On 23 January 2017, US President Donald J Trump signed a presidential memorandum reinstating the so-called Mexico City Policy. Under this policy, any and all non-US-based nongovernmental organizations (NGOs) wishing to receive US foreign assistance for family planning or global health must pledge to not use any funds – received from the US government or any other source – to “perform or actively promote abortion as a method of family planning”.
The International AIDS Society (IAS) is deeply concerned about the significant and negative impact this policy could have on both the global AIDS response and the improvement of women’s health worldwide.
Although the use of US foreign assistance to provide abortion services is already prohibited under the Foreign Assistance Act, the Mexico City Policy bars even the discussion or provision of information on such services. In the past, the policy’s application has been limited to US assistance for family planning, specifically. The most recent iteration, however, has been expanded to include all US assistance for global health – including funds for global AIDS programming.
Through PEPFAR, the US government has become the single largest source of international funding for the global AIDS response. It currently supports more than 11.5 million men, women and children on life-saving antiretroviral (ARV) treatment, and has allowed nearly 2 million babies to be born free of HIV.
“The provision of high-quality health services for women, including honest and clear information on sexual and reproductive health, is essential for the long-term success of our efforts to control the epidemic,” IAS President Linda-Gail Bekker said. “In regions like southern Africa, where we continue to see stubbornly high infection rates among young women in particular, we need to redouble our efforts to expand access to appropriate health services, and we need all hands on deck to do it. PEPFAR has made an extraordinary difference in this region. This policy undermines that work and could severely hamper our ability to take on the epidemic as aggressively as we need to.”
IAS Executive Director Owen Ryan said: “Key to PEPFAR’s success has been its ability to work with strong and trustworthy partners on the ground to deliver comprehensive and integrated services. There is a real concern that the conditions of this policy will significantly narrow the scope of who the programme can work with. We know that when the Mexico City Policy has been in effect in the past, it has had tangible consequences for the AIDS response – clinic closures, supply-chain disruptions, staff layoffs, to name just a few. The expansion of the policy to include all global health assistance only amplifies the potential consequences.”1 ,2 , 3, 4