Biden faces ‘uphill struggle’ to restore abortion access around the world, experts warn

‘The damage the Trump administration has done in four years is immense,’ one group says

The new president has pledged to rescind the Mexico City Policy within days (Getty Images)

Joe Biden faces an “uphill struggle” to repair the damage done to women's health services around the world by Donald Trump, including restoring access to abortion, advocacy groups have warned.

On taking office, Mr Trump reimposed the Mexico City Policy, or global gag rule, which has been reinstated by every Republican president since the 1980s and prevents foreign NGOs that receive US funding from performing or giving advice about terminations. This forces organisations that also provide unrelated care, like infectious disease treatment, to restrict their work

In addition to this, Mr Trump also drastically expanded the policy to include the majority of federal global health assistance. This rule now covers some $9bn (£6.6bn) in global health funding as opposed to less than one-tenth that under the original policy.

The 45th president became a strong opponent of abortion when he needed to woo evangelical, conservative Christians in his election bid.

While Mr Biden has long pledged to rescind the Mexico City Policy, it will take time to address the scale of the previous administration's actions, experts said.

Anthony Fauci, director of the National Institute of Infectious Diseases, told the World Health Organisation on Thursday that the full gag rule would be repealed in the next few days as part of Mr Biden’s “commitment to protect women’s health and advance gender equality at home and around the world”.

Mr Biden is personally opposed to abortion, but has said he will not impose his beliefs on others.

Sarah Shaw, head of advocacy at MSI Reproductive Choices, told The Independent: “With the Democrats now in control of the House and Senate, it should, in theory, be easier for President Biden’s administration to dismantle Trump’s expanded global gag rule and permanently repeal it.  

“However, with the chilling effect of the gag rule resulting in a global roll-back of reproductive rights, increased anti-choice harassment and multiple clinic closures across all areas of global health, combined with a global pandemic and growing resistance to overseas development funding, the Biden administration faces an uphill struggle in pushing forward concrete, on-the-ground change.

“The administration should focus on collaboration and restoring partnerships to ensure the integration of family planning and sexual and reproductive health services with wider health services.

“Crucially, USAID funding will not be restored immediately and administrative changes will increase this time lag.

“Regardless, MSI will continue to deliver on long-held commitments to uphold reproductive choice, so that people globally can access the care they need, safely and with dignity.”

USAID is the federal agency that coordinates Washington's foreign aid and development programmes.

Brian Dixon, senior vice president at Population Connection Action Fund, told The Independent: “The damage that the Trump administration has done in four years is immense. Getting healthcare back up isn't just a case of rescinding a policy, it's going to take more.

“I think building things back is harder than tearing it down, but actually we don't really have a choice.”

Echoing MSI's call for integrated health schemes, he added: “Having a robust global health system is crucial to addressing future pandemics.

“Investing in these programmes isn't a luxury, it's a necessity. The US has to be a leader here.”

Mr Dixon said that Mr Biden should also focus on “restoring the US' role in the UN Population Fund, getting that money back” as well as “putting women's and reproductive rights back into our annual human rights report”.

Melvine Ouyo, a former clinic director at Family Health Options Kenya (FHOK), said the group had to shut four centres after Mr Trump's policy changes. Repealing the global gag rule “would be the first step to recovery”, she told The Independent.

Key elements of FHOK's work include HIV prevention and cancer screening.

Ms Ouyo added: “We know how much damage the pandemic has done to the US economy and people. [Mr Biden] may want to give more priority to that.

“I believe we will have different alternatives, as much as we rely on the US funding. Other organisations will come up and start up the advocacy.

“We will come up with inventive ways of getting other resources.”

People “have been gagged from speaking about what impacts they were facing” under the Trump administration, she said, but that may now change.