When people ask how my summer internship is going, I never know what exactly to say. I usually end up blurting out a rapid mix of emotions: “It’s great!” “I love it!” “But it’s also really sad!” “Super depressing day to day, but I care a lot about the work.” “An awesome place to work but a sad field to be working in right now.”

I’m interning at the United Nations Foundation in Washington, DC on the Universal Access Project, which convenes donors and advocates working to improve women’s and girls’ access to family planning around the world. Family planning is a fundamental human right and undeniably one of the best investments countries can make towards sustainable development—it can enable girls to stay in school, prevent maternal deaths, improve women’s financial independence and economic productivity, and has even been identified as a top solution to combat climate change.

The Duke Center for Global Reproductive Health and other NGOs have reported frequently about the re-imposition of the Mexico City Policy, often referred to as the Global Gag Rule, which has been implemented by every Republican president and repealed by every Democratic president since Ronald Reagan introduced it in 1984. This policy prohibits foreign NGOs from receiving any U.S. assistance for family planning if they provide abortion services, referrals, or any information on abortion to their patients, and also if they advocate for expanded abortion access. This applies even in countries where abortion is legal, and even if an organization supports these activities with its own, non-U.S. funds.

What makes this latest version of the Global Gag Rule particularly worrisome for international family planning advocates and providers is its drastically expanded reach. Rebranded by the Trump administration as “Protecting Life in Global Health Assistance,” the rule extends further than ever before, applying to all U.S. global health assistance, effectively jeopardizing up to $8.8 billion in aid to some of the world’s most vulnerable girls, women, and families. It now impacts HIV/AIDS relief efforts, maternal and child health, nutrition, water and sanitation, tuberculosis, malaria, neglected tropical diseases, and more.

What does this mean for the international and local NGOs that depend on this critical funding? They can comply with the Global Gag Rule—potentially abandoning significant legs of their work—or they can try and maintain their usual operations without U.S. funding. It’s a lose-lose situation.

In addition to an expanded Global Gag Rule, last April the U.S. government decided to withhold funding for the United Nations Population Fund (UNFPA), the UN agency that works to ensure reproductive health and rights for all. UNFPA services are especially crucial in humanitarian crises—UNFPA provides dignity kits to survivors of natural disasters, has ensured the safe delivery of nearly 10,000 babies in the Za’atari refugee camp in Jordan, and is currently on the frontlines of providing maternal and reproductive health assistance to Rohingya refugees in Bangladesh.

The U.S. was a founding member of UNFPA and had long been one of its largest contributors; with the withdrawal of the U.S., UNFPA’s lifesaving efforts that benefit millions of women and girls around the world are in jeopardy.

My work at the Universal Access Project is in support of experts who advocate for better policies for girls, women, and communities. I’ve been working to gather stories that track the impact of these policies on the ground, and the results are heartbreaking. Without U.S. funding, hundreds of community health workers have been laid off in Mozambique, adolescent health outreach programs in Zimbabwe are forced to shut down, and health clinics in rural Kenya are closing their doors. As we’ve seen in the past, these funding decisions are directly reducing access to contraceptives, and increasing unintended pregnancies and unsafe abortions. Unsurprisingly, these harmful impacts are felt most strongly among the poorest communities.

So, when people ask me about my internship, I continue to give a mixed response. I’m heartened by the work we’re doing, and by the continued work of organizations on the ground under trying circumstances. Through the Universal Access Project’s advocacy efforts, we’ve seen family planning champions in Congress step up to reaffirm their support of reproductive health. But, until U.S. policies once again reflect these values, millions of women and families in low-income countries will continue to suffer. We know that family planning is not only a fundamental human right, but unlocks a ripple effect that benefits girls and women, families, communities, and countries. It’s a shame that two policies implemented by the U.S., historically a leading supporter of global reproductive health and rights, are stifling organizations across the world trying to do just that.

-Emily Nagler, Duke University 2019

Photo Credit:© UNFPA Rwanda/David Ssekyanzi

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