Written by GlobeMed member Paula Moszczynski
The Global Gag rule, also known as the “Mexico City Policy”, is one that has existed since the Reagan presidency in 1984. However, it fluctuates with the coming and going of democratic and republican presidents, thus creating a on-again and off-again source of funding for many NGOs that depend on the U.S. for their resources. The main point of this policy is to cut money and resources to foreign non-governmental organizations that are in any way associated with legal abortion services or referrals. These organizations must decide if they will abide by the US’s policies in order to keep relations positive, or give up their main source funding in order to continue offering their services at what minimal rates they are able to. This rule also discourages collaboration between “gagged” and non-gagged organizations. Not only affecting sexual education and family services, this gag rule also creates heavy cuts in water, sanitation, and hygiene programming.
This policy creates a major loss in categories of sexual education and STI testing, prenatal care, contraceptive methods, and HIV programming/counseling. The cut in resources, however, not only affects the services themselves that are provided, but also cuts the workforce down, in order to keep up with the money that is left. This creates workforce losses such as the 40% decrease in employment in these facilities during the Bush administration. With less clinics operating, they become less accessible to many teenagers and adults, who thus do not find it easy to get tested for HIV or various STIs, and only go to clinics and/or hospitals once they are experiencing symptoms.
The areas that are the most heavily affected are rural areas, such as the district of Rufunsa in Zambia. This district, home to the Planned Parenthood Association of Zambia, provides care to over 68,000 people. With the implementation of the Gag rule during Trump’s administration beginning January 2017, the rate of teenage pregnancy has already doubled into 2018. The total amount that is being lost is close to $3.8 million, thus leaving the original 23 health facilities with only seven packages of up to 144 condoms to distribute across their population. In Nyangwena, the number of sites operating has decreased heavily from 16 to just 3, with only two workers educationally equipped to provide HIV care and counseling, and one equipped for tuberculosis care. These three workers are left with the responsibility of over 3,000 people. Along with strict rules against underage teenagers being allowed to buy condoms, the trek to buy them nearby totals almost three hours — discouraging many, even if they have parental consent.
The International Planned Parenthood Federation has estimated the losses during the complete Trump administration to total over $10 million. This is equivalent to the clinics’ abilities to stop 20,000 maternal deaths, 4.8 million unintended pregnancies, and 1.7 million unsafe abortions. This funding could also have provided over 70 million condoms, 725,000 HIV tests, 275,000 treatments for those living with HIV, and treatment for 525,000 STI’s. The results are staggering, however, they are true. With the lack of resources, these clinics are operating on very little and the work they have put in over the past decades is beginning to revert back to how it had started. Thus, it is imperative to work towards not only resuming the funding that these clinics desperately need, but also towards ending the stigma and judgement that is reflected by the government towards key populations. Ending the stigma would create a more conducive environment for successful sexual education and sexual health.