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Global gag rule: what the executive order means | May 16, 2017

For years, the Mexico City policy has been a point of contention within the U.S. The regulation, less formally known as the global gag rule, blocks federal funding for international, non-governmental organizations that offer a wide array of abortion-related and family planning services. These institutions tend to advocate for the decriminalization and expansion of abortion as well as counseling and referrals for the procedure.

With every change of party affiliation within the White House and Congress, the issue comes up again. The partisan split on the global gag rule has existed since 1984 and continues to this day. On Jan. 23, 2017, President Trump signed an executive order reinstating the Mexico City policy. Let’s take a closer look at this rule and what the administration’s action really means:

The Mexico City policy: A history

On August 6-14, 1984, the 2nd annual United Nations International Conference on Population was held in Mexico City, Mexico. While the event focused on research and data-based discussions and decisions related to human rights and population control, according to the United Nations, it also spurned the Mexico City policy.

The idea was announced by the administration of Ronald Reagan at the conference and formally instituted later that year. The global gag rule, as it was deemed by opponents, created harsher restrictions for charities that promote abortion as a means of family planning and also received funding from the U.S. government. Prior to the regulation, non-governmental organizations were able to use non-U.S. money to continue abortion-related activities and advocacy, as long as they had a separate account for the U.S. funds they were entitled to, according to The Hill.

Under the global gag rule, however, this was no longer the case. Instead, the Mexico City policy forbids these NGOs from partaking in these types of services if they wish to receive funding from the U.S. government. In short, these organizations cannot promote abortion-relation offerings – even with non-U.S. money – if they hope to earn financial support from the U.S. government.

A back-and-forth game

In the 33 years since the Mexico City policy was created, it has been in effect for 17 – and counting, due to President Trump’s recent executive order. The revocation and reinstatement of the rule has been a party-affiliated issue over time. According to the Kaiser Family Foundation, the history of the rule, by president and party, is as follows:

President In Effect? Years
Reagan (R) Yes 1985-1989
Bush, Sr. (R) Yes 1989-1993
Clinton (D) No 1993-1999
Clinton (D) Yes 1999-2000
Clinton (D) No 2000-2001
Bush, Jr. (R) Yes 2001-2009
Obama (D) No 2009-2017
Trump (R) Yes 2017-Present


The policy was reinstated for one year during former President Bill Clinton’s second term, due to a legislative reinstatement by Congress. That reinstitution was part of a larger agreement to repay U.S. debt to the U.N. Clinton was able to partially waive some of the regulation’s restrictions at that time. This is the only time Congress has interfered in this matter. All other revocations or reinstatements have been by executive order.

Trump’s executive order

In addition to the provisions previously explained and instituted under the Mexico City policy, Trump’s executive order expands the reach of the rule further than past iterations. The new regulation extends restrictions to all U.S. global health assistance – instead of just that specifically for family planning. According to Human Rights Watch, that could be up to $9.5 billion in support for things like maternal and child health, nutrition, infectious diseases, HIV/AIDS and more – as opposed to the $575 million set aside for family planning alone.

NGOs have a decision to make under the Mexico City policy: agree to the rules within the regulation when their contract for renewal comes up, or lose U.S. funding altogether as long as the law is instated. Funding agreements can be amended or redeveloped over time to lessen the burden of this action – essentially upping other funding to take the place of U.S. money – but those steps will not lessen the current burden felt by these charities.

The impact of the global gag rule

President Trump’s restoration of the Mexico City policy came on the heels of the Women’s March on Washington on Jan. 21, 2017, as well as the 44th anniversary of the Roe v. Wade Supreme Court decision on January 22.

The decision, although made early in his administration, is not much of a surprise. Trump took an anti-abortion stance during his presidential campaign, and his vice-President, Mike Pence, has been a long-time abortion opponent. The latter, the former governor of Indiana, took many steps during his tenure in that position to restrict the procedure’s use and expansion.

Although organizations like the International Planned Parenthood Foundation have faced this rule in the past, it still presents an uphill climb. Many NGOs will choose to give up their federal funding in lieu of stopping abortion-related services. That’s the case with the IFPP, which will lose around $100 million for programs that offer sexual and reproductive health services, according to the organization’s website. While the Mexico City rule targets abortion, in particular, it will also affect provisions of contraceptives, maternal health actions and HIV/AIDS prevention and treatment, especially in developing countries and in low-income families.

