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The Trump Administration Reinstating and Expanding the Global Gag Rule

Donald Trump signed an executive action reinstating and expanding the Mexico City policy, also referred to as the “Global Gag rule.” While U.S. law already prohibits aid from directly funding abortion, in the past the Global Gag rule has prevented clinics receiving family planning aid from providing women with information or access to their full range of health options, even with their own resources. President Trump for the first time has gone much further, massively expanding the policy to apply to the entire global health assistance budget.

The Global Gag Rule Has Already Created Conflict With Partners Hampering Care

  • The policy has created legal problems in countries like South Africa, where health providers are legally required to inform women of their full reproductive health care choices
  • USAID’s biggest family planning partners have refused to accept funding under the policy

Reinstituting And Expanding The Global Gag Rule Is Expected To…

  • Cause an additional 2.2 million annual abortions worldwide
  • Lead to clinic closures
  • Reduce access to contraception
  • Increase fatalities from unsafe abortions and preventable disease
  • Make it impossible for U.S. policy to reach its targets in combating the HIV/AIDS epidemic

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Donald Trump Signed An Executive Action Reinstating And Expanding The Global Gag Rule

Trump Reinstituted The Mexico City Rules Blocking Federal Funding For International NGOs That Provide Or Even Discuss Abortion

Donald Trump Signed An Executive Action Reinstating The Mexico City Abortion Rules Blocking Federal Funding For International Nongovernmental Organizations That Provide Or “Promote” Abortions By Providing Patients With Information About It. According to the Hill, “President Trump on Monday morning signed an executive order blocking foreign aid or federal funding for international nongovernmental organizations that provide or ‘promote’ abortions. The order comes one day after the 44th anniversary of the Roe V. Wade Supreme Court ruling that made abortion legal. The so-called Mexico City policy, established by Republican President Ronald Reagan in 1984, blocks federal funding for international family planning charities that provide abortions or ‘promote’ the procedure by providing patients with information about it, including by offering referrals to abortion providers.” [The Hill, 1/23/17]

Trump Not Only Reinstated Bush’s USAID Policy But He Expanded It To Include All Global HEalth Funding

Donald Trump Revoked President Obama’s Memorandum From 2009 And Reinstated The Presidential Memorandum Of January 22, 2001, For The Administrator Of The United States Agency For International Development, Restoring The Mexico City Policy. According to a Presidential Memorandum, “I hereby revoke the Presidential Memorandum of January 23, 2009, for the Secretary of State and the Administrator of the United States Agency for International Development (Mexico City Policy and Assistance for Voluntary Population Planning), and reinstate the Presidential Memorandum of January 22, 2001, for the Administrator of the United States Agency for International Development (Restoration of the Mexico City Policy). I direct the Secretary of State, in coordination with the Secretary of Health and Human Services, to the extent allowable by law, to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies.” [Whitehouse.gov, 1/23/17]

Donald Trump Directed The Secretary Of State In Coordination With The Secretary Of Health And Human Services To Implement A Plan To Extend The Requirements Of The Reinstated Memorandum To Global Health Assistance Furnished By All Departments Or Agencies. According to a Presidential Memorandum, “I direct the Secretary of State, in coordination with the Secretary of Health and Human Services, to the extent allowable by law, to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies.” [Whitehouse.gov, 1/23/17]

  • In The Past The Global Gag Rule Was Applied To The $575 Million Family Planning Budget; Trump’s Policy For The First Time Would Impact The Entire $9 Billion Global Health Assistance Budget. According to CBS, “President Donald Trump has massively expanded the ban on providing federal money to international family planning groups that perform abortions or provide abortion information to all organizations receiving U.S. global health assistance. […] The order directs the secretary of state, in cooperation with the secretary of health and human services, for the first time to extend the requirements in the ban ‘to global health assistance furnished by all departments or agencies.’ […] U.S. support for family planning currently amounts to about $575 million in 40 countries, she said, while global health assistance totals about $9 billion to about 60 countries.” [CBA, 1/24/17]
  • CBS: “Any International Organization Receiving U.S. Funds For Health Programs Will Now Be Required To Certify That It Does Not Provide Abortion Services, Counseling, Referrals Or Information Or Advocate For The Liberalization Of Abortion Laws, Even With Non-U.S. Funds” Or Their Funding Will Be Cut. According to CBS, “According to CBS, “Any international organization receiving U.S. funds for health programs will now be required to certify that it does not provide abortion services, counseling, referrals or information or advocate for the liberalization of abortion laws, even with non-U.S. funds. If they don’t, their funding will be cut off.” [CBS, 1/24/17]

