How the Expanded Global Gag Rule Affects Water, Sanitation and Hygiene

Trump’s Global Gag Rule is a U.S. presidential policy that restricts how foreign nongovernmental organizations (NGOs) can use their privately-raised funds if they wish to receive U.S. global health assistance. These organizations must agree to not use their own money for abortion-related advocacy, including abortion law liberalization, and services—like counseling or referral. Otherwise, they will not be eligible to receive U.S. global health assistance funds.

Versions of the policy have been instituted by every Republican president since 1984, but previous presidents have tied the restriction specifically to international family planning assistance—an estimated USD 575 million in aid. In 2017, President Trump renamed the policy “Protecting Life in Global Health Assistance” and expanded it to cover all global health assistance received by foreign NGOs. This policy now applies to USD 8.8 billion in U.S. bilateral assistance to 64 low- and middle-income countries. The policy does not apply to humanitarian assistance.

On March 26, 2019, the Trump administration announced a new interpretation of language included in the standard provisions implementing the Global Gag Rule, related to the meaning of “provide financial support to any other foreign organization that conducts such activities.” This is legal language contained in the standard provisions to which foreign NGOs must agree in order to remain eligible to receive U.S. global health assistance.

In May 2019, the language of the standard provisions was updated and revised to:

• Provide discretion to the U.S. government in the event a partner is found in violation of the policy; and
• Clarify that application of the policy does not extend to recipients and beneficiaries of in-kind training and technical assistance if they are foreign NGOs that have not received an award or sub-award of U.S. global health assistance funds.

The standard provisions were not changed with respect to what it means to “provide ‘financial support.’” While the Trump adminstration maintains that “there is no change to the ‘financial support’ requirement in the standard provision” [as emphasized in a May 2019 letter from the U.S. Agency for International Development (USAID) to its implementing partners], this is only true in terms of there being no change to the actual text of this clause in the standard provision. However, this is an expansive and new interpretation in terms of implementing this provision based on how the Trump administration is interpreting the language. The letter to implementing partners makes it clear that this provision means a foreign NGO that agrees to comply with the policy as either a direct recipient or subrecepient of U.S. global health assistance is prohibited from providing any financial support—regardless of source or activity—to any other foreign NGO that conducts activities prohibited under the Global Gag Rule.

Any organization that does not comply with the Global Gag Rule is ineligible to receive any U.S. bilateral global health assistance.