LONDON — A top United Kingdom aid official has reassured advocates that the Department for International Development remains a “loud and strong voice for universal access to sexual and reproductive health” services, including abortion, for women and girls in developing countries.
Speaking at the launch of a new report from the U.K. All-Party Parliamentary Group on Population, Development and Reproductive Health, which calls for the U.K. government to support safe abortion at home and abroad, international development minister Alistair Burt said:
“DFID is absolutely clear that safe abortion is a crucial element of the full range of comprehensive sexual and reproductive health and rights services.”
He added that “this is not a reluctant position from DFID,” and that “we recognize that in the world where we’re operating — and where some women have no choices whatsoever and where some people would like to close down choices — safe abortion really matters and access to rights matters.”
Burt’s comments were greeted with enthusiasm by attendees at the event, held in the House of Commons on Wednesday evening, and may help allay concerns among some sexual and reproductive health and rights services — or SRHR — advocates that DFID’s position on abortion could be watered down to maintain relations with the United States. The U.S. government has taken a strong antiabortion stance in its development policy through the reinstatement of an expanded “global gag rule.”
“DFID has remained committed and has had a strong position on abortion for a long time,” Marge Berer, coordinator of the International Campaign for Women’s Right to Safe Abortion, told Devex. The parliamentary group’s report is aimed at “the entire political establishment, every MP, and every government department,” she said, adding that “there is still a lot of work to do.”
The report includes 10 specific recommendations for DFID, including increasing its budget for SRHR to 10 percent of official development assistance.
Opening the event, Baroness Jenny Tonge, chair of the parliamentary group, described DFID as “second to none” when it comes to promoting safe abortion in international development. She pointed out that abortion rates are roughly the same in countries where it is legally available compared with countries where it is not; but rates of maternal death are far higher where abortion is illegal.
She called on the department to fund work to expand the availability of medical abortion in developing countries. “To take pills to procure abortion in the first 12 weeks of pregnancy is so much easier than all the procedures that have gone before now,” Tonge said. “I hope DFID is going to be promoting it widely.”
The report also calls on DFID to encourage health ministers to allow community and primary care health workers, pharmacists, nurses, and midwives to provide abortion. “You don’t need to see a doctor necessarily,” Tonge said. The report similarly calls for legal reforms in the U.K., where women currently require the approval of two doctors in order to access abortion, and in Northern Ireland, where it is typically only available if a woman’s life is at risk.
Approximately 25 million unsafe abortions are carried out every year, leading to approximately 7 million complications, including maternal death, according to figures cited by the World Health Organization. The vast majority of unsafe abortions — 97 percent — take place in developing countries. Between 5 and 13 percent of all maternal deaths are the result of unsafe abortion, WHO says.
Yet funding and political support for abortion is on the decline, driven in large part by the reinstatement of the “global gag rule,” which prevents any U.S. government funding from going to foreign NGOs that offer services related to abortion. Advocates warn the stance could also be having a “cooling effect” on other previously supportive governments and donors.
Last week, senior executives at the International Planned Parenthood Federation and Marie Stopes International, the two organizations that have been hit hardest by loss of funding following the gag rule, spoke of an increasing reluctance among donors to talk about abortion, opting instead to talk about “family planning,” which tends not to cover support for safe abortion, although it can cover postabortion care. Labour MP Gareth Thomas, a former DFID minister, said he suspected DFID had declined to fund She Decides — a movement set up to raise funds for NGOs cut off by the gag rule, which has been funded by a number of European governments — in order to maintain good relations with the U.S.
At the annual meeting of the Inter-Agency Working Group on Reproductive Health in Crises, NGOs and U.N. agencies agreed on key updates to the guidelines on providing sexual and reproductive health services in humanitarian contexts — but they were forced to compromise on the issue of abortion, as representatives grappled with political sensitivities and the loss of U.S. funding.
The all-party parliamentary group also called on DFID to push for access to safe abortion “to the full extent of the law” in conflict settings, specifically noting DFID’s own 2014 policy concerning abortions in conflict situations to humanitarian and other partners. Women and girls in humanitarian settings face greater risks of sexual violence and unwanted pregnancy, but advocates working on access to safe abortion in these contexts have faced resistance, as Devex reported in November.
On the policy side, the report asks DFID to advocate for developing country lawmakers to ensure that more health workers are legally allowed to carry out abortions, and to advocate for the decriminalization, working towards the release of any women, girls, and practitioners currently incarcerated due to abortion laws.
Joint research from WHO and the Guttmacher institute shows that restrictive laws do not deter women from seeking abortion, but push them toward unsafe options. In countries where abortion is banned or only allowed in cases where it is needed to save a woman’s life, three-quarters of all abortions are unsafe, according to the research, which was published in September. However, many countries still have restrictive laws in place.
The report also calls on DFID to push for comprehensive sexuality education, including information on contraception and abortion, and ensure access to youth-friendly sexual and reproductive health services.
In January, the United Nations released an updated technical guidance on sexuality education, aimed at helping education policymakers design and deliver better education programs about sex and relationships to young people. It did not explicitly mention abortion, but was welcomed by SRHR advocates as being more progressive and inclusive than the previous iteration, as Devex reported.