Trump expands 'global gag rule,' targeting $8.8B in global health aid

U.S. President Donald Trump

The State Department told reporters that Secretary of State Rex Tillerson has approved "a plan to implement the manner in which U.S. Government departments and agencies will apply the provisions of the Mexico City policy to foreign nongovernmental organizations that receive U.S. funding for global health assistance". On a myriad of issues, Donald Trump hasn't disappointed evangelicals since he's taken office.

However, the anti-abortion policy was not well-received by everyone.

The president, on his third day in office, reinstated the policy, which requires non-governmental organizations (NGOs) receiving federal funding to certify that they are not carrying out or promoting abortion - even using funds from other donors.

Under this expanded policy, "global health assistance" includes funding for worldwide health programs, such as those for HIV/AIDS, maternal and child health, malaria, global health security, and family planning and reproductive health.

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"The policy will apply to all new funding agreements (grants, cooperative agreements and contracts) for global health assistance, and to existing agreements when amended to add funding", the State Department said in a statement posted on its website. Those past actions were limited to about $600 million in family planning funding. A report from the Center for Health and Gender Equity predicted that Trump's reinstatement of the Global Gag Rule could lead to 6.5 million unplanned pregnancies, 2.1 million unsafe abortions, and 21,700 maternal deaths; now, with the expansion of the policy, it's likely that each of those statistics will increase.

President Donald Trump's administration is reportedly planning to expand its "Mexico City" policy that bans U.S. funding for overseas abortions. It will also apply to funding that comes from the U.S. Agency for International Development, the U.S. State Department or even the Department of Defense.

It's up to the legions of civil servants who work for the State Department to enforce the policy, however, and they can have some leverage as to how aggressively it's enforced, said Duff Gillespie, a professor at the Johns Hopkins Bloomberg School of Public Health, during a February panel discussion at his university. It's illegal for any USA aid money to go toward abortion care itself; what the global gag rule does is prevent these organizations from using even separate funding on abortion care or referrals, even if abortion is legal in their country. The same would go for any NGO that receives US funding to maintain its public health initiatives - whether those are related to containing the spread of malaria and tuberculosis, for example, or to providing contraception - if that organization did not formally agree to scrub abortion from its services and sever ties with other providers.

What is not included in the change is funding to foreign governments, multilateral organizations, migration and refugee assistance, and disaster and humanitarian relief from USAID and the Pentagon.

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The new plan prohibits foreign nongovernmental organizations from receiving any health-care related US funding if they "perform or actively promote abortion as a method of family planning in other nations". But other USA government support for organizations' overseas health efforts were unaffected.

Trump's initial announcement to reinstate the Mexico City Policy in January was significant in that it went farther than other previous Republican presidents.

"President Trump is treating women's lives like political bargaining chips, trading them away to shore up his flagging support", said Sasha Bruce, senior vice president of campaigns and strategy for the pro-choice organization. "Right now there's a lot of unknowns, ' she said". Denying organizations funding just for talking about abortion is a step in the wrong direction, and allocating more money to organizations who do not talk about or provide abortion will only incentivize fewer global health organizations to provide this essential care.

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