In the middle of a global pandemic, the Trump administration is trying to make it harder for people to get the sexual and reproductive health care they want and need. This week, the administration announced that it is proposing to expand the dangerous and harmful “global gag rule” even further than it already has.
The global gag rule is a harmful policy that prevents foreign nongovernmental organizations that receive U.S. funds through grants and cooperative agreements from using their own, non-U.S. funds to provide abortion services, information, counseling, referrals or advocacy.
The proposed expansion of the policy would, for the first time, cover all contracts that organizations have with the United States for global health work, not only grant funding. It would double down on the current negative impacts and push sexual and reproductive health care even further out of reach for so many people around the world who want and need it.
Let us make one thing perfectly clear: This administration is fully aware that the global gag rule is coercive and demonstrably hurts women and families worldwide. By choosing to expand the gag rule even further and apply it to contracts and subcontracts of any group that is even partially funded by U.S. global health programs, they are intentionally deciding to deprive people all over the globe of access to abortion—essential, life-saving health care.
Why would the United States stand by—and explicitly expand—a policy that is known to harm people? The reality is that this policy serves a manipulative ideological agenda to prevent people from having safe abortions.
All around the world, abortion is a widely shared experience. New findings from a study in Lancet Global Health by Guttmacher and HRP show that 121 million women face an unintended pregnancy every year; that means almost half of all pregnancies worldwide are unintended. And more than 60 percent of all unintended pregnancies end in abortion.
The United States has a critical role to play in making abortion safe and accessible for all, but the global gag rule runs counter to that responsibility. When performed following World Health Organization guidelines, abortion is an overwhelmingly safe procedure—but unfortunately, 35 million abortions take place every year in unsafe conditions. This results in an estimated annual 23,000 preventable pregnancy-related deaths.
While there have been numerous studies that document how harmful the policy is, there is no evidence that the global gag rule has had any positive impacts.
In fact, the U.S. State Department’s own report last month admitted that people are being deprived of health care because of this bad policy.
Furthermore, the report also clearly showed that the global gag rule’s harm extends well beyond family planning programs—its original target—to a whole range of additional health programs, impacting delivery of health care “including for HIV/AIDS, voluntary family planning/reproductive health, tuberculosis, and nutrition programming.”
In April 2020, the Guttmacher Institute and partners published a study in the peer-reviewed journal PLOS ONE documenting some of the harms the early stages of the Trump administration’s global gag rule have inflicted on family planning services in Uganda. The study found that the global gag rule led to a reduction in the number of community health workers engaged in family planning work; these health workers are the critical backbone of the country’s health care system. Having fewer of them could result in reduced contraceptive use and an increase in unintended pregnancies, among other health outcomes.
One of the most important parts of that study is that it also suggests rapid organizational responses and emergency stopgap funding from foreign governments likely mitigated the impact of the global gag rule on the ground. Unfortunately, these interventions may not be sustainable over the long term.
What Can Congress Do to Put an End to the Global Gag Rule?
However, there are actions that policymakers can take to combat this harmful policy that keeps getting worse under this administration.
First, Congress should pass the Global Health, Empowerment and Rights (Global HER) Act. This bill would reverse and permanently repeal the global gag rule. The legislation has 194 cosponsors in the House and 46 in the Senate, including two Republicans.
Second, Congress should pass the Abortion Is Health Care Everywhere Act to repeal the 1973 Helms Amendment—named for the late, self-proclaimed bigot, Senator Jesse Helms (R-N.C.)—which in effect prohibits U.S. funding from being used to provide safe abortion services.
It’s time to address the larger legislative architecture that prevents abortion from being included as part of a comprehensive package of U.S.-supported sexual and reproductive health services.
The bottom line is that limiting access to abortion is a violation of human rights, and it is shameful that U.S. foreign assistance is being weaponized to attack sexual and reproductive health and rights. This country can, and must, do better for people around the world and stop harming them through the global gag rule and other discriminatory policies.
The publication of the proposed rule starts the clock on a 60-day public comment period through Nov. 13—10 days after the presidential and congressional elections.