Senator Jeanne Shaheen is challenging U.S. President Donald Trump’s “global gag rule” in Congress with the Global Health, Empowerment and Rights (HER) Act, which seeks to permanently repeal the order, as NGOs and activists warn of the severe impact of the rule.
The bill, introduced in January by Shaheen, a democratic senator from New Hampshire, and Democratic Rep. Nita Lowey from New York, has garnered bipartisan support, including from Republican Senators Susan Collins and Lisa Murkowski.
If passed, it would guarantee that organizations providing family planning services abroad are eligible to receive U.S. government funding regardless of any health or medical services they offer using non-U.S. funds, including abortion, so long as those services are legal in the country in which they are provided and would not violate federal law if they were provided in the U.S.
However, it faces an uphill battle in the Republican-controlled Congress.
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President Trump reinstated the “global gag rule” — also known as the Mexico City Policy — two days after his inauguration in January. It prevents non-U.S. NGOs that provide services or information relating to abortion from receiving U.S. government funding for any of their activities.
Hundreds of people marched to the White House on International Women’s Day last week to protest against it, an event organized by the Center for Health and Gender Equity.
Although the rule has been implemented by previous Republican presidents, Trump’s memorandum indicated that he would extend it to cover all U.S. government global health spending, rather than family planning streams alone. This could affect up to $9.5 billion worth of funding for HIV work, maternal and child health, immunizations and Zika prevention.
However, guidelines issued by Trump earlier this month leave the extent of the order unclear.
National governments, foundations and other groups have attempted to plug the looming funding gap, with Canada announcing that it will spend $650 million on sexual and reproductive health and rights worldwide, including on access to safe abortions, and donors pledging a total of $190 million at a conference in Brussels this month.
Shaheen spoke to Devex about the implications of the policy, the progress of the HER Act and what the development community can do to safeguard health care services.
How do you think President Trump intends to position the U.S. on global health assistance and family planning?
The global gag rule is bad enough, but this [expansion] is a dramatic shift in policy that will affect millions of people in some of the most impoverished areas of the world. President Trump’s executive order may encompass as much as 15 times more federal funding than when implemented under previous Republican administrations.
Playing politics with family planning is nothing new, but threatening some of our most successful global health programs — like the U.S. President's Emergency Plan for AIDS Relief — sends a signal that no global health program is off limits. These are successful programs with a long history of strong bipartisan support. Our PEPFAR program has prevented almost 2 million babies from being born with HIV. So making cuts to these programs and the services they provide will have a real impact on the lives of women and their families.
Last week, I sent a bipartisan letter to President Trump expressing opposition to the policy and its expansion, and requesting details on how his administration plans to implement it. Specifically, I want to know how it will affect the delivery of basic health services, PEPFAR and other programs funded through the State Department, the U.S. Agency for International Development, and the Department of Health and Human Services, as well as how it will impact women and girls.
NGOs have described the response from the international community as more forceful than it has been in previous years. Why do you think that is?
The U.S. has long been a leader on global health assistance, forging a path for other nations to follow and invest in the developing world. In the wake of President Trump’s ill-conceived executive order, I am glad to see countries like Norway, the Netherlands and Canada, among others, step up to raise money to fill the shortfall left by this policy.
However, I remain very concerned about the chilling effect that is already happening in the global health community. It’s in our best interest to continue our support for family planning and other global health programs, and we should be encouraging other countries to join us in supporting women and girls’ access to basic health services and family planning in developing countries.
What are the next steps in passing the HER Act?
I’m very glad to have bipartisan support for the HER Act, which has 47 co-sponsors in the Senate. Despite this broad support, it still faces significant opposition from members who want to curtail women’s full access to family planning.
In years past, I used my role on the Senate Foreign Relations Committee to strike global gag rule language from the state and foreign operations appropriations bill. While this will certainly be more challenging this time around, I will continue to work with my colleagues on the committee on this issue and see what inroads can be made.
I’ll also continue to educate my colleagues on the importance of U.S. supported family planning services in the developing world. The fact is, family planning is a smart investment that helps reduce the cycle of poverty globally.
What advice would you give to those working in the sector who wish to oppose the order?
Call President Trump and call your members of Congress about the HER Act. Use your expertise and experiences from the field to let your elected officials know the impact that the global gag rule will have on your work. And reach out to my office to share your experience. Restricting access to family planning services affects real women’s lives. We need to share those stories to take this conversation out of the abstract and place it in reality.