The global gag rule on abortion and reproductive health care must be repealed | Congressman Ami Bera

The global gag rule on abortion and reproductive health care must be repealed

Feb 19, 2020
In The News

Last month marked three years since President Donald Trump reinstated and expanded the Global Gag Rule, jeopardizing life-saving global health programs and making it even harder for people in developing countries to access crucial reproductive health care – care that we know saves lives.

Under this abhorrent policy, health care providers are barred from receiving desperately-needed financial assistance if they offer abortion-related services or counseling – even if they offer those services with non-U.S. funds.

Perhaps even more insidiously, although up to 31,000 women – nearly all of them in the developing world – die from unsafe abortion each year, the Global Gag Rule imposes restrictions on the speech of aid recipients. Because losing this assistance would be devastating for many groups, this speech restriction has led some groups to avoid any reproductive health care advocacy, preventing them from advocating for changes in the laws that could save their patients’ lives.

Under the Global Gag Rule, clinics are forced to choose the lesser of two evils: accept the restrictions and stop offering the full range of information and services to their patients, or refuse to sign onto the policy, forfeit U.S. funding, and risk closure. There is no good choice: either harms the very people we’re trying to help with our foreign aid.

This harmful policy is apparent in places like Kitengela, Kenya, where Family Health Options Kenya, the nation’s largest reproductive health care provider, was forced to close in 2018. The closing of this health care provider deeply impacted the community, 20 miles south of Nairobi.

Women like Justine – who had an unexpected pregnancy at age 39 after the contraceptive she used to get from this clinic ran out – are not always able to travel to get the care they need. And even when they can, the stigma attached to reproductive health care can be fatal.

After the health provider shut down, a pregnant mother of four in Justine’s community had nowhere to go when she began to suffer from abdominal bleeding. Though she found a clinic in another community, the doctor accused her of attempting a self-induced abortion and refused to treat her. She bled to death as a result.

The impact of the Global Gag Rule runs beyond decreased access to contraception, safe abortion, and pre-natal care. The policy now applies to all global health funding – impacting $8.8 billion in U.S. global health aid, putting HIV/AIDS, tuberculosis, malaria and nutrition programs at risk.

Winifred, an HIV-positive former patient at the Kitengela clinic, used to go to go there for her antiretroviral treatment. She now has to go much farther for treatment at a poorer-quality facility, where stigma against HIV-positive patients is high. Some of Winifred’s friends who can’t afford transportation to far-away clinics have ceased treatment.

These stories are not uncommon. For three years now, Trump’s Global Gag Rule has threatened the lives and wellbeing of people and communities around the world. It has to end.

Thankfully, there is a growing recognition of the havoc unleashed by this cruel and reckless policy. All of the 2020 Democratic presidential candidate frontrunners have promised to end the Global Gag Rule. But an end to Trump’s terrible version of the policy isn’t enough.

A bill currently in Congress, the Global Health, Empowerment, and Rights (Global HER) Act, would end the Global Gag Rule permanently. We need all legislators – both Democrats and Republicans – to fight to ensure that clinics around the world receive the funding they need to serve their patients. We must end the attack on reproductive rights and permanently repeal the Global Gag Rule.

Rep. Ami Bera is a medical doctor and a member of Congress serving on the House Foreign Affairs Committee.
Melvine Ouyo is the former Kibera Clinic Director for Family Health Options Kenya and a recent graduate of Harvard University’s Kennedy School of Government.