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Kaiser Daily Global Health Policy Report

In The News

News Outlets Continue To Look At Potential Impacts Of Expanded Mexico City Policy On Women's Health, AIDS Programs

Broadly: Trump’s Massive Expansion of the Global Gag Rule Will Kill Women, Advocates Warn
“…On Monday January 23, Trump signed an executive action that reinstated the global gag rule, just as Republican presidents have done for the past 30 years. However Trump took it a step — or rather, a flying leap — further by massively expanding the scope of the rule, and the impact will be catastrophic. Reproductive health advocates warn that millions of women could suffer and die as a result. … Due to [the Helms amendment], the U.S. government has maintained a de facto ban on funding abortion care with foreign assistance dollars for over forty years. Apparently this wasn’t sufficiently restrictive for conservative politicians, who found it necessary to police words as well. It’s worth noting that American NGOs are not required to make the same certifications because the policy violates the constitutional right to free speech. Foreign NGOs, on the other hand, are considered fair game…” (Grant, 1/25).

Devex: NGOs scramble to safeguard programs in wake of Trump’s expanded ‘global gag rule’
“…Trump’s Jan. 23 memorandum takes it further [than past applications of the Reagan-era policy], expanding on previous iterations by restricting funding to all [foreign] organizations that receive global health funding, rather than only family planning providers — potentially including maternal health programs, efforts to fight Zika, and the PEPFAR program to prevent and treat HIV and AIDS. With this addition, global health NGO PAI estimates the rule could impact $9 billion in U.S. funds, 15 times as much funding as it did under President George W. Bush. … Even though the move was widely expected, it still leaves foreign global health NGOs with two hard options: Continue to accept U.S. funds and be prohibited from providing abortion counseling, referrals, or engaging in advocacy efforts and from providing abortions outside of the three exceptions; or refuse U.S. funds and look for alternative sources of funding to keep health clinic doors open…” (Rogers, 1/25).

The Guardian: ‘Global gag rule’ could have dire impact in Latin America, activists warn
“…Not only will [the Mexico City policy] hit wider civil society programs, such as contraception provision and campaigns to combat HIV/AIDS, but aid workers, academics ,and activists warn it could also bolster political opposition to women’s reproductive rights. ‘This is very discouraging,’ said Mary Ellsberg, director of the Global Women’s Institute at George Washington University. ‘It will have a chilling impact on the work done by U.S. organizations that work with Latin American women’s groups that advocate safe abortion. It also adds to the recent conservative backlash in the region, which has seen bans on all forms of abortion, including in cases of child rape and where the mother’s life is at risk. This will have a huge negative effect on maternal mortality’…” (Watts, 1/26).

Huffington Post Australia: There’s A Whole Lot At Risk With Donald Trump’s Executive Order On Abortion
“…Australia’s Foreign Minister Julie Bishop insists the Government ‘remains committed’ to the protection and promotion of sexual and reproductive health rights in Australia’s foreign policy and aid program. A spokeswoman said, ‘the Foreign Minister has elevated the issue of gender equality in our foreign policy and aid program.’ Labor is calling on the Turnbull Government to lobby the Trump Administration to repeal the global gag rule…” (Barlow, 1/25).

New York Times: Clinics for World’s Vulnerable Brace for Trump’s Anti-Abortion Cuts
“…The wording in the Trump order extends the restrictions to all American global health aid, an $8.5 billion pot of money, according to an analysis by the Kaiser Family Foundation, a research organization. More than half of that money goes to programs for HIV and AIDS, including services for women of reproductive age, the analysis found. An additional nine percent goes to maternal and child health care, which is partly aimed at promoting safe pregnancies. By contrast, the last time the rule was in place, under President George W. Bush, it applied only to family planning money, an amount that is currently around $520 million, the analysis found…” (Searcey et al., 1/26).

