Trump Administration Earns Failing Scores in Meeting Global Commitments to Reproductive Health

Multiple U.S. government agencies and actors are failing to live up to their commitments to promoting sexual and reproductive health and rights across global health assistance—for the third straight year.

Trump Administration Earns Failing Scores in Meeting Global Commitments to Reproductive Health
At the Women’s March in Los Angeles in January 2017. (Larissa Puro / Flickr)

In 33 days, the American people vote for elected officials who determine U.S. global health policies that impact women and girls around the world.

On Thursday, CHANGE, a U.S.-based sexual and reproductive health and rights (SRHR) organization, released the 2019 grades for the annual Sexual and Reproductive Health and Rights Index: Grading U.S. Global Health Assistance.

Known as the SRHR Index, it critically assesses the U.S. government’s global health policies, actions, and funding that impact SRHR and measures its performance by grading it annually.

In the calculation of the 2019 grades, the SRHR Index identified multiple U.S. government agencies and actors that are failing to live up to their commitments to promoting SRHR across global health assistance for the third straight year.

Trump Administration’s Drops From “B” in 2016 to a “C-” in 2019

The retroactive, anti-human rights policies enacted and implemented by some of these actors during this administration have resulted in a drastic drop in the U.S. government’s grade from a B in 2016 to a C- in 2019.

The decline in the 2019 grades emphasizes what we already know to be true about the Trump administration: It is one that purposefully defunds and deprioritizes the SRHR of women, girls and the LGBTQIA+ community by prioritizing power and patriarchal control over support and security.

In 2019, the SRHR Index graded the White House’s Strategy on Women, Peace, and Security, a document that purposefully ignored the importance of access to healthcare in the success of women’s peace and security programs. Instead of taking a comprehensive, evidence-based approach, the White House decided to politicize this policy through its abnegation of SRHR issues, including the importance of providing gender-based violence (GBV) care in conflict and crisis settings.


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Department of Health and Human Services

A similar anti-human rights approach is evident in this year’s grades for the Department of Health and Human Services (HHS). HHS’s grade dropped drastically in 2019 due to statements made by Secretary Alex Azar in numerous international fora—The Nairobi Summit on ICPD25, the World Health Assembly, and a High Level UN Meeting on Universal Health Coverage—that denounced the term SRHR in an effort to double-down on  the administration’s regressive stance on abortion.  

Some Specific Programs Promoted Sexual and Reproductive Health and Rights

However, despite the administration’s attempts to hinder SRHR, some actors continued to implement specific programs that promoted SRHR. The grades in the HIV and AIDS domain were the highest across actors in 2019 and have remained high in past years due to bipartisan support for the evidence-based PEPFAR program.

The grade of Congress also depicts the important rule of the legislative body in stabilizing the appropriations process and funding for SRHR—despite drastic proposed cuts by the president. 

Looking Ahead to 2021

The SRHR Index grades for 2020 will be released in 2021 and will grade the U.S. government across issues that are impacting people—both in the U.S. and globally—today,  including the U.S. response to COVID-19 and the White House’s decision to leave the WHO. 

Since its release in 2019, the SRHR Index has been a tool for advocates to hold the U.S. government accountable and provide a roadmap to the government to improve SRHR globally. It is clear what the U.S. government needs to do to advance SRHR – now it must take action.

For more information, see the newly published policy brief that explores the trends identified by the SRHR Index: Sexual and Reproductive Health and Rights Index: Trends in U.S. Policy and Funding for SRHR (2016-2020).

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About and

Lienna Feleke-Eshete is Senior Associate of Public Policy and Movement Building at CHANGE (the Center for Health and Gender Equity) where she champions the right to sexual and reproductive health and rights for all, particularly for Black and brown women and girls around the globe.
Sammy Luffy, MPH is the Senior Policy Research Associate at CHANGE where her research focuses on U.S. global health assistance policies and programs that impact SRHR.