Gag to the Global Gag Rule and the forces that reinstated it

January 23, 2017 marks the day that the Trump Administration reinstated the Global Gag Rule, also known as the Mexico City Policy. This act of injustice strips all US funding from foreign aid groups, who not only provides abortions, but also educates and advocates for the service. This action will devastatingly affect millions, lead to an increase in abortions (predominately unsafe), devastate the global health system, and most importantly, deny the rights of women to have access to comprehensive reproductive health services.

Under the Reagan Administration, the Global Gag rule originated in 1984 at a United Nations population conference in Mexico City.[1] This was the first initiation of integrating domestic abortion politics into the international aid agenda. Since then, it has been a political seesaw. Each US Republican president has reinstated this rule, being in effect for 17 of the past 32 years, and has subsequently been repealed by Democratic Presidents (most recently by Obama).2

Along with a multitude of critics, including global health leaders, the Trump Administration has widely broadened the Rule’s impact compared to previous years. The language of the memorandum applies to an estimated 9 billion USD of international health funding used to fight malaria, HIV, Zika virus, Ebola, and others.[2]  Health clinics around the world relying on US funding will be forced to close their integrated family planning programs. In addition, the Trump administration and Republicans in Congress made large accusations that US tax dollars were currently being used to financially assist abortions and the purpose of this bill was to prohibit this.[3] However, this is a large misconception as the Hyde Amendment has prevented this from happening since 1976.[4] Tax dollars were never spent on abortion services, and this has introduced a massive misconception to American citizens and arguably has increased societal support of the bill. Fundamentally, using and violating women’s sexual and reproductive rights as political ammunition is unethical and inhumane.

For foreign NGOs funded by the US, they are forced to choose between two options:[5]

1. Accept the policy and continue to receive U.S. family planning funds and being prohibited from providing abortions, abortion counseling, referrals, and/or advocacy efforts. This is in exception to cases of rape, incest or life endangerment.

2. Refuse the policy, promote and support women’s rights, and seek alternative sources of funding to prevent health clinics from closing down, provide comprehensive and a large range of sexual and reproductive health services to clients, and continue advocacy efforts for law reforms in their respective countries to decrease unsafe abortions.

This grave situation calls for a serious reflection on power and decision-making processes. I ask, how does the stroke of a pen in the Oval Office, surrounded by only men (who are white, there I said it), stand against years of advocacy, scientific evidence, reproductive health progress, and the blood, sweat and tears put in to improve access to reproductive services? To make matters even more un-imaginable, and makes you question if vegetables are even good for you anymore, this all happens just 48 hours after millions of women marched the streets across the world, calling for the protection of women’s reproductive rights. Not only did he forbid international organizations around the world from receiving U.S. aid funding, the Trump Administration also passed H.R. 7, which permanently prohibits money from using federal funding for abortions, making the Hyde Amendment permanent. If successful, this will continue to devastate vulnerable, low-income, and underserved populations right in the United States, as well as penalizing private health insurers who cover abortion services.[6] Finally, Donald Trump's Supreme Court nominee, Neil Gorsuch, has an alarming history of interfering with reproductive rights and health. For example, he ruled that bosses should be able to deny women access to birth control coverage. 

As demonstrated extensively in other global contexts, such as Africa and Latin America, extensive research has shown that this Bill has indirectly resulted in significant cuts in funding for family planning services, HIV/AIDs treatment, emergency contraception, not solely just abortion services.[7] Studies have shown that this rule has increased abortion rates in sub-Saharan African countries, reduced access to contraceptives, increase unintended pregnancies, and has put women’s health and lives at risk.[8] High rates of unsafe abortions are strongly acute in the Caribbean and Latin America. Between 2010 and 2014, there was an estimated 6.5 million induced abortions each year in both regions. At least 10% of all maternal deaths (900 in total) annually were due to unsafe abortion. About 760,000 women in the region are treated annually for complications from unsafe abortion.[9][10] The most common complications from unsafe abortion are incomplete abortion, excessive blood loss and infection. Less common but very serious complications include septic shock, perforation of internal organs and inflammation of the peritoneum.

The political forces of the reinstated GAG rule has re-enforced how my role, as an intern working for the Jamaica Family Planning Association (JFPA), is greatly influenced by incomprehensible forces. JFPA is an organization that uses integrated approach to serve low-income citizens and responds to the country’s everyday context: extremely high rates of adolescent pregnancy, sexual abuse and assault, unsafe abortions, and rape. Further, since abortion is illegal here, one might think the rule does not have a significant impact for family planning services; however, this is not the case. Jamaica relies heavily on US funded grants and initiatives, therefore, any grant or current program that is funded by the government poses our organization at risk to receive funds. To stay afloat as an organization with day-to-day activities, JFPA is lucky in the sense that we are heavily funded by the International Planned Parenthood Federation (IPPF), a large organization that does not receive a significant amount of US funding. They have already confirmed they will not sign the policy.[11]

Further, JFPA is a large advocate for women’s rights and we continually urge the government to amend the law for women to have choice and access safe and affordable abortion services. Abortion is illegal in Jamaica under the Offenses Against the Persons Act of 1864 that is based on the 1861 English Act of the same title. Those who seek abortion services and their providers are at risk of prosecution. The consequences of criminalizing women who seek abortions (or the healthcare providers who do or refer the procedure), is still a significant issue. This forces innocent individuals to spend years incarcerated even though this is a complete violation of human and reproductive rights. The illegality of abortion makes individuals more vulnerable to unsafe abortion practices. About 1,200 cases of abortion complications are treated every year in Jamaican public hospitals. Physicians in Jamaica are hesitant to perform an abortion as the law provides then with no real protection, and many fear prosecution. As such, access to adequate sexual and reproductive healthcare can reduce the demand for abortions.

