“When the U.S sneezes, the rest of the world gets a cold”.

This is what Moses Mulumba recently said on a webinar to discuss the impact of the U.S. presidency on global sexual and reproductive health and rights (SRHR). Moses is the Director of the Center for Health, Human Rights and Development (CEHURD) in Uganda. He was referring to U.S. led policies and funding decisions, which inevitably have a significant impact far beyond their citizens. One example is the Mexico City Policy, known by many as the “Global Gag Rule”. It restricts U.S. funding from being given to any organizations that provide, or even show support for safe abortion care. This policy is rooted in abortion stigma. It attempts to separate safe abortion care from other health services, to delegitimize it.

What is the ‘Global Gag Rule’?

President Ronald Reagan brought in The Global Gag Rule in 1984. Since then, every Democrat President has withdrawn the policy, and every Republican President has re-enacted it. This makes organizations around the world vulnerable to losing funding every time the U.S. Presidency changes hands. They are forced to either comply with the policy (which means cutting any activity or partnership which might be seen to support the right to safe abortion), or to stand by their commitment to SRHR and lose out on crucial funding.

The Trump administration did not just reinstate the Global Gag Rule in 2017. They also expanded it to apply to all U.S. global health funding. This meant the affected funding rose to $12 billion and now includes not just work related to sexual health, but also HIV/AIDs, nutrition, malaria, water and sanitation and more. In 2019 it was expanded once again. This time to prevent ‘gagged’ organisations from funding others who might provide abortion services or information, further spreading the sanction.

What is the impact of the Global Gag Rule?

CEHURD, Moses’ organisation, refused to sign up to the gag rule. He explained that the Ugandan healthcare system is hugely reliant on U.S. funding. Following cuts to this funding under the Trump administration they are now seeing a reduction in contraceptive supplies, including condoms, which is unprecedented.

There is a rise in unplanned pregnancies and unsafe abortions.

This fits with the global picture. Despite being led by an anti-abortion agenda, studies have found that the Global Gag Rule has actually increased abortions. This is largely due to reduction in contraception services where funding has been cut. In many instances of course these abortions are unsafe, which lead to a number of health issues, including death.

“The reinstatement and expansion of the Global Gag Rule demonstrates how repressive political decisions from other countries can affect population, health and wellbeing in countries like Uganda. It is not an easy choice to comply and keep the funding or refuse and lose access to those resources: jobs and indeed lives are on the line. Nevertheless, CEHURD cannot work on one area of health and not others, or prioritize some human rights and not others. This would compromise our values as an institution.”  Moses Mulumba, Executive Director, Center for Health, Human Rights and Development (CEHURD)

What will Joe Biden’s Presidency mean for abortion rights?

The good news is that President-Elect Joe Biden has already promised to remove the Global Gag Rule on his first day in office. Though his track record on supporting abortion rights is shaky, his current policy commitment is to “reverse the Trump Administration and states’ all-out assault on women’s right to choose”. However, reproductive rights advocates are still pushing not just for the gag rule to be reversed, but for it to be permanently revoked. This can be achieved through the passing of the Global Health, Empowerment and Rights (HER) Act.

Abortion stigma kills.

The Safe Abortion Action Fund was set up in 2006. It is the only global fund dedicated solely to supporting small, grassroots organisations working on abortion. Donors and partners decided that there needed to be a reliable source of funding to tackle the global issue of unsafe abortion. A fund that could provide consistent support for all reproductive rights.

We are proud to fund CEHURD, and other organisations doing this important work whose stance on abortion should not affect their ability to serve the communities they work with. We hope to see a change in policy to remove the Global Gag Rule early next year. Beyond that we hope for an eradication of the abortion stigma, which plagues global health funding and does real harm to women, girls and their families and communities.

The Conversation

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