Drawing on previously published findings and on-the-ground interviews, a report from Planned Parenthood details damage to global health gains, including in closed programs, weakened civil society, divided communities, and squandered local training, as well as direct impacts to public and individual health from the policy introduced by the Trump administration two years ago called “Protecting Life in Global Health Assistance.” The policy, better known as the “global gag rule,” is a reinstated and expanded version of the policy originally signed into effect by President Ronald Reagan in 1984 as the Mexico City Policy.
While the original policy restricted any overseas U.S.-funded family planning program from providing any information or services, including referrals, related to terminating a pregnancy, the Trump version applies the restriction to all overseas U.S.-funded health programs, including services to treat and prevent HIV, tuberculosis, and malnutrition.
Every Republican president since Reagan has retained or reinstated that policy, and every Democratic president has revoked the policy, providing ample opportunities, seized by global health and human rights advocates, affected organizations, public health and policy researchers and others to document impacts of the policies real and perceived restrictions on services and information.
The Planned Parenthood report, which combines observations from earlier reports on the earlier policy and on the present iteration, as well as with observations from 22 individuals affected by the policy across seven countries was prompted by the February 2018 release of the State Department’s six-month review of the policy’s impacts, which, the department concluded were insignificant.
Before and after the release of the State Department’s report, however, data and anecdotal evidence gathered by organizations directly affected, as well as by organizations advocating for global gains in areas that include healthcare access, HIV responses and reproductive health, indicated that while the earlier policy had created gaps in women’s healthcare access with harms to them and their communities, including with increasing rates of unintended pregnancies, abortions, and poor child health, the new one, affecting funding across the spectrum of health services affects brought with it the potential for far greater community impacts. Those have been realized with closed programs and reductions in services causing the numbers of people accessing HIV tests rates, routine gynecology exams and cancer prevention services to plummet according to the report.
The Planned Parenthood Assessing the Global Gag Rule: Harms to Health, Communities and Advocacy report cites reports and issue briefs from the Kaiser Family Foundation, the International AIDS Alliance, the International Women’s Health Coalition, Population Action International, Human Rights Watch, and CHANGE — the Center for Health and Gender Equity.
For more on the “Protecting Life in Global Health Assistance” policy and its impacts, this report in the Guardian focuses on a Zambia health district.