Expanded Trump ‘Mexico City’ policy causing cuts in HIV, Reproductive Care in East Africa
Washington, US | THE INDEPENDENT | Early effects of United States restrictions to global health aid will include cuts to essential health services in Kenya and Uganda, Human Rights Watch (HRW) has warned. Human Rights Watch has sent its findings in advance of a six-month review by the State Department of these funding restrictions.
In a letter to US Secretary of State Rex Tillerson released in October, HRW said the changes have resulted in a loss of training and equipment from non-governmental groups for government health clinics, and widespread confusion about implementation.
On January 23, 2017, US President Donald Trump issued an expanded “Mexico City Policy,” later renamed the “Protecting Life in Global Health Assistance” policy.
The policy requires foreign nongovernmental organizations receiving US global health aid to certify they do not use their own, non-US funds to provide abortions except in cases of rape, incest, or to save a woman’s life. If they wish to keep their US funding, the groups also cannot offer information or referrals for abortion – even where abortions are legal – or advocate liberalizing abortion laws.
This policy is widely known as the “Global Gag Rule” because it restricts the type of information organizations can provide even with their own funds from non-US sources, including restricting what a doctor can say to her patient. US law already prohibits using US funds for abortion in foreign family planning assistance.
Kenya and Uganda to be hit by cuts
“Our research shows that the expanded Mexico City Policy is already erecting barriers that will block people in Kenya and Uganda from the health care they need,” said Skye Wheeler, women’s rights emergencies researcher at Human Rights Watch. “Because the US is the world’s largest health donor, this indefensible change in policy puts the lives of many women and girls at risk.”
Previous Republican administrations have consistently enacted versions of the Mexico City Policy, and these affected US family planning funds, approximately $575 million in FY2016.
The Trump administration’s policy extends the restrictions to an estimated $8.8 billion in US global health assistance, including for family planning and reproductive health, maternal and child health, nutrition, malaria, tuberculosis, infectious diseases, neglected tropical diseases, water, sanitation, and hygiene programs, and HIV/AIDS – including The President’s Plan for Emergency Relief for AIDS (PEPFAR).
In July, Human Rights Watch interviewed representatives of 24 organizations in Kenya and 21 in Uganda affected by the funding restrictions. These organizations provide reproductive and HIV health services, conduct health outreach to marginalized populations, or advocate for improved health policies.