Trump 2.0 instills fear in African abortion activists

A patient talks to a health worker at the Family Health Options clinic in Nairobi, Kenya, May 16, 2017. REUTERS/Baz Ratner

A patient talks to a health worker at the Family Health Options clinic in Nairobi, Kenya, May 16, 2017. REUTERS/Baz Ratner

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African women's health advocates fear a renewed anti-abortion onslaught as Trump reinstates ‘global gag rule’

  • Trump reinstates 'global gag rule'
  • African charities expect renewed anti-abortion onslaught
  • Charities seek new funding for reproductive health

NAIROBI - African health activists fear a new crackdown on abortion across Africa after President Donald Trump reinstated an anti-abortion pact that cuts off U.S. funds to foreign charities that provide or promote abortions.

When Trump signed the Mexico City Policy, or "global gag rule", during his first term some African charities were forced to close, denying women safe abortions. It also emboldened local opposition to women's reproductive choice.

The policy also hit antenatal care, contraception, HIV testing and treatment, along with tuberculosis and malaria programmes run by African health organisations.

Many charities also faced an uptick in persecution from local, far-right Christian groups and home governments.

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The result: a severe curtailment in reproductive healthcare for women across the continent.

Now reproductive rights experts fear a repeat after Trump reinstated the pact on Friday.

"From where I sit, we are likely to see a repeat of the same cycle, but with much more vigour," said Martin Onyango of the Center for Reproductive Rights (CRR) in Kenya.

Evelyne Opondo, Africa director at the International Centre for Research on Women, also expects attacks on sexual reproductive health and rights (SRHR) to worsen under Trump 2.0 and said African charities were already fearful - and prepping.

"There are organisations that were scrambling to sign new funding contracts just before the U.S. elections in November. There are also organisations that cancelled their reproductive health programmes in anticipation of the Trump win," said Opondo.

"What we expect to see is a re-energised and more funded, well-organised, anti-gender, anti-SRHR mobilisation."

A health worker speaks to patients at a Family Health Options clinic in the Kibera slums in Nairobi, Kenya, May 16, 2017. REUTERS/Baz Ratner

A health worker speaks to patients at a Family Health Options clinic in the Kibera slums in Nairobi, Kenya, May 16, 2017. REUTERS/Baz Ratner

A health worker speaks to patients at a Family Health Options clinic in the Kibera slums in Nairobi, Kenya, May 16, 2017. REUTERS/Baz Ratner

Global gag expansion

Among his first acts as president in 2017, Trump reinstated the global gag rule, which has been backed by Republican administrations, then repealed by Democratic ones, since the 1980s.

But Trump went further than his predecessors by expanding the pool of money subject to a cut-off from the $600 million ring-fenced for family planning to cover the entire pot of U.S. global health aid funding – hitting an estimated $12 billion.

He also expanded the gag to prohibit overseas charities using U.S. funds from offering abortion-related information, referrals, or services - and even prohibited the charities from using money they had raised privately for the same end.

This left many charities in Africa with a tough choice: either offer SRHR programmes - or else desist and stick purely to services such as HIV care, malaria or TB treatment.

"We applied for a grant to support our TB programme, but when Trump reinstated the global gag rule, we were told we would only get the money if we signed a form committing to stop all our safe abortion advocacy work," said Allan Maleche, executive director of the Kenya Legal and Ethical Issue Network on HIV and AIDS.

"We were unwilling to stop our SRHR programmes, so we had to withdraw our application and look elsewhere for the TB funds."

A 2024 study by the Guttmacher Institute, an abortion rights research organisation, tallied fallout from the gag in Ethiopia and Uganda, and found multiple negative effects.

Ethiopia had fewer family planning facilities and more contraceptive shortages.

Uganda lost community health workers, hindering women's ability to use contraceptives effectively.

A study from 2022 found the gag had disrupted contraception and abortion from Kenya to Madagascar to Nepal.

"Losing resources also meant that we were not able to continue to provide training to our providers," said Nelly Munyasia, executive director of the Reproductive Health Network in Kenya, which trains health care providers.

