In The News

When doctors take a pledge to do no harm, it means we have an obligation to not knowingly hurt people who come to us for help. It also means we have a duty to talk with our patients about their options and to make sure they're fully informed partners in their own care. That's why, as both a doctor and a member of the U.S. Congress, I'm so deeply disturbed by a 38-year-old American policy known as the global gag rule.

On paper, the global gag rule prohibits non-governmental organizations in other countries from receiving any U.S. global health assistance if they provide, refer, counsel, or advocate for legal abortion in their country — even if these activities are supported solely with non-U.S. funds.

In practice, this dangerous policy jeopardizes life-saving global health programs and makes it even harder for women and families in marginalized populations to access critical reproductive health care. It demands that health care providers across the globe — often already fighting daunting odds to help patients in low-income nations facing extreme poverty or living in conflict zones — not provide or even talk to their patients about abortion. Even if abortion is safe and legal in that country. Even if their patient's health is at risk.

The research shows us how damaging this policy is. Study after study has demonstrated that the global gag rule devastates health care access for people around the world, especially those who already face systemic barriers to care — including women and girls, young people, and LGBTQ+ people. And it isn't just sexual and reproductive health care that's being blocked. This policy also hinders our ability to fight against epidemics like HIV/AIDS, tuberculosis, malaria, and puts life-saving nutrition programs at risk.

One year ago today, President Biden rescinded the global gag rule. I know I speak for many of my colleagues in Congress when I say we were deeply grateful for his leadership. But sadly, this action isn't enough to end the devastation of this rule.

This cruel policy was originally imposed by the Reagan administration, before being rescinded in 1993 by President Clinton, and then reinstated in 2001 by President Bush on his first business day in office. President Obama rescinded the global gag rule in January 2009, but less than a decade later, President Trump reimposed and radically expanded the policy, extending its harm to even more women and communities.

If you found those sentences a bit dizzying, imagine how disorienting this roller coaster has been for the international organizations on the ground just trying to get patients care or to advocate for better access to sexual and reproductive health care in their countries. Probably the easiest thing to keep track of about this U.S. policy for them has been: the global gag rule always comes back.

The ever-looming threat that the next American president could immediately reinstate the global gag rule creates what is known as a chilling effect. Studies show this causes organizations in places like Kenya to self-censor themselves — even beyond what the policy mandates. Even when it is not in effect.

So despite President Biden's action, we know the global gag rule lives on today. It's up to Congress to put a stop to this rule once and for all — and we have got to get moving, fast.

Last year, Sen. Jeanne Shaheen (D-N.H.) and Reps. Barbara Lee (D-Calif.), Jan Schakowsky (D-Ill.), and I were proud to introduce the Global Health, Empowerment, and Rights (HER) Act to permanently end the global gag rule and its attack on reproductive rights. The language has been included in the House and Senate funding bills and passing it will ensure this cruel rule can never come back, and will get the ghost of a bad policy out of private conversations between health care providers and their patients across the globe. We have until Feb. 18 to act and as a doctor and a member of Congress: I know we can't pass this bill fast enough.

Rep. Ami Bera is a medical doctor and a member of Congress serving on the House Foreign Affairs Committee.