All these abortion restrictions, the anti-abortion legislation—what you’re doing is not stopping us from getting abortions, but driving us into the back alleys, making abortion more costly, dangerous, and stigmatized.6

- Melissa Madera  

The Gag Rule affects countries who heavily rely on US funding dramatically, whether abortion is illegal or not. It puts developing countries where abortion is legal at great risk to looking services, and puts countries where abortion isn’t legal even further behind achieving equality for women. Global leaders, such as the US, should be champions of sexual and reproductive health given the vast availability of resources, knowledge, and evidence. Human rights are at stake. It is devastating that certain state politicians and world leaders are putting unjust value systems that stand against women’s rights and affordable, comprehensive and scientifically accurate sexual education and services.

My small reflection on the current global dialogue on the Gag Rule is a reminder to those of us who have the privilege to stand-up to women’s rights that we cannot sit back and wait until the next extreme attack on fundamental rights is being debated before the Supreme Court. If the world wants to protect global health, we must stand together with allies for social justice and it has to be today. With current strong activist moments on the streets demanding justice for all, there is indeed hope and a network of solidarity to fight the good fight! For instance, last Wednesday, the Dutch government has announced plans to establish an international fund to fill the gap created by this reinstatment of the Rule, funding contraception, abortion and education for women. This was quickly supported by Belgium and Canada is currently under consideration. As Canadians and global citizens, we can play an important role. I highly recommended keeping up to date with Action Canada for Sexual Health & Rights and to take action: http://www.sexualhealthandrights.ca/ggr-take-action/

President Trump is now following a worrying tradition that has a dangerous impact on the sexual and reproductive rights, health and life of women and girls across the world, particularly those who are most at risk of human rights abuses. The gag rule during both Reagan and Bush´s administration was a barrier to comprehensive sexual and reproductive health in many parts of the Global South7

- Erika Guevara-Rosas, Americas Director at Amnesty International

 


[1] Talbot, M. 2017. Trump makes the Global Gag Rule on abortion even worse. The New York Times. Retrieved from: http://www.newyorker.com/news/daily-comment/trump-makes-the-global-gag-rule-on-abortion-even-worse

[2] The New York Times. 2017. Mr Trump’s Gag Rule will harm global health. The New York Times Retrieved from https://www.nytimes.com/2017/01/26/opinion/mr-trumps-gag-rule-will-harm-global-health.html

[3] Crockett, E. 2017. The House just passed a sweeping abortion funding ban, Here’s what you should know. Vox. Retrieved from: http://www.vox.com/identities/2017/1/24/14370748/taxpayer-funded-abortion-house-passed-permanent-hyde-amendment

[4] Diamond, A. 2017.. Trump Strikes at Abortion with a Revived Foreign-Aid Rule. The Atlantic. https://www.theatlantic.com/health/archive/2017/01/mexico-city-policy/514010/

[5] Centre for Health and Gender Equality. 2017. Global Gag Rule. Retrieved from: http://www.genderhealth.org/the_issues/us_foreign_policy/global_gag_rule/

[6] Modera, M. 2017. I talked to 200 women who had abortions –here’s my letter to congress. Self. http://www.self.com/story/i-talked-to-200-women-who-had-abortions-my-letter-to-congress

[7] Guevara-Rosas, E. 2017. Trump’s global gag a devastating blow for women’s rights. Amnesty International. Retrieved from: https://www.amnesty.org/en/latest/news/2017/01/trumps-global-gag-a-devastating-blow-for-womens-rights/

[8] Schvey, A. 2017. Trump’s global gag rule hurts the world’s most vulnerable women. The Hill. Retrieved from: http://thehill.com/blogs/pundits-blog/the-administration/316930-trumps-global-gag-rule-on-abortion-hurts-the-worlds

[9] Guttmatcher Institute. 2016. Abortion in Latin America and the Caribbean. Retrieved from: https://www.guttmacher.org/fact-sheet/facts-abortion-latin-america-and-caribbean#2

[10] Sedgh G et al., Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends, The Lancet, 2016, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30380-4/abstract.

[11] IPPF. 2017. What is the Global Gag rule? Retrieved from: http://www.ippf.org/global-gag-rule

 

Georgia Venner is working as Health Education Programme Manager with Jamaica Family Planning Association/FAMPLAN in Jamaica.