Opinion: UK aid cuts will cause more damage than 'global gag rule'

Worsening insecurity has sparked an unprecedented internal displacement crisis in Burkina Faso, uprooting more than 1 million people from their homes since 2019.

Marie Ouedraogo, a midwife from MSI Reproductive Choices, brings reproductive health care to women and girls who have been forced into cramped internally displaced persons camps in Kaya, 100 kilometers north of the capital Ouagadougou.

It is hard and dangerous work, but for Ouedraogo, whose name has been changed to protect her identity, the mission is unwavering: “Our fight is to ensure that women and, in particular, young girls in IDP sites are not victims of unwanted pregnancies,” Ouedraogo said in a recent interview with a team member.

Here, in one of the lowest-income countries on Earth, lack of access to contraception leads to 287 women resorting to unsafe abortions and six women dying every day from pregnancy-related complications. But outreach workers like Ouedraogo refuse to give up.

However, following the recent reduction in U.K. official development assistance to 0.5% of gross national income, the funding for this desperately needed service is at risk.

MSI alone is facing a £45 million ($64 million) funding gap, as a result of U.K. aid cuts — an even greater loss than when former U.S. President Donald Trump reinstated and expanded the Mexico City Policy, also known as the “global gag rule.”

Life-changing sexual and reproductive health services, including MSI’s programs in Burkina Faso, Nigeria, Mali, Senegal, and Madagascar, have been severely impacted, with cuts coming from all sides.

Front-line health care workers at both MSI and International Planned Parenthood Federation have been hit by the reduced funding to the U.K. government’s flagship Women’s Integrated Sexual Health program, which over the last two years has saved the lives of 22,000 women, while vital contraceptive supplies have been devastated via brutal cuts to the U.N. Population Fund.

The speed and magnitude of these cuts will undermine trust between women and health care providers such as Ouedraogo, and we fear the damage to women’s lives and futures will be worse than that caused by Trump’s global gag rule. 

In Burkina Faso, MSI is the main provider of longer-term contraceptive methods in the country, and the reduction in U.K. aid will significantly reduce access and choice for women and girls across the country.

As a result of the reduction in U.K. funds we had expected through the WISH program, in Burkina Faso nine MSI outreach teams and 12 MSI Ladies — mobile midwives who work in the community — are at risk of closing.

As MSI’s Sahel director, I am seeing this same devastating outcome repeated across West Africa, as country directors are having to make the agonizing choice about which health teams and clinics to close.

As a result, women from the most marginalized communities will no longer be able to get the information or services they so desperately want. U.K. funding enabled us to serve 270,000 people every year in the Sahel. The health clinics and teams offering life-saving care that they have relied on will be forced to close, and their lives will be changed forever.

At MSI, we passionately believe that choice cannot be given and then taken away. We are still facing a funding gap for taking a stand against the global gag rule, and these new cuts to U.K. aid are yet another reminder of how precarious current funding approaches can be. 

Contraception is one of the cheapest and most effective life-saving, poverty-ending, women-empowering innovations we have and I have seen the consequences when it is not available. I’ve seen women dying in childbirth, mutilating their bodies, or risking their lives with backstreet abortions.

But it doesn’t have to be this way. The onus is on the sector to look at how we can diversify our funding base to protect women’s access. This starts with MSI and other sexual and reproductive health and rights advocates driving home the message that reproductive choice is pivotal to a range of other development goals, including girls’ education and building resilience to the climate crisis.

Alongside new sources of donor income, MSI is also looking at how, where possible, we can make services self-sustaining.

We are also committed to working with local governments toward national ownership of SRHR services. But it is imperative that this be a dual approach. As a sector we must work hand-in-hand with the donor community to make sure there are no gaps in service provision and that organizations such as MSI can continue going to the last mile to ensure that no-one is left behind.

We know that governments and donors are going to be under a lot of pressure due to the huge gaps to fill across so many sectors, but it’s women’s and girls’ lives and futures that are on the line.

For those who say we cannot afford to do this, I say we cannot afford not to.

It costs less than 2 pence per day to protect a young woman from an unintended pregnancy, and as the largest generation of young people in history approaches their reproductive years, provision of information and services is key to building their resilience and unlocking their potential.