Bonus Pod: End the Global Gag Rule: Pass Global HER Now

The Global Gag Rule has been intermittently preventing global communities from accessing comprehensive healthcare for the last 37 years. This Global Gag Rule Repeal Week of Action, it’s important to recognize that ending this harmful policy is extremely urgent. Rebecca Dennis, Senior Legislative Policy Analyst at PAI, sits down to update us on the Global Gag Rule, the impacts it has had around the world, and what we can do to make sure it is repealed once and for all.

The Global Gag Rule is an executive-level policy that has existed under every Republican presidential administration since Ronald Reagan, but was vastly expanded under Donald Trump. The policy under Trump withheld global health assistance funding from foreign NGOs unless they agree to not use any of their own, non-U.S. funding to provide abortions or any information, education, counseling, or referrals for abortion care. This was a huge expansion compared to under previous administrations where it only applied to family planning funding.  To learn more about the history of the Global Gag Rule, find our podcast episode here!

The Global Gag Rule has prevented people around the world from accessing sexual and reproductive health care, maternal and child health care, HIV testing and treatment, tuberculosis and malaria testing and treatment, and nutrition programs. It has limited which commodities—including methods of contraception—can reach communities, and caused organizations to have to end entire programs. The rule has also restricted outreach to hard-to-reach communities, including young people, LGBTQI+ people, and those living in very rural areas or refugee camps.

For many years, the policy only applied to U.S. family planning and reproductive health programs. But after the Trump administration’s entry into the Oval Office in January of 2017, one of their first executive actions included re-instating and massively expanding the Global Gag Rule to impact all U.S. global health assistance funding. This expansion went above and beyond USAID, ultimately impacting programs in the State Department and the Centers for Disease Control and Prevention. The administration expanded it a second time, changing the interpretation of the policy and forcing organizations that were complying with the policy to ensure that any of their partnerships were complying, as well even if they did not get any impacted U.S. health funding.

In January of 2021, the Biden-Harris administration repealed the Global Gag Rule. Despite this momentous step, the policy is not a light switch that can be turned on and off. Many organizations who did not comply with the rule now have to wait until there are additional funding opportunities with the U.S. government, while some are concerned that the policy might return and interrupt their work, again. Even beyond all of this, clinics have closed, and staff have been laid off around the world due to this rule.

Congress has the ability to amend the Foreign Assistance Act and clarify than an organization cannot be deemed ineligible to receive U.S. global health assistance on the basis of the services they provide. Passing the Global Health, Empowerment, and Rights Act (Global HER Act) would prevent the Global Gag Rule from ever being re-instated again.

Links from this episode

PAI on Facebook
PAI on Twitter
PAI Global Gag Rule Evidence and Advocacy Resources
Global HER Act One-Pager
Global HER Act Petition

Transcript

Jennie: Welcome to rePROs Fight Back, a podcast where we explore all things reproductive health, rights and justice. I'm your host, Jennie Wetter, and I'll be helping you stay informed around issues like birth control, abortion, sex education and LGBTQ issues and much, much more-- giving you the tools you need to take action and fight back. Okay, let's dive in.

