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AVAC applauds the executive action taken today by US President Joe Biden to repeal the Mexico City Policy, also known as the Global Gag Rule (GGR), which prohibits many foreign groups receiving US foreign aid from speaking about, referring for, advocating for access to, or providing abortion. The GGR has had an enormous deleterious effect on US-funded global health work and led to loss of life and harm to cisgender women, adolescent girls and young women worldwide.
As COVID-19 exacerbates gender-based violence, disrupts contraceptive programming and threatens HIV prevention for women in all their diversities, this repeal is a welcome, necessary action—and must be the first step in broad, bold US government commitment to the health and wellbeing of girls and women.
There is much more that needs to be done now to undo the damage done by the policy, including immediate communication about the repeal, and proactive outreach to ensure partners who declined US funding while the GGR was in place are brought back into US-supported networks of prevention, care and support. Steps must also be taken to ensure that the GGR is eliminated as an option for controlling women’s health programming. AVAC stands in solidarity with allies, including Health GAP, who have been clear in demanding that the Biden Administration correct the extensive harms already done and end this cycle by establishing a permanent policy that supports sexual and reproductive health and rights for all, in the US and globally.
Four years ago, the Trump Administration reinstated and expanded the GGR (originally enacted by Ronald Reagan in the 1980s and reinstated in all successive Republican administrations). The Trump expansion of the Global Gag Rule vastly increased the range of groups subjected to its lethal restrictions. As it has in every prior era, the 2016-2020 imposition of the GGR resulted in increased unintended and high-risk pregnancies, unsafe abortions and maternal deaths, and hampered introduction HIV and sexual and reproductive health and rights programs that are urgently needed worldwide. It will take years to rebuild the programs that were damaged by this policy, and the damage done to women’s lives is incalculable.
The Biden Administration must ensure immediate, multi-channel communication with partners about the repeal of the GGR; it must also launch an urgent review of all federal guidance and rules to purge the references to the GGR that may still affect funding and programs. The Office of the Global AIDS Coordinator must immediately clarify that section 5.9.4 of its 2021 Country Operational Plan guidance on implementation no longer applies, including to plans for the coming year. The administration must also allow PEPFAR funds to be used to procure a range of contraceptives beyond condoms, as is the current policy. Women’s health should not be divided between one clinic to access HIV treatment or prevention and a separate one to access contraceptives and other sexual health interventions. It is past time for PEPFAR to support integrated health options for women, especially in the context of the COVID-19 pandemic.
Along with expanding PEPFAR support, the administration should immediately reinstate funding for UNFPA to help ensure increased and sustained funding for contraceptive options for women.
The Administration must also work with the US Congress to ensure that the GGR is permanently legislatively repealed so that it cannot be easily reinstated by a future administration. To this end, the Administration should enthusiastically support the Global Health, Empowerment and Rights (HER) Act, which was introduced today by bi-partisan leadership in the House and Senate and would ensure the US could make permanent and long-lasting partnerships in support of women’s health and rights without fear of programs being rolled back with each new administration.
The Biden Administration has spoken of a desire to dismantle white supremacy and racist structures in the US. That commitment must extend to its foreign policy and development programs. For too long, US global health and development support has relied on policies and programs that at their worst are colonialist and antifeminist. Repealing the GGR is an important step in the right direction, but AVAC looks to the Biden administration to work with advocates and public health experts to examine all current policies and programs with a lens of anticolonialism and human rights and make the necessary changes to truly bring US foreign policy for health and development into the 21st century.