The Global Gag Rule Has Created Conflict Hampering Care

The Mexico City Policy Or “Global Gag Rule” Has Gone Further Than Restricting Foreign Aid Funding For Abortions, But Rather It Prevented “Any Organization Receiving U.S. International Family Planning Funds From Providing Counseling Or Referrals For Abortion Or Advocating For Access To Abortion Services In Their Country — Even With Their Own Money.” According to Planned Parenthood, “The global gag rule (also known as the Mexico City Policy) prevents any organization receiving U.S. international family planning funds from providing counseling or referrals for abortion or advocating for access to abortion services in their country — even with their own money. Separate and permanent U.S. foreign assistance laws already restrict funding for abortions overseas. The global gag rule goes a step further. In practice, this means that means a doctor would be barred not only from providing abortion services, but from referring women to alternate providers or even counseling women on their full range of reproductive health options. Politicians should never come between women and their doctors.” [Planned Parenthood, 7/19/13]

Legal Problems With Partner Countries

The Mexico City Policy Has Created Legal Problems For Organizations In Countries Like South Africa, Where The Groups Are “Legally Required To Inform A Woman Seeking An Abortion Of Her Rights And Refer Her To A Facility That Would Perform An Abortion.” According to the Miami Herald, “The policy creates legal problems for organizations in certain countries, such as South Africa, where the groups are legally required to inform a woman seeking an abortion of her rights and refer her to a facility that would perform an abortion.” [Miami Herald, 1/23/17]

USAID’s Biggest Family Planning Partners Have Refused To Accept Funding Under The Mexico City Policy

USAID’s Two Biggest Family Planning Partners, Marie Stopes International And The International Planned Parenthood Federation Have Refused To Sign Onto The Policy. According to BuzzFeed, “President Donald Trump has reinstated the controversial ‘global gag rule’ — a policy reversal that women’s rights and health advocates fear will bring a rise in unsafe abortions around the world. […] USAID’s two biggest family planning partners, Marie Stopes International (MSI) and the International Planned Parenthood Federation (IPPF), will refuse to sign onto the policy, officials at each organization told BuzzFeed News.” [BuzzFeed, 1/23/17]

  • Director General Of London-Based International Planned Parenthood Federation Dr Gill Greer, Estimated The Gag Rule Had Cost The Group More Than $100m For Family Planning And Sexual And Reproductive Health Programs During The Bush Administration, Which Amounted To 36 Million Unplanned Pregnancies And 15 Million Induced Abortions. According to the Guardian, “The rule was signed by President Ronald Reagan in 1984, overturned by Bill Clinton in 1993, and reinstated by Bush. Critics of the rule say it deprives the world’s poor women of desperately needed medical care, while proponents say US tax dollars should not promote abortion. Family planning groups in America and the UK cheered the rule change. Dr Gill Greer, director general of London-based International Planned Parenthood Federation, estimated the gag rule had cost the group more than $100m for family planning and sexual and reproductive health programmes during the eight years of the Bush administration, which she said amounted to 36 million unplanned pregnancies and 15 million induced abortions.” [Guardian, 1/23/09]

Reinstating And Expanding The Global Gag Rule Won’t Prevent Abortion But It Will Be Devastating For Global Health

The Global Gag Rule Has Not Decreased But Increased Abortion Rates

There Was No Evidence That The Global Gag Rule Reduced The Number Of Abortions Worldwide But Only That It Harmed Women And Damaged Critical Health Care Infrastructures. According to Planned Parenthood, “Moreover, there is no evidence to suggest that the global gag rule has reduced the number of abortions worldwide. Indeed, the only available evidence suggests that the global gag rule has harmed women and damaged critical health care infrastructures, all in the name of satisfying a conservative, ideologically motivated political base in the U.S.” [Planned Parenthood, 5/12/14]

  • BuzzFeed: Abortion Rates Went Up 40% The Last Time The Gag Rule Was In Place, Under President George W. Bush. According to BuzzFeed, “Earlier research also suggests abortion rates will rise. A 20-country study by the Stanford University School of Medicine, published by the WHO in 2011, found that abortion rates actually went up 40% the last time the gag rule was in place, under President George W. Bush. In countries most heavily affected by the policy, contraceptive use dropped, and a woman’s odds of having an unsafe abortion were more than two times higher after the policy went into effect.” [BuzzFeed, 1/23/17]
  • Experts Expect The Mexico City Policy Will Lead To An Additional 2.2 Million Abortions Annually Worldwide. According to BuzzFeed, ‘Experts expect the Mexico City Policy, as it’s also known, to lead to an increase in abortions and maternal mortality worldwide. MSI estimates there will be an additional 2.2 million abortions globally each year — 2.1 million of which will be unsafe, Newman-Williams said.” [BuzzFeed, 1/23/17]

