Editorial: Ditch the global gag rule once and for all

One of President Trump’s first misguided actions in office was to reinstate an antiabortion policy known colloquially as the “global gag rule.” Under the rule, any foreign nongovernmental organization receiving U.S. aid for healthcare must agree not to spend any of its other funds — the money it does not receive from Washington — on abortion services or referrals for abortions. Organizations are even barred from counseling clients about abortion or advocating for abortion rights laws. Hence the “gag” rule.

It’s an absurd restriction, given that Congress has long barred federal dollars from being spent on abortion, and all foreign recipients of U.S. aid must comply. Demanding that organizations must also accede to the gag rule — now dubbed “Protecting Life in Global Health Assistance” — puts foreign health organizations in the terrible position of either stopping abortion-related services in countries where poor women have a difficult time finding access to safe abortions or losing U.S. funding for other much needed health services (including, ironically, contraception).

But in recent weeks, there have been signs that Congress may be ready to roll back the global gag rule through its power over the federal purse.

Earlier this month, the newly Democratic-controlled House passed a package of spending bills, including one on foreign operations that sought to rein in the policy. That bill went nowhere, caught in the crossfire between President Trump and congressional Democrats over the border wall Trump covets. Notably, however, the House bill copied the language in the foreign operations spending bill that the Senate Committee on Appropriations unanimously approved last June, including a provision explicitly allowing abortion counseling by aid recipients.

Opponents of the gag rule contend that there is more bipartisan agreement than ever across the House and the Senate on repealing it. In the next few weeks, Rep. Nita Lowey (D-N.Y.), the chair of the House Appropriations Committee, will reintroduce a bill she offered in 2017 to permanently repeal the policy.

Unfortunately, Trump is unlikely to sign any measure containing a repeal of the global gag rule. Still, a bipartisan effort to repeal this harmful and unnecessary policy is worth pursuing. The policy was first established by the Reagan administration and has been alternately rescinded by Democratic presidents and reinstated by Republicans ever since. The Trump administration took things further, however, by extending the policy to far more health providers globally than ever before. When it was in effect under President George W. Bush, the gag rule applied only to about $575 million in foreign aid, and only to organizations doing family-planning work. Now it applies to about $8.8 billion in aid and covers organizations working on maternal and child health, nutrition, HIV/AIDS treatment, tuberculosis, malaria and other infectious diseases, among other concerns.

The State Department surveyed the effect of the new policy six months after it was adopted and found that 729 prior aid recipients had accepted the money and agreed to the new strings attached, while four had not. But even the State Department said it was too early at that point to gauge how broad the policy’s reach is. In fact, the nonpartisan Kaiser Family Foundation estimates that at least 1,300 organizations could be affected by the policy — nearly twice the number the State Department found.

For example, Family Health Options Kenya, a provider of sexual and reproductive health services, is part of the International Planned Parenthood Foundation, which refused to sign on to the policy. The Kenya organization closed one of its 14 clinics, cut staff at another and stopped outreach services to poor communities — reductions that affected more than 76,000 women and young girls by May 2018, the organization estimated. The outreach services affected include cervical cancer screenings, HIV testing and family planning counseling.

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Or take Marie Stopes International, which says it has cut five mobile health and outreach teams across Uganda and slashed the number of outreach sites it visits in Zimbabwe from 1,200 to 600. The Marie Stopes organization, which uses non-U.S. dollars to provide safe abortions in three dozen countries, estimates that 1.4 million women in the countries it serves could lose access to contraception and other services by 2020.

Advocates predict that the effects could be increasingly devastating as time passes and groups have to apply for new or renewed funding.

Even the staunchest abortion opponents should be able to see that crippling these organizations’ efforts to deliver crucial non-abortion healthcare services to underserved and desperately poor communities is cruel and harmful. The global gag rule should be repealed once and for all.

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UPDATES:

11 a.m.: This editorial was updated with more current numbers from Marie Stopes International.