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  January 26, 2017

Trump's 'Global Gag Order' Will See Countless Women Lose Access to Essential Health Services


A number of organizations will reluctantly obey the gag order because they are in need of U.S. funding in order to financially survive - Panel with Shannon Kowalski of International Women's Health Coalition and Dilly Severin of the International Family Planning Coalition Communicators
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biography

Shannon Kowalski oversees IWHC's work on international and U.S. foreign policy advocacy. She is an experienced and effective advocate for sexual and reproductive rights and health, is very familiar with UN negotiations, and is an expert on HIV and AIDS, the Global Fund to Fight AIDS, TB and Malaria, and programs to advance youth sexual and reproductive health.

Dilly Severin crafts and implements PAI's communications strategy and also supports PAI's international partners through training and communications assistance. Dilly is co-chair of the International Family Planning Coalition Communicators' group along with the Guttmacher Institute and Planned Parenthood Federation of America.


transcript

KIM BROWN: Welcome to The Real News Network in Baltimore. I'm Kim Brown.

President Trump signed, on Monday, the Global Gag Rule. It's also known as the Mexico City Rule, first established by President Reagan in 1984. It was rescinded by Democratic Presidents Clinton and Obama, and reinstated again under George W. Bush in 2001, and now again, under Donald Trump.

Now, what the Global Gag Rule is is an Executive Order banning funding to any health care organization around the world who provides abortion services, or even mentions the word "abortion" to patients. Here's White House press secretary, Sean Spicer, defending this action.

SEAN SPICER: The President, it's no secret, has made it very clear that he's a pro-life president. He wants to stand up for all Americans, including the unborn. And I think the reinstatement of this policy is not just something that echoes that value, but respects tax payer funding as well.

KIM BROWN: Joining us to discuss this, we're joined with Dilly Severin. She crafts and implements Population Action International's communications strategy; she also supports PAIs international partners through training and communications assistance. Dilly is the co-Chair of the International Family Planning Coalition Communicators Group, along with the Guttmacher Institute in Planned Parenthood Federation of America.

We're also joined with Shannon Kowalski. She oversees International Women's Health Coalitions work on international and U.S. foreign policy advocacy. She's also an experienced and effective advocate for sexual and reproductive rights and health. She's very familiar with U.N. negotiations, and an expert on HIV/AIDS, the Global Fund to Fight AIDS, TB, Malaria and programs to advance youth and sexual reproductive health. Ladies, thank you so much for being here.

SEVERIN/KOWALSKI: Thank you so much for having me/us.

KIM BROWN: All right. Now President Trump once said, during his campaign, that, "No one respects women more than me." And then he also admitted to groping women, specifically his word, "Grabbing them by the pussy." And he also said, however, that he believes that women who have abortions should be punished.

Now, this Executive Order, in your opinion ladies, is this a response to the women's march, the very successful women's march on Washington, that not only took place in Washington, but globally, or is this an expected part of his policy, Shannon?

SHANNON KOWALSKI: We expected that President Trump would reinstate the Global Gag Rule. As you said, it's been put in place by every Republican since Reagan, but Trump has made this worse. And make no mistake about it, this is an attempt to punish women. It's a cruel policy. It will put safe, legal abortion services further out of reach for millions of women who need it.

But it's likely to have a much bigger impact than that. The last time that this was put in place, fewer women were able to access contraceptives. More women experienced unwanted pregnancies, more women sought unsafe abortions from clandestine providers, and as a result more women died.

KIM BROWN: Dilly, as Shannon alluded to, what was the result, or the outcome, for women globally, the last time a Republican president was in office and implemented the Global Gag Rule?

DILLY SEVERIN: So, again, you know, as Shannon alluded to, the effects on this policy for women are really just devastating. First, you have to just remember the context in which this is happening. Many of these women are living in some of the most challenging communities around the world. And the providers that are being affected by the policies are the only ones in their communities.

And so, when you have a policy that's telling a provider to get between a woman and the commission, and telling the provider that they cannot give the woman full information about abortion services, about even information about abortion or referrals. That is usually part of a suite of services that's provided at that primary healthcare level.

If an organization shuts down as a result of the Global Gag Rule, you really will see immediately, the effects on women, in terms of unintended pregnancies, unsafe abortion, the maternal mortality rates skyrocketing. Even, you'll see the effects on newborn and child health, on HIV prevalence rates. So, the affects and the impacts are quite wide ranging, and it is a punishment to women globally.