According to Engender Health, which documented the impact of the regulation in countries such as Nepal, Kenya and Zambia, the policy did not reduce abortions but led to an increased amount of unwanted pregnancies and unsafe abortions. As a result of this newly expanded policy, fewer women and girls will have access to contraceptives, maternal mortality will impact a higher number of women and services related to vaccinations, child nutrition and treatment of infectious diseases will likely have to be cut.

International action in opposition

Since reinstating the Mexico City policy, President Trump and his administration have received backlash from private citizens as well as organizations such as the American Civil Liberties Union, Population Action International, Planned Parenthood and hundreds more. They all oppose and are calling for a revocation of the global gag rule, even signing coalition statements against the ruling.

In addition, countries around the world have voiced their opposition to the policy, banding together to raise money to make up for the deficit caused by Trump’s executive order. Sweden, Denmark, Belgium, Luxembourg, Finland, Canada and Cape Verde are the eight that have joined the fight, taking their own steps to support the organizations losing funding, according to The Independent.

On March 2, at least 50 governments came together at the “She Decides” conference in Brussels, specifically aimed at gathering funds for family planning services affected by the Mexico City policy. The initiative was started by Dutch Minister for Foreign Trade and Development Cooperation, Lilianne Ploumen, and has received widespread support since its creation. Although the goal was $600 million, the group came up with about $200 million on that day, with the following contributors pledging funds, according to CNN:

  • Sweden, Canada, Finland: $21 million each
  • Belgium, Luxembourg, the Netherlands: $11 million each
  • The Bill & Melinda Gates Foundation: $20 million
  • Anonymous U.S. donor: $50 million

The HER Act

On Jan. 24, 2017, just one day after President Trump reinstated the Mexico City policy, Democratic Congresswoman Nita M. Lowey of New York introduced The Global Health, Empowerment and Rights Act to the House of Representatives. The legislation aims to permanently rescind the Mexico City policy.

The HER act would enable NGOs to continue offering health services with U.S. federal funds, while paying for abortion-related provisions on their own. Jeanne Shaheen, a democratic senator from New Hampshire, introduced the bill to the Senate shortly after it was heard by the House.

As New York magazine stated, a Republican-led Congress and White House means the passing of this bill is unlikely. Yet, it is a demonstrative move with bipartisan support that if Democrats return to the majority in the future, they will take action to repeal the Mexico City policy for good.

The Mexico City policy reinstated by President Trump has widespread consequences on public health. Individuals, both in the U.S. and worldwide, face reduced access to family planning, nutrition, child health and disease prevention and treatment services under this legislation. Furthermore, communities will likely witness increased maternal mortality, unwanted pregnancies and unsafe abortions as a result of this rule – which tends to impact developing countries and low-income women and families most.

It’s crucial for public health officials to not only be aware of the outcomes of the Mexico City policy, but to create and implement strategies to lessen the effects of the rule for the people they serve. Earning a Master of Public Health degree from the University of Arizona can help these professionals learn the knowledge and skills they need to make positive impacts on communities as a whole and on individuals, in particular.

Recommended Readings:

http://mphdegree.arizona.edu/resources/articles/6-traits-that-mark-a-successful-public-health-professional/

http://mphdegree.arizona.edu/resources/articles/social-determinants-and-their-effects-on-quality-of-life/

http://mphdegree.arizona.edu/resources/articles/usb-hiv-test-could-help-developing-countries/

Sources:

http://www.un.org/en/development/devagenda/population.shtml

http://kff.org/global-health-policy/fact-sheet/mexico-city-policy-explainer/

http://thehill.com/policy/healthcare/abortion/315652-trump-signs-executive-order-reinstating-global-gag-rule-on

http://www.ippf.org/news/why-we-will-not-sign-global-gag-rule

http://www.engenderhealth.org/media/info/definition-global-gag-rule.php

https://www.hrw.org/news/2017/03/07/trumps-mexico-city-policy-or-global-gag-rule

http://www.independent.co.uk/news/world/europe/donald-trump-abortion-clinic-funding-cut-global-gag-rule-eight-countries-raise-money-sweden-a7570596.html

http://www.cnn.com/2017/03/02/europe/millions-raised-after-trump-global-gag-rule/

https://euobserver.com/foreign/137053

http://nymag.com/thecut/2017/01/her-act-bill-in-congress-would-repeal-abortion-global-gag-rule.html