The beginning of this year saw the reinstatement of the Global Gag Rule, also known as the ‘Mexico City policy,’ which will draw extensive implications on the health and survival of citizens, especially women in developing countries. The newly elected United States (US) President, Donald Trump, signed an executive order banning foreign non-governmental organisations (NGOs) from receiving US aid for counselling health patients seeking abortion services. The order further bans organisations from supporting or advocating for the instituting of the service.
Following up on the severity of the matter, organisations across the globe have highlighted the threat being brought by the rule. MSF (Doctors Without Borders) hosted a roundtable discussion to draw insight on the implications of the Global Gag Rule on women. Panellists included Dr Tlaleng Mofokeng; Vice-Chairperson of the Sexual and Reproductive Justice Coalition, Zani Prinsloo; MSF Midwife, Lucy O’Connell; MSF Sexual Reproductive Health Nurse, and Tshego Bessenaar; IBIS Reproductive Health Senior Project Manager.
The Expansion Threat of the Rule on other Health Care Services
In the past, the implementation of the Global Gag Rule meant that foreign NGOs must disown any involvement with the administration of abortion services in order to continue being recipients of US funding. However, with the new expansion under Trump’s office, the rule now implicates and threatens all other global healthcare services that are embodied in the objectives of NGOs which support abortions, and fall under US funding.
An NGO that provides healthcare services to malaria or AIDS patients will now be under threat of void by US funding if it supports or suggests an abortion or termination of pregnancy (ToP) for women’s reproductive health. According to Suzanne Ehlers; President and CEO of the global reproductive health organization, PAI, the new rule will not be impacting $600 million in US foreign aid, but rather it will affect $9.5 billion in US foreign aid on organisations working on AIDS, malaria, or maternal and child health which will have to make sure they do not even refer patients to seek abortion healthcare services.
An example of implicated HIV/AIDS clinics that fall under US funding to provide antiretroviral medication to their patients was given by a senior fellow at the United Nations Foundation, Geeta Rao Gupta, who said; “If they’re giving advice to women on what to do if they’re pregnant and HIV positive, giving them all the options that exist, they cannot now receive money from the U.S.” The severity of the new expansion on the rule impacts a number of healthcare organisations even if they do not administer abortion services.
A Matter of Republican vs Democrats?
“This comes as no surprise as it is always a matter under the debates of Republicans versus Democrats in the US,” said sexual health educator, Dr Tlaleng Mofokeng. The first sighting of the ban was issued by Republican President, Ronald Reagan, in 1984 as the Mexico City Policy. The policy removed US family planning funds from organisations involved with abortion services. Many reproductive rights advocates assert that the policy is reinstated at the sitting of every Republican president in the US. “It wasn’t unexpected that they would reinstate the Global Gag Rule, but the dramatic expansion of the scope of it is truly shocking,” said Gupta. In 1993, the rule was rescinded by President Clinton, only to be reinstated again in 2001 by President George W. Bush on his first day in office. President Barack Obama then rescinded the Global Gag Rule in 2009, and this year the rule has once more been reinstated by President Donald Trump.
“Governments should not play politics with the lives of women and girls,” said MSF- USA executive director, Jason Cone, adding that, “the Trump Administration needs to face these facts and end policies that endanger the lives of women and girls.”
Whether the rule may be drawn from a political base, its socio-economic impact will devastatingly wound organisations and their patients. Many organisations will be threatened by the broad scope of the new rule, and may have to forgo US funding. NGOs often work on a partnering and referral system where their services become interrelated and interdependent, and the new rule not only threatens this relationship but their joint effort of decades in working to reducing illness, death and disease across the globe.
Stigma injuries to Healthcare Service Objectives
“There is a need for openness to normalise abortions as a continuum to family planning,” said MSF Sexual Reproductive Health Nurse, Lucy O’Connell. She said research to inform policy is lacking and further misdirects communities against being informed on their reproductive health options.
“Understanding quality of care is critical to ensuring that abortion services are grounded in women’s priorities and voices, and is an important foundation for improvements to care,” said Bessenaar. However, at the throat of this is the strangling tie drawn by stigma, lack of information, lack of adequate leadership, and subjective policymakers; all of which make the service appear strange rather than allowing openness and normalised approach towards it.
“Abortion remains stigmatised at different levels,” said Bessenaar, highlighting that the stigma to abortion does not only affect the patients, but it can also affect medical practitioners, individual practitioners, communities, funders, and donors.
According to MSF, policies that ban medical providers from educating women about abortion and their family planning options, actually lead to more unwanted pregnancies, more unsafe abortions and deaths, and higher rates of sexually transmitted diseases, such as HIV. “People need reproductive health services, including access to contraceptives and safe abortion care. This access has decreased in the past when the Mexico City Policy was in place,” said Cone, adding that, “as providers of medical care in places where women and children will be directly affected and hurt by this policy, it is important to state the enormous damage this policy will have on collective efforts to reduce maternal mortality and suffering worldwide.”