03/05/2009 05:12 am ET Updated May 25, 2011

Playing Games with Women's Lives

President Obama has rescinded the Mexico City Policy (the so-called Global Gag Rule), but unfortunately he didn't eliminate the possibility that it will be re-imposed. In fact, this policy has been imposed, rescinded, and re-imposed several times since 1984. Only legislative action can stop this ping pong match--clearly the United States Congress should step in.

The Global Gag Rule restricts U.S. foreign aid to non-US-based organizations that provide legal voluntary abortion services or advocate for less restrictive abortion laws within their country, even if they have separate funding for those purposes. It was the brainchild of the Reagan administration, supported by the first President Bush, rescinded by President Clinton in 1993, and reinstated by the second President Bush on his very first day in office in 2001.

The damage wrought by the policy has been tremendous, exacerbated by the funding instability created by the on-again, off-again status of the rule.

In Zambia, for example, a country with extensive unmet needs for family planning, the Planned Parenthood Association of Zambia gave out around 3.8 million condoms a year during the Clinton administration through a successful system of youth education and small distribution booths.

In 2001, when President Bush reinstated the rule, the group had to choose between changing its operations and losing its largest funder. It decided to continue running the programs. But because it lost so much funding, it had to roll back its education programs and could only keep a few distribution booths open.

In a similar situation, in Ethiopia, another country with extensive unmet needs, the Family Guidance Association of Ethiopia lost 35 percent of its funding in 2001.

The full impact of losing these services on social and economic conditions in countries that receive American aid is hard to measure, but there is little doubt it contributed to unwanted pregnancies and unsafe abortions, increased the risk of HIV transmission and undermined HIV prevention messages.

It is even more difficult to quantify the effect of the funding instability on the effectiveness of the message these programs are sending on critical health care issues. Research from Human Rights Watch and elsewhere shows that family planning and other health programs depend for their success on trust between the service provider and the individuals who need help. When services are provided, then taken away, trust is breached and the effort is likely to suffer, even if services are later reinstated. This is particularly pertinent in an area as intimate as family planning. Service providers in other countries are now hesitant about receiving US funding again. They want and need guaranteed, condition-free funding to have a real impact.

Unfortunately, whiplash could happen at any time. On January 28, only five days after President Obama rescinded the Gag Rule, Senator Mel Martinez (R-FL) tried to attach an amendment to a children's health bill in the Senate that would have nullified the presidential order. The amendment failed 60-37, with senators voting largely along party-lines.

There is a way to end this uncertainty. The Global Democracy Promotion Act (S.311), introduced this year in the Senate on January 22 by Senator Barbara Boxer (D-CA), would do just that. This bill would prohibit any administration from imposing conditions on funding to non-US based organizations that would be unconstitutional if imposed on US groups. The Global Gag Rule has already been found unconstitutional in a number of court decisions if imposed on US- based groups. The Global Democracy Promotion Act was introduced in both houses during the last Congress, and passed in the Senate. Judging by the vote on Senator Martinez's amendment, it should have no problem getting through the Senate again, and there is hope that the new House would be equally supportive of this key issue.

President Obama did the right thing to rescind the Global Gag Rule. The Global Democracy Promotion Act would prevent any other administration from reversing this decision. Clearly, it is time for the United States to stop playing politics with the health and well-being of women around the world.