New York Times: Q. and A.: How Trump’s Revival of an Abortion Ban Will Affect Women in Kenya
“…Caitlin Parks, a family planning fellow at Washington University in St. Louis, provides reproductive health services to women at clinics and a teaching hospital in western Kenya. Her clinics receive American funding, and she says that the ban, called by critics the global gag rule, could have a major impact on poor women and communities like the ones she serves…” (Ingber, 1/26).

SELF: Trump’s Global Gag Rule May Have Terrible Impact On HIV/AIDS Patients
“…Amesh A. Adalja, M.D., a board-certified infectious disease physician at the University of Pittsburgh and an affiliated scholar at the Johns Hopkins Bloomberg School of Public Health Center for Health Security, tells SELF that this expansion will make it nearly impossible for global HIV/AIDS providers to be able to inform their clients of all of their options. ‘If someone becomes pregnant when they’re HIV-positive, you need to be able to talk about what the options are,’ he says. ‘When you inject something like the global gag rule into it, you’re automatically walling off certain avenues of discussion, and that makes it difficult to provide comprehensive care’…” (Miller, 1/25).

Washington Post: Does Trump’s Mexico City policy ban funds to groups that ‘even mention’ abortion?
“…Trump plans to reduce global aid overall. Draft executive orders obtained by the New York Times showed a termination of funding ‘for any United Nations agency or other international body that meets any one of several criteria’ — including organizations that support programs that fund abortions. In general, the executive branch has broad discretion over foreign affairs and foreign aid. So in theory, Trump could decide to expand the policy to strip the previous exclusions (i.e., the exceptions for rape, incest, and life of the mother) or even ban an organization that ‘even mentions abortion.’ But until the regulation is written and entered into the Federal Register, it would be pure conjecture to say how the policy will change under Trump…” (Lee, 1/26).

Yahoo Beauty: 8 Not-So-Obvious Ways the Global Gag Rule Can Harm Women
“…In response to Trump’s executive order, nearly 140 diverse advocacy organizations issued a joint open statement. ‘Countries around the world are making significant progress in improving women’s health,’ it said, ‘and the global gag rule undermines that momentum.’ … To break it down into eight points of harm…” (Uffalussy, 1/25).

Yahoo News: How global gag rule could have devastating effects for world’s most vulnerable women
“…MSI’s ability to provide health care in [Uganda’s] Kimombasa and throughout the world has been threatened now that President Trump, in one of his first moves as chief executive, reinstated the U.S.’s global gag rule, which bars foreign aid to any [foreign] NGO that offers abortion services, or even discusses abortion options, to its patients, ever. The rule is also known as the Mexico City policy, named after the host city of the U.N. International Conference on Population where the U.S. announced it in 1984…” (Conley, 1/25).

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Trump Administration To Propose Funding Audits For U.N., Other International Organizations, Including UNFPA

CNS News: Top U.S. Aid Recipients Could Face Cuts in Trump’s Proposed Funding Audit
“President Trump’s proposed audits of U.S. international funding will reportedly call for a review of development aid to countries that ‘oppose important United States policies’ — a plan that could prove uncomfortable for some of the biggest recipients of U.S. taxpayer dollars. … The report did not say whether the draft indicates how this will be quantified…” (Goodenough, 1/26).

New York Times: Trump Prepares Orders Aiming at Global Funding and Treaties
“The Trump administration is preparing executive orders that would clear the way to drastically reduce the United States’ role in the United Nations and other international organizations, as well as begin a process to review and potentially abrogate certain forms of multilateral treaties. … The order establishes a committee to recommend where those funding cuts should be made. It asks the committee to look specifically at United States funding for peacekeeping operations; the International Criminal Court; development aid to countries that ‘oppose important United States policies’; and the United Nations Population Fund, which oversees maternal and reproductive health programs…” (Fisher, 1/25).

