One Down, the Rest to Go: Global Gag Rule Reimposed on Family Planning

Last Friday, the U.S. Agency for International Development (USAID) slipped without fanfare a new section into the guidance governing agency funding to overseas nongovernmental organization (NGO) partners reimposing the Global Gag Rule—but only on family planning programs. In singling out family planning, the implementation of the directive to expand the Global Gag Rule to the rest of “global health assistance furnished by all departments and agencies” mandated in the January 23^rd presidential memorandum will have to wait for another day.

The action comes just two days after President Trump vowed that the United States would “continue to fight for women’s rights and equality across the country and around the world” in a statement commemorating Women’s History Month. But a gratuitous and disingenuous presidential proclamation cannot conceal the fact that the Trump-Pence administration just began the implementation of draconian policies intended to reverse progress on reproductive health and rights around the globe.

The new “Mexico City Policy (March 2017)” section was quietly added at the end of the standard provisions for non-U.S. NGOs and posted on USAID’s Automated Directives System (ADS) and is “applicable to all awards that include family planning funds.”

The GGR section added to the standard provisions is largely identical to the March 28, 2001 standard provisions in force during the administration of President George W. Bush with no differences in the text with the exception of a few inconsequential introductory and concluding lines and appears to be simply cut and pasted from the previous Bush 2001 version. Since the text is verbatim, a 2006 PAI brochure on “what you need to know” about the GGR may serve as a useful resource in deciphering the legalese of the guidance and understanding how it may be interpreted on the ground in its latest iteration.

As outlined in a March 2^nd agency notice to USAID headquarters and field staff, the GGR section is to be inserted in new USAID family planning assistance grants and cooperative agreements and existing USAID FP agreements “when such agreements are amended to add incremental funding.” The notice also reiterates for emphasis that the GGR does not apply to agreements with foreign governments or multilateral organizations, which are composed of governments, consistent with implementation during the previous Bush administration.

The singling out of family planning assistance for priority action and divorcing it from the rest of global health will magnify GGR’s dangerous chilling effect, create confusion and over-interpretation, and broaden the burden and harm to integrated health programs, particularly those that combine family planning with maternal and child health and HIV prevention. The issuance of piecemeal and incomplete guidance will inevitably result in disorder and inefficiency for both foreign NGOs and the U.S. NGOs charged with monitoring their overseas partners and enforcing their compliance with the GGR.

Timing of the announcement of an implementation plan to apply the Trump Global Gag Rule to the rest of U.S. global health assistance remains unclear but is moving forward through an interagency process which is expected to present recommendations to the Secretary of State in the next several weeks.