KFF Daily Global Health Policy Report

In The News

News Outlets Examine Possible Impacts Of Expanded Mexico City Policy On U.S. Global Health Aid, Women's Health Worldwide

Associated Press/ABC News: Trump Expands Anti-Abortion Ban to All U.S. Global Health Aid
“…The order directs the secretary of state, in cooperation with the secretary of health and human services, for the first time to extend the requirements in the ban ‘to global health assistance furnished by all departments or agencies.’ The ban is known as the Mexico City policy or global gag rule. Suzanne Ehlers, president of Washington-based Population Action International which lobbies in the U.S. and developing countries for women’s reproductive health, told the Associated Press on Tuesday that targeting health assistance expands the amount of U.S. funding affected by a magnitude of 15 times and will impact millions and millions of women in low- and middle-income countries…” (Lederer, 1/24).

Bustle: The Global Gag Rule Is Unconstitutional For Reasons That Have Nothing To Do With Abortion
“…Much has been said about how this is another example of the Trump administration’s war on women’s and reproductive rights. However, there is a point that is often overlooked: the global gag rule is also an affront to another fundamental American right, free speech. … If international family planning and health care NGOs want to receive funding from the United States — which is the largest bilateral donor to health care and family planning services in the world — they must agree not only to refrain from providing abortions in countries where it is safe and legal to do so, but they cannot refer women to other clinics for abortions, offer abortion counseling, or even provide literature on the topic. They also are barred from lobbying for pro-choice legislation in the countries in which they are working…” (Spychalsky, 1/24).

BuzzFeed News: Trump’s Anti-Abortion Rule Is Broader Than Anyone Expected
“…The Trump order applies to HIV/AIDS prevention and treatment, including the Bush-era PEPFAR (President’s Emergency Plan for AIDS Relief) program; some gender-based violence prevention programs; maternal and child health; nutrition; infectious diseases, including malaria, tuberculosis, and neglected tropical diseases; and foreign projects of the Centers for Disease Control and the National Institutes of Health. It’s unclear if the rule will affect the Global Fund for AIDS, Malaria and Tuberculosis, which leads prevention globally on those diseases. The World Health Organization also receives U.S. funding that could impacted by the rule, but those funding streams are complicated, and a WHO spokesman said it was too soon to comment on whether or how it might be affected by the rule…” (Moore, 1/25).

BuzzFeed News: No, Trump Didn’t Ban U.S. Funds From Paying For Overseas Abortions
“…People thought that before the Trump policy, U.S. aid money was paying for abortions in foreign countries. … That’s just not true. U.S. foreign aid has two kinds of abortion-related restrictions on it. One is the global gag rule, which was first signed by Ronald Reagan in 1984. … The other restriction is the Helms Amendment, which is a U.S. law. It’s been around since 1973. The Helms Amendment prohibits U.S. foreign aid from being used to provide abortions, or to persuade women to get abortions, as a method of family planning. In practice, this policy is a steadfast no-abortion policy — with no exceptions, not even for rape, incest, or when the mother’s life is in danger. … Activists have been arguing that the language of the Helms Amendment should actually allow abortion services for rape survivors, because the amendment prohibits only ‘abortion as a method of family planning.’ Activists say abortions after rape, or when a pregnant woman’s life is in danger, cannot be considered family planning…” (Moore, 1/24).

CBS News: Trump expands anti-abortion ban to all U.S. global health aid
“…[Sen. Jeanne] Shaheen [D-N.H.] and Sen. Susan Collins, a Maine Republican, introduced legislation late Tuesday to repeal the global gag rule, with support from 43 other senators. A companion bill was introduced in the House by Rep. Nita Lowey, a New York Democrat. ‘Women’s reproductive health care remains under constant assault,’ Shaheen said, and Trump’s action has broadened the assault…” (1/24).

CNS News: International Planned Parenthood Will Lose U.S. Funds Because of Trump’s Pro-Life Policy
“The International Planned Parenthood Federation and Marie Stopes International, two major beneficiaries of U.S. funding, indicated Monday they will not comply with a newly reinstated policy that prohibits federal funding for organizations that promote or perform abortions around the world…” (Goodenough, 1/24).

