Over the last eight years, the impact of the Global Gag Rule has been harshest in parts of the world most in need of better health services. The policy forbids any foreign organization receiving U.S. family planning aid from providing, referring to, or advocating for abortion services in their country – even with their own funds, and even if abortion is legal. Organizations that do not comply lose all U.S. support, including essential supplies of contraceptives.
I am a physician and was working with EngenderHealth in Ghana at the time that President Bush reinstated the policy during his first days in office. We felt the effects almost immediately, as the Global Gag Rule began to limit our reach as an organization. We could no longer work with local partners who put women’s health and the integrity of their medical staff above U.S. policy, even though they counted on us for support that made it possible for them to offer care in rural communities where no other health services were available.
In Ghana, not only were supplies of contraceptives cut in half, but clinics were forced to shut down or drastically reduce their family planning, maternal and child health, and HIV services. And there is no evidence that that this policy has reduced abortion. Indeed, unsafe abortion remains among the leading causes of maternal deaths.
So, while the Global Gag Rule was designed to reduce abortion, the policy’s domino effect has had negative effects on people’s lives in ways that have nothing to do with abortion. Because health clinics often offered integrated care, the loss in funding due to the Global Gag Rule has had dramatic consequences for services like immunizations for children, voluntary counseling and testing for HIV, and treatment for malaria. Throughout Africa, and in parts of Asia and Latin America, entire communities have seen their health care compromised by this policy.
But we are at a turning point. President-elect Obama has the opportunity to repeal the Global Gag Rule, and we must put pressure on him to do so. No doubt there are a number of priorities that he must address immediately (the economy, two ongoing wars), but getting rid of the gag will cost nothing. Rather, it will be a symbolic move saying that the United States cares about women’s health and rights and about the rural poor.
I was in Tanzania at the time of the U.S. election, and I felt a great sense of excitement and expectation. Visiting a clinic where EngenderHealth had worked before the Global Gag Rule was reinstated – a clinic that has faced years of dwindling support and difficult times – I found the few remaining staff exuding optimism.
We believe that things will change now, that your president will understand how American policies directly affect us," the chief doctor told me. She, like many others, hope-some even pray-that the Global Gag Rule will be lifted, that their funding and main source for contraceptive supplies will be renewed, and that they will no longer have to turn away people who walk miles to their clinic for care.
Indeed, as the United States reexamines its role in the world and the ways in which it can restore its image abroad, the value of eliminating the Global Gag Rule becomes very clear. In addition to affirming that the United States is committed to women’s health and rights, to global health and development, and to the principles of informed choice, the impact on "the street" would be significant. In rural communities across Africa, where the only clinic in an entire district may be one supported by the United States, people notice and are thankful.
To be sure, there is much more to be done to ensure that every woman has access to high-quality reproductive and maternal health care, and funding increases are needed. The simple fact is that U.S. support for overseas family planning is lower today than it was in the mid-1990s, even though demand is higher and rising every day. But first things first: I hope you will join me in calling on President-elect Obama to lift the Global Gag Rule during his first 100 days in office. Visit www.engenderhealth.org/globalgag to sign a petition asking for just that.