Opinion | Women’s Health Isn’t a Geopolitical Game

Satyajit Pradhan, who has spent the last six years working for MSI in Nepal as its “Evidence to Action director,” spoke to me from Kathmandu. “Our inability to secure any USAID funding meant we were cut off from being able to provide essential health care, as we call it, for women across Nepal,” he said. “The chilling effect resulted in partners failing to refer women to MSI for abortion care, even in the case of rape or incest or if the life of the woman was at risk.” Further, he added, “No one wanted essentially anything to do with us. We were secluded … it was pretty hard.” MSI, he said, had to shutter nine clinics in Nepal alone.

Analyzing data collected by the International Women’s Health Coalition, two years into Trump’s gag rule, editorialists in The Lancet, the British medical journal wrote, “118 interviews with health service providers, civil society organisations, government agencies, and anti-abortion groups in Kenya, Nepal, Nigeria, and South Africa revealed that access to services for abortion and post-abortion care has been reduced, along with contraceptive services, antenatal care, H.I.V. testing and treatment, and screening for cervical, breast, and prostate cancer.”

In 2019, a retrospective analysis by researchers for the The Lancet Global Health journal looked at data collected from sub-Saharan African countries during the Clinton, Bush and Obama administrations. Years with the gag rule in place saw a 40 percent increase in abortion in the countries analyzed, a decrease in contraceptive use and a rise in pregnancies. In other words: the policy worked directly counter to its purported anti-abortion goals.

The irony of the gag rule is that no U.S. funding has supported abortion overseas since the passage of the 1973 Helms Amendment. The gag rule really is about speech.

President Biden’s reversal of the global gag rule is, in a way, “a short-term fix,” Nina Besser Doorley, associate director of Advocacy and Policy at the International Women’s Health Coalition, told me earlier this week ahead of the White House announcement. “What we have seen about this policy is that its impacts aren’t going to go away just because the policy is revoked. The threat of it being reimposed in a few years if the political winds in Washington change will continue to have impact.

“What we are looking for is a permanent legislative fix to this problem. And congressional legislation to prevent a future president from unilaterally reinstating the policy.”

In other words, repeal of the gag rule is only part of the answer. The best option is a law that puts the global gag rule out of reach of the capricious presidential pen.

Sarah Wildman is a staff editor in Opinion. She is the author of “Paper Love: Searching for the Girl My Grandfather Left Behind.”