The Open Society Institute is concerned about the Bush administration's plan to extend the scope of the Mexico City Policy—also known as the global gag rule. As one of the largest private donors in the area of health, OSI believes that the extension of this policy will severely compromise efforts to address the global HIV/AIDS pandemic. Extending the gag rule will also restrict freedom of speech by banning health care providers from speaking freely with their patients and advocating with their governments.
The existing gag rule prohibits foreign non-governmental recipients of USAID family planning funds from providing abortion services, even with non-U.S. funding. In addition, groups receiving aid cannot refer clients to abortion services, provide information about abortion, or even advocate for liberalization of abortion laws or improving quality of care.
The administration recently indicated that it planned to extend and expand the gag rule. An internal State Department memo recommends that the rule now apply to virtually all overseas health assistance programs, including the new AIDS initiative unveiled by President Bush in the State of the Union address.
The rule would apply to more USAID-funded programs and, for the first time, to programs sponsored by the State Department. The gag rule would then apply to programs for HIV/AIDS prevention and treatment, refugee services, maternal and child health, and violence against women.
The memo says that exceptions may be made to allow some health groups that provide or counsel abortions to receive funding if they have a "discrete" HIV /AIDS program. But this concession may not be a solution. Research has clearly demonstrated that HIV/AIDS prevention and treatment efforts are most successful when integrated into routine health services. Separating HIV/AIDS education and treatment from routine provision of health care makes no sense for either providers or their patients.
We know from our work around the world that the current gag rule has already had an adverse impact. Many family planning organizations have lost USAID funding, which has reduced their ability to distribute condoms. The gag rule has also prevented providers from engaging in public policy debates about unsafe abortions—which claim the lives of more than 70,000 women a year.
According to UNAIDS estimates, 42 million people globally live with the HIV virus. In 2002, the epidemic left more than three million dead. We believe that extending the gag rule would prohibit effective efforts to reverse the epidemic.