Devex: Impact of the global gag rule on health sector: Q&A with DKT International CEO Chris Purdy
“…Devex spoke with Christopher Purdy, CEO of [U.S.-based] DKT International — one of the largest private providers of family planning services and safe abortions overseas — to learn how the reinstatement of this policy will impact other health providers across the globe…” (Roby, 1/24).

The Guardian: ‘Global gag rule’ on abortion puts $9bn in health aid at risk, activists say
“…Campaigners fear the move could affect a wide range of groups providing lifesaving treatment, such as those working to combat HIV and Zika, as well as those helping prevent child and maternal deaths and unwanted pregnancies worldwide. … The U.S. is the most generous bilateral donor to reproductive rights causes worldwide — with current funding at $575m. What is still unclear is to what extent the gag rule will affect the U.S.’s wider global health funding, which the reproductive rights campaigners PAI estimate to be more than $9bn…” (McVeigh, 1/25).

International Business Times: Globally 14 pregnant women could die each day as consequence of Trump’s abortion-gag order
“… ‘In one breath the U.S. is telling my government to promote human rights and good governance. In the other breath it’s saying, take away the rights of women to know about all the issues that surround their reproductive health,’ explained Nkandu Luo, former health minister of Zambia, in an eight-minute documentary about the effect of the gag rule in the country produced by the reproductive health charity PAI…” (Persio, 1/24).

The Nation: Trump’s Anti-Abortion Order Is Actually Likely to Increase Abortions
“…MSI (which often works in unstable and emergency settings, such as in Nepal after the deadly 2015 earthquake) will lose $30 million, or about 20 percent of its annual budget. The organization estimates the shortfall could, during Trump’s first term, lead to 6.5 million unintended pregnancies, 2.2 million abortions, 2.1 million unsafe abortions, and the deaths of 21,700 pregnant women…” (Carpenter, 1/23).

NBC News: Global Gag Rule Will Cause More Abortions, Not Fewer, Groups Say
“…Anti-abortion-rights groups welcomed the new order. ‘This is a welcome step toward restoring and enforcing important federal policies that respect the most fundamental human right — the right to life — as well as the long-standing, bipartisan consensus against forcing Americans to participate in the violent act of abortion,’ said the U.S. Conference of Catholic Bishops…” (Fox, 1/24).

Slate: Trump Didn’t Just Reinstate the Global Gag Rule. He Massively Expanded It.
“…[Foreign o]rganizations working on AIDS, malaria, or maternal and child health will have to make sure that none of their programs involves so much as an abortion referral. Geeta Rao Gupta, a senior fellow at the United Nations Foundation who previously served as deputy executive director of UNICEF, gives the example of HIV/AIDS clinics that get U.S. funding to provide antiretrovirals: ‘If they’re giving advice to women on what to do if they’re pregnant and HIV positive, giving them all the options that exist, they cannot now receive money from the U.S.’…” (Goldberg, 1/24).

VICE News: Anti-abortion collateral damage
“…If the past is any indication, the policy won’t necessarily spur a decrease in abortion rates — but it could cause an increase in unsafe or illegal abortions by women who no longer have access to the procedure. This in turn could cause a rise in deaths; unsafe abortions remain a leading cause of maternal mortality worldwide…” (Becker, 1/24).

Washington Post: Trump’s revival of the antiabortion ‘gag rule’ could have a big impact in Africa
“… A similar policy was implemented under President George W. Bush. Researchers discovered that the policy seemed to lead to ‘increases in abortion rates in sub-Saharan African countries,’ according to a report published in the Bulletin of the World Health Organization in 2011. ‘The results were exactly the opposite as the intended effect of the policy,’ said Eran Bendavid, one of the researchers and an assistant professor of medicine at Stanford University. One possible reason for the increase was that the U.S. policy, while aimed at abortion, curtailed the activities of organizations that provided condoms and other birth control methods, resulting in more unwanted pregnancies, the study said” (Soffen/Sieff, 1/24).