Washington Post: Trump administration could cut funding to United Nations
“…Trump’s new U.N. ambassador, Nikki Haley, has pledged to put U.S. interests first and use the leverage of disproportionate U.S. funding of the body. But the draft order would go much further, and with an apparent goal of slashing U.S. participation across a swath of U.N. agencies and activities to which the Trump administration objects on fiscal or ideological grounds. Haley, who was confirmed this week by a vote of 96 to 4, told senators at her confirmation hearing that the Trump administration would question whether the U.S. ‘gets what it pays for’ from the United Nations…” (Gearan/Eilperin, 1/25).

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WHO Executive Board Announces Final 3 Candidates For Director General

Devex: And the top 3 WHO director general candidates are …
“After a full day of closed-door sessions, the World Health Organization’s Executive Board at last announced its three director general nominees set to face election in May. Ethiopia’s Tedros Adhanom Ghebreyesus, Pakistan’s Sania Nishtar, and Britain’s David Nabarro made the cut, with the results released in Geneva on Wednesday evening…” (Ravelo, 1/25).

POLITICO: Three candidates from three continents vie to be next global health chief
“…Two other candidates, both of them European — Italy’s Flavia Bustreo and France’s Philippe Douste-Blazy — were eliminated after just one round of voting at the WHO’s annual board meeting. All the candidates were interviewed in a closed-door, day-long session with country representatives gathered in Geneva…” (Huet, 1/26).

Reuters: WHO seeks new leader to rebuild damaged reputation
“…The next WHO chief will replace Margaret Chan, who took over its reins 10 years ago and came under fire for the agency’s sluggish reaction to the Ebola epidemic, which spread across one of the world’s poorest regions, killing thousands of people. Chan’s second five-year term ends on June 30…” (Nebehay, 1/25).

STAT: World Health Organization names nominees to lead global agency
“…Tedros — a former health and foreign affairs minister from Ethiopia, he is known by his first name — has the support of the African Union, potentially a bloc of 54 votes at the World Health Assembly. His is the only non-physician among the candidates; he has a PhD in community health. Nabarro has spent much of his career in first the WHO and then the United Nations. He is currently the special adviser to the U.N. secretary general on sustainable development and climate change. Nishtar is a former health minister from Pakistan with extensive experience both nationally and internationally in the civil society sector” (Branswell, 1/25).

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Gates Foundation Grants $279M To University Of Washington's IHME To Continue Health Data Research

Nature: World’s foremost institute on death and disease metrics gets massive cash boost
“The world’s premier center for health metrics — the science of measuring and analyzing global health problems, and how they relate to health care and biomedical research funding — will receive a US$279-million cash injection from the Bill & Melinda Gates Foundation. The University of Washington’s Institute for Health Metrics and Evaluation (IHME) in Seattle, also home town to the Gates Foundation, announced the funding boost on 25 January…” (Butler, 1/25).

Seattle Times: Historic gift: Gates Foundation gives $279 million to University of Washington
“The Bill & Melinda Gates Foundation is once again shattering donation records at the University of Washington, this time with a $279 million grant to continue and expand pioneering programs that measure health around the globe. The money will fund another decade of work at the UW’s Institute for Health Metrics and Evaluation (IHME), which was founded 10 years ago with a $105 million Gates grant that was at the time the largest gift in UW history…” (Doughton, 1/25).

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Russia Will Not Spend Planned $1.2B On HIV/AIDS Response, According To News Agencies

ScienceInsider: Russia ditches plan to increase spending on HIV/AIDS
“The Russian Health Ministry has decided that the country cannot afford to spend $1.2 billion that was supposed to go toward ramping up the response to its burgeoning HIV/AIDS epidemic. RBC, a respected Russian news agency, broke the story, which subsequently was reported by the English-language Moscow Times. The money would have helped both slow HIV’s spread and treat infected people with antiretrovirals over the next four years…” (Cohen, 1/25).

