The Global Gag Rule May be Gone (For Now) But Its Harm Continues

The Global Gag Rule (GGR) prevents foreign non-governmental organizations that receive U.S. foreign assistance funds from providing, advocating for, counseling on, or referring for abortion services even when done with their non-U.S. funds. Bergen Cooper, Director of Policy Research at Fòs Feminista and Kat Olivera, Associate Director for U.S. Global Policy at Fòs Feminista, sit down to talk to us about the unmitigated harm caused by the GGR and why permanent repeal of this rule is needed immediately.

 The Global Gag Rule, or the Mexico City Policy as introduced in 1984 by President Ronald Raegan, which is a presidential memorandum that is either reinstated or revoked depending on party lines. During the Trump administration, the Global Gag Rule was expanded and rebranded as the Protecting Life in Global Health Assistance Policy, and Biden revoked the GGR early in his tenure. Still, even when the GGR is not in effect, it can be impactful. When the policy is put into place, purposeful communications are made to ensure cooperation; when the policy is revoked, communications are one-off. In fact, Fòs Feminista’s research team found an alarming breakdown in communication between the U.S. government and relevant global stakeholders. It was found that, this particularly damaging game of telephone resulted in the prolonging of the policy’s implementation and unnecessarily prevented people from accessing legal abortions.  

The Global Health, Empowerment, and Rights Act (The Global HER Act) is a bicameral piece of legislation that would repeal the Global Gag Rule permanently. The overturning of Roe v. Wade has the potential to embolden anti-abortion policies like the GGR, which is why it’s important to take advantage of our remaining time left with the Biden administration, the Senate majority, and the House to continue priming the Global Her Act and permanent repeal of the GGR. Especially when many countries’ own national laws and policies permit for the funding and provision of abortion care, the United States’ restriction of providers speech and services abroad is racist and unconscionable. The failure of the administration, Congress, and other government actors to monitor for and ensure compliance with the GGR revocation and provide clear communication only perpetuates the policy’s harm.

Links from this episode

Fòs Feminista on Twitter
Fòs Feminista on Facebook
Information on Reintroduction of the Global HER Act
Fòs Feminista’s report Chaos Continues: The 2021 Revocation of the Global Gag Rule and The Need for Permanent Repeal
The Sexual and Reproductive Health and Rights Index

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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 I cannot believe it is April. Already this year has been just like, I mean, honestly chaos for me. And I, I feel like I completely lost February between Covid and then my dad dying. Like I, it is just like a blur and like, so I just feel like I lost time and, uh, have been just like playing catch up and now March is over and I don't really know how that happened. Like y'all, I just, I don't know. I can't believe it. Like I said, I cannot believe it is April, but, you know, watching all of the flowers bloom here in DC, we have, you know, the cherry blossoms and stuff, and lots of other flowering trees, which are delightful to look at. Um, you know what I mean? They play hell on my allergies, but they're delightful to look at. I've just been enjoying the nice weather and having my windows open. The kitties have been enjoying laying in the windows and like staring out at the wider world. And, um, honestly, if I could have the windows open all the time, like Luna, one of my cats would just be like the happiest little kitty ever. Um, but we can't do that. Uh, let's see here, what else has been going on? I think like the, one of the bigger things that have been happening, other than the ongoing assault on trans rights, like, and we always need to keep our eye on that, things are really bad right now and we need to make sure that we are speaking up and speaking out in support of our trans brothers and sisters. Um, they, they really need us in this fight right now, and it is just more important than ever to make your voice heard. But there has been just like a huge swath of repro bills that have been introduced in the House and Senate in the last couple weeks. And while I won't do like a deep dive on them, uh, right here, let's just like talk real quick about them. And honestly, there are some episodes that, uh, we have back in our archives that you can learn more about all of these bills. So first, uh, last week the House reintroduced the Women's Health Protection Act that would enshrine abortion rights, um, into federal law. And the Senate had introduced their version earlier, uh, earlier this month. Uh, also last week, the Senate reintroduced the EACH Act, which would repeal the Hyde amendment, which prevents taxpayer funding for abortion domestically and would guarantee insurance coverage for abortion. So some huge domestic bills were introduced in the last couple weeks. Um, also last week, uh, the House and Senate reintroduce the Global HER Act, which would repeal the global gag rule, uh, which is what this episode is all about. So I won't go any further into that here. And then earlier this month, uh, the Senate and the House reintroduced the Abortion is Healthcare Everywhere Act that would repeal the Helms Amendment, which, bans US funding for, uh, for abortion globally. It, it is generally implemented as a complete ban on abortion funding globally, even though the Helms amendment on its own says that it bans abortion as a method of family planning. So there should be circumstances where the US is funding abortion that they currently do not. But this, uh, bill would ensure that the US would be able to fund abortion and global health, um, which would be really, really important and would save so many lives.