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Dutch Government In Discussions To Establish International Fund For Birth Control, Abortion Access After U.S. Reinstates Mexico City Policy

Associated Press/TIME: The Netherlands Wants to Set Up Its Own International Fund for Abortion Access
“The Dutch government says it wants an international fund to finance access to birth control, abortion, and education for women in developing countries. Minister for Foreign Trade and Development Cooperation Lilianne Ploumen announced the plan Tuesday in reaction to an executive memorandum U.S. President Donald Trump signed a day earlier…” (1/25).

Reuters: Dutch to set up global abortion support fund to counter Trump’s cuts
“…The Dutch government has held preliminary discussions on the initiative with other European Union members who have responded positively, a foreign ministry spokesman said on Wednesday. Governments outside the E.U., companies, and social institutions will also be approached to participate…” (Escritt/Deutsch, 1/25).

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U.S. Senate Confirms Nikki Haley As U.N. Ambassador

CNN: Nikki Haley easily confirmed as U.N. ambassador
“The Senate voted Tuesday to confirm Nikki Haley as ambassador to the United Nations, making her the fourth member of President Donald Trump’s Cabinet to be approved even as Republicans and Democrats battle angrily over the pace of confirmations…” (Barrett, 1/24).

The Hill: Senate confirms Trump’s U.N. ambassador
“…The final vote was 96-4, with Democratic Sens. Chris Coons (Del.), Martin Heinrich (N.M.), Tom Udall (N.M.), and Independent Sen. Bernie Sanders (Vt.) voting against her. The Senate vote came hours after the Foreign Relations Committee approved the pick, 19-2. Coons and Udall were the only committee votes against her…” (Carney, 1/24).

Washington Post: Nikki Haley confirmed as new U.S. envoy to the United Nations
“…She will step down from her post [as governor of] South Carolina to take one of the country’s highest profile diplomatic jobs and one that would burnish her résumé for higher office later. Haley, who has no formal diplomatic experience, won significant Democratic support…” (Gearan, 1/24).

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Ambassador Deborah Birx Speaks With Religion News Service About Work With PEPFAR, Faith-Based Organizations' Roles In Ending AIDS

Religion News Service/Deseret News: Obama appointee Deborah Birx: President Trump can control AIDS pandemic
“The Trump administration will allow Ambassador Deborah L. Birx, an Obama appointee to the President’s Emergency Plan for AIDS Relief, to remain in office until the Senate confirms her successor. … Experts believe unless effective prevention is achieved in Africa, HIV will remain at epidemic levels for many years to come. Birx, a graduate of Houghton College in New York and a lifelong evangelical, spoke to RNS about her work…” (Morgan, 1/24).

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WHO Executive Board Trims Director General Candidate List To 5

Agence France-Presse: Campaign heats up to lead under-fire WHO
“The World Health Organization was set Wednesday to pick three finalists for the role of its next director general, a high-stakes choice for the powerful agency described as facing an ‘existential crisis.’ WHO’s executive board was interviewing five remaining candidates before eliminating two by the end of the day…” (Simon, 1/25).

Devex: WHO director general candidates down to 5
“The World Health Organization’s Executive Board whittled its list of candidates running to be its new director general down to five, with Ethiopian candidate Tedros Adhanom Ghebreyesus in the lead. Executive Board Chairman Ray Busuttil announced the shortlist Tuesday morning, following a closed-door session. Apart from Tedros, the list included Britain’s David Nabarro, France’s Philippe Douste-Blazy, Italy’s Flavia Bustreo and Pakistan’s Sania Nishtar…” (Ravelo, 1/24).

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Editorials and Opinions

Opinion Piece, Letters To Editor Respond To President Trump's Action To Reinstate, Expand Mexico City Policy

New York Times: Silence on Abortion Equals Death
Serra Sippel, president of the Center for Health and Gender Equity

“In one of his first acts as president, Donald Trump introduced a ban on funding for any international organization that, anywhere in its health care programs, provides or even discusses abortions with patients, other than in cases of rape, incest, or life endangerment. … [C]ontrary to its stated purpose of reducing the number of abortions, the rule is actually associated with increased abortion rates as family planning programs disappear without funding. … Without access to contraceptive education and resources, more women face unwanted pregnancies, and opt for unsafe abortions. … A growing body of research over the past few decades shows that family planning services contribute to healthier lives and stronger economies. If President Trump really respected women the way he claims, he would support their health rather than endangering it” (1/24).

