Giving Compass' Take:

• Leila Hessini shares four strategies that advocates have developed to the on again off agiain global gag rule that impedes women's health and rights around the world. 

• Which of these strategies are you best positioned to leverage? What partnerships could help you elevate your impact? 

• Learn how education and access to reproductive healthcare can fight climate change


As one of his first acts as president of the United States, Donald Trump reinstated a policy prohibiting organizations from receiving US government aid if they provide services, referrals, and advocacy related to abortion abroad. In late March 2019, the Trump administration expanded this policy to include subcontractors serving groups that provide or discuss abortion.

The United States is the world’s largest donor to global health, and abortion-related services are often integrated into general health care involving HIV, contraceptives, and families. The policy, known as the Mexico City Policy and dubbed the global gag rule by women’s groups to reflect the act’s intentions and impact, was first introduced by President Ronald Reagan in 1984. Since then, each Democratic president has rescinded it and each Republican president has reinstated it. Under Trump, the policy covers all $8.8 billion in US global health aid, nearly 15 times the reach of previous iterations.

My organization, Global Fund for Women, supports many organizations that provide reproductive health care and which feel the pinch of this policy on their operations. Rhythm of Life, for example, a Ugandan health nonprofit serving women in red-light districts, regularly sets up makeshift clinics under blue plastic tarps to provide HIV and STI testing, maternal health care, vasectomy procedures, contraception, and abortions to some of the world’s most vulnerable people. “Often, it is the only health care that is accessible to people in such communities,” says Harriet Kamashanyu, the organization’s founder and executive director.

The policy has had a direct impact on the women Rhythm of Life serves. “The global gag rule limits our coverage and general operations,” Kamashanyu says. “We simply watch many girls and women of Uganda die due to unsafe abortion.” During the last iteration of the global gag rule, under President George W. Bush, reduced access to contraception led to more unwanted pregnancies and an increase in abortion rates in Sub-Saharan Africa.

Through conversations with our grantees and partners, we identified four strategies for mitigating the effects of the global gag rule and other restrictive funding policies.

  1. Document the Impact and Advocate
    Documenting and communicating the effects of the global gag rule locally, nationally, and internationally is a critical strategy for many of the groups we fund. This includes communicating around the underlying need for the sexual and reproductive health and rights programming that the global gag rule inhibits.
  2. Redirect Local Funding and Circumvent INGOs
    Because the global gag rule has stripped away international non-governmental organization (INGO) funding that would have previously supported sexual and reproductive health work, more women and organizations are engaging in national and regional budgetary advocacy efforts, lobbying their home countries to step in with additional aid.
  3. Encourage Other Large Government and Foundation Donors to Step In
  4. Set Up Alternative Sources of Information, Services, and Care
    To provide women with abortion access and services, organizations are setting up alternative and often confidential sources of information and care. New partnerships typically aid these efforts.

Read the full article about responding to the global gag rule by Leila Hessini at Stanford Social Innovation Review.