"We saw an increase in HIV infection in Kenya ... an increase in the number of teen pregnancies, school dropouts, HIV infection among adolescents and youth."

Munyasia said she feared unsafe abortions and maternal mortality rates had risen, but there was little comprehensive data available to confirm this.

Along with the global gag order, reproductive rights in the United States have come under heightened risk from a 2022 Supreme Court ruling to end the constitutional right to an abortion - a move that has emboldened conservative Christian organisations worldwide.

In Kenya, Christian groups promoting "family values" launched anti-abortion campaigns on billboards in Nairobi, trolled pro-choice activists online and lobbied politicians to restrict access to abortion.

Intimidation and legal action against healthcare providers, as well as women seeking abortion services, also rose.

"The harassment, intimidation, profiling, stigmatisation of providers heightened ... including arrest of service providers and women seeking abortion care," said Onyango, CRR's Africa legal strategist.

A box of HIV medicine is seen before being given to an HIV positive patient at the IOM treatment centre in Eastleigh, Nairobi, Kenya, November 29, 2018. Picture taken November 29, 2018 REUTERS/Baz Ratner

A box of HIV medicine is seen before being given to an HIV positive patient at the IOM treatment centre in Eastleigh, Nairobi, Kenya, November 29, 2018. Picture taken November 29, 2018 REUTERS/Baz Ratner

A box of HIV medicine is seen before being given to an HIV positive patient at the IOM treatment centre in Eastleigh, Nairobi, Kenya, November 29, 2018. Picture taken November 29, 2018 REUTERS/Baz Ratner

Trump 2.0 expectations

In a memorandum signed on Friday, Trump said the reinstatement of the Mexico City Policy would "ensure that U.S. taxpayer dollars do not fund organizations or programs that support or participate in the management of a program of coercive abortion or involuntary sterilization”.

Trump's Secretary of State Marco Rubio also announced on Friday that the United States was rejoining the Geneva Consensus Declaration, which critics say aims to limit abortion access for millions of women and girls around the world.

The declaration was co-sponsored by the United States, Brazil, Uganda, Egypt, Hungary and Indonesia in 2020, during Trump's first term. It now has more than 35 signatories.

The State Department said on Friday that one of the four objectives of the pact was to "protect life at all stages."

Last week, Trump also pardoned 23 anti-abortion protesters, including people convicted of blockading a clinic.

Kenya Christian Professionals Forum (KCPF), which seeks to uphold "values centred around life, family, religion, value-based education and governance", said it was hopeful Trump's abortion stance would influence policy in Kenya.

"There needs to be more restrictions because we stand to advocate the sanctity of life and also to protect it … We still feel there is an open door to abortion (in Kenya) ... so yeah, I think there's still more that needs to be done," said a KCPF spokesperson, who spoke on condition of anonymity.

Women's health advocates in Africa expect Trump may expand the gag rule further during his current term.

They point to Project 2025, a policy suggested to Trump by a conservative U.S. think-tank, the Heritage Foundation, urging the president to enact "a more comprehensive global gag rule".

According the Guttmacher Institute, Project 2025 proposes expanding the gag to apply to all U.S. foreign assistance, including humanitarian aid offered to women and girls affected by disaster or conflict.

The blueprint also proposes blocking funding to the United Nations Population Fund - which stood at more than $160 million in 2023. The UNFPA provides sexual and reproductive health services to millions of women and girls globally.

All of which means the race is on for alternate funding - especially in those countries heavily exposed to U.S. support.

In 2017, 79% of Kenya's official development assistance for sexual and reproductive health came from the U.S. government.

When the previous gag was enacted, other countries, such as the Netherlands and Sweden, stepped in but now some governments align closely with Trump's conservative policies, said health rights advocates.

"We have philanthropy in Africa that is untapped and I think we've over-relied, as Africans, on the goodwill of countries like Canada, France, the Netherlands," said Tabitha Saoyo, a Kenyan lawyer who advocates on reproductive rights.

"There's no one coming to rescue us. We have to prepare and fight this battle on our own."

(Reporting by Nita Bhalla; Editing by Lyndsay Griffiths.)


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