The global gag rule is a policy that bars the federal government of the USA from offering US aid to any foreign health organisation that offers or provides information on abortion services. Even mentioning abortion as a family planning option is not allowed to health organisations under the policy. The gag rule, also known as the Mexico City Policy or the Protecting Life in Global Health Assistance (PLGHA) Policy, was first created in 1984 under the then US President Ronald Reagan. Ever since, each Democratic president has revoked it, and each Republican president has put it back in place.

Let’s talk about how it affects sexual and reproductive healthcare. 

According to a research published in The Lancet, almost half of abortions that occur every year are unsafe. That means around 25 million terminations take place every year! Of those that are unsafe, 97% are undertaken in developing countries alone. And there are a lot of factors that make a termination safe like performed by a qualified clinician in a clean environment, along with proper guidance and counselling about post-abortion care. Since funding for providing this information is taken away, how are people expected to be informed and educated? 

For some of the world’s poorest communities, sexual health organisations are essential for providing family planning services like birth control, maternal health care and, sometimes, abortion services. These organisations can sometimes be the only affordable and accessible medical care in the area. Because of the gag rule, now the organisations were forced to make a choice. If they agreed to the terms, they couldn’t provide reproductive-age women with information on abortion even if the women themselves requested it and if they refused to comply with the rule, they would not only lose out on much-needed aid but will also have to scale back public health programmes. Moreover, it has been seen that despite its anti-abortion messaging, the gag rule reduces access to contraception, which creates an increase in unintended pregnancies and actually leads to more unsafe abortions. 

If this was not enough, President Donald Trump added to our problems!

In 2017, Donald Trump reinstated the global gag rule (being as he is a Republican, this was expected). However in 2019, he and his secretary of state, went further expanding the rule to cut off funding to any organisation found to be supporting other NGOs that provide abortion services or counselling. Trump’s version expands the policy to all global health funding. According to Suzanne Ehlers, president and CEO of the global reproductive health organization PAI, the new rule means that rather than impacting $600 million in US foreign aid, the global gag rule will affect $9.5 billion. And it did affect a majority population in the global south.

Although Médecins Sans Frontières does not accept US government funding, the medical aid charity said it had seen the harm that the gag rule has had on limiting women’s access to healthcare. In 2019, MSF treated more than 25,800 women and girls with abortion-related complications. “We’ve seen women who have used pens, broken glass, or sticks to try to induce an abortion. We’ve seen women who drank chlorine or poisons,” Dr. Manisha Kumar, head of MSF’s task force on safe abortion care, said in a written statement. The implications have obviously been grave for women in countries already struggling with debilitating healthcare systems and restrictive laws and access to safe abortion services (Let’s not forget here that 2020-2021 have shown us that India too is a country struggling with the healthcare system). Also, the move is very symbolic in terms of how the Trump administration viewed women’s struggle to demand and access sexual and reproductive health (SRH) services and prioritizes dismantling the rights that already exist. Donald Trump and six other old white men sat down in a room and signed a legislation about what women can do with their bodies, especially their reproductive organs! Dr. Kumar goes on to say, “We can only guess how many women lost their lives over the last several years because access to this essential healthcare was cut off. And we know that policies such as the global gag rule disproportionately affect Black women and women of colour.”

When the Trump administration reinstated the global gag rule in 2017, the International Planned Parenthood Federation (IPPF) lost some $100 million in funding in the following years, impacting a spectrum of healthcare projects in 32 countries and going well beyond the intended goal of preventing abortions. The Guttmacher Institute reported that projects related to HIV/AIDS, nutrition, malaria, water and sanitation, tuberculosis and other infectious diseases were adversely affected. It says a lot about Trump’s insecurity and fear – who is a billionaire and the President of the most powerful country in this world – but in his first acts as the president sought to control women’s bodies. 

Thankfully though, President Trump lost in 2021 and a Democrat, Joe Biden is the new president of the USA. This means reversal of the global gag again. In fact, current President Biden even announced that reversing the global gag rule will be a priority for his party. However, reversing the work of four years of the most extreme anti-woman presidential administration in recent history won’t be easy. “Rescinding the [global gag rule] policy is not like turning a light switch on and off,” said Jonathan Rucks, senior director of policy and advocacy at PAI. 

It is true. What we need now is a permanent repeal of the global gag rule. The constant flip-flop of Republicans vs. The Democrats fight has affected women’s reproductive health way too much already. One way the Biden administration can stop the seesaw effect of the gag rule and make a clear statement in support of reproductive rights worldwide is to pass the Global Health, Empowerment and Rights Act (HER), which would repeal the global gag rule permanently by preventing future presidents from easily reimplementing the policy through executive order. We must ensure the harm of the previous four years ― and the long shadow the global gag rule has cast since 1984 ― are completely stopped once and for all.