We must repeal the Global Gag Rule to protect girls’ and women’s lives

Earlier this month, at the Blair House in Washington D.C., U.S. Secretary of Health and Human Services, Alex M. Azar II kicked off the latest attempt to eradicate women’s and girls’ control over their own bodies. Invoking Eleanor Roosevelt — of all people — Azar said, in a case of Orwellian doublespeak, to the 35 U.S allies gathered: “Every country has the right, and the duty to its own citizens, to decide for themselves how laws and policies can best strengthen the family, ensure optimal health for women and adolescents throughout their lifespan, and protect the unborn.”

The Trump administration’s record grossly contradicts this statement. This month marks three years since the administration re-instated an expanded Protecting Life in Global Health Assistance (PLGHA), informally known as the “Global Gag Rule,” which blocks or gags, U.S. global health assistance to any foreign non-governmental organizations that provide, counsel, refer, or advocate for abortion services — even if they provide these services with their own funding or if abortion is allowed in their countries.

This policy directly violates the national sovereignty of countries receiving U.S. global health assistance “to decide for themselves.” 

Recently, Reps. Nita Lowey (D-N.Y.) and Andy Levin (D-Mich.) took a step in the right direction by introducing the Global HER Act (HR 1055) which would repeal the Global gag Rule. Also last week, however, 60 Republican lawmakers sent Secretary of State Mike Pompeo asking for even further expanding the scope of the rule.

Our team has been documenting the devastating impact of the gag rule, which has caused debilitating funding losses to NGOs that provide family planning, maternal and child health, nutrition, HIV, primary care, and other critical health services. 

One international organization that did not sign on to the global gag rule was forced to close many of its health facilities and end outreach to rural areas.

We have seen the end of a program that provides free contraceptives to 170,000 women and girls living in poverty, and broad shortages in family planning supplies. More women are seeking post-abortion care services treatment due to complications arising from unsafe abortions or miscarriages.  

Banning abortion or imposing restrictions on funding only increases unsafe abortion and decreases access to contraception. A 2019 study in The Lancet found that, instead of reducing abortion, the gag rule actually caused a 40 percent increase in a country’s typical abortion rate, a 14 percent decrease in the use of contraception and a 12 percent increase in pregnancies. (The Lancet)

Unfortunately, unsafe abortion is directly tied, in many cases, to sexual violence and risk for death in childbirth. Roughly, 13 percent of maternal deaths globally are attributable to complications from abortion.

But the administration does not talk about these connections. According to the WHO, almost all morbidity and mortality associated with abortion could be prevented through education, the use of effective contraception, the provision of safe and legal induced abortion, and the timely care for complications of abortion. (WHO)

Women living in low-income countries and poor women are more likely to have unsafe abortions than more affluent women (WHO). Three-quarters of abortions in Africa and Latin America between 2010 and 2014 were unsafe, compared with just over half of all abortions globally (WHO). Mortality from unsafe abortion disproportionately affects women in Africa, which is home to 29 percent of global unsafe abortions 62 percent of abortion-related deaths (WHO). An expanded global gag rule will dramatically worsen these statistics.

In his Blair House speech, Deputy Secretary Azar ignored these facts while misstating “there is no international human right to abortion. On the other hand, there is an international human right to life.”  

Azar praised Hungarian Minister of State for Family and Youth Affairs Katalin Novák – who is known for demonizing feminists, non-Christians and LGBT individuals alike — as a “valued ally that has been unafraid to recognize and promote the importance of the family for a healthy society.”

To this administration, the “importance of family” is code for limiting women’s and girls’ choices and regulating who gets to have a family.  

We need to push back, as difficult as it may seem, against this grotesque tableau and disrupt this administration’s attempt to distort established principles of public health and human rights. The women and girls of the world deserve better.

Terry McGovern is Harriet and Robert H. Heilbrunn professor and chair, Heilbrunn Department of Population and Family Health.