Why Obama’s already good for Africa
February 5, 2009
So here’s Priti’s take on Obama’s lifting of the global gag rule, and what it means for Africa.
In one of his first acts in office, Barack Obama put an end to the U.S. refusal to provide funding to any organization worldwide involved in abortion or abortion-related work. This rule, known around the world as the “global gag rule” was first issued by President Ronald Reagan in 1984. It was rescinded in 1993 by President Bill Clinton and reinstituted by President George W. Bush on his first day in office in 2001.
Under the Bush administration, the U.S. Agency for International Development (USAID) was prohibited from providing funding to any organization that provided advice, counseling, or information regarding abortion, or engaged in lobbying a foreign government to legalize or improve access to legalized abortion. Even more astonishing, the USAID was prohibited from providing any funding or assistance (such as free condoms) to an organization that engaged in “abortion-related” activities even if the funding was for another aspect of the organization’s work such as HIV prevention or treatment.
The perceived goal of the policy was to reduce the number of abortions throughout the world by restricting access to abortions and abortion-related information. But studies indicate that these types of restrictions only serve to further drive abortion underground resulting potentially in increased maternal deaths due to unsafe abortions but not necessarily in a reduction of abortions.
Regardless of what your personal position is on a women’s right to abortion, it is clear that the global gag rule’s effect had debilitating consequences not only for a woman’s access to safe abortions but on access to adequate and much-needed health care. In many countries in Africa, the global gag rule constituted an assault on an already fragile health care system.
According to a study published in 2003 (by a coalition of reproductive rights organizations), the global gag rule resulted in the reduction of health and family planning clinics throughout Africa. In Kenya, the withdrawal of funding in 2001 meant the closing of the sole health clinic providing services such as malaria treatment, screening for cervical cancer, as well as infant and child healthcare check-ups, and immunizations to a poor community of 300,000 near Nairobi.
This devastating effect of the global gag rule is even more telling in the HIV/AIDS sector. In Zambia, HIV/AIDS organizations were forced to scale back on services due to a reduction of funding in light of the global gag rule. In Lesotho, health care providers were unable to access free UNAIDS supplied condoms—a critical tool in preventing HIV transmission. In Ghana, health care clinics providing comprehensive family planning services, including HIV prevention and voluntary counseling and testing, were forced to reduce HIV and other services.
In southern Africa where the HIV prevalence rate ranges from 11% to 26% of the population and where women continue to bear the brunt of the epidemic, Obama’s rescission presents an opportunity for HIV/AIDS organizations to re-envision and re-establish critical relationships with family health care providers to integrate sexual and reproductive needs with access to HIV prevention and treatment information and establish a more directed focus on HIV positive women’s sexual and reproductive rights.
This is needed now more than ever as violations of HIV positive women’s sexual and reproductive rights continue to mount. In Namibia, HIV positive women report being subjected to coerced sterilization due to their HIV status. In a number of these cases, pregnant women were told to sign consent forms for the sterilization without being informed of the contents of the forms. In other cases, women were forced to sign the forms as medical personnel threatened to withhold lifesaving medical procedures if the forms were not signed. A number of these cases are in court in Namibia, and the International Community of Women Living With HIV/AIDS in Namibia continues to document additional cases, some occurring as recently as 2008.
Where a women’s right to control her body is inextricably linked to her ability to access adequate health care among other things, the repeal of the global gag rule and its straight-jacketed mandate regarding funding can have a substantially positive effect on reducing women’s vulnerability to HIV both in terms of minimizing their exposure and in empowering HIV positive women to advocate for redress when their rights are violated.
The priority placed by the Obama administration in repealing the global gag rule—which was among only a handful of executive actions issued by the President in his first few days—is of course a cause for celebration throughout southern Africa but more importantly, it is also a moment of opportunity.
Obama’s rebuke of those who would politicize the funding of international family planning assistance and his commitment to focus on finding the best and most effective solutions to the interconnected issues relating to a women’s access to the best attainable healthcare should serve as a call to action for everyone in southern Africa regardless of which side of the abortion debate you sit.