KIM BROWN: Now, the U.S. is the single largest donor to global health efforts, providing nearly $3 billion to organizations such as U.S.A Aid and the Peace Corps. So, do you expect that these organizations will succumb to the demand, and stop operating reproductive health services to women, or will the U.S. lose its place as the largest donor to global health, Dilly?

DILLY SEVERIN: So, I think there are two things at play here. I think some of the most effective organizations will not sign the Global Gag Rule. They just feel bound and determined to provide the most comprehensive care possible.

However, there are some strong providers who cannot survive without U.S. assistance and they may sign the Gag Rule. And so, absolutely, we will see a number of services becoming out of reach for women. And, again, that includes the range of services from just access to contraception, information about HIV and STIs. Even organizations, for example, that are addressing issues like Zika, and would have to talk to women about abortion as a possible option for them, would not be able to do so.

In terms of the U.S.'s place in the world, I think that remains to be seen. President Trump has indicated that he is not a fan of global assistance, and we anticipate some severe cuts to the global assistance budget. And so, whether the U.S. will maintain its leadership position, is something we're watching for very closely, especially as the president issues his first budget in the spring.

KIM BROWN: Shannon, give us an idea what this looks like, or the types of organizations globally that will be impacted, and the kind of services. So, I mean, most people in the western world can conceptualize of a planned parenthood or a family clinic.

You go to the clinic if you want to obtain contraception, or you want to obtain condoms, or well-woman exams, or anything like that. I mean, abortion is on the menu of many of these places of services that they do provide, but obviously not the only service that they provide.

But when you're talking about a less industrialized country, or an impoverished nation, and you have a facility offering these types of services, and now with funding POPs perhaps being cut, these services will either be limited or just outright done away with altogether.

Can you put us in a country and tell me what this looks like, or what it could look like, to women in those communities who might be facing these healthcare cuts?

SHANNON KOWALSKI: Sure. I think, in some respects it is a lot like the U.S. People go to a health provider expecting to get comprehensive care. Whether that's contraceptives, whether that's a vaccine, or HIV testing or counseling -- and abortion may or may not be on the menu -- but they expect to be able to be told about their options and where they can get safe abortions, if it's legal in that country and there are providers available.

Now, what often happens in many of these places is that it's very difficult for women to access a healthcare provider in the first place, especially in rural areas; there might be only one clinic that provides these services. And in the case of Marie Stopes International, one of the organizations we know will be most affected by this; in some countries they are the only provider for millions of women.

Now, if they're not able to continue providing the same services, it means that women, their families and their children, will lose access to healthcare providers all together. So, we're not talking just about limiting access to abortion services, because this was never about funding abortions in the first place. It's actually cutting off essential health services for women, such as contraceptives, cancer screenings, HIV testing and treatment, lifesaving services that people need.

KIM BROWN: So, this defunding is not just for providing actual abortions, Shannon, as you just said, but the other services will also lose their funding as a result of that. And the International Planned Parenthood Federation has already announced that they will not abide by the Global Gag Order, and will therefore lose about a $100 million. But it should be noted that those $100 million were not there to fund abortions in the first place. So, what areas will be affected by this decision and how, Dilly?

DILLY SEVERIN: So again, you know, as Shannon indicated, services, for example, like HIV and other STI screenings will be affected. One of the important things about the U.S. leadership right now is that the U.S. not only donates funds, but the U.S. donates supplies, such as condoms and contraceptives.

Because we know that Trump's Global Gag Rule is sweeping and will affect all areas of assistance, including now programs like PEPFAR, we anticipate that any programs, any organizations actually working against HIV, working for HIV prevention efforts, will be affected by this policy. And you can imagine the effects on the communities that they will be impacting.

Again, I mentioned, even maternal health. I mentioned, for example Zika, again there is a huge reproductive health component to some infectious diseases like Zika. And so, if a portion of what an organization was counseling a woman on, was related to her reproductive health and an option for an abortion, those services will go away, in addition to increasing infection rates for those kinds of diseases as well.

KIM BROWN: The organization, Marie Stopes International, estimated that the loss of funding to family planning organizations around the world, because of the Global Gag Rule, will cause millions of unintended pregnancies, 2.2 million abortions, 2.1 million unsafe abortions and over 20,000 maternal deaths until 2020, the end of Donald Trump's first term. So, how is the Global Gag order actually causing more abortions? Shannon.

