Health groups around the world are celebrating the end of a damaging policy that prohibits US funding for humanitarian organizations abroad that facilitate or promote abortion, which was dismissed by US President Joe Biden in a presidential memo Thursday -market.
Proponents of reproductive rights are asking the new government to go further and permanently revoke Mexico City’s policy – known as the “global gag rule” – to prevent it from being reinstated by a future Republican president. The policy has been blamed for contributing to thousands of maternal deaths in the developing world in the past four years.
The gag rule prevents foreign organizations that receive American aid from using their own money to provide information about abortion or to perform abortions. First adopted by the Reagan administration in 1984, it has been revoked by all Democratic governments and reinstated by all Republicans since then.
In a brief appearance in the Oval Office on Thursday afternoon, Biden said he ended the policy as part of an effort to “protect the health of women at home and abroad”.
But Donald Trump went further than previous Republican presidents. The policy generally applies to family planning organizations. But the Trump administration has expanded the policy to include all global health programs, including programs that address HIV, nutrition, malaria and cholera.
The extension of the rule has increased the pool of aid funds allocated from about $ 600 million to about $ 12 billion (£ 8.7 billion), according to the Guttmacher Institute, a health policy research group.
“We can breathe,” said Serra Sippel, president of the Center for Health and Gender Equity, about Biden’s plans to repeal the policy. “There is so much hope and optimism in Washington DC now. We have a lot of work to do, but it is much better. “
The consequences of Thursday’s memo will spread from Washington to more than 70 countries, including some of the poorest places in the world, where essential women’s health operations were abruptly halted or reduced after Trump reinstated the rule in January 2017.
In Zimbabwe, a women’s health team led by Abebe Shibru, from the organization MSI Reproductive Choices, reduced its operations by 60%. “We have reduced our reach from 700,000 women to about 300,000,” Shibru, who now heads the organization’s operations in Ethiopia, told the Guardian.
“Women lost information, did not have access to family planning and, in return, were exposed to unwanted pregnancies and unsafe abortions, which contributed to increasing maternal mortality.”
The teenage pregnancy rate in Zimbabwe has increased by 2% in the past four years, according to Unicef data, a trend that Shibru said was exacerbated by cuts as a result of the gag rule.
“We were not providing services to rural women, so they had no choice but to become pregnant against their will,” he said.
Donation conferences have attracted hundreds of millions of dollars in donations from governments and private groups to try to close the gap in American funding, but have failed to address the total deficit.
An assessment of the impact of the rule released last year, researching health organizations in Nigeria, Kenya, South Africa and Nepal, found a sector in “crisis” with confusion over what was banned and allowed to use US aid, a stigma growth around reproductive health services and widespread closures and program reduction.
Trump’s ban also sparked a new wave of activism, including a new popular movement, SheDecides, which is pressuring lawmakers around the world to pledge to defend reproductive and sexual health rights.
Zara Ahmed, associate director for federal affairs at the Guttmacher Institute, said repealing the gag rule “is just the first step in undoing [the US’s] current situation as the biggest global obstacle to reproductive health ”.
“We are happy that the Biden-Harris government is addressing the global gag rule … But let’s be clear, repealing the global gag rule is the least that this government can do to deal with the damage caused by the coercive and spiteful approach from the previous government towards foreign policy, ”she said.
“The Biden-Harris government can, and must, take a comprehensive approach to unravel the dangerous, punitive and coercive policies that the outgoing government has created in our foreign policy, and must take steps to deal with long-standing harmful policies, such as the amendment Helms. ”
The Helms amendment was widely misinterpreted as a total ban on American funding used for abortion abroad, when in fact it can be used to support abortion in cases of rape, incest or a woman’s life threatening. A bill to repeal it permanently was introduced last year.
On Thursday, the Global Health Act, Empowerment and Rights (Global Her Act) to permanently repeal the global gag rule will be presented for the third time in Congress. The project, co-sponsored by the new vice president, Kamala Harris, has received support from all parties and there are high hopes that it will be approved.
“It is not automatic and it will not be easy, but we are starting in a very strong place for the act to be approved,” said Sippel. “If not the bill itself, but the language of the bill incorporated into another bill. Getting rid of GGR, that’s what we seek. “
Sippel also called on the Biden government to reject the “Geneva consensus statement” – an anti-abortion policy promoted by Trump last year – to “signal to the world that abortion and LGBTQ rights and sexual and reproductive rights are important, and declare it out loud to the world “.
She added that some activists wanted the Biden government to issue a formal apology for US policies on sexual and reproductive health and rights over the past four years.
Biden also ordered that funding be restored to the UN population fund, UNFPA, which Trump stopped.
The agency’s executive director, Natalia Kanem, praised the “huge” impact of the decision.
“Ending UNFPA funding has become a political soccer ball, a far cry from the tragic reality that leads on the ground. Women’s bodies are not a political bargaining chip, and your right to plan your pregnancy, deliver safely and live without violence should be something we can all agree on, ”she said.