[By restoring funding cut off by his
predecessor, President Biden ended four years of what abortion rights advocates
called a concerted assault on women’s reproductive health in the developing
world.]
By Bhadra
Sharma, Ruth Maclean, Oscar
Lopez and Rick
Gladstone
Family planning education and
birth-control distribution slowed or stopped in Nepal, which relies heavily on American
financial assistance for public health programs. While abortion is legal in the
country, the options for safe procedures were abruptly narrowed.
“We couldn’t provide contraceptives
to needy people,” said Subhash Shrestha, the association’s acting director.
“Because of this many couples failed to control births. They were forced to
give unwanted births.”
His group lost $5.5 million in aid,
part of Mr. Trump’s promise to anti-abortion activists in the United States,
who had exhorted him to revive a Reagan-era rule known as the Mexico City Policy and by its critics as the Global
Gag Rule.
The rule, first announced in 1984
during a United Nations population conference in Mexico City, bans American aid
to groups that offer abortions or abortion counseling, even if those services
are not financed by U.S. tax dollars. Ever since, Republican administrations
have enforced the rule, and Democratic administrations have rescinded it.
But under Mr. Trump the scope of
the rule was greatly expanded, effectively denying aid to groups that provided
a range of other health services, including H.I.V. medicine and tuberculosis
treatment, in some of the world’s most deprived places. He also invoked what is
known as the Kemp-Kasten Amendment, another Reagan-era measure,
used to deny aid to any group that the president determines to have supported
forced abortion or involuntary sterilization.
Under that measure, Mr. Trump
terminated aid in 2017 to the United Nations Population Fund, the leading provider of
family-planning services, although no evidence had been found that the agency,
known as UNFPA, ever engaged in such activity.
With executive orders issued Thursday, President Biden revoked
Mr. Trump’s enforcement of the Mexico City Policy and Kemp-Kasten Amendment,
restoring the aid and ending four years of what abortion rights advocates
called one of the most concerted assaults on women’s reproductive health in the
developing world.
“The return of the United States as
a major donor to UNFPA at this challenging time sends a message of hope to
vulnerable women and girls everywhere,” said Dr. Natalia Kanem, executive director of the U.N.
agency, which operates in more than 150 countries. It lost nearly $70 million
in U.S. funding in 2017.
With that money, Dr. Kanem said,
UNFPA could help avert 1.4 million unintended pregnancies, prevent 32,000
unsafe abortions, provide reproductive health services to 4.2 million women and
young people, and provide counseling to 76,000 women and girl survivors of
sexual violence.
For Mr. Shrestha and others on the
front lines of threats to women’s health in Asia, Africa and Latin America, Mr.
Biden’s action was greeted with elation and relief.
“For us this has reopened the door
of opportunity to continue our work in family planning and safe abortion,” Mr.
Shrestha said.
Mr. Biden’s action came at a time
when Nepal, a country of about 30 million people where nearly a third of the
population is younger than 16, was facing a resurgence of risks to women’s
health, which had been improving until Mr. Trump revived the anti-abortion
rule. The global coronavirus pandemic has only made things worse.
In Nigeria, Africa’s most populous
country, where 10 percent of the world’s maternal deaths occur and where more
than 1.8 million unsafe abortions are believed to be performed annually, Mr.
Biden’s actions were major news.
“You can’t imagine my excitement,”
said Effiom Effiom, the head of the Nigeria chapter of MSI Reproductive
Choices, a provider of women’s health services, including abortion, in 37
countries. “The gag rule was bad enough, but Trump went further, to expand that
gag rule.”
In 2016, when the MSI chapter in
Nigeria was still receiving American government funding, it helped to avert
about 799,000 unintended pregnancies and 313,000 unsafe abortions, Mr. Effiom
said.
Since the denial of funding in
2017, he estimated that the chapter’s workers had failed to reach 5.3 million
users of family planning, failed to avert 1.1 million unsafe abortions and
failed to prevent 16,000 maternal deaths.
“What Marie Stopes would have done
with U.S. government funding, at the pace it was going, was just going to be
enormous,” he said, referring to MSI.
In Latin America, where there are
high rates of poverty, teenage pregnancy and domestic violence, the impact of
the Trump administration’s anti-abortion policy has been devastating, women’s
health advocates said, with hundreds of thousands of women affected.
“The damage to the world’s women
and girls hasn’t yet been fully measured,” said Giselle Carino, chief executive of the International Planned
Parenthood Federation Western Hemisphere Region, which works on
reproductive health across Latin America.
Ms. Carino said her organization
had lost $5 million in funding under the Trump administration, forcing the
dismissal of 700 health care workers and the halt of many services, ranging
from providing contraception to Haitian migrants in the Dominican Republic to
tackling the Zika virus in El Salvador.
In all, Ms. Carino said that more
than half a million women may have been affected.
“What the rule really does is play
politics with women, girls and the most vulnerable populations,” she said. “It
uses them as target practice.”
In Colombia, Marta Royo runs Profamilia, an
organization that offers contraception, health care and support for women to
access abortion, which is legal in the country under limited circumstances.
With funding from the United
States, the group had launched a program to provide sex education to displaced
young people, including vulnerable Venezuelan migrants as well as Colombians
forced to migrate internally because of violence.
But with the anti-abortion rule,
the program was stopped abruptly, with the organization receiving only half the
$2 million promised, leaving 60,000 people without access to reproductive
information and care, according to Ms. Royo.
These young people “are left
totally exposed,” she said. “Young girls, we know that they put their lives at
risk, they seek out clandestine abortions or they end up bringing to term
pregnancies that put their lives in danger.”
While Mr. Biden’s action rescinding
the anti-abortion rule had been widely expected, it still provoked an angry
reaction among abortion opponents in the United States.
The Family Research Council, a leading anti-abortion
group that had embraced Mr. Trump’s policies, said Mr.
Biden was “forcing taxpayers back into a partnership with the overseas abortion
industry.”
Critics of the anti-abortion rule
say that rather than reducing the number of abortions around the world,
it created the opposite effect. By restricting access to
contraception, reproductive care and sex education, unwanted pregnancies and
abortions have risen.
“If they were looking to limit
abortions,” said Ms. Carino, the Planned Parenthood executive, “what they
actually produced was more abortions.”
Bhadra Sharma reported from
Kathmandu, Ruth Maclean from Dakar, Senegal, Oscar Lopez from Mexico City, and
Rick Gladstone from Eastham, Mass.