New York Times: Trump’s Action on Reproductive Rights Abroad
The newspaper published two letters to the editor — one from Akila Radhakrishnan, vice president and legal director at the Global Justice Center, and one from Ward Flad, an emergency physician — regarding its recent article covering President Trump’s action reinstating and expanding the Mexico City policy (1/24).

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Investing In CEPI Could Speed Up Vaccine Development

Nature: Vaccine initiative marks bold resolution
Editorial Board

“…For too long, the world has fatalistically acquiesced to a status quo in which, because there is no market for vaccines against pathogens that might never cause a major problem, there is no substantial investment in developing vaccines against them. Clearly, private companies cannot be expected to invest on their own. But it is incumbent on governments to invest, and thus address this market failure, in partnership with pharma. … [The Coalition for Epidemic Preparedness Innovations (CEPI)] comes at an exciting time in vaccine research. There’s a move away from a single-vaccine approach for any one disease, to developing vaccine backbones for use against multiple infections. This promises to greatly speed up vaccine development — and perhaps even to allow rapid development of vaccines against previously unknown viruses. At a time when short-termism and shortsightedness are rife, and political rhetoric often prevails over action, CEPI’s founders are offering vision and foresight — it’s an insurance policy that more governments, including the United States, would be well advised to back” (1/25).

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International Community Must Continue To Work Together To End Female Genital Mutilation

U.S. News & World Report: Stop the Silence
Jaha Dukureh, founder and executive director of Safe Hands for Girls

“…For the first time ever, the international community is standing up [against female genital mutilation and cutting]. This December we hosted the historic End Violence Against Girls: Summit on female genital mutilation in the District of Columbia. The gathering brought together more than 200 activists, ambassadors, diplomats, religious leaders, and lawmakers from around the world. … As a new year of activism begins, we must continue to foster these important connections between countries, activists, and organizations on the front lines of this change. … Women and men around the world must come together and declare, once and for all, that female genital mutilation is unacceptable and that we will not let another woman endure it.  … The summit was the first in a series of galvanizing moments, lead by millennials, that are changing cultures around the world and ensuring that every child — boy or girl — can grow up free from harm, from hate, and from violence” (1/24).

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From the Global Health Policy Community

President Trump Expands Mexico City Policy, Potentially Impacting Wider Range Of Foreign NGOs

Center for Global Health Policy’s “Science Speaks”: Transition 2017: A more sweeping global gag rule returns, as cabinet head hearings continue
Antigone Barton, senior editor and writer of “Science Speaks,” discusses the reinstatement and expansion of the Mexico City Policy, writing, “[W]hile the previous version of the policy applied to U.S. funding for international and local family planning services, the additional language in the order signed by [President] Trump on Monday directs the Secretary of State, with the Secretary of Health and Human Services and USAID Administrator ‘to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies’ … an extension that global health advocates note will impact a greatly increased range of organizations, care, and services…” Barton also notes that confirmation hearings for Secretary of State and HHS Secretary will continue this week (1/24).

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Better Measuring Aid Outcomes Could Provide Estimate Of Corruption Impacts On Development, CGD Expert Says

Center for Global Development’s “Views from the Center”: How Much Aid is Really Lost to Corruption?
Charles Kenny, senior fellow at CGD, discusses the difficulty in accurately measuring foreign aid that is lost to corruption and suggests measuring outcomes in order to do so. Kenny writes, “We still don’t have enough evidence on results to come up with any conclusive overall numbers on ‘the percentage of aid that delivers the impact it was designed to.’ … If the administration’s concerns over aid and corruption ended up improving the results focus of aid programs, that would be great news for many reasons — but not least because it would help reduce the real impact that corruption can have on development” (1/23).

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CGD Blog Post Examines Rex Tillerson's Stated Positions On U.S. Development Policy

Center for Global Development’s “U.S. Development Policy”: What Tillerson’s Leadership Could Mean for U.S. Development Policy
Erin Collinson, senior associate for policy outreach at CGD, discusses what Rex Tillerson’s nomination to Secretary of State could mean for U.S. foreign and development policy moving forward, outlining information gleaned from Tillerson’s confirmation hearing testimony (1/24).

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