In January 2017, three days after his inauguration, President Trump issued a Presidential Memorandum Regarding the Mexico City Policy. While the policy has a history dating back over three decades, President Trump's version dramatically expanded its scope. Where previous implementations have affected $575 million in U.S. global health assistance, the president's expanded version is expected to restrict up to $8.8 billion. This will have devastating consequences not only for women and family planning services around the world, but for communities battling HIV/AIDS, malaria, tuberculosis, and infectious disease.
On January 23, 2017, President Donald Trump signed the, “Presidential Memorandum Regarding the Mexico City Policy,” reinstating and expanding the Mexico City Policy (MCP). Also known as the “Global Gag Rule,” the MCP was originally implemented in 1984 under President Reagan and has been reinstituted or rescinded along party lines with each president since (The Atlantic). As explained by the Kaiser Family Foundation, the MCP, “requires foreign NGOs to certify, as a condition of receiving U.S. global health assistance, that they will not ‘perform or actively promote abortion as a method of family planning’ with any funds, including non-U.S. funds” (Kaiser Family Foundation).
The 2017 MCP, despite its thirty-year history, is uniquely severe. President Trump’s new order directs Secretary of State Rex Tillerson to expand the policy requirements to, “global health assistance furnished by all departments or agencies” (The White House). Per the memorandum, Secretary Tillerson approved a plan in May 2017 entitled, “Protecting Life in Global Health Assistance” (U.S. Department of State). While previous restrictions applied only to U.S. family planning funds, amounting to approximately $575 million, President Trump’s policy extends to all U.S. global health assistance, totaling an estimated $8.8 billion (Human Rights Watch). This means that the policy now affects funding previously used to support programs that focused on, “family planning and reproductive health, maternal and child health, nutrition, HIV/AIDS – including The President’s Plan for Emergency Relief for AIDS (PEPFAR), prevention and treatment of tuberculosis, malaria (including the President’s Malaria Initiative), infectious diseases, neglected tropical diseases, and even to water, sanitation, and hygiene programs” (Human Rights Watch).
The impact of such an expansion is not known, but early analyses suggest a range of consequences. For example, while the MCP was created to reduce global abortion rates, a Stanford University study found that in sub-Saharan African countries most exposed to the policy, abortion levels more than doubled during the early years of the George W. Bush administration (Stanford University, via the World Health Organization). While the Stanford study doesn’t analyze Trump’s expansion, it speaks to the vacuum created when family planning services are restricted. In June 2017, Human Rights Watch predicted a host of outcomes stemming from the new MCP, including among others, maternal deaths that would have been preventable; potential cuts in vaccination services for children and newborns and services preventing/treating malaria, HIV/AIDS, and tuberculosis; and the curtailing of speech of health providers and activists (Human Rights Watch).