The Global Gag Rule Has Resulted In Clinic Closures Impairing Contraceptive Access And Efforts To Combat HIV Transmission

The Mexico City Policy Has Resulted In Clinics Closing And Women And Men Have Having Reduced Access To Contraception And Family Planning In The Developing World. According to Planned Parenthood, “Since President Bush reinstated the policy, clinics have closed and women and men have had reduced access to contraception and family planning in the developing world.” [Planned Parenthood, 5/12/14]

  • BuzzFeed: Under The Bush-Era Global Gag Rule, A Network Of Clinics That Served More Than 1,300 Communities In Ghana Had To Cut Its Nursing Staff By 44%, Impacting HIV Rates. According to BuzzFeed, “Curtailed USAID funding is also expected to lead to staff reduction and clinic closures. Under the Bush-era global gag rule, a network of clinics that served more than 1,300 communities in Ghana had to cut its nursing staff by 44%, according to research by PAI. That, in turn, can impact HIV rates, Sippel said.” [BuzzFeed, 1/23/17]

The Global Gag Rule Has Deadly Consequences And Its Expansion Could Jeopardize The Lives Of Millions

Huffington Post: The Mexico City Policy Could Be “Deadly” For Women And Girls In Developing Countries “Who Resort To Dangerous Methods Of Ending Their Pregnancies When They Lack Access To Safe Abortion.” According to the Huffington Post, “The policy has severe implications and could be deadly for women and girls in developing countries and conflict zones, who often resort to dangerous methods of ending their pregnancies when they lack access to safe abortion. The World Health Organization estimates that more than 21 million women a year have unsafe abortions in developing countries, accounting for about 13 percent of all maternal deaths.” [Huffington Post, 1/23/17]

  • Experts Expect The Mexico City Policy Will Lead To An Increase In Maternal Mortality Worldwide. According to BuzzFeed, ‘Experts expect the Mexico City Policy, as it’s also known, to lead to an increase in abortions and maternal mortality worldwide. MSI estimates there will be an additional 2.2 million abortions globally each year — 2.1 million of which will be unsafe, Newman-Williams said. ‘The death rate both from maternal mortality because of more pregnancies and from those seeking unsafe abortion is going to rise quite dramatically,’ said Marjorie Newman-Williams, vice president and director of international operations for MSI. The World Health Organization (WHO) estimates that unsafe abortion causes 13% of maternal deaths globally.” [BuzzFeed, 1/23/17]

CEO Of Pathfinder Caroline Crosbie: “This Vastly Expanded Gag Rule Jeopardises Millions Of Lives, And Will Only Serve To Undercut Decades Of American Global Health Leadership.” According to the Guardian, “Caroline Crosbie, acting CEO of Pathfinder, a health programme which works globally, said the policy ‘risks the lives of millions of people around the world’. ‘This vastly expanded gag rule jeopardises millions of lives, and will only serve to undercut decades of American global health leadership.” [Guardian, 1/24/17]

Expanding The Global Gar Rule Will Make It “Impossible” To Treat HIV/AIDS As The Emergency That It IS

George W. Bush Specifically Exempted The President’s Emergency Plan For AIDS Relief, Or PEPFAR, From The Global Gag Rule Because It Was Widely Understood That The Program Couldn’t Meet Its Prevention And Treatment Targets Otherwise. According to Slate, “George W. Bush specifically exempted the President’s Emergency Plan for AIDS Relief, or PEPFAR, from the global gag rule because it was widely understood that the program couldn’t meet its prevention and treatment targets otherwise. Scott Evertz, who served as director of the White House Office of National AIDS Policy under George W. Bush, tells me, ‘It would have been impossible to treat HIV/AIDS in the developing world as the emergency that PEPFAR said it was if the global gag rule were to be applied to the thousands of organizations with which those of us involved in PEPFAR would be working.’ Evertz offers the example of a standalone health clinic in the slums of Nairobi, Kenya. Would the U.S. have to certify that it never referred any of its patients to an abortion provider before enlisting it in the fight against AIDS? ‘The notion of applying the global gag rule to them would have made it impossible to implement the program,’ he says.” [Slate, 1/24/17]