothers, as participants in the economy, as entrepreneurs, as participants in government.”
And he made the link to women’s health. “It’s important that we support women’s health first and their capacity to participate in the economic well-being of the country,” he said, “because too often we have women that are raising families without a lot of help from fathers. And so it starts with giving them capacity because they will raise better families.”
A State Department spokesperson said the agency couldn’t respond to the findings of the PAI report as the agency hadn’t seen it, but emphasized its commitment to the health of women and children.
The US is “firmly committed to the health of women and children and families,” the official said. “Anything that has been declined in terms of accepting funding … 100 percent of the funding is redirected and reprogrammed.”
The administration’s six-month review of the rule found that four international groups that deliver health services, including Planned Parenthood International, have turned down US grants rather than accept restrictions.
The PAI report said the global gag rule’s impact on health services is being compounded by the Trump administration’s move to reduce funding for United Nations Population Fund, the arm of the international agency focused on reproductive health and rights.
The $70 million cut has reduced the UN agency’s ability to respond to humanitarian crises and its ability to fulfill its mission, PAI said.
Reduced access to contraceptives and the reduced ability to deliver services because of funding cuts are raising concerns about an increase in unsafe abortions and HIV rates, according to PAI and other groups active on family planning, including Marie Stopes International.