Secretary of State Rex Tillerson has approved Protecting Life in Global Health Assistance. The announcement accords with President Donald Trump’s January 23 executive order reinstating the so-called “Mexico City policy.” The latter withholds taxpayer funds for foreign non-governmental organizations to promote abortion.
First announced by Ronald Reagan at the 1984 UN conference in Mexico City, the policy was rescinded by Bill Clinton, reinstated by George W. Bush, and rescinded again by Barack Obama. The policy will extend to all organizations that perform abortions, promote abortion, or even financially support other NGOs that do so. The restrictions also apply to foreign aid for malaria prevention, HIV treatment, and maternal health, amounting to $8.8 billion -- nearly 15 times more than the amount of restricted money under the policy as enacted under former President George W. Bush.
Trump’s version of the policy expands on its previous iteration. Rather than applying solely to contraception and abortion, the expanded policy applies to “funding for international health programs, such as those for HIV/AIDS, maternal and child health, malaria, global health security, and family planning and reproductive health,” according to a State Department spokesman.
According to a State Department news release, the Trump administration will do a comprehensive review of the effectiveness and impact of the policy’s application over the next six months, which could include identifying implementation issues, and any other new information affecting implementation going forward. This would include reviewing programs such as the President’s Emergency Plan for Aids Relief (PEPFAR), Peace Corps, Centers for Disease Control, and the Department of Defense.
The administration asserted that the restriction simply follows through on a pledge that “US taxpayer money should not be used to support foreign organizations that perform or actively promote abortion as a method of family planning in other nations.” The policy also does not apply to funds distributed directly to foreign governments.
Also, the State Department affirmed that the new policy does not reduce the overall financial commitment of the United States to global health assistance. Protecting Life in Global Health Assistance applies to approximately $8.8 billion in funds appropriated to the Department of State, the U.S. Agency for International Development, and the Department of Defense. Approximately $6 billion is directed to PEPFAR, of which some is diverted to Global Fund to Fight AIDS, Tuberculosis, and Malaria. Much of the money also goes to the US Agency for International Development contraception programs, maternal health programs, and other public health initiatives.
Foreign nongovernmental organizations are already prohibited from receiving funds for contraception programs if that organization “performs or actively promotes abortion as a method of family planning,” according to State Department guidance issued in March. An organization must “agree in writing” that it will follow this policy in order to receive federal funds. Federal funds have also long been prohibited from being used for abortions directly, inside and outside the United States.
A number of governments and global health groups have denounced the Trump administration for the initiative. Population Action International stated that the renewed Mexico City policy would “broaden the reach of the policy’s already deadly effects, including increasing unintended pregnancies, unsafe abortions, and maternal and child mortality.”
A coalition including Planned Parenthood, Marie Stopes International, a number of other pressure groups, jointly declared their opposition to the reinstatement of the Mexico City policy and cited “broad and severe” health consequences worldwide. In addition, the UK-based International Planned Parenthood Federation expects to lose $100 million. Marie Stopes International, a UK-based organization that provides abortions, has pledged not to sign on with the policy. In 2015, it received about 23 million pounds, or about $30 million, from USAID, making up about 9 percent of its budget.
To fill in, other governments have pledged at least $190 million at a conference in Brussels in March.