Jennie: Um, all of these bills are amazing and would do so much to improve access to reproductive health and rights both in the US and abroad, um, that it's really important that we support all of them. Like I said, we have episodes that talk about all of these things, so, um, maybe we'll include them in our show notes so that if you want more information you can go listen to those episodes. Um, but yeah, they're all wonderful bills to support and definitely worth checking out and making sure that your, um, members of Congress are co-sponsors or know that they should support these bills. So just a real quick recap, that is the Women's Health Protection Act or WHPA, the EACH Act, the Global HER Act and the Abortion is Healthcare Everywhere Act. Um, all great and all worth your support, and I think I will pause there and turn to this week's interview since we're gonna be talking about the global gag rule, which is then relevant to the Global HER Act. And I am so excited to have with me some amazing advocates and an amazing researcher, uh, on the podcast. So we have, uh, Kat Oliver with Fòs Feminista and Bergen Cooper with Fòs Feminista, and I am so excited for y'all to hear my conversation with them. So with that, let's go, go to my interview with Bergen and Kat.

Jennie: Hi Bergen and Kat, thank you so much for being here.

Bergen: Hi. Thank you for having us.

Kat: So happy to be here.

Jennie: Okay, so I guess before we get started, let's do the quick round of introductions. Um, Kat, do you wanna go first? Um, do a quick introduction and give us your pronouns

Kat: For sure. Hi everyone, I'm Kat Oliver. I use she/her/ella pronouns and I am the Associate Director for US Global Policy at Fòs Feminista.

Jennie: Awesome. And Bergen?

Bergen: Hi everyone. Bergen Cooper, she/her. I'm Director of Research with Fòs Feminista, which is a global-south led feminist organization centered around the sexual and reproductive health and rights of women, girls, and gender-diverse people.

Jennie: I am so excited to have you both here. You are both wonderful and I get, I'm so lucky to get to work with you, Bergen, not as much, um, as I get to work with Kat, but it's just always delightful to have colleagues on. Um, and unfortunately we're talking about something that I really just don't want to talk about anymore, like I want it to be solved. So we're talking about the global gag rule today. And I guess before we get into anything, maybe we should just do like a little background. Like some people may be familiar, but some people may not. So what is the global gag rule?

Kat: Yeah, so the global gag rule is a US foreign policy that was originally introduced as the Mexico City Policy way back in 1984 by President Ronald Reagan while in Mexico City. Um, during the Conference on Population and Development. Uh, during the last administration, Trump administration, it was expanded and rebranded as the Protecting Life in Global Health Assistance Policy. But we advocates call it for what it is, a gag rule, hence the “global gag rule”. And when enacted, it prohibits, uh, foreign non-governmental organizations that receive US foreign assistance funds from providing, advocating for, counseling on, or referring for abortion services as a method of family planning, even with their own funds. So essentially the global gag rule is a presidential memorandum that comes straight from the White House and, um, it's either reinstated or revoked depending on party lines, which is why it's often referred to as a political football. But this political football in reality is a racist, misogynistic, colonial, state-sanctioned coercion tactic that's implemented on the global scale by the US Republican Party with the intent to undermine sexual and reproductive health and rights globally. At the end, the global gag rule is essentially the US government standing in between a patient and a provider and telling that provider what they can and cannot say.

Jennie: That just, it's so frustrating that, uh, we still have to talk about it like again, but right, so it's currently not in effect, right?

Kat: That's correct. President Biden rescinded the global gag early in his tenure.

Jennie: Okay. So I think a lot of people would be like, well, if it's not effect, like why, why should I care? Like why should I care right now?

