The Global Gag Rule

This scenario is not unusual in many developing countries. Often it is the result of the contraceptive supply being interrupted, or a lapse in funding from the government. Shockingly, in this scenario, the inability of the clinic to provide contraceptives had nothing at all to do with local conditions and everything to do with a decision made thousands of miles away in the United States: the reinstatement of the global gag rule.

The Globe Gets Gagged

January 22 marked the sixth anniversary of the reinstatement by President Bush of the global gag rule, the Reagan-era policy that requires any organization outside the United States that receives U.S. family planning assistance to agree not to carry out the following activities: counsel patients about abortion, refer patients to abortion providers, provide abortions, or lobby for abortion legalization or reform in their countries. These organizations are prohibited from carrying out these activities even if abortion is legal in their countries, and even if they use non-U.S. money. (U.S. government funds are never used for abortions. Since 1973, when the Helms Amendment was passed, it has been against U.S. law to use foreign family planning assistance funds to pay for abortions.)

This policy forces reproductive health organizations to make a gut-wrenching choice: continue to accept U.S.-government funding and agree to terms that may endanger the health of their patients, or reject the money and be forced to cut basic services like contraception — also endangering their patients’ health. Organizations around the world have been making this decision since 2001, and the consequences have been swift and severe.

Services Suspended

Many reproductive health care providers in developing countries are not primarily abortion providers but rather, general reproductive health practitioners that deliver a range of services. Many of these providers — even those that don’t offer abortion services — have courageously refused to accept funding from the U.S. government so they will not have to withhold potentially life-saving information from their clients. As a result, some have been forced to cut programs and close clinics. So, along with eliminating possible abortion providers, the U.S. policy has reduced vital programs and services, such as family planning information and supplies, prenatal care and delivery assistance, and HIV-testing and prevention information.

According to Sona Sethi, the Planned Parenthood Federation of America (PPFA) regional director for Asia and the Pacific, in 2001, the Family Planning Association of Nepal (FPAN) was asked to sign the global gag rule.  FPAN refused and, as a result, lost one of its major sources of funding. PPFA stepped in and provided FPAN with one year of bridge funding so that it could continue to provide services while trying to raise funding from sources other than the U.S. government.

Also in Nepal, the Safe Motherhood Network Nepal had to turn down much-needed U.S. funding in 2004 because the network’s activities included increasing awareness about the 2002 law that legalized abortion in Nepal. PPFA is now providing support to the network to decrease maternal injury and death in Nepal by increasing access to safe abortion services and post-abortion care. 

The “Secondary” Effects

The gag rule has also split and polarized women’s groups that used to work in concert on general reproductive health issues, according to Dee Redwine, PPFA regional director for Latin America and Caribbean. “The global gag rule has created secondary effects among the NGOs [nongovernmental organizations] we work with in Latin America,” she said. These organizations are now clearly divided into two groups: those that receive and/or collaborate with those that receive U.S. funds, and those that don’t. “The former group is so fearful of losing funding and political support,” said Redwine, “that they won’t even collaborate with the other organizations that are not willing to be silenced on the issue of unsafe abortion.”

Another unexpected — and potentially catastrophic — casualty of the global gag rule is HIV/AIDS programs and services. Some of the organizations that have had to refuse U.S. funds are the same organizations that carry out HIV prevention, testing, counseling, and treatment programs. Kenya, which has an HIV prevalence rate of six percent, has seen its leading family planning organizations forced to withdraw from a U.S.-funded project to provide comprehensive reproductive and child health care that included HIV/AIDS prevention and treatment. In Saint Lucia, where HIV is spreading rapidly among young people, the local Planned Parenthood association was forced to cancel plans to train 218 "peer helpers" from eight secondary schools and one primary school as a result of its refusal to agree to the global gag rule. This program would have provided 12,000 school-aged children with information about HIV prevention and sexual and reproductive health.

Fighting Back

PPFA is working with federal lawmakers to pass legislation that would repeal the gag rule. Rep. Nita Lowey (D-NY), joined by lead cosponsor Rep. Chris Shays (R-CT) and 36 other original cosponsors, recently reintroduced the Global Democracy Promotion Act (GDPA), which states that groups cannot be deemed ineligible for funding solely on the basis of the services they provide. It also outlines the many ways in which the global gag rule defies core American values: violating free speech; contravening medical ethics; intruding upon the patient-provider relationship; and contradicting our democratic tenets of self-determination. The bill is currently in committee in the U.S. House of Representatives.

Learn More, Get Involved

PPFA is fighting the global gag rule and other harmful policies on many fronts.  It meets with elected representatives and their staffs, often bringing reproductive health providers from developing countries to relay firsthand accounts of the consequences of the global gag rule. And it spotlights the impact of the global gag rule by organizing local and national events and working with the media.  It also works with local Planned Parenthood affiliates around the country to draw attention to ill-conceived policies and demand that our government support responsible laws that protect and promote women’s health.

Learn more about PPFA’s efforts to end the global gag rule and provide much-needed sexual and reproductive health education and services in developing countries, and find out how you can get involved and support these efforts.