How Partnerships Can Deliver SRHR Under the Global Gag Rule
How Partnerships Can Deliver SRHR Under the Global Gag Rule

How Partnerships Can Deliver SRHR Under the Global Gag Rule

The Mexico City Policy has had a devastating impact on the world’s most marginalized girls and women. And while the policy set us back, it has also energized a generation of advocates to stand stronger together and to speak out for the health and rights of girls and women everywhere.

When US President Donald Trump re-enacted the Mexico City Policy (aka. the Global Gag Rule) in January 2017, the intention was to restrict women and girls’ access to safe abortion care by cutting off funding to organisations that support full reproductive choice. The current version of the Global Gag Rule (GGR) restricts all foreign NGOs who receive health assistance from the US Government from using other donor funding or their own income to undertake any abortion related work, including providing services, referrals, or advocacy. Announced in March of this year, an expansion of the rule further restricts compliant NGOs from providing funding to non-compliant NGOs, even for non-abortion related work. The GGR has a devastating impact on the world’s most marginalized girls and women. But while the policy set us back, a generation of advocates has been galvanized to stand stronger together and speak out for SRHR.

Take SheDecides, a movement of advocates, service providers, donors and decision-makers, calling for a world where every girl and woman can make decisions about her own body, life and future.

After the reinstatement of the GGR, Foreign Ministers from the Netherlands, Belgium, Denmark, and Sweden came together to launch this global campaign to promote SRHR and fill the funding gap left by the policy. The funding committed helped affected organizations, such as MSI, to continue providing contraception and safe abortion services. It also created a platform for safe abortion advocates to mobilise around; an opportunity to talk about safe abortion and girls’ and women’s right to bodily autonomy, and counter the chilling effect of the GGR.

Many organizations and individuals are coming together to strengthen their influence, messages and impact on SRHR.

In Zambia, the Safe Abortion Action Group (SAAG) brought together stakeholders from across government, service providers, the private sector and civil society—including youth, women and medical professionals—to develop a joint strategy for tackling unsafe abortions and maternal mortality.

KONJA, ZAMBIA – SEPTEMBER 24: Healthcare provider Lizzy Banda speaks to women from Konja about the family planning and the services they will offer at the Konja Clinic on September 24, 2015. (Photo: Charlie Shoemaker for Marie Stopes International)

First convened by the Zambian Ministry of Health in 2015 at the recommendation of advocates, SAAG is the first government-endorsed platform where abortion-related issues could be exclusively and openly discussed, and ensured that safe abortion advocacy was unified and co-ordinated.

The close collaboration between stakeholders and experts resulted in the launch of the new Comprehensive Abortion Care Guidelines by the Ministry of Health on 18 December 2018. These new guidelines have the potential to dramatically reduce rates of unsafe abortion in the country.

The number of doctors’ signatures needed to sign off a procedure when there is a risk of unsafe abortion has been reduced from three to one. The new guidelines also emphasize the safety of medical abortion for home use in the first trimester. They allow task sharing of medical and surgical abortions to mid-level providers with authorization from a medical doctor and support access to contraception for young people.

All of this accomplished despite the chilling effect of the GGR.

Marie Stopes Zambia’s Policy Lead, Namakando Simamuna, reflected that the SAAG has played a crucial role in improving girls’ and women’s access to safe abortion in Zambia for three main reasons:

  1. It provided a platform for meaningful co-ordination among advocates – advocacy work was often fragmented before the SAAG.
  2. It provided a platform, with Ministry of Health participation, that exclusively prioritised safe abortion.
  3. Most importantly, the SAAG created the opportunity to bring new stakeholders on board for safe abortion. The youth movement in Zambia, for example, was strongly represented in civil society, but was not focused on or vocal about abortion-related issues before being invited to join the SAAG. They are now some of Zambia’s strongest voices in the call for the elimination of unsafe abortion.

The SAAG fostered solidarity among civil society groups and other stakeholders to push the safe abortion agenda forward, and secured the Ministry of Health’s involvement and ownership of these issues.

SheDecides and the SAAG are just two examples which illustrate the growing and concerted resistance to the GGR that we see every day. Let’s build on that momentum now and continue working to ensure the realization of girls’ and women’s sexual and reproductive rights everywhere.


This PAI resource can provide further information about the March 2019 expansion of the GGR.