Just days after a global outpouring of support for a movement demanding protection for the rights of women and other advances promoted by civil society, Donald Trump has fully turned back the clock. On Jan. 23, with a stroke of his presidential pen, he banned all official American aid to any global organization that provides abortions or even information about the procedure.
This move might satisfy the Republican right and religious opponents of abortion in the Roman Catholic hierarchy as well as some evangelical Protestant churches. But worldwide, it amounts to an attack on the health and rights of millions of women in the poorest nations, conflict zones, refugee camps and ad hoc settlements thrown together after catastrophic natural disasters, where rape and other abuse -- usually perpetrated by men -- become daily experiences on a large scale.
Moreover, the US policy, dating back to 1984 and enforced by only Republican presidents since then, undermines a decision by the former UN secretary-general, Ban Ki-moon, to allow abortion in UN facilities. The Trump directive will pose serious dilemmas for both nongovernmental organizations and UN officials in the field, who often work with the relief groups receiving US funds.
To be clear, the so-called Mexico City policy targeting abortion -- which the Reagan administration shocked even its own USAID experts by announcing at an international conference on population and development in the Mexican capital -- is not aimed strictly at abortion providers but at a wide range of relief and health organizations working in scores of countries. Under the policy, known popularly as the global gag rule, the functioning of multipurpose health facilities for girls and women is threatened, even if they provide only non-promotional information.
The blanket condemnation, which not only the aid agency but also the State Department has been ordered to enforce, enables abortion critics to accuse and report on countries or organizations that they claim are offering abortions.
China was targeted under this rule during the administration of President George W. Bush, leading to a cutoff of US funds to the United Nations Population Fund, UNFPA, the largest provider of family planning assistance worldwide and the one to be most affected by the ban. Bush ignored a report by his own investigation team sent to China, which confirmed UNFPA's insistence that it had no programs in Chinese clinics where abortion was forced on women, often brutally.
Presidents Clinton in the 1990s and, more recently, Obama lifted the policy, which has now been reinstated as of Jan. 23. Advocates for women's reproductive health rights faulted both those Democratic presidents for not overturning the 1973 legislative amendment that provides the basis for anti-abortion movements.
The amendment was the work of the late Senator Jesse Helms, a social conservative and an ideologue contemptuous of the UN. That legislation, attached to the 1961 landmark US Foreign Assistance Act, has remained in place for more than four decades while public opinion and court rulings in mostly developed countries have remarkably changed positions on the issue. They now accept women's rights to choose or at least how many children women want as well as to have access to contraceptives.
The picture has been bleaker, however, for women in poverty or conflict areas around the world, starting from the "rape centers" in Bosnia in the 1990s, where imprisoned Muslim and Croat women were sexually abused by ethnic Serb forces repeatedly, to the current barbaric treatment of women by Boko Haram and the Islamic State. It is well documented by the UN and women's health organizations that in conflict areas and among refugee flows, rapists target the most vulnerable women and girls.
In Haiti after the devastating 2010 earthquake, women who with their children in tow had congregated in pop-up slums, told me that they were afraid to leave their flimsy shelters to use communal toilets. (Some women still live in such setups.) A Haitian middle-class university student whose family home was among the many thousands destroyed spoke of young women preyed on if they tried to use the barely concealed shower stalls set up by relief groups.
In 2013, Secretary-General Ban, bucking strong opposition among UN members, recommended that emergency contraception -- the "morning after" pill -- and abortion should be offered as part of an international response to the rape of women in conflict zones and other disasters. In a report to the UN Security Council, Ban said: "Sexual attacks are almost universally under-reported for various reasons, and women and girls who lack access to help after rape are often forced to either carry out unwanted pregnancies . . . or undergo dangerous abortions."
The UN and the UNFPA, in particular, stress that abortion is never condoned as a method of birth control and should be accepted only as a last resort in a crisis, and only where it is safe and legal.
Janet Benshoof, president of the Global Justice Center, led a campaign of civil society, legal, faith-based, human-rights and development organizations in the US and abroad to permanently end the restrictions on American reproductive health assistance. She said in an interview in 2015 that Article 3 of the Geneva Conventions on the rules of war entitles all victims, including civilian rape victims, to nondiscriminatory medical care of all kinds.
"The Geneva Conventions have their own medical protocols that nobody questions as absolute law," Benshoof said, adding that the protocols override local laws and restrictions in conflict areas. "That is probably the most fundamental international law."
It is too early to measure the broad fallout from Trump's decision to restore the ban on US government funds to any involvement with abortion, but nongovernmental organizations and major private foundations were expecting this move to happen from the political right. The outcry has been loud and universal.
Human Rights Watch called the reinstatement of the gag rule "a destructive policy that threatens women's lives around the world."
Marie Stopes International, a voluntary organization working globally to provided family planning and other services to poor women, is among several major women's health services, along with the International Planned Parenthood Federation, that have decided to forgo US financial assistance rather than abide by the Trump directive.
That move requires nongovernmental organizations to "forfeit all US aid if they so much as tell a woman abortion is a legal option in her country, refer her to another provider or advocate for abortion," a Marie Stopes statement said.