SHANNON KOWALSKI: It's causing more abortions because it's actually not cutting funding for abortion; it's cutting funding for other services -- so, contraceptives -- if women are not able to access contraceptives, then their ability to prevent unintended pregnancies is really limited. And we know that when abortion is out of reach, that women just don't start having abortions. If abortion is illegal women continue to have abortions, but they take their life in their own hands in order to do that.

So, they're much more likely to go to back-alley providers, or unsafe providers, in order to get the services that they know are essential for them. And so, this will undoubtedly result in an increase in unsafe abortions, and women will die because of it.

KIM BROWN: Also ladies, I mean, this is Donald Trump's executive action. Something that's going to impact women across the globe, however, but we've already seen similar policies enacted here state level in the United States. Obviously with a defund Planned Parenthood movement very strong amongst conservative lawmakers, including our newly inaugurated vice-president, Mike Pence. Who is the former governor of Indiana, who defunded Planned Parenthood and as a result saw an outbreak of AIDS, in some of the rural areas in Indiana, along with the spikes in other sexually transmitted diseases.

USADA(?)and other outlets have reported, back in September, that Texas leads the industrial world as the highest maternal death rate for women who are pregnant and trying to deliver children. More women die in Texas than they do any other place in the industrialized area. So, we've already seen how these policies have been detrimental domestically, what is the insistence to spread these policies globally?

DILLY SEVERIN: Yeah, I mean I think you're pointing out something really important, and it's ironic that this administration is describing themselves as pro-life, because many more women will die on their watch, than other presidents. And I think we cannot mistake what is happening, as just about abortion, or even health... This is like a consistent tactic of the Trump-Pence administration to get at women's fundamental rights, and autonomy, by attacking their health.

So, whether that is in the U.S., or whether that is overseas, we intend to undermine women's human rights and, honestly, the health piece is just a way to get to that. And so, women will suffer under this president, and what is happening in the U.S., what you see in Texas, what you see in terms of the outbreak in Indiana, we can just anticipate on a global scale. In countries that have fewer resources, that are already strained in terms of health systems. The impacts on women and families and children are going to be enormous.

KIM BROWN: The largest recipient of U.S. aid is the Israeli military, which also offers health services to its soldiers, including abortions. Yet it is not expected that Trump will cut aid to the Israeli military. So, is this a case of hypocrisy, or maybe, is this a loophole, which organizations can use to avoid losing their funding, as a result of the Global Gag Order? Shannon.

SHANNON KOWALSKI: Right, this funding is provided directly to government, it's not subject to the Global Gag Rule. So it is possible, that the U.S. government could increase its funding to governments and governments could in turn, provide that to non-governmental organizations in their countries that are providing comprehensive care.

Would it be a loophole? No. It will make it harder for women to get access to that funding anyway, and largely because governments are less likely to invest it in the same organizations that were providing services previously.

I think, in terms of, is this a hypocritical move of the administration? One thing that Trump said during his inaugural speech was that the U.S. would not try to impose its way of life on people around the world, or in other countries, and would respect their sovereign rights. This is a brazen attempt to do the opposite of that and to impose the perspectives and views of a minority of Americans, on women around the world. It's going to have a devastating consequence. Yes, it's a hypocritical policy.

KIM BROWN: Dilly, what have the Dutch proposed in response to this announcement from the Trump administration? They plan on kicking in some of additional funds. Is that how I understand this correctly?

DILLY SEVERIN: Yeah. So, yesterday the Dutch announced that they would set up, actually, an international fund that could be used for covering some of the gaps that would occur as a result of the Global Gag Rule. So that there would be a fund that women could access, and organizations could access, funds for safe abortion services.

I think this is really important, because we have seen a lot of change, in terms of the global funding landscape. And right now one of the strongest things we can do to combat the Global Gag Rule, is not only talk to our own Congress and talk to the administration, but donor governments and... As governments in the global south, to the extent that they can increase their own investment in reproduction health, that will only mitigate the impact of the Global Gag Rule.

KIM BROWN: Indeed. We've been speaking with Dilly Severin, she crafts and implements communication and advocacy with Population Action International.

We've also been speaking with Shannon Kowalski, she oversees International Women's Health Coalitions work on international and U.S. foreign policy for advocacy.

We've been discussing the Global Gag Rule, now reinstated under President Donald Trump. And we'll keep an eye on how this issue, and how this move by this administration will impact women's health, and women's reproductive accessibility rights across the world. Ladies, we appreciate your help and your analysis today. Thanks a lot.

SHANNON KOWALSKI: Thank you.

DILLY SEVERIN: Thank you.

KIM BROWN: And thanks for watching The Real News Network.

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