NGOs push back on positive US review of 'global gag rule'

NEW YORK — Global health organizations called the United States State Department’s new findings that the vast majority of foreign NGOS are complying smoothly with its reinstated Mexico City Policy “skewed” and “premature and inadequate.”

The policy, also known as the “global gag rule,” bars all U.S. global health assistance to any foreign NGO that either conducts, or provides consultations on abortions. President Donald Trump reinstated the policy, versions of which were also adopted under previous Republican administrations, in January 2017.

The State Department released a report last week showing that the policy has stopped funding to just four prime recipients, and 12 sub-recipients, out of the 733 awards tracked so far. Marie Stopes International and International Planned Parenthood Federation — which had already gone public with their refusal of new U.S. government funding — were named as two of the international health organizations that decided to forgo their awards.  

Trump’s reinstatement of the law received widespread condemnation by NGOs and other government aid groups, prompting some European states to move to address funding shortfalls amid accusations that the global gag rule would endanger women’s health and reproductive rights worldwide. Administration sources were pointing to the State Department report as evidence that the rule has not had such a disruptive impact.

However, critics pointed out the State Department’s analysis did not offer any information on how much funding is wrapped up in the loss of these contracts. The review also does not note that most prime recipients are U.S.-based, and not required to sign on to the policy. The Planned Parenthood Federation of America said in a media release that report was incomplete and “skewed.”

“This incomplete review tells a misleading story,” said Latanya Mapp Frett, executive director of Planned Parenthood Global.

“The truth is that the effects of the global gag rule will be far reaching and deadly … We’ve seen the impact of these policies for women around the world. In Uganda, a service provider that delivers health services to over 1 million people annually has already seen its ability to serve its patients severely limited. As a result, unintended pregnancies will rise, and with it, unsafe abortions,” Frett added.

The majority of known recipients, totaling 419, that have signed on to the policy receive funding from the U.S. Agency for International Development. Other recipients receive funding from the Department of Defense and Health and Human Services.

Serra Sippel, the director of the Center for Health and Gender Equity, remarked on how the review only mentions one group — the U.S. Catholic Bishops — to praise the administration’s expanded policy.

And the International Center for Research on Women echoed other women’s health and global health organizations, calling the review “premature and inadequate.” It called for ongoing, independent reviews of the policy.

Pathfinder International questioned the ability to assess the policy’s implementation, saying the 6-month review — from May through September 2017 — was not “a meaningful period to adequately assess impact.”

“Under the current administration, the expanded version of the ‘global gag rule’ excludes some of the most effective health organizations and advocates for marginalized people in 60 low- and middle-income countries. These organizations are often the only health care providers serving a given community. Most of the impact expected under the ‘global gag rule’ will not be evident until several months or years into the policy,” Pathfinder said in a media statement.

NGOs and research organizations have been working to assess the full extent of the global gag rule’s impact.

The policy’s effects are already apparent worldwide, some organizations report. Mozambique — where an organization that provides support to people living with HIV — will need to lay off about 130 staff, placing about 500,000 people without access to care, according to Planned Parenthood. Botswana’s only national health NGO will need to close clinics in three of the eight districts it serves.

Marie Stopes International, delivering contraception and abortion services in 33 developing countries, has said that it now faces an $80 million funding gap and a 17 percent reduction of its donor funding, as Devex recently reported.

The Kaiser Family Foundation also recently released its own analysis that at least 1,275 foreign NGOs — totaling $2.2 billion in funding — would need to comply with the rule.

There has also been reported confusion about what U.S. global health recipients and subrecipients need to do to be compliant with the rule.

The State Department intends to conduct another review of the policy’s effects by the end of 2018. U.S. government agencies also have plans to launch digital training and compliance tools, in an effort to address confusion among foreign NGOs. So far, "numerous" sessions have been conducted, reaching more than 4,500 people.

Read more Devex coverage of the “global gag rule.”