Bergen: Well, lemme tell you, unfortunately even when it’s not in effect, it still can have impact. Let's get into the data. I'm so excited about data. There’s been a lack of research and transparency on the impact of the government’s global communications, or lack thereof, when it comes to the revocation of this policy. So imagine this, when the policy is in place, the US government takes every step to inform partners around the globe. The policy is in place, you have to comply. There are checks and balances throughout the year to ensure the policy is in place. When it is revoked, a one-off communication that the policy is revoked occurs. So we wanted to understand how did that communication actually impact people around the world and impact services? So to do that, we conducted 57 stakeholder interviews, um, we talked to international civil society organizations, representatives from the US government based across the United States, United Kingdom, Malawi, Mozambique, and Zimbabwe. And we did these interviews about eight months after the revocation. What we found is that despite these efforts, the policy continues to negatively and unnecessarily impact individuals and organizations. What our research team found was this alarming breakdown between the US government and global stakeholder regarding the revocation of the policy. And this is a communication breakdown that had gone undetected by US government employees despite significant harm caused to stakeholders globally, um, by the introduction and revocation, Generally the government employees we spoke to believed they had done everything to communicate the revocation of the policy and, and take the steps to stop implementing the policy. However, most of the implementing partners we talked to, and by implementing partners , I mean people who do they work, they did not believe that the government’s communication was sufficient. So, you know, why, why does it matter? Why does bad communication matter? Well, of this as like the worst game of telephone. The White House starts with this one message and they pass it on to headquarters in DC—USAID, Department of State, uh, to Health and Human Services, even Department of Defense, who then pass these messages on to missions in the country who then pass this onto implement partners, who then may pass this message on to sub-implementing partners. You can imagine how the communication chain might go in this very bad game telephone. What we found is the failure of the US government to communicate and enforced the revocation of the policy prolonged the policy’s implementation and unnecessarily prevented people from accessing legal abortions. Lemme give you some examples, USAID enforced the policy on an organization during the Trump administration even though that organization did not receive US global health assistance. So we have this umbrella of US Foreign Assistance and global health assistance is one stream and the global gag rule applies to the global health assistance. This organization in Zimbabwe did not receive global health assistance, and yet the policy was put into their work so that to this organization restricting vital services unnecessarily. And furthermore, USAID headquarters had not communicated to this organization that the policy had been revoked; they learned about it when we reached out to do this interview. We also spoke to partners in Zimbabwe who were not allowing, uh, referrals in cases of rape, incest, or life endangerment, which the policy allows, uh, we spoke to an organization that continued to implement the policy even after revocation and in July 2021 when we were conducting interview seven, eight months, after the revocation, this organization was still not providing abortion referrals that they were legally allowed to provide under both US global health policy and the law in Zimbabwe . We also spoke to an organization in Mozambique, who received a cooperative agreement from the government after the policy had been revoked. And the global gag rule language was still in that cooperative agreement. Across multiple countries we found organizations were unaware of the revocation until we reached out for interviews. Um, what we found was that organizations said it difficult, if not impossible, to maintain continuity in their programming giving that the policy could be reinstated. You know, I spoke to, uh, colleagues in Malawi who said, “what if another regime comes, you know, and they said it's really scary to advocate or not. So we're just quiet.” We also spoke to Carl Hoffman, CEO of Population Services International, a huge organization that worked across the globe and he was very forthcoming telling us that the policy damages the ability to do holistic programming for women, for communities. Um, you know, when we think about the harm of the policy, we know that it continues even when the policy isn’t in place. So when we're thinking about what revocation means, we need to make that repeal of the policy actually real. It’s not enough to revoke it every four or eight years, we need a permanent solution to ending the policy.

Jennie: Yeah, I think one of the like biggest misconceptions I think a lot of people who aren't in this work like day in and day out, is that it's, it's in place and it's bad and it goes away and it's gone and like everything's better. And like that is just very clearly not the case.

Kat: That's exactly right. It's far from the truth. It's a wound that's never been healed. Um, and we must find a way to permanently end the global gag rule once and for all. Uh, thankfully there's a remedy out there for that. And that is the Global Health Empowerment and Rights Act, also known as the Global HER Act. And what the Global HER Act is, it's a bicameral piece of legislation that was actually recently reintroduced for the 118th Congress and it is led by Representatives Barbara Lee, Ami Bera and Jan Schakowsky in the House and in the Senate, Senators Jean Shaheen and Lisa Murkowski. So as you can see in the Senate, we actually have bipartisan support with currently 50 co-sponsors and in the House over 150 co-sponsors. And so these numbers actually reflect the progress Congress has made in understanding the importance of repealing the policy and that's what we seek to do.

Jennie: Yeah, I think, you know, one of the things I think we've talked about in other episodes, but not this one, is like, so here we're talking about the partners who were continuing to get funding and like how that is, the reversal of the global gag rule still impacts them, but we're not talking about the people who just opted out of the policy because of the harm it would cause and like what is that the impact on them?

Bergen: Yeah, absolutely. I mean that's a great question. So as part of our interview, we absolutely spoke to organizations who were unable to comply with the global gag rule, and therefore did not receive US global health assistance during the Trump administration. And when we spoke to them, you know, seven, eight months after the revocation, they still were unable in many cases to receive global health assistance because, it might be a light switch that can be turned on and off through presidential memorandums, but that’s not how money flows. And so these are organizations who are fully capable and experts in the field, uh, of, of sexual and reproductive health and rights who still don't have, at the time, didn't have the funding to do the critical work that is needed around the world.

