The Biden-Harris administration’s decision to rescind the egregious Mexico City Policy, or “Global Gag Rule”, is a welcome move, which should now be reinforced by further action to reverse the great damage inflicted by COVID-19 on the health and wellbeing of vulnerable women, children and adolescents in low- and middle-income countries.
The US administration’s decision to rescind the controversial Mexico City Policy, also known as the Global Gag Rule, was warmly welcomed today by The Partnership for Maternal, Newborn & Child Health (PMNCH), an alliance of more than 1,000 organizations from over 190 countries working to drive momentum towards global health targets for women, children and adolescents.
PMNCH expressed its hope that the new administration will go beyond restoring U. S. financial support for overseas organizations providing essential family planning and reproductive health services, and will back PMNCH’s Call to Action, which specifically seeks to reverse the pandemic’s devastating effect on the health and well-being of millions of women, children and adolescents worldwide.
“The rescinding of the Mexico City policy is welcome news for millions of women and girls around the world,” said Helga Fogstad, Executive Director of PMNCH.
“This policy has been responsible for denying essential funding and contraceptive supplies to overseas family planning agencies. That in turn increased the numbers of unintended pregnancies and unsafe abortions and endangered the health and even the lives of thousands of girls and women.”
The Mexico City Policy has been implemented by every US Republican administration since 1984. It prohibits foreign organizations receiving U.S. global health assistance, from providing comprehensive abortion services, information, counselling referrals, and from engaging in advocacy against restrictive laws, even with non-U.S. funds. The last four years have seen an unprecedented expansion of the Gag Rule, denying essential funding not only to family planning groups, but even to organizations involved in other areas of health and development, such as HIV/AIDS prevention groups, that refused to comply with the policy. This has resulted in more unintended pregnancies, an increase in unsafe abortions and higher rates of maternal mortality — ironically, the very thing the policy purported to prevent.
About 295,000 women died globally during and following pregnancy, childbirth and the postnatal period in 2017. Additionally,
Lack of high-quality sexual and reproductive health services puts women at risk. Between 2015 and 2019, it is estimated that there were 121 million unintended pregnancies annually, of which 61% ended in an induced abortion. Research shows that the proportion of unsafe abortions is significantly higher in countries with highly restrictive abortion laws than in those with less restrictive laws.
The COVID-19 pandemic has further exacerbated these problems. Throughout 2020, the delivery of essential sexual, reproductive, maternal and child health services has been disrupted, vital clinics have been closed or re-purposed, and lockdowns have curtailed free movement, putting women, children and adolescents at even greater risk.
The COVID-19 pandemic has revealed major structural weakness in our societies putting vulnerable groups even higher at risk. Access to social safety nets and essential health service regardless of ability to pay are critical functions to mitigate the impact of any health crisis.
Research in early 2020 from the Guttmacher Institute had estimated that even a 10% decline in use of short and long-acting reversible contraceptives could lead to almost 49 million additional women with an unmet need for modern contraceptives and an additional 15 million unintended pregnancies over the course of a year. A 10% shift in abortions from safe to unsafe could lead to 325,000 additional unsafe abortions; and 1,000 additional maternal deaths in 2020.
These alarming figures threaten to reverse progress made to date, unless we increase our commitment to women and girls. In July 2020 PMNCH members issued a seven-point Call to Action in response to the devastating effects of COVID-19 on the health and well-being of women, children and adolescents. Building on its 2021-2025 Strategy, the Call to Action calls on leaders to protect and prioritize the rights and health of women and girls during the COVID-19 response and recovery by strengthening political commitment, policies, and financing for vital health services, including safe abortion, particularly for the most vulnerable.
Responding to the Call to Action, in December 2020 a group of high, low- and middle-income countries and foundations made pledges of $20.6 billion to restore services and protect the health of women, children and adolescents. $6.6 billion (32%) of the total pledge came from low- and middle-income countries themselves,- specifically Afghanistan, India, Kenya, Liberia, and Nigeria.
Recognizing that the impact of the Global Gag Rule compounded by COVID-19 cannot be reversed only through the repeal of the Mexico City Policy, PMNCH is joining with other agencies to add its voice to PMNCH member the Guttmacher Institute’s call for tangible progress for women’s sexual and reproductive health and rights in the first 100 days of the Biden-Harris administration.
“Ending the divisive and egregious Mexico City Policy is a vital first step, which PMNCH hopes will be complemented by further moves to reverse the additional damage done by COVID-19. It is now essential to have the ambition to put in place multiple strategies to advance sexual and reproductive rights in all countries”, said Helen Clark, Board Chair of PMNCH and former prime minister of New Zealand.