The Global Gag Rule is gone—but its effects are still hurting women

In 2021, MSI faced a funding shortfall of $13.5 million as we came to the end of stopgap funding that was secured when Trump first signed the Global Gag Rule. While we celebrated the Biden administration’s repeal of this policy, USAID funding did not resume immediately—and in the meantime, the lingering effects of the Global Gag Rule were disastrous for women and girls.

In real terms, this shortage equates to 650,000 reproductive healthcare services delivered by our mobile outreach teams, primarily for rural and low-income women with no alternative access.

MSI providers like Annie Ramasy travel for hours to reach remote communities in Madagascar. Under the Global Gag Rule, MSI was forced to end support for health facilities serving rural women.

The Mexico City Policy, also known as the Global Gag Rule, was one of President Trump’s first acts in office in 2017. It was a decision that undid years of progress on global reproductive rights and caused untold pain to millions of women, limiting their opportunities for the future.

MSI refused to sign the Global Gag Rule in 2017 and this meant we relinquished USAID funding. For many of our programs, in Uganda, Madagascar and Nepal, to name but a few, this led to service closures, a recorded rise in unintended pregnancies and unsafe abortions and a broader chilling effect, impacting partnerships and advocacy for women’s healthcare.

In Madagascar, we were forced to end support to over 100 public and 90 private health facilities and reduce outreach services, limiting access for rural women. One woman from Androy, Madagascar, interviewed by Columbia University, shared: “I got pregnant since the [contraceptive] method wasn’t there. Food is already difficult to find, and we weren’t able to buy medicines because there are none in this health center. The truth is that I didn’t choose to get pregnant; it’s because of the stockout.”

For women who faced unwanted pregnancies due to Trump’s Global Gag Rule, the damage is done, and the toll is severe: More unsafe abortions, more pregnancy-related deaths, and families less able to make ends meet.

In January 2021, President Biden repealed this harmful policy. It was an important win for reproductive rights around the world—but the effects of Trump’s Global Gag Rule will reverberate long past its repeal.

It has taken time to re-open closed programs, re-forge partnerships and get services up and running. Most urgently, it took years for USAID funding to reach MSI—and in the meantime, we faced a serious funding gap. This gap demonstrates the urgent need to permanently end the Global Gag Rule, which limits women’s access to health care even when it’s no longer in effect.


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