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Editorials and Opinions

Opinion Pieces Discuss Possible Implications Of Mexico City Policy On Women's Rights, Health Worldwide

The Independent: As an obstetrician who just moved to America, I fear how far Donald Trump will take his anti-abortion stance
Reena Aggarwal, obstetrician

“…[B]y withdrawing [funding] from international development efforts [that] ease access to contraception services and family planning, Donald Trump has effectively restricted millions of women in developing and war-torn countries access to safe abortions … As one of the richest economies in the world, this is staggering — the money saved is miniscule — but the message it sends to women is stark: you are on your own. … A pro-choice stance is not pro-abortion; it is something very different. It values autonomy for women and recognizes that it is a woman — not the men around her — who has control over her body and what happens to it. Without that, we face very dark times ahead indeed” (1/25).

Daily Vox: Why does Trump hate women?
Shaazia Ebrahim, intern at Zambia’s Daily Vox

“…The [Mexico City policy] compels global health providers to accept the ruling and cancel all abortion-related services or to reject the ruling and lose the U.S. foreign aid that many are reliant on. But it also has numerous other possible implications for women’s health worldwide. … Studies show that once the policy is implemented, the number of family services and clinics in a country decrease, which sometimes hikes the abortion rates. … Can we just say: considering Trump’s earlier misogynistic remarks, and behavior, his pro-life stance seems less concerned with the rights of unborn children and more about controlling women’s bodily autonomy — a right which is enshrined in our own Constitution [in Zambia]” (1/25).

New York Times: President Trump’s War on Women Begins
Nicholas Kristof, New York Times columnist

“…Presumably Trump thought [the Mexico City policy] would reduce abortions, and was thus ‘pro-life.’ In fact, this is a ‘pro-death’ approach that actually increases abortions, as well as deaths among women. … Worse, Trump expanded this ‘global gag rule’ — as critics call it, because it bars groups from mentioning abortion — so that it apparently will cover all kinds of health services, including efforts to tackle polio or Zika or HIV, even programs to help women who have been trafficked into brothels. … President Trump, you may think you are ‘pro-life’ and preventing abortions, but that’s a lie or a delusion. In fact, you are increasing the number of abortions and of dying women…” (1/26).

The Hill: Trump’s abortion gag rule threatens long-fought global health gains
Latanya Mapp Frett, executive director of Planned Parenthood Global

“…United States leadership is key in meeting [the need for modern contraception], and stopping preventable maternal and child deaths by expanding access to family planning services. These investments not only save millions of lives but also save money … The global gag rule undermines this valuable effort, sending a message to the world that the U.S. is against abortion, and that we prioritize the issue of abortion above everything else. It also undercuts and undermines the efficiency of our foreign assistance dollars. … [Sens. Susan Collins (R-Maine) and Jeanne Shaheen (D-N.H.) introduced a bill in the Senate and Rep. Nita Lowey (D-N.Y.) offered a companion bill in the House] Tuesday to counteract the executive action. Entitled the Global Health, Empowerment, and Rights (HER) Act, passage of this law can permanently end this dangerous policy once and for all. We hope people will voice their support for this legislation…” (1/25).

Inter Press Service: Trump’s Global Gag a Devastating Blow for Women’s Rights
Erika Guevara Rosas, Americas director at Amnesty International

“…President Trump is now following a worrying tradition that has a dangerous impact on the sexual and reproductive rights, health, and life of women and girls across the world, particularly those who are most at risk of human rights abuses. … While discrimination against women is evident in almost all areas of life, it is in the area of sexual and reproductive health that it reaches shocking levels. It is the regulation of women’s sexuality and reproduction that most clearly reveals harmful gender stereotypes and bias. Unfortunately, in this adverse regional context, and with the reinstatement of the global gag rule, the future for women and girls and their real chances of being able to exercise their human rights are tragically uncertain. Today more than ever, a strong stand against these clear violations of women’s human rights needs to prevail. It is time to unite in action against discrimination and violence” (1/26).

American Prospect: NGOs: How will the ‘global gag rule’ affect your work?
Dorothy Samuels, senior fellow at the Brennan Center for Justice

“…By not only renewing but also expanding this harsh Republican tradition, Trump has accomplished two things, apart from pleasing the nation’s anti-abortion rights lobby. He has inflicted immediate harm on vulnerable women and girls all over the world. And, at a moment when access to reproductive health care — including affordable contraception and safe abortion — is at risk in this country, Trump has given American women a window into the future he and congressional Republicans seek for them” (1/25).

