Hangover: Adopting a permanent repeal of the global gag rule is the cure
The back-and-forth of the Global Gag Rule — which prohibits U.S. foreign aid for abortion care — is having a chilling effect on family planning and reproductive health programs around the world.
It’s been a year since the Biden administration announced the rollback of the Global Gag Rule (GGR), but a nasty hangover from its harmful effects remains. The only way to ensure that we, as a global community, do not end up in this situation is for Congress to take action to permanently end this policy.
PAI surveyed civil society organizations and implementing non-governmental organizations (NGOs) in Ethiopia, Kenya, Malawi, Nigeria, Uganda and Zambia, and the evidence was clear: the stroke of a pen not make amends for a policy designed to deny women access to comprehensive reproductive health services. Qualified and highly skilled foreign NGOs that have lost funding and partnerships remain unable to reopen closed clinics, rehire staff, or restore key services lost due to non-compliance with the policy. High stockouts of family planning supplies at facilities leave women without access, as programs that provided buffer stock and product distribution remain disrupted. Projects serving vulnerable communities, including young people, people living with HIV/AIDS and rural populations, that were abruptly closed may never be restored, leaving these groups without vital services.
The back and forth of the GGR has a chilling effect on family planning and reproductive health programs. Where the GGR is in effect, NGOs that comply with the policy are required not to provide information, referrals or services for legal abortion or to advocate for the legalization of abortion in their country with their own non-US funds. It inadvertently pits organizations that strive to provide comprehensive health care against one another. Service providers, advocates and donors who were divided between compliance and non-compliance may cautiously reach out to each other to rebuild relationships and networks, but many say they are reluctant to collaborate for fear that politics will return .
Since the GGR was first imposed in 1984 under the Reagan administration as Mexico City policy, foreign NGOs have experienced a ping-pong effect between the cancellation of the policy by Democratic administrations and the reinstatement by Republican administrations, or in the case of the Trump administration, a vast expansion of politics. Renamed “Protecting Life in Global Health Assistance,” this administration dramatically expanded the policy to include all global health financing, resulting in unprecedented impacts that have been further compounded by the COVID-19 pandemic.
When the GGR policy is put in place, foreign NGOs are quickly asked to comply or risk losing their funding. Suddenly, partnerships and subgrants that may have been developed or implemented years ago are shattered. But when the policy is canceled, it is not an automatic change. The damage caused persists for months and years. The ripple effects of rollback on political gains and supply chain disruptions due to damaged networks are deeply felt by women and girls seeking services and the organizations that provide services to them.
Since the Global Gag Rule was first imposed in 1984, foreign NGOs have experienced a ping-pong effect between policy cancellation by Democratic administrations and reinstatement by Republican administrations.
Although the GGR is not currently in place, NGOs report that they are reluctant to accept US funding or partner with US organizations for fear that support will subsequently be cut off after the next election. This same fear prevents those who have complied with the policy from entering into a relationship with partners who have not.
Loss of funding and disrupted networks allowed an insidious anti-choice, anti-rights opposition movement to grow stronger and disintegrate for years. Discussions on national policies and legislation on sexual and reproductive health and rights are still at a standstill. Advocacy campaigns for implementing comprehensive sex education in the school curriculum lost momentum when reproductive health partners were divided between compliance and non-compliance, while teenage pregnancy is at risk. record high and advocates are afraid to return to coalitions.
When President Biden announced the repeal of the GGR, congressional champions followed his lead and immediately reintroduced legislation to permanently end the GGR. the Global Health, Empowerment and Rights Act (Global HER)led by U.S. Reps. Barbara Lee (D-Calif.), Jan Schakowsky (D-Ill.), and Ami Bera (D-Calif.) and U.S. Sens. Jeanne Shaheen (DN.H.), Lisa Murkowski (R- Alaska ) and Susan Collins (R-Maine), state that the eligibility of foreign NGOs to receive U.S. foreign aid cannot be based “solely on the basis of health or medical services…provided by these organizations with non-governmental funds from the United States”.
This legislation is supported by 196 members of the US House of Representatives and 50 US Senators. Yet, like so many other vital pieces of legislation, the Global HER Act fell victim to competing priorities and partisan gridlock, which kept it from passing. submitted to the vote of the relevant authorization committees.
Last year, another avenue emerged for the Global HER Act: the Federal Department of State and Foreign Operations (SFOPS) annual appropriations bill for fiscal year 2022. In the fall of 2021, it seemed that the political stars were finally aligned, and the language was included in the House and Senate appropriations bills. The inclusion of Global HER Act language in both Houses’ fiscal year 2022 bills should have made the permanent repeal of the GGR non-negotiable as members of Congress worked to craft a spending package. final after months of delays.
However, Republican lawmakers have made it clear that advances on sexual and reproductive rights through the Appropriation Bill—such as repealing the GGR and even increasing funding for international family planning programs—n weren’t ready. As such, with a deadline looming, congressional leaders advanced a spending program that did not include the permanent repeal of the GGR or any other progress on global SRHR. Instead, it maintains a status quo that has been in place for 12 years.
The failure to address GGR in this bill is a huge setback for health organizations around the world. While they keep their eyes on American politics, these organizations are aware that the upcoming presidential election could lead to the reinstatement of the GGR if the policy is not permanently repealed, forcing them to make difficult and consequential decisions again.
But the fight is far from over. As Defenders, we will now go back to the drawing board to begin preparing for the next round of credits, where we may have another chance to end this policy. We will seek ways to advance the Global HER Act through the House Foreign Affairs and Senate Foreign Relations Committees. And we will continue to explain to members why this is not a political issue, but rather an issue of health, equity and dignity.
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