Recent attention has been focused on what the Biden-Harris administration can accomplish with executive orders starting from day one. From student debt relief to fully implementing the Defense Production Act, these actions can have a direct impact on domestic economic relief and health care. History tells us that, like every recent Democratic presidential administration, within the first few days of office Biden will also repeal the Global Gag Rule. This executive order will permit non-governmental organizations (NGOs) receiving U.S. foreign aid to provide comprehensive sexual and reproductive health care, including abortion advocacy and abortion services. But the impact this action could have goes well beyond abortion and into other areas of public health as well.

From July-October 2020, my two undergraduate research assistants (Ema Kuczura and Sarah Hubner) and I interviewed 35 sexual and reproductive health NGOs in Kenya who universally reported that the Global Gag Rule (implemented by the Trump administration in January 2017 and expanded by Secretary of State Pompeo in March 2019) had weakened their ability to respond to the COVID-19 pandemic. Specifically, the twin impacts of the Global Gag Rule and the COVID-19 crisis has resulted in 1. An increase in the demand for sexual and reproductive health services (brought on by increases in domestic violence and teen pregnancy), 2. A decrease in the supply of sexual and reproductive health providers and resources (as evidenced by clinic closures and family planning supply chain disruptions), 3. New barriers to service access (fewer open clinics coupled with curfews means laboring women cannot reach clinics in time to give birth and maternal mortality is on the rise), and 4. Spillover effects to HIV services (closures of youth centers and counseling centers where adolescents and women receive antiretrovirals). 

If President-Elect Biden repeals the Global Gag Rule, as anticipated, NGOs offering comprehensive sexual and reproductive health in low- and middle-income countries will again have access to U.S. foreign aid. Our research indicates that NGOs need these funds, not just to provide abortion services, but to meet the new challenges brought on by the COVID-19 pandemic.

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