The Trump administration’s Global Gag Rule is depriving women of essential information and health care, stripping them of their right to make decisions about their bodies, and, ultimately killing them, says a new report from the International Women’s Health Coalition (IWHC).
“This deadly policy violates the rights of patients and ties the hands of providers,” said IWHC President Françoise Girard. “After two years of implementation, the impact is clear: The Global Gag Rule reduces access to contraceptives and abortion care, leading to unwanted pregnancies, unsafe abortions, and preventable deaths.”
By prohibiting US global health funding to foreign nongovernmental organizations (NGOs) that provide abortion services, counseling, referrals, or advocacy—or fund other organizations that do so—the Global Gag Rule forces NGOs to make the difficult choice between offering honest and comprehensive sexual and reproductive health care or receiving critical US funding.
Since implementation began two years ago, IWHC and grantee partners in Kenya, Nepal, Nigeria, and South Africa have conducted more than 170 interviews with individuals affected by the policy. The interviews reveal that the Global Gag Rule is reducing the quality and availability of care, particularly for marginalized communities. In all four countries, the policy has cut off access to both comprehensive sexual and reproductive health information and services, leading one interviewee in South Africa to declare that the Global Gag Rule “promotes unsafe abortion.” In Kenya, an organization that serves sex workers and other young women was forced to stop providing abortion information and referrals; two clients died after resorting to unsafe methods to terminate their pregnancies.
Even interviewees from faith-based groups that hold anti-abortion views recognize the harmful impact of this ideologically driven policy. In Nigeria, a representative from a faith-based youth organization acknowledged that the Global Gag Rule robs women of the information needed to make safe and informed decisions, ultimately increasing maternal deaths.
The policy directly conflicts with national laws and interviews show that it threatens governments’ ability to protect the human rights and health of its people. In Nepal, which has a progressive abortion law, it has forced the early closure of a US-government supported project intended to increase access to contraceptives and other services in 11 remote districts. In South Africa, it has meant that a national sexuality education curriculum under development will exclude any mention of abortion, even though the right to abortion is protected by the country’s constitution.
The policy is also dismantling a decade of US investments to integrate health care services and strengthen health systems. The Trump administration’s expansion of the policy to cover all global health funding—including for HIV—has driven a wedge between the delivery of sexual and reproductive health and HIV services, reducing the ability of patients to access the care they most need. Organizations working with women and girls described being forced to “ignore a huge part of what makes them susceptible to HIV infection, like limited information around their bodies, their health, their rights, and their right to access safe abortion,” ultimately threatening the sustainability of HIV responses.
The Global Gag Rule stigmatizes and silences the voices of organizations that work on abortion, and has emboldened anti-abortion ideologues in all four countries. Documentation in Kenya and South Africa shows that there has been an uptick in funding to organizations that provide abstinence-only education and hold extreme anti-rights views. This has shifted policy conversations from a focus on human rights and bodily autonomy to one on religious values and subjective morality.
“The Global Gag Rule is a reflection of the Trump administration’s extreme anti-women agenda, and a rejection of evidence, rights, and national health priorities,” said Girard. “US policymakers have the power to end this policy, and they must, because women’s lives are on the line.”
IWHC’s recommendations to stop or mitigate the impact of the Global Gag Rule include:
- The US Congress should permanently end the Global Gag Rule through passage of the Global HER Act.
- Donor governments and organizations should seek to close the funding gap by increasing funding to groups affected by the Global Gag Rule, while prioritizing local and community-based organizations.
- Civil society implementers, donors, and other affected entities should, whenever feasible, document and publicize the impact of the Global Gag Rule on their work, including misapplication, over-application, and chilling effects of the policy on civil society.