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Jennie: Welcome to this week's episode of rePROs Fight Back. I'm your host, Jennie Wetter, and my pronouns are she/her. So y'all, I don't know that I have anything too new or exciting to talk about before this episode, but I have to tell you about what happened while I was recording this episode. So, since I've been recording everything remotely, I've been doing the interviews. I mean, some have done over the phone, but generally we use some sort of video platform so we can see each other's faces while we're recording. Well, this time, while I was recording my interview, Cinder, who is one of my two cats, came and plunked herself down right across my entire laptop. So I couldn't see my notes. She was laying across my notes and had her feet up on the screen, basically covering Rebecca's face the entire time, just made herself at home, just lounging on the laptop, refusing to move. So, you know, so much for being able to see everybody's face in a helpful way, but these are the things you learn to work around with cats. I knew I could have fought and pulled her off, but she would have come right back. Cause she really loves laying on the laptop. And she was clearly determined that that is where she was going to lie for the entire interview. So luckily, I had put my notebook over the keyboard because I could see her eyeing it. So, she wasn't able to stop recording, which she has done before or any of her other usual mischievous things she gets into when she lays on my laptop; it's been a real adventure working from home with cats. Y'all like, they are totally zoom divas, like seriously y’all. If you talk to anybody who's been in any sort of video meeting with me, the number one thing they would talk about is how often my cats make appearances. They really love being on camera. It is wild. And then they have also this ability to… Cinder has figured out how to mute the calls, which has also been super fun. And she ended the meeting the other day I was in, I mean, they're just such a handful, but it has made working from home a lot more fun if sometimes irksome. [I] thought y'all would enjoy it. The little behind the scenes peek. We'll see if I can share a picture I took while I was recording the interview. Honestly, you can't see Rebecca at all because Cinder has her feet covering her face. You just see her sprawled across my entire laptop. And it's pretty funny. And with that, let's turn to this week's interview. We're doing a special bonus episode this week for very important reason. There is a week of action surrounding permanent repeal of the global gag rule. And to talk about why this is so important and why this year is the moment to make sure that this finally happens. I'm really excited to have on with me, Rebecca Dennis, at PAI, to talk about global gag rule, what it is, why it needs to go, why having the Biden administration reverse it… reverse the Trump administration's policy is not enough. We need a permanent repeal, and we talk about that. And then we talk about what you can do to make that happen. And there are a lot of little things you can do this week because there is a week of action. So, make sure to stay tuned, to find out what you can do, but also do visit our shownotes at reprosfightback.com. So, you can access the toolkit, which will have tweets and [info] for making phone calls to ask your member of Congress to support the Global HER Act or thank them for supporting the Global HER Act. So that way we can make sure the global gag rule stays gone for good. And with that, I will turn it to my interview with Rebecca.

Jennie: Hi Rebecca. Thank you for being here today.

Rebecca: Hi Jennie. Thanks for having me.

Jennie: So before we get started, do you want to do a quick introduction and include your pronouns?

Rebecca: Yeah, absolutely. So my name is Rebecca Dennis. I use she/her pronouns and I am the Senior Legislative Policy Analyst at PAI.

Jennie: Awesome. So I'm really excited to talk to you today because one, we are kicking off a big week of action around the global gag rule. So it's a great opportunity for people to learn more about it.

Rebecca: Yeah, we're really excited for this week of action to be taking place over the next couple of days. It's a really great opportunity to really raise the profile of the issue and help people understand why it's so urgent that we permanently repealed this policy once and for all.

Jennie: So, you know, we talked about the gag rule on the podcast before, but I think it's always helpful to start at the beginning. So what is the global gag rule?

Rebecca: Sure. So the global gag rule is an executive branch policy that has existed under every Republican president going back to Ronald Reagan in the mid 1980s. And essentially what it is, is a policy that states that in order to be eligible to receive US global health assistance, a foreign NGO must agree to not using any of their own funding-- So non-US funding-- to provide any information, counseling, referrals, or of course, actual abortion services in order to continue to receive that funding.

Jennie: Yeah, and I think that's a really important point that I think sometimes gets overlooked a little bit. Like it tells them what they can do with their own money, not the US money.

Rebecca: Exactly. So as many of your listeners might be aware, there is actually another law that dictates what organizations can do with US funding. That's called the Helms amendment. It's another terrible policy that does damage around the world and something that we could dedicate probably numerous other podcasts too, but this really goes a step above and beyond that and dictates what organizations can do with funding that they're receiving from other donors. So, it's a really unfortunate policy in how expansive it is in that sense.

Jennie: So what are the impacts? What does this mean for people on the ground? What does this mean for people?

