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Expanded “Global Gag Rule” Threatens Global HIV/AIDS Progress

In a move that delighted the religious right in America and raised a near unanimous outcry from the public health community across the globe, the Trump administration placed $8.8 billion in U.S. foreign aid and health care for millions of the world’s neediest individuals at risk on Monday when the State Department announced an implementation plan to significantly expand the Mexico City Policy, also known as the “global gag rule." While not a surprise following on the heels of President Trump’s January Presidential Memorandum reviving and expanding the Mexico City Policy, Monday’s announcement—which cruelly was made the day after a statement honoring National Women’s Health Week—brings this public health nightmare back to reality.

The global gag rule is a Reagan-era policy that prohibits the U.S. federal government from providing certain types of global health assistance to any foreign non-governmental organizations (NGOs) that provides abortion services, counsels or refers clients to abortion services, or in any way advocates for laws permitting abortion. Since the gag rule was first instituted in 1984, Republican presidential administrations have utilized the rule in a targeted fashion, reserving the policy’s restrictions for any global health assistance intended specifically for family planning programming. However, under the expanded policy put forth by the Trump administration, the restrictions on funding applies to virtually all U.S. global health assistance, including maternal and child health care, nutrition, and funding for an array of infectious disease prevention and treatment including HIV/AIDS programs.

It is hard to overstate the amount of damage, disease, and potential death the Trump administration’s expanded global gag rule will impose on developing nations who have come to rely upon U.S. funding to provide adequate care for their citizens and to reverse the spread of the HIV epidemic and other infectious diseases. Under the previous iteration of the policy, roughly $600 million in global health assistance was at risk of being taken away. Now, under President Trump’s version of the policy, nearly $9 billion in U.S. foreign aid is in danger of being denied to those in need for ideological and unscientific reasons, with HIV/AIDS programs taking a disproportionate brunt of the burden.

Of the $8.8 billion in funding put at risk by this new Global Gag Rule, roughly $6 billion is marked for HIV/AIDS programs across the globe, under the President’s Emergency Plan for AIDS Relief (PEPFAR). Since its creation in 2003 by the George W. Bush administration, PEPFAR has been an unequivocal and unprecedented success in combatting the HIV epidemic in sub-Saharan Africa and across the developing world, and it has enjoyed broad bipartisan support. Both Republicans and Democrats in Congress and in the White House have worked together over the past 14 years to provide the funding that enabled PEPFAR to place 11.5 million men, women and children living with HIV on antiretroviral treatment and drastically reduce HIV incidence in countries like Malawi and Zimbabwe by as much as 76%.

The reinstatement and expansion of the global gag rule would put all those hard-fought gains of PEPFAR at risk and for what? The Trump administration and anti-abortion advocates say that the Mexico City Policy—or the “Protecting Life in Global Health Assistance” plan as the State Department disingenuously calls it—is all about protecting the unborn and preventing abortions. The experience of countries placed under the Mexico City Policy, however, tells a different story. According to a Stanford study of sub-Saharan African nations during the George W. Bush administration, the number of abortions increased in the nations where U.S. global public health funding  was cut the most, an unintended consequence of the lack of available family planning and contraceptive services that resulted from the funding cuts.

AIDS United stands in firm opposition to the Trump administration’s expanded global gag rule and call on all HIV advocates and people of conscience to do the same. Political posturing and trying to appease religious conservatives are not sound reasons for reinstating a policy that places the lives of millions of people at risk and threatens to undo all the progress that the global HIV community has made in fighting back against the epidemic. America can and should be proud of its position as the leading provider of global public health funding in general and HIV funding specifically, and we should all vehemently oppose the Mexico City Policy or any policy that jeopardizes that standing. 

Posted By: AIDS United, Policy Department - Friday, May 19, 2017

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