Women’s Groups and Funders Respond to Global Gag Rule

“The solidarity among the organizations who are addressing safe abortion has grown” under the global gag rule, says Rakshya Paudyal, a program manager with Beyond Beijing Committee, a Nepal-based feminist human rights organization. (Photo by Alison Wright/Global Fund for Women)

As one of his first acts as president of the United States, Donald Trump reinstated a policy prohibiting organizations from receiving US government aid if they provide services, referrals, and advocacy related to abortion abroad. In late March 2019, the Trump administration expanded this policy to include subcontractors serving groups that provide or discuss abortion.

The United States is the world’s largest donor to global health, and abortion-related services are often integrated into general health care involving HIV, contraceptives, and families. The policy, known as the Mexico City Policy and dubbed the global gag rule by women’s groups to reflect the act’s intentions and impact, was first introduced by President Ronald Reagan in 1984. Since then, each Democratic president has rescinded it and each Republican president has reinstated it. Under Trump, the policy covers all $8.8 billion in US global health aid, nearly 15 times the reach of previous iterations.

My organization, Global Fund for Women, supports many organizations that provide reproductive health care and which feel the pinch of this policy on their operations. Rhythm of Life, for example, a Ugandan health nonprofit serving women in red-light districts, regularly sets up makeshift clinics under blue plastic tarps to provide HIV and STI testing, maternal health care, vasectomy procedures, contraception, and abortions to some of the world’s most vulnerable people. “Often, it is the only health care that is accessible to people in such communities,” says Harriet Kamashanyu, the organization’s founder and executive director.

The policy has had a direct impact on the women Rhythm of Life serves. “The global gag rule limits our coverage and general operations,” Kamashanyu says. “We simply watch many girls and women of Uganda die due to unsafe abortion.” During the last iteration of the global gag rule, under President George W. Bush, reduced access to contraception led to more unwanted pregnancies and an increase in abortion rates in Sub-Saharan Africa.

“As a community initiative, it is a big gap that we still fight to close so that we don’t fail the girls and women that we serve,” Kamashanyu says.

As a funder, we feel the same way. We are fighting to close the funding gap created by the global gag rule so that we don’t fail the women and organizations we support. So how can women’s rights and global health groups effectively organize in response to the global gag rule? And, more broadly in this time of wide-reaching restrictive policies, how do service providers and funders operate in a policy environment that directly opposes their core work?

Through conversations with our grantees and partners, we identified four strategies for mitigating the effects of the global gag rule and other restrictive funding policies.

1. Document the Impact and Advocate

Documenting and communicating the effects of the global gag rule locally, nationally, and internationally is a critical strategy for many of the groups we fund. This includes communicating around the underlying need for the sexual and reproductive health and rights programming that the global gag rule inhibits.

“The main tactic is to continue the advocacy and not stop,” says Rakshya Paudyal, a program manager at Beyond Beijing Committee, a Nepal-based feminist human rights organization working for gender equality.

Another one of our grantees, ROOTS Africa (Real Open Opportunities for Transformation Support), an organization working with young people in Zimbabwe, shifted their strategic focus to become an information hub for adolescents after the global gag rule cut their funding. Working with a national radio station, they trained adolescent talk show hosts to lead conversations on sexual health and reproductive needs with their peers. This gives adolescent girls space to create their own content on sexual reproductive health and rights issues and advocate on their own behalf.

Beatrice Savadye, community solutions leader of ROOTS, says her group has witnessed marginalized groups becoming even more vulnerable in terms of access to sexual and reproductive health services, products, and information.

Within the United States, 60 percent of Americans oppose the global gag rule, according to a 2018 poll—a majority that could be mobilized to action with compelling information and storytelling about the policy’s effects on the ground.

2. Redirect Local Funding and Circumvent INGOs

Because the global gag rule has stripped away international non-governmental organization (INGO) funding that would have previously supported sexual and reproductive health work, more women and organizations are engaging in national and regional budgetary advocacy efforts, lobbying their home countries to step in with additional aid.

For example, Women’s Action Group in Zimbabwe is using the Abuja Declaration, a pledge by African Union countries to spend 15 percent of their budgets on health, to hold the Zimbabwean government accountable. Through a combination of national and local media coverage, lobbying, debates, rigorous public expenditure tracking, public budget hearing meetings, and on-the-ground mobilization, the organization is pushing the government to provide funding for sexual and reproductive health efforts.

ROOTS Africa is also holding both community and national dialogues with parliamentarians to advocate for domestic health financing. "We are taking part in coalitions and collaborations so that we are able to make meaningful change with the limited resources we have,” says Savadye.

3. Encourage Other Large Government and Foundation Donors to Step In

Just months after Trump announced the expanded gag rule policy, foreign ministers in Sweden, Denmark, and Belgium responded by launching SheDecides, a movement to protect the rights, health, safety, and livelihoods of girls and women worldwide. The group has since raised more than $400 million from foundations and governments to support sexual and reproductive health and rights and narrow the funding gap the global gag rule has created.

Similarly, Canada announced the creation of its Feminist International Assistance Policy in 2017, with the goal of focusing all Canadian international development funding on advancing gender equality and empowering women and girls around the world.

4. Set Up Alternative Sources of Information, Services, and Care

To provide women with abortion access and services, organizations are setting up alternative and often confidential sources of information and care. New partnerships typically aid these efforts. In Kenya, TICAH (Trust for Indigenous Culture and Health) provides women with access to abortion information and care through hotlines and mobile apps, and other networks are stepping up to train abortion providers at all levels.

In Uganda, Rhythm of Life continues to scale up its work in making sexual reproductive health and rights services accessible to marginalized populations by working in tandem with community health centers—including government health centers—where Ugandans can access affordable, non-stigmatizing, and non-discriminatory services.

Simply sharing information can become a basis for partnership. Meetings that bring together officials from local governments, civil society organizations, and development organizations have been an important strategy in getting different partners and stakeholders on board and fully knowledgeable about the magnitude of the global gag rule.

Paudyal, of Beyond Beijing Committee, echoed the importance of partnership: “The solidarity among the organizations who are addressing safe abortion has grown. The best tactic has been to work together.”

What’s Next

As a funder, we will continue to hold the US government accountable to global agreements to advance reproductive health and rights. The gag rule policy itself is confusing and open to interpretation, so we will also continue to provide information to our grantees, working to ensure they have the most up-to-date information to continue providing services allowed under the policy. We will continue to advocate that donors allocate more resources to those women, girls, and gender non-conforming individuals who are most negatively impacted by the global gag rule. And finally, we will continue to ensure that discussions of the global gag rule are not limited to reproductive health spaces but are also included in the work of a broader range of human rights, social justice, and pro-democracy organizations.

Our grantees will continue raising the voices of those most affected by these restrictive funding policies to convey their impact. “When girls and young women come out to raise their voices against the effects of the global gag rule, they are given maximum attention,” says Kamashanyu, of Rhythm of Life. “Sharing their experiences and stories has been humbling, causing change.”

The global gag rule is just one example of the concrete funding implications that often accompany decisions to pull away from international agreements. When Trump withdrew the United States from the Paris Climate Accords, the administration also reneged on $2 billion pledged to the Green Climate Fund to support projects aiming to reduce greenhouse gas emissions and address the effects of climate change. As the United States continues to distance itself from multilateral institutions and cuts domestic spending to environmental and social causes, these principles—around impact documentation, redirecting funding, and ushering in other donors—can help sustain financing for other social programs around the world.

Read more stories by Leila Hessini.