Rebecca: It's a great question. And it's another thing that I think often can get overlooked, particularly in the DC circles. When you hear anti-choice politicians talk about this policy, which they often refer to as the Mexico City Policy, or Protecting Life in Global Health Assistance under the Trump administration, they really frame it as it's all about just ensuring that money is not going to abortion. Well, as we've already talked about, it's not about US money going towards abortion. This is about what organizations are doing with their own funds and for the millions of women and girls and communities who rely on US global health assistance. It's not a question of politics. It's not a question of what their position on abortion is for them. It's a question of whether or not they're able to access the healthcare that they need in their everyday lives, whether that be access to contraception or HIV testing and treatment, TB and malaria treatment, vaccine programs, in some cases, even nutrition programs have been impacted by this policy. It goes so far above and beyond the issue of abortion. And so we've seen around the world, this policy has in many cases cut off access to those health services for people. It has closed down clinics. It's limited what commodities can get to people in the field. It's caused organizations to have to end programs partway through the thing we're running to try and increase access to things like certain contraception for going people, for example. And we've seen a lot of programs that have been interrupted or shut down that specifically do outreach to what we offer are to reach communities. So that can be young people, LGBTQ people, those who are in literal hard to reach places, very rural areas. Those who are perhaps living in refugee camps, we've seen all of these sorts of groups of people really bear the brunt of this policy over the past four years. And it was in place over the Trump administration.

Jennie: Yeah. And I think also worth noting is it doesn't even do what they say it's supposed to do, which is reducing abortions.

Rebecca: You are absolutely correct. We've seen in research time and time again, that it does not actually decrease the number of abortions that take place anywhere. In fact, in some cases, research has shown that it actually increases the number of abortions and certainly increases the number of unintended pregnancies that we see during the time period that the policy is in place. And again, a lot of that comes down to, for people who were reliant on US family planning and reproductive health programs to access their contraception. If those programs are shut down because of this policy, they're no longer able to access contraception in order to be able to prevent an unintended or unwanted pregnancy. So it really runs a very much counter to what its proponents claim it's supposed to do.

Jennie: Yeah, it's just so devastating, in this most recent iteration where the Trump administration just expanded it so much, like it impacted so many programs and that's care that was supposed to be getting to people who needed it.

Rebecca: Exactly; for many, many years under Republican administrations, the policy only applied to US family planning and reproductive health programs. But when the Trump administration came in January of 2017, one of the first things that they did was reinstate this policy and massively expanded to cover all US global health assistance programs. And that went above and beyond USAID. So we also saw programs being run out of the State Department out of CDC and elsewhere caught up in this policy as well, this time who had never before had to deal with it under previous administrations. And then as if that wasn't bad enough, we saw the Trump administration expand it again about a year and a half or so later when they changed how they were interpreting the policy. And so for organizations who were complying with the policy in order to stay compliant with it, they actually had to ensure that any partners that they were granting to were in compliance as well. And that applied not only to the global health funding that they were receiving from the US government that applied to any funding coming out of those organizations. So suddenly we saw this policy impacting programs like girls' education programs, for example, or you know, programs to prevent gender based violence, things that we had never imagined that this policy would touch before suddenly becoming impacted under the Trump administration.

Jennie: So that was under Trump. So we have a new administration. What has the Biden administration done?

Rebecca: We do have a new administration and from the get-go, one of the things that we've really wanted to ensure was that the Biden-Harris administration understood how important it was to prioritize the repeal of the global gag rule. And so going back to when President Biden was still a candidate in the primaries, we were already working on for organizations that are able to do the campaigning piece, we're already highlighting the global gag rule for him and ensuring that he understood that this needed to be an immediate priority of his administration. If he took office and in the lead up to the election, when we saw his women's rights agenda, we saw that in terms of women's health issues internationally, global gag rule was at the top of the list for President Biden. And we wanted to make sure to hold him to that when he took office. So in January of 2021, in the days following inauguration, we saw the Biden-Harris administration really take an approach of focusing pretty much on different thematic areas every day for that first like week and a half or so. And so on January 28th, they focused entirely on healthcare, both in the US and abroad. And one of the key components of what they did in terms of global health was repealed the global gag rule and direct agencies within the US government to immediately begin the process of rescinding the policy.

