The Cable

To ‘Protect Life’, State Department Rolls Out Women’s Health Policy Critics Call a ‘Death Warrant’

Battle lines are drawn over the State Department’s sweeping new restrictions on aid for international women’s health organizations that perform or advocate abortions.

TONGO, DR CONGO - NOVEMBER 04:  (ISRAEL OUT) Refugees wait near their shelters in the village of Tongo, in the hills outside Goma, on November 4, 2008 in North Kivu province,Democratic Republic of Congo. Fighting has continued in the region occupied by rebel commander Laurent Nkunda, despite a ceasefire brokered last week, leaving outside observers fearful of "another Rwanda tragedy" in the Democratic Republic of Congo.  (Photo by Uriel Sinai/Getty Images)
TONGO, DR CONGO - NOVEMBER 04: (ISRAEL OUT) Refugees wait near their shelters in the village of Tongo, in the hills outside Goma, on November 4, 2008 in North Kivu province,Democratic Republic of Congo. Fighting has continued in the region occupied by rebel commander Laurent Nkunda, despite a ceasefire brokered last week, leaving outside observers fearful of "another Rwanda tragedy" in the Democratic Republic of Congo. (Photo by Uriel Sinai/Getty Images)

The State Department on Monday rolled out plans to drastically expand a Reagan-era ban on federal funding for international groups that perform or advocate for abortions. The controversial ban won praise from pro-life groups who say it aligns U.S. foreign aid funding with conservative policies, but drew condemnation from many in the NGO community, who called it a “death warrant” for some women in developing countries.

While similar guidelines have been instituted under every Republican president since Ronald Reagan, under the Trump administration, the policy’s scope is much more sweeping. The “Protecting Life in Global Health Assistance” policy places new restrictions not just on funds that go to family planning assistance, but also money that supports malaria eradication, maternal and child health, and AIDS prevention and treatment, amounting to a total of $8.8 billion.

Under former President George W. Bush, the Mexico City policy only put limits on a budget of $575 million — funding that went directly to family planning-related services. But other U.S. government support for organizations’ overseas health efforts were unaffected.

The new plan prohibits foreign nongovernmental organizations from receiving any health-care related U.S. funding if they “perform or actively promote abortion as a method of family planning in other nations.” NGOs say it confirms their fears that the demands would focus on a larger slice of funding than its predecessors and its implementation would mean danger, and sometimes potentially even death, for women in developing countries seeking access to healthcare and contraception.

Pro-life experts praised the Trump administration’s decision, saying it aligned with his campaign promises to promote conservative policies worldwide.

“This isn’t about cutting funding or cutting services,” said Melanie Israel, a research associate at the Heritage Foundation’s DeVos Center who focuses on religion and civil society. “It’s about saying we’re going to partner with organizations that share our common values.”

A senior administration official, speaking on condition of anonymity, told reporters Monday the policy would be instituted immediately for all new projects and “gradually” phased in to existing projects the United States funds around the world. The State Department will evaluate the policy’s effectiveness over the next six months, given its expansive nature, the official said.

“The United States remains deeply committed to supporting health programs around the world,” the senior official said. “This change will have no impact on the total amount of U.S. government funding for health programs around the world.”

But other aid experts disagree. The rollout is devastating to women’s health and rights activists who focus on access to contraception and medical care, some experts charge. While hardly unexpected, the more expansive scope of the Trump administration’s Mexico City Policy has dismayed NGOs who stand to lose a significant chunk of their funding — which they say will have a devastating impact.

“This is a death warrant,” said Lisa Shannon, the president of Every Woman Everywhere, a human rights coalition committed to ending violence against women. “I just find it amazing they’re calling it protecting life, because this policy backs women so far into a corner the only choice that’s left is to die,” Shannon added.

Under the new Mexico City Policy, organizations have to agree not to promote abortion every time they receive a new grant or want to take out money from an old one. But even some who aren’t involved in advocating abortion as a family planning method say they won’t sign on.

“I talked to clinics that aren’t involved in abortion in any way,” Shannon said. “They still won’t sign the policy because they consider it unethical.”

It remains an open question whether others, with their back to a wall, will shift their family planning policies to guarantee continued U.S. funding.

For many, the policy represents a long-overdue correction. Marjorie Dannenfelser, president of the pro-life Susan B. Anthony List lauded the policy, saying in statement, “with the implementation of Protecting Life in Global Health Assistance, we have officially ceased exporting abortion to foreign nations.”

It’s also a boon to Trump’s conservative base. “It’s very encouraging. It’s reiterating the repeated commitments Trump had made on the campaign trail about defending life,” Israel said.

Under the Bush administration’s Mexico City Policy, in effect from from 2001 to 2009, the abortion rate in sub-Saharan Africa actually rose, according to a  2011 Stanford University study. In defunding organizations that offered those services, the government also defunded the primary family planning facilities that provided women with contraception, resulting in more pregnancies and more abortions. Many of those abortions however, were done underground, making them unsafe, and at times lethal.

“This policy is sure to tragically increase the number of unintended pregnancies, unsafe abortions and women dying from pregnancy-related complications around the world,” said Latanya Mapp Frett, executive director of Planned Parenthood Global.

The International Planned Parenthood Federation estimates it will lose $100 million in funding over the course of the next three years as a result of this policy. While some organizations have refused to sign on to the agreement, other NGOs will likely accept its terms and stop mentioning or administering abortions in order to keep their very existence afloat.

Of the 64 countries the United States provides with global health assistance, 37 have legalized some form of abortion which groups would not be able to perform were they to sign on to the Mexico City Policy, according to research from the Kaiser Institute.

Photo credit: URIEL SINAI/Getty Images

Ruby Mellen is a fellow at Foreign Policy. @RubyMellen

Robbie Gramer is a diplomacy and national security reporter at Foreign Policy. @robbiegramer

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