The global gag on reproductive health rights

It is of vital importance for refugees and internally displaced persons that their reproductive health needs are covered. There has been a growing understanding of this in recent decades but in the last few years there has been a stark rise in the number of campaigns aiming to erode support of reproductive health.

The problem originates in a minority of anti-choice groups - mainly US-based - who seek to hijack the reproductive and sexual health rights agenda by focusing on the controversial issue of abortion. On his first day in office in January 2001, President George W Bush reintroduced the Mexico City Policy, also known as the 'Global Gag Rule'. This stringent policy disqualifies foreign NGOs from receiving US funds for development if they in any way provide legal abortion services or if they lobby or counsel about or refer to abortion, even with funding which does not originate from the US. The law would be considered unconstitutional if imposed on US-based organisations. Therefore it is ironically only imposed on foreign NGOs.

In a worst case scenario, this will leave thousands, if not millions, of women without choices, forcing them into seeking unsafe/illegal and back-street abortions. Such a development will only increase the problem, not diminish it. The damaging effects are not only on the provision of family planning services worldwide (and reduction in family planning services will inevitably and ironically increase the number of unwanted pregnancies) but also on the fight against HIV/AIDS. Organisations providing family planning services - including pregnancy counselling and/or abortion services - are also at the forefront of the fight against AIDS.

The Mexico City Policy is inconsistent with international human rights standards and US legal principles, including the freedom of speech, democratic participation and reproductive autonomy. It calls into question US foreign policy objectives that encourage the building of democracy, civil society and women's participation as equals in society.

Expansion of the Gag Rule

On Friday 29 August 2003, President Bush issued a Memorandum placing additional restrictions on US financial assistance to foreign NGOs that use their own funds to counsel, perform or advocate on the issue of abortion. The Memorandum extends the Mexico City Policy, which had previously applied only to programmes administered by the US Agency for International Development, to all voluntary population planning funds administered by the State Department. The State Department is still assessing which programmes and organisations would be affected by this.

Many groups are concerned that this policy will encumber efforts and slow responses in refugee situations where time is of the essence. By requiring US agencies to spend time investigating their partner agencies in the field, this policy could delay or prevent implementation of critical health care programmes proven to reduce rates of maternal and child mortality.

Members of the European Parliament like myself have a key role in contributing to an enabling environment for reproductive health and refugees, in shaping policy and ensuring commitment through the annual EC Budget. The European Union decided to bridge the funding gap by paying to UNFPA and IPPF the money which was already pledged by the US.

The EU is a major funder of relief and development work, including reproductive health. Its most recent relevant financial instrument, adopted in July 2003, is the 'Regulation on reproductive and sexual health and rights in developing countries', which also provides for displaced populations(1). This regulation implements the EU's commitment to upholding the principles agreed on at the International Conference on Population and Development (ICPD), held in Cairo 1994, and the ICPD+5 in New York in 1999.

Women's lives around the world are tragically being lost due to unsafe childbirth, illegal and unsafe abortions and HIV/AIDS infection, in large part because they cannot access reproductive health care. The US must change its policy if it is not to become a major contributor to the tragedy.


Ulla Margrethe Sandbæk is a Danish Member of the European Parliament. She is Chair of the European Parliament Working Group on Population, Sustainable Development and Reproductive Health. Email:


  1. Fund of €74 million over four years.


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