Jennie: Awesome. So we're done, great. Work's done. I'm so glad we have a nice short podcast, but nothing else we need to do. Awesome.

Rebecca: Only if it were that simple.

Jennie: All right. So why is this not enough?

Rebecca: A couple of reasons why it's not enough first and foremost, although you had agencies within the US government like USAID, who've been through this many times before, and we're really prepared and expecting that this policy would be repealed when the new administration came in and were ready to take action immediately. It was a slightly slower process for some other offices outside of the family planning and reproductive health space. And for some other agencies outside of USAID to go through that process of rescinding the policy and getting the word out to their implementing partners, that they no longer needed to worry about this. But even with that, this policy, it's not a light that just gets turned on and off. And unfortunately, the case often is that it can be turned on very quickly, but the process of rescinding, it takes a much longer time. So we saw many organizations who were unable to, or chose not to comply with the policy who then were ineligible to receive funding. Well, now those organizations have to wait until there's new funding opportunities that are available with the US government and then go through the process of deciding whether or not they want to take a chance of accepting US money. Again, knowing that this policy could potentially come back in four or eight years and interrupt their work again. So that's one issue. And then even once organizations are able to get refunded, clinics have closed. Staff have been laid off. All of those things take time to remedy and get back up and running in country. So it's not as simple as just signing an executive order to say, it's done, it's gone. And even beyond the immediate term, Joe Biden will not be President forever. We know that in potentially four years, eight years we'll have another administration come in. If that administration has a Republican administration, we can assume based on history that the global gag rule will come back. And I think at this point, there's no reason to assume that the version that we'll see another administration put in place is anything other than the Trump version. So I think this massively expanded policy that we saw over the past four years is likely to become the new baseline for any future Republican administration. So it's not to just have taken care of it for the moment we need to look at what can be done to make sure that this policy doesn't come back.

Jennie: Yeah. And I think one of the things, you know, we've kind of talked about, but just to be really explicit, right? Like it doesn't matter what the US policy is to a person who is going to try and access care, right? If you're going to a clinic because you need whatever service and they're closed, or all of a sudden, they're not telling you that abortion is an option, and that's what you need. Like this is impacting the care you're receiving in profound ways.

Rebecca: Absolutely. And you know, for a lot of people, it's not something that changing the policy now is going to fix. There was potentially damaged, done to people's health over the past four years that we can't just magically wave a wand and have it go back to normal just because the US has gotten rid of this policy for individuals. It's so much more than just a political debate. It is quite literally their health, their wellness, their ability to make decisions about their own reproductive rights. If they want to have children, when they want to have children and being able to access the ability type of supplies that they need to make those decisions.

Jennie: Yeah. I think that's just something that often gets lost when you hear gag talks about and like the policy circles, right. It's in the abstract. And so often the people who are impacted are not in the center.

Rebecca: Yeah, absolutely. And it's something that we've really been trying to do at PAI. And I think really across the board in the community is elevate the stories of those who are impacted, whether that be at the individual level or organizations that are impacted in countries around the world. You know, we've seen huge impacts in Sub-Saharan Africa, but also in Asia. And we need to make sure that those stories are known. And so I know as someone who spends a lot of her time talking to policymakers about what the impact of this policy is, it's so critically important that we're able to raise those stories with them that are coming from those who are actually impacted by the policy or see the impacts of this policy every single day in their own lives and in their own communities.

Jennie: Okay. So we know that it's terrible and that just having the Biden administration reverse it isn't enough. So what do we need to do? What needs to happen to make sure it's gone and stays gone.

