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POPULATION: Bush ‘Gag Order’ Chokes Global Family Planning – NGOs

Miriam Kagan

WASHINGTON, Sep 24 2003 (IPS) - President George W. Bush’s cuts to funding for global reproductive health programmes have not only failed to reduce abortions, but have devastated family planning and reproductive services in some of the world’s poorest countries, says a report released Tuesday.

‘Access Denied: U.S. Restrictions on International Family Planning’, by a consortium of population-planning non-governmental organisations (NGOs), examines the effects of the ‘Mexico City policy’ on reproductive health services in Ethiopia, Kenya, Zambia and Romania.

The Global Gag Rule Impact Project, a collaborative effort of Population Action International, IPAS, the Planned Parenthood Federation of America, and several other NGOs, developed the report.

On Jan. 22, 2001, Bush reinstated restrictions on overseas health care organisations in effect during the Reagan and Bush Senior administrations known as the Mexico City Policy, or the Gag Rule (which were not enforced under the Clinton administration).

These restrictions prohibit assistance for family planning from the U.S. Agency for International Development (USAID) to foreign NGOs that use funding from any source to perform abortions, provide counselling or referral about them, or to lobby for the practice.

Although originally the restrictions applied only to funds from USAID, Bush recently extended the rules to State Department aid.

NGOs in countries across the globe depend on USAID for significant portions of their programme funding, as the United States is the world’s largest aid donor in absolute terms.

According to Terri Bartlett, vice president for public policy and strategic initiatives at Population Action International (PAI), ”this policy significantly reduces access to vital family planning services”.

While one of the aims of the Gag Rule is to prevent abortions, the report found that not only does the policy fail to prevent abortions, it causes women to seek them more frequently, the groups said at the report’s release Tuesday.

The policy ”does not prevent women from getting abortions; it only prevents access to safe and reliable information and healthcare”, leading to more unplanned pregnancies and more abortions, said Valerie DeFillipo, director of Planned Parenthood’s Global Partners Project.

Bartlett added that the Gag Rule is "another example of ideology trumping science. The Bush administration is ignoring evidence that access to healthcare is vital to healthy development of women, children, and community”.

The report says the Gag Order has hindered healthcare activity in the countries surveyed, where access to family planning and related health services were reduced or in some cases eliminated.

In Kenya, where the maternal death rate is 1,300 per 100,000, two of the leading family planning NGOs closed five of their clinics.

Three of the clinics were operated by the Family Planning Association of Kenya (FPAK), which served almost 19,000 clients in 2000. One clinic was located in a neighbourhood with no government service, so its closure has left residents with no access to healthcare, says the report.

In Zambia, where abortion is legal, the leading family planning organization, PPAZ, lost 24 percent of its funding and was forced to cut crucial service to rural areas because of its refusal to sign the Gag Rule.

In rural Ethiopia, where women have an average of six children and only eight percent of women use contraception, rural clinics rendered ineligible to receive USAID supplies have run out of Depo-Provera, a contraceptive used by 70 percent of its clients.

And in Romania, where women often use abortion as their main contraceptive method – the country averages 2.2 abortions per woman – the Gag Rule has reinforced the separation between abortion and family planning services, hindering efforts to counsel post-abortion patients.

According to Hilary Fyfe, chairperson of the pro-life Family Planning Movement in Zambia, "unfortunately, the Gag Rule has had devastating effects on planned parenthood in Zambia. Youths have nowhere to go.”

Fyfe pointed out that in Zambia, where one in five adults is infected with AIDS, nearly 70 percent of the population is under the age of 24, and most of these people need family planning counselling because they will soon reach child-bearing age.

The report says the Gag Rule has also affected efforts to educate, prevent, and treat HIV/AIDS patients in Africa.

For instance, the organisation Marie Stopes International was forced to close a reproductive health clinic in a province in Kenya that has the highest rate of HIV/AIDS in the country.

The groups’ say the policy puts many NGOs in an impossible position.

Signing the Gag Rule means they receive crucial funds but it curtails free speech and outreach efforts. Refusing to sign means losing essential funds while maintaining the ability to choose actions that suit individual communities.

Many NGOs have refused to sign, citing free speech and arguing that the Gag Rule is completely out of touch with the needs of local communities.

According to Bartlett, ”clinics on the ground in developing countries are comprehensive”, delivering a range of services, including mother and childcare, reproductive services, and HIV/AIDS information.

Cutting off funding hurts all of those services, not just the family planning aspects, she adds.

IPAS Executive Vice President Barbara Crane says the Bush administration has a ”blindness and unwillingness to hear the facts that are staring us in the face”.

And according to the groups, the U.S. public does not support the Gag Rule.

DeFillipo told the audience that ”nearly 70 percent of Americans believe the U.S. should be supportive of these programs – on par with the support for the war on terrorism’.”

Members of IPAS also told IPS that colleagues and friends at USAID, although unwilling to say so on record, disapprove of the reinstatement and feel the Gag Rule is undoing years of hard work by USAID to establish important aid distribution networks abroad.

According to Crane, the Gag Rule violates the central tenets of U.S. foreign assistance: distributing funds efficiently and promoting Democratic values abroad.

It is "interfering with (other countries’) democratic processes. Who should be making the choice, the White House or the women and governments affected?" she asked.

"How ironic,” said Fyfe, ”that an administration that claims to be pro-life is killing women”.