On January 28, President Biden is expected to repeal the Mexico City Policy (also knows as the “Global Gag Rule”), a cruel and anti-science policy that bans U.S. global health funding for foreign non-governmental organizations (NGOs) that use their own funds to provide information on, offer referrals to, or conduct advocacy about abortion and/or abortion-related services.
The Global Gag Rule was created by President Ronald Reagan in 1984 but Donald Trump greatly expanded the rule to encompass all funding for development assistance for health, including for the first time, life-saving HIV programs. This resulted in an increase in affected funds from about $600 million in US funding for family planning to at least $7.3 billion in affected foreign aid. Trump further expanded the policy in 2019 to require all NGOs that were bound by the Global Gag Rule to enforce the same obligation in all of their own sub-grants with partner NGOs and to require inclusion of contracts, not only grants and cooperating agreements among the financial awards affected by the Global Gag Rule. The effects have been profound: under Trump’s expanded Global Gag Rule, people have faced major barriers to essential health services, ranging from HIV testing, treatment, and prevention services to maternal health care and medical male circumcision. Evidence shows that rates of unsafe abortions most likely increased, too. In a recent article, researchers found that implementation of the Global Gag Rule was associated with a 13.5% reduction in the use of contraception and a 40% increase in the rate of abortion. Organizations delivering life-saving health care have seen their budgets slashed. In Mozambique, for example, a country with one of the highest burdens of AIDS-related mortality in the world, at least 90 family planning clinics have closed since 2017 as a result of Mexico City Policy implementation, further undermining extremely poor access to essential treatment and prevention services in that country.
Since its creation, U.S. policy on sexual and reproductive health rights has been tossed like a political football, with access to essential healthcare determined by which political party is in power. Now it’s time to put an end to the deadly gamesmanship.
Global AIDS activists fighting for health justice around the world are calling on President Biden to do more than merely repeal this policy. He has a unique obligation: he must correct the extensive harms done by the unprecedented expansion of the Global Gag Rule. He must also end this cycle by establishing a permanent policy that supports sexual and reproductive health and rights for all, in the U.S. and globally.
Our allies have seen first hand the harm of Trump’s vastly expanded Global Gag Rule:
Nakibuuka Noor Musisi, the Program Manager at the Center for Health, Human Rights and Development (CEHURD): “In Uganda our efforts to improve health justice for women and adolescents, including through abortion rights advocacy, have been harmed by four years of Trump’s policies. From our work to combat maternal mortality to efforts to expand provision of safe abortion, no aspect of our sexual and reproductive health and rights work was untouched by this wrong headed policy. Under Trump, the cruelty directed globally at women was the point. Under Biden, justice for women who demand their bodily autonomy and their right to health must be the point.”
Joy Asasira, Ugandan SRHR expert and human rights lawyer: “No one human being should hold power over women’s health decisions. They are personal and these policies take an issue that should be based on the health and wellbeing of the woman and turn it into a cheap political bargaining chip. Countries everywhere that continue to criminalize a woman’s right to choose whether to terminate a pregnancy are saying that women’s lives do not matter, and this is unacceptable.”
Dorothy Amuron, Health Rights Activist, Center for Health, Human Rights and Development and (CEHURD): Member, Coalition to Stop Maternal Mortality Due to Unsafe Abortion in Uganda (CSMMUA): “We are calling on the Biden administration to take bold action to stop this deadly cycle of granting or rescinding human rights when the political tides shift. The U.S. has an obligation to safeguard human rights for all. But policies like the Global Gag Rule are an attack on our sovereignty and our humanity,” said Amuron. “We call on the Biden administration to use its power to get rid of them forever.”
The Biden administration must systematically root out the extensive harm done to HIV and other healthcare service delivery and correct it, permanently, through executive action.
The status quo is unacceptable – the U.S. must never return to this deadly policy which causes irreversible harm to countless people’s lives every four or eight years.
What are we watching for? We call on the Biden administration to not only reverse this policy, but to commit to, at a minimum:
The Trump administration’s expansion of the Global Gag Rule has been nothing less than an attack on the health and rights of women with HIV around the world. The U.S. can no longer use partisanship as a cloak for anti-woman, anti-science, and anti-human rights policies. The Biden administration has an opportunity and an obligation to take bold action to undo the years of unprecedented harms done by Trump’s expanded Global Gag, and to ensure it never happens again. Activists around the world are watching.