The Global Gag Rule Impedes Global Health Progress
Sam Weitzel
The wishy-washy nature of bipartisan politics generates a lot of change in U.S. policy and governmental action. Since 1984, this fact about politics has affected global access to reproductive rights through a policy called the Mexico City Policy. This policy has historically established an ultimatum related to U.S. funding, restricting any US aid from being used at foreign organizations and clinics that perform or advocate for abortions, granting it the nickname the “Global Gag Rule.” As of 2022, this policy is not currently in effect. However, foreign countries are still reeling from the repercussions. This is especially true since the law can be repealed and reinstated based on which political party is in power, so there is always a chance that it may go back into effect.
The Global Gag Rule was first announced by the Reagan administration in 1984 [1]. In summary, the rule forces the hand of foreign NGOs, making them choose between providing comprehensive sexual and reproductive healthcare (including information related to safe abortions) or continuing to receive U.S. funds [2]. There are many definitions of foreign NGOs, showing the wide range of affected organizations. An NGO is a non-governmental organization operating as a nonprofit group that is commonly seeking to address some sort of societal problem. A foreign NGO includes international, regional, and local organizations, meaning that the scope of effect of the Global Gag Rule is quite large [3]. U.S. NGOs are not forced to choose between providing sexual/reproductive resources and receiving funding under this rule, but they are not allowed to support foreign NGOs that don’t abide by this policy.
Talking specifically about what the Global Gag Rule says and the massive effect that it has on foreign reproductive and sexual health, there are multiple things prohibited under this policy. NGOs that accepted the U.S. funding were prohibited from providing information about access to safe abortions, even in areas where abortions are legalized. They were not allowed to promote or advocate for changes in their government’s laws/policies related to abortions, even using their own funds. This means that the U.S. government is using this as chance to use their financial influence to enact global changes that are in favor of their own interests (such as pro-life viewpoints).
This rule fits under the umbrella of pro-life policy, but data gathered from foreign countries demonstrates that it is truly having the opposite effect. The largest repercussions seem to have been felt in countries with high exposure to this policy due to their need for U.S. funding, such as Sub-Saharan Africa. When the Global Gag Rule was in place, abortion rates rose 40% in the high-exposure areas [3]. It is important to note that this does not specify safe abortions, as without access to NGO information about reproductive health, many people were forced to resort to unsafe alternatives. Contraceptive use declined approximately 14%, and pregnancies increased by about 12% [3]. This displays the overall effect that this policy has not just on abortion access, but access to other important elements of sexual health, such as contraceptive access. Many of the exposed NGOs had previously been offering services such as accessible contraception, reproductive health screenings for diseases such as cervical cancer, and other family planning resources. But since many turned down U.S. funding to continue providing information about abortion access, they could not offer these resources anymore without the money.
Even with the current repealed state of the Global Gag Rule, NGOs are still recovering from the lack of U.S. funding and the consequential effects on resource provision. Integral health programs and projects serving vulnerable communities (youth, those with/at risk for HIV/AIDS, etc.) were forced to shut down due to the expansion of the program. Commodity insecurity with contraceptives was created and progress was significantly slowed for national sexual and reproductive health rights policies in numerous countries [4]. The Global Gag Rule’s enforcement has not been consistent, but its consequences have been severely felt.
There has been a back and forth in the U.S. government about the instatement of this policy. This law changes active status often due to its enactment and repeal being controlled by a presidential executive order. Since created under the Reagan administration, the policy has gone back and forth between active and inactive states. President Bush continued the Global Gag Rule, but it was soon formally repealed by President Clinton [5]. However, he faced significant resistance from Republican congressmen, who would often block release of family planning funding in Congress to retaliate [1]. President W. Bush then reinstated the policy and expanded its influence. Now not only did the rule include the U.S. Agency for International Development (USAID), but also the U.S. State Department “voluntary population planning” activities under the Bureau of Population, Refugees and Migration (excluding HIV/AIDS assistance) [1].
The back and forth continued with the repeal of the policy under the Obama administration. But soon after, the policy was expanded to the greatest point yet under President Trump. Even after the repeal under the Biden Administration, the changes enacted by Trump are still having a significant effect. The expansion included the vast majority of U.S. global health assistance – now reaching categories such as malaria, nutrition, and maternal and child health [3]. Foreign NGOs were now forced to sacrifice funding for even more aspects of global health if they desired to continue advocating for and supporting safe abortions. The amount of money affected by the policy skyrocketed from about $600 million to about $12 billion, which was unprecedented [6]. What is important to note about this back-and-forth expansion of this policy is that some foreign NGOs are nervous about accepting U.S. funds even when the policy is not in effect. They fear the funding could quickly disappear at the discretion of U.S. politicians. This is creating even more limitations on global health funding.
What is the future of the Global Gag Rule? There is always a chance that this policy could be reinstated once more, depending on future administrations. Many Republican politicians are still advocating for its reinstatement in Congress and other sections of the U.S. government. However, many organizations and Congressmen are advocating for the passing of a new law: The Global Health, Empowerment and Rights (Global HER) Act that would protect foreign NGOs from exposure to the Global Gag Rule through presidential executive action once and for all [7]. However, there is still much resistance, so only time will tell if the Global Gag Rule has yet another chance to restrict foreign access to safe abortions and other crucial reproductive and sexual health resources.
References
“Home.” The Global Gag Rule, https://globalgagrule.org/.
“Global Gag Rule: How U.S. Aid Is Threatening Health and Speech Worldwide.” Open Society Foundations, https://www.opensocietyfoundations.org/explainers/what-globalgag-rule.
Published: Jan 28, 2021. “The Mexico City Policy: An Explainer.” KFF, 28 Jan. 2021, https://www.kff.org/global-health-policy/fact-sheet/mexico-city-policy-explainer/.
“Trump's 'Mexico City Policy' or 'Global Gag Rule'.” Human Rights Watch, 28 Oct. 2020, https://www.hrw.org/news/2018/02/14/trumps-mexico-city-policy-or-global-gagrule.
Guttmacher Policy Review | Guttmacher Institute.https://www.guttmacher.org/gpr/2000/08/title-x-gag-rule-formally-repealed%27A%3D0.
Ahmed, Zara, and Guttmacher Institute. “The Unprecedented Expansion of the Global Gag Rule: Trampling Rights, Health and Free Speech.” Guttmacher Institute, 30 Aug. 2022, https://www.guttmacher.org/gpr/2020/04/unprecedented-expansion-global-gag-rule-trampling-rights-health-and-free-speech.
Sully, Elizabeth A., et al. “The Case for Ending the ‘Global Gag Rule’ and the Helms Amendment.” Guttmacher Institute, 30 Aug. 2022, https://www.guttmacher.org/article/2021/02/case-ending-global-gag-rule-and-helms-amendment.