Rebecca: So even though we often think of it as an executive branch policy, really what we need to do at this point is look to Congress. Congress has the ability to amend a law called the Foreign Assistance Act and make clear in that law that an organization cannot be deemed ineligible to receive US global health assistance on the basis of what health services they provide. And the best way that we can do that is by passing a piece of legislation that is called the Global Health Empowerment and Rights Act or what we refer to often as the Global HER Act. This piece of legislation is led in the House by representative Barbara Lee, along with representative Ami Bera and representative Jan Schakowsky. And on the Senate side, we see that bill led by Senator Shaheen along with actually, uh, Senator Collins and Senator Murkowski. So on the Senate side, we actually have a bipartisan bill. And right now we have 50 members of the US Senate who support that piece of legislation. And on the House side, we have over 180 members of the House who support this legislation. So we've made significant progress with getting Congress to understand how important it is to repeal this policy once and for all. And now what we really need them to do is take action to make that happen by either marking up the Global HER Act or thinking through if there's different ways that we can get that language included in other pieces of legislation that might be moving. So for example, we actually have seen the language from the the Global HER Act to permanently repeal. The global gag rule has occasionally been incorporated into appropriations bills in either the house or the Senate. It actually passed the House starting in about two years ago. Now, since Democrats took control of that chamber, but we've never seen it in both appropriations bills in both chambers at the same time. So we haven't seen what could be done with permanent repeal through that venue yet. But I think it's something that we're very interested in potentially utilizing to help move this legislation forward and bring this policy to an end.

Jennie: So why is now the moment? Like why do we need to get it done now?

Rebecca: So there's a couple of reasons. First and foremost, we know that it can take some time for things to move through Congress. And right now we have a political reality where we have a solid majority in the House of Representatives who support permanent repeal of the global gag rule. And we have a narrow majority in the Senate, thanks to our bi-partisan support on this issue there that would like to see this policy gone once and for all. And we have a White House right now that would like to see this policy go on once and for all. So that puts us in a unique position at this moment, where there is a chance that we could actually get it through the House, the Senate, and signed by the President. And it's critical that we take advantage of that now, while we can, you know, next year we'll have another congressional election and we don't know what the outcome will be from that. We might not retain that majority support for repealing this policy beyond 2022. So it's really important that we seize on this moment that we have right now and make this a thing of the past.

Jennie: So I think the important part right now is we always ask what our listeners can do and this week, have we got a bunch of things for you because we have a big week of action. So what can, oh, sorry. I said listeners, I meant audience because not everybody listens. So what can our audience do?

Rebecca: Great question. There are so many things that the audience can do this week ranging from tweeting about the importance of repealing the global gag role permanently--you can encourage your representatives and senators to either co-sponsor the Global HER Act or for the many that already have encouraged them to move this bill forward and pass it. And there's a couple of different ways you can do that. You could use social media, you can email their offices, you can send their offices a letter, or you can call their offices. We have some partners who are planning a national call in day for later on this week. So that is a perfect opportunity to call your, your representatives and senators and let them know how you feel about this issue.

Jennie: Yes. And we will make sure to share all of the tools. So you have all of the tweets and all of the links to take action so that you can easily take action to make sure that we get rid of the global gag rule once and for all. Okay. Well, Rebecca, thank you so much for being here today. I had so much fun talking to you.

Rebecca: Absolutely. Thanks so much for having me. It was great to be able to let everyone know where things stand on the global gag rule right now and what we can do to make sure that we never have to have this conversation again.

Jennie: That'd be nice. So other things to talk about, right? So many other issues we could be putting time and attention to, if this was no longer something we needed to be concerned about. Well, we'll have to do that another time because we are getting rid of it this year.

Rebecca: Yeah, let's do it.

Jennie: Okay. Y'all I hope you enjoyed my conversation with Rebecca. I had a great time talking to her and I hope you all go and take action to make sure that we can end the global gag rule once and for all. And with that, I will see y'all back for a regularly scheduled episode next week. Jennie: Thanks for listening everyone. For more information, including show notes from this episode and previous episodes, please visit our website at reprosfightback.com. You can also find us on Facebook and Twitter at RePROS Fight Back, or on Instagram at reprosfb. If you like our show, please help others find it by sharing it with your friends and subscribing, rating and reviewing us on iTunes. Thanks for listening.

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