Jennie: Yeah, I, you know, we've definitely done episodes focusing on like the harm the global gag rule and talking about that part, but it just felt important to like bring that up again today. Like the ones who continue to get funding aren't the only ones who are impacted. And again, I think people kind of think it's like this magic of like all of a sudden the money is going to where it needs to go. And that's not how funding cycles work.

Bergen: No, it's not. I mean it's not how funding cycles work after the revocations. It's not how funding cycles work when the policy is in place. I know, I know you and I have talked about the impact of the policy again, but you know, there's this one story that I always come back to, which was um, when was in Zimbabwe during the Trump administration working with an organization called Roots that works on women’s economic empowerment under the DREAMS partnership and they lost funding cause they were unable comply with the global gag rule. I was speaking to them and they had gone months and months without services and I asked “who is the organization that is supposed to step in here an pick up the work?” and that organization, their office was located five feet away and it had been three months and you know, this is how, this is how funding cycles work. They hadn't gotten funding yet. And what it meant was that these roles were without services even though there was organization literally five feet away.

Jennie: Why is now so important, uh, for passing Global HER?

Kat: Yeah, it's such a great question. I think it's important for us to recognize and take stock of our political landscape and our reality in light of the Dobbs decision, right? What it means to be living in a post-Roe world, which note, many of us are already living in that world. Um, but we do know that the decision and the overturning of Roe has the potential to embolden egregious anti-abortion policies like the global gag rule. So we should actually not expect anything less, um, if and when a Republican administration is elected. Recognizing that, it's important to take advantage of our remaining two years with a Democratic administration, a Senate majority, and yes, even House despite the political makeup. So that way we continue priming the Global HER Act, the language around it and why it's necessary to permanently end the global gag rule so that once we do have an opportunity for passage, it's a no-brainer, we can easily secure it and pass it. Um, and like you mentioned in the beginning, we're exhausted having this conversation about the global gag rule. Overturning it is long overdue. Um, and in fact now we're at a point where the US is actually, uh, running against the overwhelming international trajectory where countries like Argentina, Mexico, Colombia, and Kenya are liberalizing their own abortion laws. So there's no reason as to why the United States should continue restricting and intimidating providers abroad when their own national laws and policies permit for the promotion and the procurement of abortion. In essence, it's just racist and unconscionable.

Bergen: Yeah, absolutely. And you know, there are efforts that the government could be taking at this time, but they simply are not. Um, Jennie, I think you and I have had the opportunity to talk about Fòs Feminista’s sexual and reproductive health and index before. So we have this index and in that we grade the US government’s commitment to sexual and reproductive health assistance through global health assistance. What we do is we look at everything that these agencies do throughout the year. What does the White House do? What does State do? What does USAID do; there are tons of opportunities for these agencies to properly communicate the revocation and uplift the president’s presidential memorandum, which states that it is the policy of the US government to promote sexual reproductive health rights both domestic and abroad. And there are actions the government could take. So HHS, the CDC has, uh, additional requirements that go out to partners around the world were they could explain what the revocation of the global gag rule means, where they could explain what the promotion of sexual and reproductive health and rights looks like in foreign assistance. USAID has e-learning forces for partners all around the world. They could have one on the promotion of sexual and reproductive health and rights and that talks about what it means to revoke the global gag rule and what that means for programming. The Department of State and PEPFAR, our largest global health funding area, that they have systems in place to monitor progress around the world, there could be checklists in place to monitor around complying with the revocation of the global gag rule or promotion of sexual and reproductive health and rights, uh, in general. And the White House absolutely has communication opportunities through presidential memorandums, executive orders, and other actions. But really, it’s the failure of Congress, the Biden administration, and other US government actors to monitor for and ensure compliance with the GGR revocation, and provide clear, accessible communication to stakeholders. That has only perpetuated the harm of the global gag rule.

Jennie: Brain is going like in a couple different directions... It's like trying to pick the right one. Okay. So I guess my first thought I was having is like starting to think through like, oh, this could come back, right? We kind of had that conversation and like what comes back, right? Do we get the, the bad earlier version or like the even more terrible Trump version and like, and where it just like so drastically expanded the harm. Um, so that was like one bucket that my brain was going down. And I guess I'll pause there cause I think I forgot the other one.

Kat: I think we should expect the worst, right? The Trump administration rebranded it, uh, it introduced it as the Protecting Life In Global Health Assistance-- that's the narrative that they're running behind and we should expect nothing less from them. I think we should actually expect that to be their new base and for them to be creative and finding new ways to continue undermining and hurting communities around the world.

