Ethiopian health clinics supporting teenagers have been shut down. Decades worth of HIV care integration and family planning progress have completely unraveled in Kenya (Henderson, 2020). The duties of government workers dedicated to traveling the Himalayas to share health related information have been stopped (Henderson, 2020). These are some of the effects from the implementation of President Trump’s 2017 global aid policy, “Protecting Life in Global Health Assistance.” 

The “Protecting Life in Global Health Assistance,” also referred to as the “The Global Gag Rule,” has made lasting impacts under the Trump administration (Kaiser Family Foundation, 2020). This policy requires non-governmental organizations to refrain from using funds from U.S. and non-U.S. sources to promote or provide abortion care as a form of family planning (Kaiser Family Foundation, 2020). This policy is an extension of the Mexico City Policy which was first announced in 1984 at an international conference under President Reagan’s administration and the policy has been in and out of effect since (Kaiser Family Foundation, 2020). 

As a result of the 2017 global aid policy adoption, many countries around the world have been forced to cut back on their public health projects to keep in line with President Trump’s anti-abortion legislation (Henderson, 2020). Over half of the countries receiving financial support from the US have at least one case for legal abortion that this is prevented under this extended policy (Kaiser Family Foundation, 2020). The Trump administration has now expanded the “global gag rule” from previous years to touch $9 billion worth of global aid (Henderson, 2020). 

The impacts of this expansion under Trump has included decreases in funding for HIV, maternal and child health, malaria, nutrition, neglected tropical diseases, tuberculosis, and other programs (Kaiser Family Foundation, 2020; Henderson, 2020). A review completed in 2020 found that about 1,340 grants and cooperative global assistance funds had been impacted since 2017 (Kaiser Family Foundation, 2020). In addition, major organizations, such as Marie Stopes, have completely withdrawn longstanding partnerships due to the strong U.S. support for anti-abortion legislation (Henderson, 2020). 

As mentioned earlier, there have been heavy cutbacks in family planning programs in African countries. With these cutbacks, there is potential for HIV infection rates to rise (Henderson, 2020). Many families received HIV testing and care as part of a family planning visit. But, now that those programs have been halted, there are worries that women will not have as many opportunities to receive HIV screening (Henderson, 2020). 

Given the global impacts of this legislation, there are concerns that other foreign groups may not be able to trust the U.S. administration, even after the shift in presidency (Henderson, 2020). The influence is felt broadly across healthcare sectors, as foreign organizations have cut ties with providers, deleted references to abortion on websites, and have stopped discussing methods of contraception in fear that they will lose aid from the U.S. (Henderson, 2020). 

Although unpredictable, the weight of the pandemic has been detrimental for women’s health outcomes, as noted in my prior post Reproductive Health During COVID-19. The pandemic has made it even harder for women to access reproductive services and the United Nations warned that millions of unintended pregnancies could be a result of the estimated 47 million women across the world who are unable to obtain modern contraception (Berger, 2020). This is an important consideration in conjunction with the impact the globe has already experienced with anti-abortion legislation in place. 

Per the World Health Organization guidelines, contraception, sexual education, and legal access to safe abortions are essential in preventing unsafe abortions (2012). The WHO go further states that, “the legal status of abortion has no effect on a woman’s need for an abortion, but it dramatically affects her access to safe abortion” (World Health Organization, 2012).

References: 

Berger, M. (2020, September 26). How the pandemic has affected abortion rules around the world. Washington Post. Retrieved from https://www.washingtonpost.com/world/2020/09/26/coronavirus-pandemic-global-abortion-access-reproductive-health/

Kaiser Family Foundation. (2020, November 4). The Mexico City Policy : An explainer. Retrieved from https://www.kff.org/global-health-policy/fact-sheet/mexico-city-policy-explainer/#

Henderson, E. (2020). Trump’s anti-abortion zeal shook fragile health systems around the world. Retrieved from https://www.news-medical.net/news/20201110/Trumpe28099s-anti-abortion-zeal-shook-fragile-health-systems-around-the-world.aspx

World Health Organization (WHO). (2012). Safe abortion: Technical and policy guidance for health systems. (2nd edition). Retrieved from https://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241548434/en/

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