Leading experts in the field of public health joined Thoai Ngo, Professor and Chair of the Heilbrunn Department of Population and Family Health, in order to discuss the imminent expansion of the Global Gag Rule on international communities. 

On Thursday, December 12, Columbia University Mailman School of Public Health’s Dr. Thoai Ngo moderated a discussion between panelists from the Zamara Foundation, the Population Action International (PAI), and the Marie Stopes International (MSI) Reproductive Choices to unpack the consequences of expanding Global Gag Rule. 

Ngo, Chair of the Heilbrunn Department of Population and Family Health, began the conversation by explaining the Global Gag Rule, a US policy that prevents foreign, nongovernmental organizations from using their own non-U.S. funds to provide abortion services, information, counseling, referrals, or advocacy for reproductive services. Since it was first created in 1984, the policy has historically been put in place by Republican presidents and rescinded by Democratic ones. 

The first panelist was Rachel Clement, Senior Director of US Governmental Strategy at PAI, who explained the history of the Global Gag beginning in 1984 under Presidents Ronald Reagan, George H.W. Bush, and George W. Bush. From 1984 to 2009, $600 million in funding for organizations like PAI was impacted due to international family planning and reproductive health assistance being “gagged,” or suspended, from their funding. Clement explained that the PAI predicts that in 2025, under Trump’s second presidency, all foreign assistance and/or US-based NGOs will be impacted by the Gag Rule. Clement further predicted $51 billion of US foreign assistance will be taken away. But the expanded Global Gag rule is just the beginning. 

Clement explained how the US will likely also make a more broadly anti-rights agenda the center of US foreign policy and therefore make this agenda across issues and agencies mainstream, which would effectively stifle dissent and encourage the over-implementation of these same policies in other governments around the world. The US will likely re-engage in the Geneva Consensus Declaration, a policy that seeks to protect the sovereign right of nations to support reproductive health, life, and family through national policy and legislation, in order to undermine efforts of multilateralism between countries.  This policy would effectively limit the US funding, assistance, and advocacy that human rights groups like the PAI, MSI, and the Zamara Foundation rely on for maintaining international reproductive health. 

Next, panelist Sara Casey, Columbia Assistant Professor of Population and Family Health, explored the harm that the impact of the expanded Global Gag Rule will have on sexual and reproductive health rights on countries like Nepal, Kenya, and Madagascar. These countries already have extremely limited abortion access, if at all. Esther Kimani, founder and executive director of the Zamara Foundation, a Kenyan based organization for sexual and reproductive health, concurred with Casey. Kimani detailed how during Trump’s 2017 presidency, Kenya was hit hard by this policy and many organizations had to make the difficult choice of putting women’s lives at risk in order to continue receiving US funding. Kimani offered chilling statistics, citing how every day, eight women in Kenya die due to abortion-related complications as a result of unplanned pregnancies, and one in every five teenage girls between the ages of 15-19 has begun childbearing while many teenage girls fall pregnant every day resulting in unsafe abortions. The expansion of the Gag rule under the 2025 Trump presidency will only further limit access to safe reproductive health for the people of Kenya. 

Lastly, the final panelist Beth Schlachter, Senior Director of US External Relations at MSI, expanded the conversation in order to outline how the US provides more than half of the global development assistance for all forms of sexual, reproductive, and maternal health, not just abortion access. International funding for HIV/AIDs, maternal and newborn health, and reproductive health for adolescents and in humanitarian settings are also in grave danger, according to Schlachter.  This includes funding for organizations like the UNFPA Human Rights group, which provides funding for reproductive aid in places like Gaza, Afghanistan, and Sudan. 

The infamous Project 2025 was brought into the conversation, where the experts unpacked how Trump’s presidency will likely result in withdrawal from or termination of funding for UNHCR, UNESCO, UNRWA, and WHO organizations that protect reproductive health and all other forms of healthcare worldwide. 

The panelists stated that Project 2025 and the implementation of “Christian Nationalist ideals” remain imminent as the US approaches another Trump presidency. The experts recommended preparing for continued efforts, funding, and coordination in support of reproductive access. Schlachter ended the conversation with an important message: “We must plan for opportunities as well. With ongoing assault on our ideals, it can be difficult to plan and hope for positive outcomes, but we must protect our ambition, creativity, and solidarity.” 

While the future may feel grim for the protections of sexual and reproductive health in our entire international community, these experts highlighted how education, advocacy, and continued collaboration are crucial tools in the fight for reproductive rights. Especially at institutions like Columbia, education empowers individuals and communities to resist the overwhelming influence of propaganda and political agendas. In times like these, where international laws and policies may be manipulated for ideological purposes, the transformative power of knowledge becomes even more essential.

The resilience of these public health organizations, the power of solidarity between them, and the importance of maintaining the collective ambition they shared on Wednesday has the power to offer a foundation for meaningful change. I highly recommend checking out the PAI, MSI Reproductive Choices, and the Zamara Foundation for more resources and information on their advocacy. 

Image via @ColumbiaPopFam