Trumped Again! Fight the Gag Rule!

Fight the Gag RuleTrumped again: reinstating the global gag rule

This unilateral action must not be allowed to derail women’s right to sexual and reproductive health
By Sarah Hawkes and Kent Buse

There was nothing unexpected about President Trump’s reinstatement of the Mexico City policy (known as the global gag rule) in the first days of his presidency. Trump’s administration is the latest in a line of American presidencies that have played fast and loose with sexual and reproductive health and rights. After the 1973 historic Roe v Wade ruling upholding the rights of American women to decide whether to terminate a pregnancy,1 Senator Jesse Helms supported an amendment to the 1961 Foreign Assistance Act to ensure that no US funds could be used to pay for abortions “as a method of family planning or to motivate or coerce any person to practice abortions.”2

Variations on the Helms amendment have shuffled back and forth across the American legislature in the ensuing four decades, but the Mexico City policy, enacted under President Reagan in 1984, proved to be the most contentious because it restricted US funding to foreign non-governmental organisations (NGOs) that provide voluntary abortion services, even if those services do not use American funds directly for abortions.3 This policy was overturned by President Clinton (1993), reinstated by President G W Bush (2001), rescinded again under President Obama (2009), and re-established by President Trump.

Trump’s version, however, goes further and requires implementation of a plan “to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies.”3 In other words, it potentially restricts American funding not only to foreign NGOs but to all other recipients that enable the provision of safe abortion services; this could include governments as well as the United Nations system.

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In Memory of Dr. Halfdan Mahler

Dr. Chan and Dr. MahlerDr. Halfdan Mahler passed away in Geneva on 14th December at the age of 93.  Dr Mahler’s vision inspired the Alma Ata Declaration on Primary Health Care in 1978, and the  related call for ‘Health for All by the Year 2000’  Dr.Mahler squarely placed health in the domain of the ‘public’. Dr.Mahler was a Danish physician who joined WHO in 1951 and went on to be elected thrice as the Director General of the organisation, between 1973 and 1988. Before moving to the organisation’s headquarters in Geneva he worked for a decade in India in the National Tuberculosis programme in a mutually respectful relationship with national counterparts.

When Dr.Mahler moved to Geneva in 1962 WHO was very different from its current state. It was still recognized as the leader in international health. Dr.Mahler’s later dissatisfaction with the demise of  WHO’s leading role (and the usurpation of this role by agencies such as the World Bank and private foundations such as the Gates Foundation) was clear in his address to the 61st World Health Assembly in 2008 when he said: “Most importantly, the very first constitutional function of WHO reads: ’To act as the directing and coordinating authority on international health work.’ Please do note that the Constitution says ’the” and not ’a’ directing and coordinating authority”. The 1960s and 70s were the ‘cold war’ period with the then Soviet Union and the United States vying with each other to assume leadership. It was also the era of ‘disease control’ when health systems were primarily designed to control infectious diseases through what were known as ‘vertical programs’.

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