Attacks on reproductive health will have devastating consequences worldwide
MSF is committed to ensuring people have access to sexual and reproductive health services, but we cannot do it alone.
Doctors Without Borders/Médecins Sans Frontières (MSF) condemns the Trump Administration’s recent reinstatement of the Mexico City Policy, more commonly known as the Global Gag Rule, as well as the US government’s support of the so-called Geneva Consensus Declaration.
The Global Gag Rule prevents organizations abroad from using their own non-US government funds to provide or advocate for safe abortion care as a condition to receive US global health assistance. This includes direct services, as well as information, counseling, and referrals, even in countries where abortion is legal. When the policy was last in place from 2017 to 2021, critical health programs were disrupted and suspended in low- and middle-income countries.
"Health care providers should not be forced to navigate political considerations and complexities before providing patients with essential and lifesaving sexual and reproductive health services." - Rachel Milkovich, global health policy specialist at MSF USA
"There are deadly consequences anytime access to sexual and reproductive health care is restricted," said MSF USA CEO Avril Benoît. “In the countries where MSF works, our staff see the lifesaving impact of comprehensive sexual and reproductive health services—and we have seen patients who have died or suffered life-altering injuries because they were denied access to care. In emergency cases where urgent care is needed, delays in access to safe abortion care pose substantial risks to patients’ health and wellbeing. While MSF stands committed to ensuring people have access to essential medical services, we can't do it alone. Across the world, we work closely with other health providers who are now essentially banned from doing their jobs and providing patients with essential information, referrals, and direct services."
Far-reaching and harmful consequences for any person who can become pregnant
The Geneva Consensus Declaration is a non-binding political statement which asserts that country governments have no obligation to facilitate abortion care. The Geneva Consensus Declaration purposefully distorts the meaning of international agreements on health and human rights in support of this position to rationalize restrictions on patient-centered sexual and reproductive health services. The consequences of the Global Gag Rule and influence of the Geneva Consensus Declaration will be far-reaching and harmful for any person who can become pregnant, including people seeking health care in crisis- and conflict-affected settings, like those in which MSF operates.
MSF does not accept US government funding and its programs are not directly affected by the Global Gag Rule. However, MSF health care providers have seen firsthand how policies impeding access to sexual and reproductive health services harm patients and communities globally.
"There are deadly consequences anytime access to sexual and reproductive health care is restricted." - Avril Benoît, MSF USA CEO
When safe abortion care is not accessible, it increases the likelihood that individuals will seek out unsafe abortion methods, one of the leading causes of maternal death and injury worldwide. The risk of unsafe abortion is elevated in humanitarian settings where it’s even harder for people to access medical services. In 2023, MSF provided more than 31,000 consultations for post-abortion care, most of which were due to complications related to unsafe abortion. With the reinstatement of the Global Gag Rule, MSF expects these already troubling numbers to increase.
“The reinstatement of the Global Gag Rule will have devastating consequences for health,” said Rachel Milkovich, global health policy specialist at MSF USA. “It means that people around the world will have fewer points of service for their sexual and reproductive health needs, fewer safe places to talk about their medical options, and fewer providers to go to for help during medical emergencies. Health care providers should not be forced to navigate political considerations and complexities before providing patients with essential and lifesaving sexual and reproductive health services.”
What is the Global Gag Rule?
In 2017, President Trump expanded the Global Gag Rule to all US global health assistance, affecting an estimated $12 billion, including more than 1,300 global health grants in more than 70 countries. Previously, the policy only applied to US assistance for family planning and reproductive health. The expanded policy impacted projects related to HIV/AIDS, maternal and child health, malaria, nutrition, sexual and gender-based violence, tuberculosis, and other health programs. The Global Gag Rule exacerbates the harm of the Helms Amendment, which prohibits all US-funded organizations from using US foreign assistance to fund abortion-related services.
When the Global Gag Rule was last in place, from 2017 to 2021, health advocates reported widespread clinic closures, termination of mobile outreach programs, loss of integrated health programs, weakened health advocacy coalitions, and fractured referral networks. Even four years after the policy’s rescindment, organizations are still trying to rebuild programs lost due to the Global Gag Rule.
The Global Gag Rule puts organizations in an impossible position. Either they must comply with the policy to receive US government funding—restricting the provision of sexual and reproductive health services and information to the communities they serve—or decide not to comply and lose access to significant financial support, which many organizations rely on to operate. Those unable to access alternative funding may be forced to cut staff or services. Some may be forced to close their programs altogether. In either scenario, patients lose access to vital health services.
The Global Gag Rule has been repeatedly reinstated or rescinded for the last 40 years, according to the will of the administration in power. It is not feasible or sustainable for organizations to constantly adjust their services each time there is a change in the US government’s political priorities.
To stop the pervasive harm caused by the Global Gag Rule, MSF USA is calling for a permanent end to the policy. MSF USA supports the Global Health, Empowerment, and Rights (Global HER) Act, which would permanently repeal the Global Gag Rule, and preserve access to safe abortion care.