Effects of the Global Gag Rule

The Global Gag Rule is one of cruelest policies ever enacted on foreign assistance funding. It penalizes foreign health care providers that provide a full range of information and services that are legal within their own countries. It stifles democratic participation by prohibiting assistance to organizations that speak out about the impact of unsafe abortion in their own countries—and to be clear, it’s simply impossible to have a serious discussion about women’s health and maternal mortality in the developing world without discussing the role of illegal, unsafe abortion. And finally, it’s utterly counterproductive to the stated goals of its promoters: in 2011, independent researchers at Stanford University found that the imposition of the Global Gag Rule caused abortion rates in the African countries most affected to double between 2001 and 2008 when the policy was being enforced.

Donald Trump’s version of the policy goes even further. Previous versions of the policy applied only to family planning funding. Trump’s version applies to all global health funding—at least $8.8 billion in foreign aid. HIV/AIDS funding, childhood nutrition programs, and funding for TB and malaria programs are all at risk.

From 2017-2020 alone, Marie Stopes International (which wasn’t a grantee the last time the Gag Rule was in effect) estimates that under the policy the loss of their services around the world could result in 6.5 million unintended pregnancies, 2.2 million abortions (2.1 million of them unsafe), and 21,700 maternal deaths.

Here are just a few of the specific impacts the policy had on the last time it was in effect (we’ll update the list with documented effects of Trump’s version as they come in):

  • After the Global Gag Rule was reinstated in 2001, the Planned Parenthood Association of Ghana (PPAG) saw its overall budget slashed by 40 percent. As is often the case, women in rural areas were most affected by the shuttering of clinics and loss of staff. Contraceptive use declined by 17 percent in rural areas causing a 50-67 percent increase in the abortion rate in those areas.
  • In Zambia, the Family Life Movement of Zambia (FLMZ), a faith based, anti-abortion organization was stymied in efforts to expand programs because the global gag rule has disqualified Planned Parenthood Association of Zambia (PPAZ), a partner organization. FLMZ promotes abstinence among young people in Zambia, and did not provide contraceptives of any kind.  For those young people who were sexually active, FLMZ would refer them to PPAZ, where they could receive information about condoms and other contraceptives. But the Global Gag Rule has forced PPAZ to close three of its nine rural outreach programs and cost them more than $100,000 worth of condoms and other contraceptives.
  • In Kenya, the Family Planning Association of Kenya (FPAK), which does not provide abortion, had to cut its outreach staff in half, close three clinics that served 56,000 clients in traditionally underserved communities, and raise fees at the remaining clinics. One of the clinics that closed housed a unique well-baby center that provided comprehensive infant and post-partum care. That well baby center is now lost to the community.
  • The Family Guidance Association of Ethiopia (FGAE), the largest reproductive health provider in the country, operates 18 clinics, 24 youth service centers, 671 community-based reproductive health care sites, and hundreds of other sites for health care provision. Still, fewer than 20 percent of Ethiopians live within a two-hour walk of any health provider. The Global Gag Rule cost the FGAE more than half a million dollars—and cut off the supply of condoms and other contraceptives—even though abortion is illegal in Ethiopia. Because the organization participated in a long and serious national discussion that led to a change in the abortion law in order to reduce the staggering maternal mortality rate, it was ineligible for U.S. assistance. The result was a loss of services to 229,947 men and 301,054 women in urban areas.
  • In Nepal, women who had abortions—and survived—were routinely sentenced to long prison terms. In one infamous case, a 13-year-old girl was raped by a relative and made pregnant. Another relative took her for an illegal abortion. Yet another relative reported her to the authorities, and the girl was sentenced to 20 years in prison. The Family Planning Association of Nepal advocated releasing her and other women imprisoned under the abortion law and worked with the Nepalese government, at the government’s request, to legalize abortion in Nepal. Under the Global Gag Rule, these actions disqualify the agency from receiving U.S. family planning aid.