USAID’s celebration of International Women’s Day Wednesday included the release of a statement noting that when women and girls “are empowered to make decisions related to their health, infant deaths decline, nutrition improves, agricultural productivity rises, population growth slows, economies expand and cycles of poverty are broken.”
By then, however, the agency’s Standard Provisions for Non-US Nongovernmental Organizations had already been amended with a dozen pages outlining the strict limits to which USAID could support women to “be empowered to make decisions related to their health . . .”
The quiet addition last week to USAID’s instructions for international NGO funding of RAA29 Mexico City Policy (March 2017) reinstated restrictions that had been there before, and maybe that added to the air of anachronism the renewed rules carried, with their one sentence of approval for “passively responding to where a safe, legal abortion may be obtained . . .”
The 1984 “Mexico City Policy” (also known as the Global Gag Rule for the restraints it puts on what medical providers can tell their patients) has been off the books for the last eight years. Its restrictions include a prohibition against USAID-funded international programs “actively promoting abortion as a method of family planning,” including “abortions performed for the physical or mental health of the mother.” It defines “active promotion” of abortion to “providing advice that abortion is an available option in the event other methods of family planning are not used or are not successful.” It differentiates between “active” and “passive” services by allowing that providers “passively responding to a question regarding where a safe, legal abortion may be obtained is not considered active promotion if the question is specifically asked by a woman who is already pregnant, the woman clearly states that she has already decided to have a legal abortion, and the family planning counselor reasonably believes that the ethics of the medical profession in the country requires a response regarding where it may be obtained safely.” (Science Speaks-added bolding).
Concerns raised by the rule’s reinstatement go beyond evolution over the last decade in views of women’s rights and health needs, and the impact that the rule will have on reproductive health service access around the world. Under the widely expanded version of the rule signed by President Trump, it soon will apply to global health assistance furnished by all departments or agencies. That could include the President’s Emergency Plan for AIDS Relief, which, through support for women’s health services over the last 13 years, protected nearly two million babies from vertically transmitted HIV infection. It may include services around the the world providing Zika testing for women in areas where the virus is endemic. And it comes at a time when the outbreak of that virus has highlighted unmet needs for family planning worldwide.
Concern over the renewal, and scope of the rules restricting what health providers may tell their patients prompted the “She Decides” initiative, launched by a Dutch lawmaker, and leading last week to a Brussels conference that raised nearly $200 million to help fill the widened funding gap opened by the Trump administration’s expanded policy. World Health Organization Assistant-Director General Dr. Flavia Bustreo attended the conference and described some of the dividends of reproductive health service access on the organization’s web site. They include that access to contraception enables girls to stay in school, where each year of education raises her future earnings by 10 to 20 percent. Higher incomes among women, are “strongly associated with better health outcomes for women and children,” she notes.
“Having more women in politics is one important way to ensure that women’s health and rights are protected and advanced,” she adds “but with women making up only 22.8 percent of national parliamentarians worldwide, there is still a long way to go.”