Background: The Global Gag Rule
In January 2001, the Bush Administration reinstated restrictions on overseas health care organizations, officially known as the Mexico City Policy and called the Global Gag Rule by family planning supporters. Under these restrictions on programs supported by USAID, no U.S. family planning assistance can be provided to foreign NGOs that use funding from any other source to:- perform abortions in cases other than a threat to the life of the woman, rape, or incest
- provide counseling and referral for abortion; or
- lobby to make abortion legal or more available in their country.
U.S. NGOs and foreign governments are exempt from the restrictions, although U.S. NGOs are required to enforce the restriction on foreign NGOs receiving U.S. family planning assistance. The restoration of the gag rule has resulted in tremendous confusion among health care providers and others. In response, PAI published the brochure What You Need to Know About the Global Gag Rule Restrictions:An Unofficial Guide to help clarify for both U.S. and foreign NGOs the specific restrictions imposed by the policy. The brochure identifies the types of activities that foreign NGOs can engage in without endangering their eligibility to receive U.S. family planning assistance.
In addition, the provision of emergency contraception (EC) is not prohibited by the gag rule, or by any other USAID policy.U.S. and foreign NGOs receiving USAID assistance for family planning may provide emergency contraception pills (ECPs) and may engage in EC advocacy, in accordance with host country laws and policies. PAI published another brochure, Emergency Contraception and the Global Gag Rule – An Unofficial Guide, to make these facts clear.
The President’s Emergency Plan for AIDS Relief (PEPFAR)
In May 2003, the U.S. significantly increased its political and financial commitment to combating HIV/AIDS globally with passage of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Public Law 108-25). At the heart of this new law – also known as the President’s Emergency Plan for AIDS Relief, or PEPFAR – is the funding goal of providing $15 billion over five years (2004-2008) for AIDS-related services in 12 African countries, 2 Caribbean countries and 1 Asian country. The funds are being administered by the newly-created Office of the U.S. Global AIDS Coordinator housed in the U.S. Department of State.
PEPFAR represents a major shift in U.S. HIV/AIDS policy: 80 percent of the new bilateral assistance will be directed to AIDS treatment and care.The remaining 20 percent will go toward HIV prevention activities, and of this amount, at least one-third must be set aside for “abstinence until marriage” programs. Field staff need to be aware of the new restrictions on HIV prevention activities under PEPFAR. (These are described later in this brochure.)
In August 2003, the Bush Administration explicitly clarified that PEPFAR funds are exempt from the gag rule restrictions. The August 29, 2003 memorandum from the President to the Secretary of State concerning his decision to apply the gag rule to State Department “family planning grants,” explicitly states that the restrictions “shall not apply to foreign assistance furnished pursuant to the United States Leadership Against HIV/AIDS,Tuberculosis, and Malaria Act of 2003.” (See appendix for full text of memorandum.) President Bush could not have said it more clearly – U.S.are not restricted by the gag rule.