Forbes: Trump’s ‘Global Gag Rule’ On Abortion Hurts All Women
Judy Stone, infectious disease specialist

“…The global gag rule seems somehow fitting for a misogynistic administration hell-bent on making decisions behind closed doors and imposing its will on others — especially women and people of color. In addition to the global gag rule to hurt women — one of Trump’s first actions as leader — in the past day Trump has also reportedly imposed gag orders on the EPA, NPS, and USDA. So much for transparency and spreading democracy. This administration is increasingly trampling on women’s autonomy and human rights. Expanding the global gag rule is likely just the start” (1/25).

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From the Global Health Policy Community

Friends Of The Global Fight Releases Issue Brief Examining Return On Investment From U.S. Support Of Global Fund

Friends of the Global Fight Blog: Brief: The Case for U.S. Investment In The Global Fund And Global Health
“Friends of the Global Fight today released ‘The Case for U.S. Investment in the Global Fund and Global Health,’ an issue brief to highlight the extraordinary return on investment from U.S. support for the Global Fund. The brief illustrates how, as an innovative public-private partnership, the Global Fund is challenging the status quo in the way the world fights disease, saving millions of lives, and producing economic, security, and humanitarian gains for the U.S. in the process…” (1/26).

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Congressional Democrats Introduce Legislation To Repeal President Trump's Reinstatement, Expansion Of Mexico City Policy

Rewire: Democrats Challenge Trump’s ‘Global Gag Rule’ Expansion
Christine Grimaldi, federal policy reporter at Rewire, discusses Sen. Jeanne Shaheen’s (D-N.H.) introduction of the Global Health, Empowerment, and Rights (HER) Act in the U.S. Senate and Rep. Nita Lowey (D-N.Y.)’s companion bill offered in the U.S. House of Representatives, legislation aimed at repealing President Trump’s executive order reinstating and expanding the Mexico City Policy. Grimaldi notes, “[T]he Global HER Act marks a cohesive effort among Democrats in the early days of Trump’s presidency to push back against legislative assaults on reproductive health care” (1/25).

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Confirmation Hearings For HHS Secretary Nominee Rep. Price Conclude; TAG Releases Statement Opposing Nomination

Center for Global Health Policy’s “Science Speaks”: Hearings on Price for HHS Secretary conclude, with finance committee vote possible next week
Antigone Barton, senior editor and writer of “Science Speaks,” highlights several issues discussed during the confirmation hearing of HHS Secretary nominee Rep. Tom Price, including several global health-related topics. “The conclusion of the second several-hour hearing, during which support for the nominee appeared divided along party lines opens the way for a [Senate] Finance Committee vote on whether to recommend that the Senate approve Rep. Price’s nomination as early as next week,” Barton writes, noting the Treatment Action Group (TAG) released a statement opposing Price’s nomination (1/25).

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Gates Foundation's Grant To Washington University's IHME Will Support 'Robust And Rigorous Data,' CEO Writes

Medium: How do you spend $5 billion a year?
Sue Desmond-Hellmann, CEO of the Bill & Melinda Gates Foundation, writes, “[R]obust and rigorous data are essential in helping us turn the tide on many of the deadly and debilitating diseases that kill millions of people, and trap millions more in poor health and poverty.” Desmond-Hellmann discusses the work of the Institute for Health Metrics and Evaluation (IHME) on data and global health and announces a $279 million grant to the IHME. “This 10-year investment means the IHME can not only build on its current efforts, which include evaluating progress on the Sustainable Development Goals and tracking how health resources are spent throughout the world, but also develop innovations that forecast future health scenarios to allow decision-makers to plan more purposefully. As one of the largest donations in the foundation’s history, this contribution is a vote of confidence in IHME’s work,” she writes (1/25).

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