Trump’s Radical Attack on Global Health

Trump’s Radical Attack on Global Health
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“I think the president, it’s no secret, has made it very clear that he’s a pro-life president,” White House Press Secretary Sean Spicer told reporters at his first briefing as he defended President Donald Trump’s decision to wildly expand what is known as the Global Gag Rule. But if Trump’s move was pro-life, it was pro-life only by name. The new and expanded Global Gag Rule is a radical policy, far beyond what any other Republican president has ever done before. And it will lead to an enormous loss of life.

In a nutshell, the Trump Global Gag Rule would deny funding to any organization that even discusses abortion as a health option in the developing world – even at the cost of cutting off life-saving aid to millions of the poorest and most vulnerable people in the world.

As one of his first acts as president, Trump was widely expected to reinstate an earlier, less draconian version of the Global Gag Rule. The rule—first put into place by President Ronald Reagan in 1984 and formally known as the Mexico City Policy—is a policy that restricts U.S. foreign aid recipients from using their own, private funds to offer abortion-related services or advocate for the legalization of abortion within the countries where they work. This earlier version of the Global Gag Rule has been upheld or reinstated by every Republican administration and subsequently rescinded by every Democratic administration since its development. It’s critical to note that Reagan’s version—and the version adopted by both Presidents George H.W. Bush and George W. Bush—was only applied to organizations that received U.S. international family planning funding.

President Trump’s Global Gag Rule, however, goes miles beyond what any other president has imposed on global health programs. In fact, Trump’s Global Gag Rule applies restrictions to 16 times the amount of monetary funding as the previous application to only international family planning programs—now spanning all health programs across all departments and agencies.

In practical terms, this means that all global health assistance administered by the U.S. Agency for International Development, the State Department, and Health and Human Services in areas like HIV/AIDS, family planning, maternal and child health, malaria, nutrition, infectious diseases, tuberculosis, and neglected tropical diseases now fall under a set of restrictions that approach the fanatical. (For context, President Bush—who launched the United States’ flagship anti-malaria and HIV/AIDS prevention efforts, and with broad bipartisan support—exempted such programs from the gag rule, recognizing the number of lives at stake.)

Here’s how Trump’s order could play out in practice: If even a single nurse or doctor in a clinic in South Africa (a country where abortion is legal) were to merely discuss abortion with a patient, even if that patient had been raped, the U.S. government and all the non-profits with which it works would be barred from immunizing children, providing AIDS treatment, or doing anti-malaria education programs in that clinic. And if a non-profit chose to work with that clinic, all of their funding for all of their programs—including those outside of South Africa—could be stripped by the U.S. government.

Research has demonstrated again and again that the Global Gag Rule does nothing to reduce abortion rates. In fact, it has had the opposite effect: abortion rates increased two-fold in countries where organizations lost U.S. funding due to their refusal to accept the Global Gag Rule the last time it was imposed. Under the Global Gag Rule, the number of unintended pregnancies increases, as women are denied access to contraception, pushing more women to risky and often deadly backroom abortion procedures.

All the while, President Trump and Vice President Mike Pence appear not to care how much suffering their administration’s order imposes on the most vulnerable people of the world.

Put simply, the Trump-Pence White House is using the Global Gag Rule as a political bludgeon to hammer away at women’s rights, in an attempt to placate the so-called “pro-life” movement. To further justify the matter, White House Press Secretary Sean Spicer attempted to peddle the false claim that Trump’s executive order would protect taxpayers from paying for abortions overseas. What Spicer failed to mention is the fact that federal law has long prohibited U.S. funding from being used for abortion services abroad. 

Globally, 225 million women would like to avoid or delay childbearing, yet lack access to effective contraception. Access to contraception is critically important to a woman’s ability to lead a healthy and productive life, and complications from unwanted pregnancies remain a leading killer of women in the developing world. In the continuum of comprehensive sexual and reproductive health care, women should be afforded a suite of services that include sex education, maternal health, family planning, testing and treatment of sexually transmitted infections, and access to safe abortion. The Global Gag Rule stifles efforts to ensure that services like these are integrated or co-located. This is particularly important for health care providers working in settings like the developing world where resources are the scarcest.

Make no mistake: Trump’s Global Gag Rule will directly lead to the needless and preventable deaths of tens, if not hundreds of, thousands of mothers and children, all while causing the number of abortions around the globe to spike. Furthermore, Trump’s order is positioned to devastate not just family planning and basic health care for women, but also everything from HIV/AIDs prevention to anti-malaria efforts.

The Global Gag Rule is not pro-life. It’s a full-fledged assault on the health and rights of women all over the globe.

Dr. Jamila K. Taylor and John Norris are both Senior Fellows at the Center for American Progress.

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