It was a sunny afternoon as most days are in Ethiopia in April. I was taking an individual tour of a large hospital in the middle of Addis Ababa where I got to talk to doctors, nurses, and see waiting rooms and even patients who were recovering from care.
I distinctly remember the room of women who had recently had abortions or were awaiting one. The room was eerily silent despite the number of patients in the large recovery room with few windows and no air conditioning. Personal effects were on all of the beds: blankets, purses, food, extra clothes . Some of the women had female visitors, others did not. While the Ethiopian abortion law on the books is considered “semi-liberal” by African standards, there is some pushback on abortion services although in practice if a woman wants an abortion she can most likely get one. This is mostly to help decrease maternal mortality rates and to curb the rates of unsafe abortions.
As I concluded my tour, the last room I saw was where the abortions took place with all of its machines and lone hospital bed. At that moment I was glad that despite the law, these Ethiopian medical professionals along with the hospital’s policy allowed women to have a choice about their own bodies and reproductive rights.
As is true with each new presidential administration the global health community hangs in the balance. According to KFF.org the US global health funding was set at $11 billion in FY 2019 and in 2020 the funding was significantly decreased. This funding goes towards programs in more than 70 countries for HIV, malaria, maternal and child health among other health challenges. But now with the Biden administration the global health imperative is back on the table with increased funding and a dedication to countries’ health. Here are four reasons why.
At the start of the last administration the lamentations were heard around the world about the reinstatement of the Mexico City Policy or the Global Gage Rule, that cut overseas funding from advocating for the legalization of abortions, provide abortions, mention the word, or even refer women to health practionioners that provide safe, legal abortions. Biden has already revoked the Mexico City Policy, but according to Time magazine the Trump effect may take some time to undo.
The Trump administration also withdrew from the World Health Organization (WHO), something that seemed unfathomable, but was a stark wakeup call for the global health community. Biden stopped the United States’ official withdrawal from the WHO. This is important as the US provides significant funding for global health and by re-entering the worldwide health community, the US will help stabilize the global COVID-19 response.
Not only did the Trump administration withdraw from the World Health Organization, it also withdrew from The Paris Climate Agreement signed in 2015. Make no mistake, while the Agreement sets conditions and milestones for countries to reach to stave off and prevent further climate extremes it is very much a health agreement. Again, Biden rejoined The Paris Agreement, putting the United States back on a solid footing on climate change initiatives.
Biden’s nominee for administrator of USAID is Samantha Power. With years of global health and administration experience under her belt, Power is the former US ambassador to the United Nations under Obama. Additionally, Power served as Special Assistant to the President and Senior Director for Multilateral Affairs and Human Rights at the National Security Council. Power will certainly raise the profile of USAID and usher a renewed sense of the United States’ responsibility to global health and security.
In the first few weeks of Biden’s administration there have been several notable changes in how the United States approaches global health. This is especially imperative with the COVID-19 pandemic still raging out of control with new variants and a backed-up vaccine rollout. Now, there is a plan in place not only for the United States, but also for global distribution of the vaccine where the vast majority of the vaccines have gone to high-income countries according to Duke Univeristy’s Global Health Instutute.
The Kenyan Medical Practitioners and Dentists Board has stopped the NGO Marie Stopes International from performing abortions in Kenya. Marie Stopes is a global organisation that provides contraception and safe abortion to women in urban and rural communities. Abortion is illegal in Kenya, unless a trained medical professional judges that there’s a need for emergency treatment, or that a woman’s life or health is in danger.
The Conversation Africa’s Moina Spooner spoke to Michael Mutua about the Marie Stopes ban and its implications.
How did the ban come about?
According to the Kenya Medical Practitioners and Dentists Board, they banned abortion services provided by Marie Stopes following complaints from the general public. The public claimed the organisation was running pro-choice media campaigns. These adverts specifically sought to provide women with a solution when faced with crisis pregnancies.
The adverts were also criticised by the Kenya Film Classification Board, which ordered Marie Stopes to pull them down for allegedly promoting abortion.
Throughout my visits to clinics in Africa I have seen the work of Marie Stopes International in South Africa, Tanzania, Ethiopia as well as Zambia. They provide a full range of quality reproductive health services for women. I have always been impressed by the comprehensive care they provide. Now, their work will be hampered because of an imposed policy of the new administration.
Yesterday morning President Trump signed an executive order to reinstate the Global Gag Rule, or Mexico City Policy, that prevents international NGOs that accept USAID (taxpayer) money from advocating for the legalization of abortions, provide abortions, mention the word, or even refer women to health practionioners that provide safe, legal abortions.
The Global Gag Rule was instated during the Reagan admininstration in 1984 and since then there has been a virtual seesaw effect between Republican and Democratic administrations regarding whether the Rule is reinstated or revoked. According to the WHO, 78,000 women die every year from unsafe abortions. Under Obama’s eight year administration, that number was reportedly decreased by more than half. Now, that President Trump has signed this executive order reinstating the Global Gag Rule, the fear among the global health community is that that number will rapidly skyrocket again.