Jennie: Okay. Oh, there we go. Okay. So that's the, the other thing that I was thinking of is like, you know, we talk about how far the administration, the previous administrations went in making sure people knew what was restricted under global gag and like really put in the work to like really make it explicit of like what you couldn't do and like, and that friendly administrations are basically just like, “okay, it's gone. Bye.” And that seems like a problem.

Bergen: I mean it's a problem for sure. So, you know, our data is very clear that it’s a problem. And as I said there is a lack of data in this area, um, and I hope that there will be more, but also I want to shout out, um, our friends and colleagues at CREHPA in Nepal who documented the impact of the policy while it was in place in Nepal and further looked at the revocation and they’re finding similar data… this is not an isolated incident. We have found that around the world, organizations felt that the, that the communication of the revocation was not clear, was not efficient, and did not give guidelines for what they could do moving forward. Really, it's not enough to say policy is gone. We need context for what that means. What can partners do? What does it look like to fully promote sexual and reproductive health and rights? The government has a duty to explain to partners around the world and simply stating that the US government promotes sexual and reproductive health and rights is not the same as implementing it.

Jennie: It's just so frustrating. And like as an advocate, right? Like we push and push for these policies to change and then to see it like not be implemented to its fullest extent is just like…

Bergen: Yep. Yep.

Kat: Exactly.

Jennie: Okay. So we always love to wrap it up with thinking through what step, like what can our audience do? There seems like, you know, so much going on and the audience wants to be able to take actions. So what, what actions can they take?

Kat: My favorite question, definitely so urge the audience to contact their representatives and our senators. You know, Congress must make the repeal real by permanently ending the global gag rule, and that's through legislative action in this instance, the Global HER Act, so that we avoid prolonging the policy and its disastrous impacts. And also, quite frankly, we just really need to shut the door on any future administration seeking to implement the policy. Um, if your representative and senator is already a co-sponsor, thank them, thank them and urge them to mark up the bill and to find other avenues to move the bill forward. I also highly suggest the audience follow, actively listen and engage with the organizations, the people and the communities that are impacted by the policy every day. And I say every day because as long as this policy can easily be put into place, people's lives will continue to be put at risk. You know, you hear myself and Bergen talk to you, Jennie, about the policy. You provide the data and the numbers. And as much as I love data and numbers and Bergen, um, you know, at the end of the day these are people, not numbers. And these are people who deserve to live healthy just and dignified lives. And so the global gag must go.

Bergen: Absolutely. I can't, I can't agree more. What I can say is you should contact your reps, but also maybe you should do it with music? Um, I'm a researcher, and a musical theater nerd at heart, and so I would shout out the Global HER Project, which is fantastic musical about the global gag rule, um, we were really thrilled to engage the support of the creation of this musical which at the end helps you contact your representative to call and make the repeal real. So absolutely contact your representatives and maybe do it with music.

Jennie: That's so fun. Kat, I really love that you brought it back to like, these are people and not, not numbers, right? Because that's, that's why we do what we do, right? Is because it's people's lives who are impacted and people's lives who are being harmed. And that's why, that's why I know I'm in the fight. That's why I know y'all are in the fight.

Kat: Yeah.

Jennie: Like, and so often like talking about these big concepts and stuff, that part can, I mean not be forgotten but like not front and centered as much in a way as it could be.

Kat: Exactly. You know, I think we spent some good time talking about what else the US can do, what Congress can do, but ultimately, we only take care of ourselves, right? We are the community that we have and Bergen and I as advocates and as feminists will continue to monitor the policy and its harms, will continue talking to those directly impacted and not just talking to them, you know, directly centering their needs, their voices and their experiences. And as we will do everything in our power to see the day in which we end the global gag rule.

Jennie: Okay. Well ladies, thank you so much for being here. As always, it was a joy to talk to you.

Bergen: Oh, thank you.

Kat: Thank you for having us.

Bergen: Yes, we love being here. Thank you so much and thank you for shining a light on a disastrous policy.

Jennie: Okay y'all, I hope you enjoyed my conversation with Bergen and Kat. It was really lovely to get to talk to them both about the global gag rule and Global HER, but as I said, y'all, I'm so tired of having to talk about global gag. This has just been on my whole career and I really would just love to see the Global HER Act be passed and, uh, enshrined into law so that global gag rule goes away forever. Uh, that would be just so delightful.

Jennie: Thanks for listening everyone. And we'll see you on our next episode of RePROS Fight Back. 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.