Mexico City policy (global gag rule)
The Mexico City policy, commonly referred to as the global gag rule, is a U.S. government initiative that restricts foreign non-governmental organizations (NGOs) from using U.S. federal funds to provide abortion services or related information. First introduced by President Ronald Reagan in 1985, the policy has been reinstated and rescinded by various administrations, most recently by President Donald Trump in 2017, who expanded its reach to include blocking global health assistance for organizations involved in abortion-related services. This policy prohibits NGOs from offering counseling, referrals, or any advice regarding abortion, although exceptions exist in specific circumstances, such as threats to a woman's life.
The implementation of the Mexico City policy has sparked significant debate. Critics argue that it limits access to vital reproductive health services, potentially increasing unintended pregnancies and the demand for abortions, especially in regions where healthcare options are already limited. Proponents of the policy advocate for it on pro-life grounds, asserting that U.S. funds should not support organizations that perform or refer for abortion. The ongoing impact of this policy raises concerns about the health and well-being of communities, particularly in low-resource settings where access to comprehensive healthcare is crucial.
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Mexico City policy (global gag rule)
The Mexico City policy, also known as the global gag rule and Protecting Life in Global Health Assistance, is a US government policy that prevents foreign nongovernmental organizations (NGOs) that receive US federal funding for certain health services from providing abortion services. This includes the procedure itself, information about abortion, counseling, and referrals. The policy has been in effect intermittently since 1985 at the discretion of the president in office at the time. President Donald Trump reinstated the policy in 2017 and added a provision that blocked organizations that performed abortion-related services from receiving other global health assistance besides just funds tied to family planning.
Background
President Ronald Reagan first introduced the Mexico City policy at the International Conference on Population held in August 1984 in Mexico City, Mexico. While the policy refers to all international NGOs, the policy took the name of the venue of the conference. The policy went into effect the following year. The president or Congress can institute or rescind the Mexico City policy. Historically, the president usually decides whether to keep or cancel it.
The Mexico City policy stayed in effect until 1993, when President Bill Clinton canceled it. Congress stepped in to reinstate the policy during Clinton's second term in 1999, but Clinton overturned this decision in 2000. President George W. Bush restored the policy when he took office in 2001. It remained in place until 2009, when President Barack Obama assumed the presidency. President Donald Trump renewed the policy in 2017, but he added other provisions to it. President Joe Biden rescinded this when he took office in 2021, however, Trump reinstated the order in 2025.
The Mexico City policy bans foreign NGOs from using US federal funds earmarked for global family planning—and as of 2017 for global health assistance—to provide abortion services. The legislation is a way to further restrict federal funds to foreign facilities that provide abortion services. Prior to 1985, NGOs could use non-US federal funds to provide women with voluntary abortion-related health services. In addition to using the funds for direct abortion services, the NGOs could use them for providing educational information about abortion as a method of family planning and for lobbying governments to legalize abortion services. However, the NGOs had to keep their US federal funds separate and could not use them on these types of services.
After the implementation of the Mexico City policy, NGOs that continued to use non-US funds for abortion services would no longer be eligible to receive US family planning assistance funds through the US Agency for International Development (USAID), and as of 2003, family planning assistance from the US Department of State. The Mexico City policy refers to most global health programs, including family planning; reproductive health; maternal and child health; nutrition; the President's Emergency Plan for AIDS Relief (PEPFAR); tuberculosis; malaria; neglected tropical diseases; global health security; and some types of research activities.
When the policy is in effect, it prohibits NGOs from providing abortion services. It also bans them from giving information or advice about abortion services, such as referrals or locations that offer the procedure, to individuals as part of family planning services. However, in certain cases, such as when a pregnant mother's life is in danger or the pregnancy resulted from rape or incest, NGOs can offer advice and referral of abortion services. The policy also bans NGOs from lobbying to change a country's laws on abortion services.
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When President Trump took office in January 2017, he reinstated the Mexico City policy. While no US federal funds go toward abortion abroad, the legislation further restricts to which organizations these funds are allotted. This means that organizations that offer or refer abortion services no longer can receive USAID funds if they continue to provide these services. In addition to blocking family planning assistance to organizations that perform abortion, the Trump administration also prevented these organizations from receiving other global health assistance, including funds for HIV/AIDS treatment and prevention, maternal and child health services, malaria treatment and prevention, and nutrition services.
Many critics of the Mexico City policy believe it is nothing more than an effort to restrict abortion. They say the policy does nothing to reduce the need for abortion and can cause pregnancy rates to rise when other services such as birth control are cut due to lack of funding. Proponents of the policy, many of whom support pro-life values, advocate for it because they believe that the United States should not fund organizations that provide abortion-related services in other countries.
The policy forces NGOs to decide whether they will accept the regulations and no longer offer abortion services or reject the ruling and forfeit US funding. Many healthcare providers rely on US funding, making the decision difficult. In addition, the NGOs that forgo the funding usually must cut other services, such as providing contraceptives, thus increasing unintended pregnancies and demand for abortions. Healthcare providers who reject the policy may be forced to cut staff, reduce services, or close clinics. This could have significant effects on people's health, especially in poorer regions that have high demands for these types of medical facilities.
A 2011 study of abortion rates in sub-Saharan Africa has shown that during the times the United States has implemented the Mexico City policy, abortion rates increased in countries that declined US funding; however, use of family planning resources such as contraceptives decreased because not enough resources existed to support providing both abortion services and family planning methods. This means that abortion rates were higher likely because of decreased access to birth control. Because the 2017 version of the Mexico City policy includes funding tied to other health services, it is unknown how many NGOs will be able to forgo the funding and continue to provide abortion services. The Department of State conducted two reviews of the new policies. The first review mainly contained directives on providing greater support to support understanding of the policy. The second review found that many NGO's lost their awards including in areas of family planning and reproductive health, HIV and AIDS, Tuberculosis, and others. Many of the awards lost provided services to the area of sub-Sahara Africa. It is uncertain what the long-term effects of these new rules will be on the overall health of people in areas that receive funds.
Bibliography
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