One Year Later: The Global Gag Rule

By Blake Plante (PO ’18)

On January 23, 2017 the Trump administration reinstated and amplified a policy that has been implemented by every Republican president since Reagan. It is called the Mexico City Policy. Critics call it the global gag rule. The policy cuts off U.S. government aid to health agencies which offer or mention family-planning abortion services. The Reagan administration instituted the policy in 1984, following a Mexico City conference. It has since been rescinded by every Democratic administration and reinstated by every Republican one. Nearly a year later, what have been the results of this policy change?

The Trump administration has taken the global gag rule even further than previous administrations. The expanded policy cuts funding to an organization’s entire U.S. aid grant, rather than just the money for reproductive healthcare. Aid groups that under previous iterations of the policy would have forfeited $600 million annually, now, with the Trump administration’s changes, are at risk of losing $9 billion in funding.

The policy deprives qualified providers who refuse to deny women their reproductive rights. International Planned Parenthood Federation reports that it will lose around $100 million in funding from the U.S. government over the next four years. Pledged support from other donors like Denmark, the Netherlands, and Canada, so far do not come close to replacing the aid (SheDecides, for instance, raised €390 million in 2017—an impressive sum, but not proportional to the aid held back).

The NGO Population Action international (PAI) writes that Even if the U.S. and other donors maintained current funding levels, funding is inadequate to meet the needs of women. The Guttmacher Institute estimates that to provide all women with modern contraceptives who need them would require more than doubling current levels of funding, including from donors. The reduction in unintended pregnancies resulting from sufficient funding for family planning would lead to 52 million fewer unintended pregnancies, and 24 million fewer abortions.”

Roughly two-thirds of the $9 billion in funding affected by the expanded policy is for HIV/AIDS programs around the world, which reach more than 13.3 million people with lifesaving antiretroviral treatment. HIV is a leading cause of death for women of reproductive age in low/middle-income countries, particularly in Africa. Reinstatement of the policy rolls back progress and U.S. leadership on global HIV/AIDS relief.

Marie Stopes International (MSI), an aid agency in Africa, provides reproductive health services, and its work is crucial to curb some of the world’s fastest population growth rates. It had previously received about $30 million annually from the U.S., and all this was cut in January when Trump reinstated the policy. Dana Tilson, Kenya director for MSI, says “It’s the whole range of health care services that’s affected by this. It’s HIV. It’s malaria. It’s cervical cancer, tuberculosis. So, the impact globally is massive.”

In support of the policy, Majorie Dannenfelser, who advised Trump on the new policy, argues that “The only thing Marie Stopes has to do is come into compliance with the policy. If they actually provided that they were focusing on the health of all people, including the unborn child in Africa… I would support any amount of funding if they would take away their abortion services.” Even though abortions amount to only 10% of Marie Stopes’ work, the group chooses not to curtail their services because of U.S. politics.

A Stanford University study during the Bush administration found that abortion rates rose when money for family planning was cut off. With fewer services available, this resulted in higher maternal mortality rates. Dana Tilson explains, “where women have unintended and unwanted pregnancies, they will do anything to terminate the pregnancy. Where there are not safe services available, they will go to the backstreets.” The study furthermore suggests that “reduced financial support for family planning may have led women to substitute abortion for contraception.” It concludes, “regardless of one’s views about abortion, the findings may have important implications for public policies governing abortion.”

With its loss of U.S. funding, Marie Stopes International expects an $80 million funding gap during the Trump administration. This will result in, estimates MSI, 2.5 million unintended pregnancies; 870,000 unsafe abortions; 6,900 avoidable maternal deaths; and a $148 million increase in direct healthcare costs. These are the effects of just one organization’s loss of U.S. funding.

A legislative battle over the Global Gag Rule is occurring inside of the Fiscal Year 2018 State & Foreign Operations (SFOPs) bill. The House of Representatives SFOPs bill approved on July 24 expands the Global Gag Rule to all global health programs and prohibits U.S. contributions to the United Nations Population Fund (UNFPA). The bill, in total, proposes cuts of about $10 billion from 2017 levels.

There is, however, some hope for continued funding for these health programs. In the Senate’s iteration of the bill, an amendment proposed by Senator Jeanne Shaheen (D-NH) would repeal the Global Gag Rule. The amendment received approval from members of both parties, and even includes an increase to the amount of funding for family planning to $622.5 million. Nevertheless, this iteration of the bill is likely to face significant opposition in the House, and the measure may not make it into a final funding bill. It must still be passed in the Senate and House, and signed by the President.

By implementing deontological policy that asserts abortion is wrong, the current administration has created a result that is the inverse of what it had intended. Rather than decrease the amount of abortions, the new global gag rule has resulted in an increased number of unwanted pregnancies due to a decrease in available contraceptives. This has, therefore, caused an increase in abortions, of which a higher proportion are performed under unsafe conditions. Regardless of whether a person is “pro-life” or “pro-choice,” one must agree based on the results that the results of this policy are the antithesis of both.

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