Most people don't think of HIV prevention as being a political issue.
Yet at the Mathare Valley health clinic in Kenya, where women comprise 60% of HIV cases and workers routinely provide screening, treatment, and counseling to patients, it became a political issue almost overnight.
When the United States last enacted the “global gag rule” in 2001, cutting off US funding for healthcare organizations that discuss abortion with their patients, the Mathare Valley clinic was forced to close and its community of 300,000 residents were left without local access to healthcare. The women who relied on it for HIV treatment no longer had a clinic to go to.
The US doesn't provide funding for abortion in any part of the world, and yet the global gag rule — a policy enacted by Republican administrations going back to Ronald Reagan — has routinely cut off US funding for any group that even mentions the word with their patients, even if the group isn’t providing abortions, even if abortion is legal in the country where it operates, and even if thousands of women’s lives depend on the health clinic for other life-saving care.
Now, the reinstatement and expansion of the global gag rule under President Donald Trump threatens to have the most far-reaching effect on women’s healthcare of any of its predecessors. The new gag rule, signed into law the first week of Trump’s presidency, expands the rule from just family planning funding to all US healthcare funding.
Lori Adelman, director of communications for Planned Parenthood Global, which has chapters around the world providing healthcare to women, said that this expansion means the funding cut has gone from about $600 million to as much as $9 billion with the swipe of a pen.
“It’s an unprecedented scaling up of policy,” Adelman told Global Citizen. “We expect it to mean it will be expanded to encompass all global health funding, including HIV prevention, maternal and child health care, even Zika response.”
Today, Global Citizen, CHIME FOR CHANGE, the Dutch government, and a group of other dedicated partners are launching the #SheDecides campaign, a fundraising effort to make up some of the difference in funding that will be lost under the new US policy and a life-saving measure for millions of women around the world.
The campaign is trying to raise $600 million, the amount that the US typically funds in a single year in its family planning assistance funding. The US is the largest international provider of family planning assistance to developing countries.
That money will help 27 million women and couples get access to contraceptives and help prevent 6 million unintended pregnancies, 11,000 maternal deaths, and 2.3 million abortions, Adelman said. A 2011 study by Stanford University found that the gag rule has actually had the unintended consequence of increasing the amount of abortions in developing countries from 10.4 abortions per 10,000 women to 14.5 in sub-Saharan Africa last time it was in place.
The campaign will ask governments, nonprofits, and even individuals to help contribute to keep these vital healthcare groups funded for as long as Trump’s policy is in effect.
“The world’s most vulnerable women and communities will absolutely suffer as a result of this policy,” Adelman said. “We know from our partners the devastating impact of this policy in the past and the impact it will have on women’s lives. It will result in clinic closures resulting in more unintended pregnancies and unsafe abortions, not less.”
Earlier this week, Melinda Gates of the Bill and Melinda Gates Foundation published a video in which she heralded the life-saving effects and societal benefits of access to contraceptives.
“When a woman has the power to decide when to get pregnant, she has power over her future,” Gates says in the video, noting how a woman who can choose when to get pregnant can better space out her pregnancies to allow her body to recover, improving the health of her babies.
She can also invest more in each child to be able to pay for school, food, and doctor’s visits. And when a child is healthy and well-fed, that child can go onto to improve his own health and success in the future and raise another generation of healthy, successful citizens.
“Children who are well nourished and healthy do much better in school and children who do better in school go onto earn a better living. As a result they have more to invest in their children and their community,” she says.
In Kenya, one-quarter of married women who want to space their births don’t have access to family planning, and maternal deaths in Kenya hover around 1,300 per 100,000 live births — an extraordinarily high number. But as a result of the previous global gag rule, five health clinics run by the leading family planning NGOs in the country closed and cut their staffing by 30%.
“The global gag rule has always had a chilling effect on the field of global health and family planning write large because it sends a message that America is opposed to abortion above all else,” Adelman said.
The #SheDecides campaign hopes to reverse that chilling effect, and help keep clinics in Kenya, Zambia, Ethiopia, and other developing countries around the world open and able to provide life-saving care to women.
Take part in the #SheDecides campaign today, and let the world know that women’s healthcare isn’t a political point to be scored.