Report: Global Gag Rule Spurring Deaths, Disease

(WOMENSENEWS)–The Mexico City policy, also known as the global gag rule, has led to closed clinics, cuts in healthcare staff and dwindling medical supplies, leaving women, children and families without access to vital healthcare services, according to a report released yesterday by policy opponents.

The policy, reinstated by U.S. President George W. Bush as one of his first acts in office, prohibits any organization receivingpopulation funds from the U.S. Agency for International Development from using those or other funds to provide or promote abortion as a method of family planning.

“I think they are killing these women, just as if they are pointing a gun and shooting. There is no difference,” said Hilary Fyfe, chair of the Family Life Movement of Zambia. Her organization opposes abortion, but still lost approximately $30,000 in U.S. funds for telling adolescents and young adults that unsafe and potentially fatal abortions are one possible consequence of unprotected sex and unwanted pregnancies.

The report, titled “Access Denied,” is the first to document the effects of the policy on health services delivery around the world. The policy was reinstated by President Bush on January 22, 2001 and marked the 28th anniversary of Roe v. Wade, the 1973 Supreme Court ruling that decriminalized abortion in the United States. Three vocal critics of the policy, Population Action International, Ipas, and the Planned Parenthood Federation of America, put together the report based on interviews and field research conducted since the policy was reinstated.

“When we counsel, we have to talk about abortion. You can’t do counseling on reproductive health without talking about the whole business,” Fyfe said by phone from Washington, D.C. where she is helping publicize the new report. “We were told, ‘you talk about abortion, you’re out,'” she said.

To retain funding, grantees must certify that they will comply with the rule barring discussion of abortion.

In 2000, Fyfe’s organization counseled adolescents and families in nine provinces in Zambia, offering information on birth control, family planning and HIV/AIDS prevention. They had to cut services in four provinces due to the funding cuts. Planned Parenthood of Zambia also scaled back programs when it lost 24 percent of its funding, according to the report.

In Kenya, a total of five family planning clinics, two affiliated with Marie Stopes International, have been forced to close, the report said.

A state department official pointed out that these organizations had made the choice not to comply with the policy and could have kept their funding had they chosen to comply. The official also pointed out that the amount of money distributed by USAID has not been reduced and that USAID is committed to spending it through other programs and organizations that agree to comply with the Mexico City policy.

Organizations receiving U.S. funds are also prohibited from promoting the liberalization of abortion laws in their country. “It denies organizations the ability to participate in an important policy decision in their country,” said Amare Bedada, executive director of the Family Guidance Association of Ethiopia in Addis Ababa.

The association lost 12 percent of its funding directly and another 25 percent that it received from the International Planned Parenthood Federation, which also refused to comply with the policy. The Ethiopian association curtailed programs, lost members of their senior staff and ran short on donated contraceptives due to the policy.

In Ethiopia, abortion is permitted when the mother’s life or health is in grave danger. Legislators there are debating liberalizing those restrictions. The World Health Organization estimates that one in seven Ethiopian women die from pregnancy-related complications. According to the Ministry of Health, unsafe abortion is the fifth leading cause of maternal death in Ethiopia.

In Zambia, women are permitted to have an abortion if three doctors write letters saying that her life or health is in danger. In practice, said Fyfe, this is a requirement that few women can satisfy. “They end up dying, either from the pregnancy or from an abortion induced by themselves,” Fyfe said.

In Romania, women have an average of 2.2 abortions and regard birth control methods with suspicion due to long indoctrination by Soviet administrations. Family planning organizations that signed the rule can not partner with abortion providers, hindering family planning advocates that try to reach women who undergo multiple abortions in the absence of information on alternatives.

Rule Cuts Condom Distribution

Bedada’s organization also provides contraceptive services and HIV/AIDS prevention counseling, traveling into isolated rural communities to treat women who could not make the arduous and time-consuming trip into a town.

“The whole rural program came to a standstill,” said Bedada, who has joined Fyfe in trying to publicize the damaging affects of the rule. “It is jeopardizing the programs we have been doing for 37 years,” he said.

Both Bedada and Fyfe cited in particular shortages of condoms. Increasing awareness of HIV/AIDS prevention, especially among adolescents and young adults, has led to a growing demand for latex condoms–a demand these organizations can no longer meet. “There are condoms in the shops, but young people can’t afford them,” said Fyfe.

Fyfe would send those interested in condoms to Planned Parenthood affiliates in her area, but those affiliates are running short of condoms because the International Planned Parenthood Federation based in London lost $20 million in USAID funds when it refused to sign the rule. The USAID donations of cash and supplies, including condoms, made up about one-fifth of the federation’s annual budget.

The agency and the United Nations Population Fund are the largest donors of contraceptive supplies, including condoms, to the developing world. The agency is the most important single donor, delivering about one-third of all donated supplies, worth about U.S. $75 million. (In a separate action, the administration eliminated $32 million in support for the U.N. fund as well.)

By 2002, the policy had cut off shipments of USAID-donated supplies to 16 developing countries, according to the report, because the only recipients in those countries were members of the International Planned Parenthood Federation. The leading family planning organizations in 13 other countries, including Ethiopia and Zambia, were also cut off.

AIDS Funding Reduced

Condoms procured with HIV/AIDS funds are not subject to the rule, but critics of the rule say that, in practice, organizations that refused to sign the rule have not been able to get funds earmarked for HIV/AIDS prevention.

“In practice, that is what is happening. They are getting blackballed,” said Wendy Turnbull, legislative policy analyst with Population Action International and one of the authors of the report.

A state department official said it was unclear how USAID determined which programs qualified for HIV/AIDS funds and which were disqualified as family planning programs not in compliance with the Mexico City policy.

The Saint Lucia Planned Parenthood Association affiliate was forced to cancel plans to train 218 “peer helpers” that would have reached more than 12,000 primary and secondary school students with information on HIV/AIDS, according to the report.

The Cameroon National Association for Family Welfare closed a youth center that taught young people about responsible parenthood and HIV/AIDS. They also eliminated family planning services in two branches, one in a province where 9 percent of the population lives with HIV/AIDS and another in a province where 6 percent of the population is infected, according to the report.

The International Planned Parenthood Federation distributed condoms donated by USAID. Bedada’s organization, a member of the federation, did not receive enough donated condoms to supply the demand for nearly a year and has run low on other contraceptives as well.

“We are not able to supply the youth demand as much as we’d like,” Bedada said. “We tell them to go to the government health institutions to get them if they can, but mostly the people that we serve are in rural areas and they have nowhere else to go,” he explained. When they finally returned to the rural areas, they found women upset and suspicious.

“It was just demoralizing for them and for the community,” Bedada said, “They thought that we were going to abandon them.”

President Reagan introduced the Mexico City policy in 1984 during a U.N. population conference in Mexico City. It has remained in effect as long as Republicans have held the presidency, and was rescinded by then-President Clinton in 1993 on the 20th anniversary of Roe v. Wade.

In late August, President Bush extended the Mexico City Policy to cover U.S. Department of State population funds. A state department official said it was still unclear what funds and organizations would be affected by this rule.

Asjylyn Loder is a freelance writer in New York.