It is almost 22 years since the United Nations held its ground breaking International Conference on Population and Development (ICPD) in Cairo. The ICPD conference often dubbed the “Cairo Consensus” presented a political victory for women. Cairo touched on many sensitive issues often highlighting the will of some to control the lives and values of others. It made significant advances in the formulation of reproductive policies and programs towards strengthening the rights of women. The ICPD became the first international conference explicitly to recognize reproductive rights as human rights. The needs and rights of the individual having control over their sexuality and fertility were emphasized, people were also allowed to choose how to live their lives and that freedom was to be extended to apply to women in that their lives must no longer be governed by men.
Family planning programs occupy an unusual place in the public policy arena. They are widespread and are also generally considered effective public health policies. Yet family planning programs are persistently controversial. In part because they centre on birth control, reduction of unwanted pregnancies through safe abortion by strengthening family planning programs, a sensitive subject that has drawn criticism from a wide range of perspectives, religious, political, ideological and Scientific. However, while many may pretend or out rightly deny to have ever carried out abortion, many have participated in carrying out back street abortion and many have done it more than once, using it as a vital reproductive health option. The decriminalization of abortion in South Africa for instance gave rise to cross border abortion operation thus saving many women from Botswana to unwanted pregnancies. Both female and male have jointly participated in the abortion practice with the male counterpart playing a significant role in abortion as instigators, facilitators, advisors, informers, supporters, or even punishment givers.
Whilst there has been legislative advances made by a number of countries particularly geared to reducing un-safe abortion, Botswana is still lacking behind. For, example, when Assistant Minister of Local Government and Rural Development Hon Botlhogile Tshireletso, called for the decriminalization of abortion in the country many people were in disagreement and saw that as very irresponsible suggestion coming from a minister. Now she has turned that call into an annual public relations talk show.
The Roman Catholic Church on the other hand believes that life begins at conception and thus abortion is considered to be a grave moral offense. Each new life that begins at this point is not a potential human being but a human being with potential. Since the sixteenth century, causing or having an abortion was grounds for automatic excommunication within the Catholic Church. The Christian Church itself has played a major role in the politics of the abortion debate throughout the world. In 2002, Pope John Paul II, the leader of the Roman Catholic Church, took a strong line on abortion, describing it as murder.
However, not all Catholics agree with the Vatican line on abortion. The Church of England, while strongly opposed to abortion, has admitted that there are some instances where an abortion may be morally preferable to any available alternative. As with Hinduism and Buddhism, an abortion might be deemed permissible if the birth of the child threatens the life of the mother.
On Jan 23, 2017, on his fourth day in office, President Donald Trump signed an executive order imposing the global gag rule, an anti-abortion policy that under other conservative presidential administrations has caused serious disruptions to US overseas family planning efforts. Alarmingly, Trump’s order goes even further than in the past, with potentially devastating effect.
The global gag rule, also known as the Mexico City policy, was devised in 1984 by the administration of Ronald Reagan to impose a draconian set of anti-abortion rules on US overseas family planning programmes. This policy banned US family planning funds from going to foreign non-governmental organisations (NGOs) that provide abortion services, counselling, or referrals, or advocate for liberalisation of their country’s abortion laws even if they use non-US government funds for these activities. In 1984, and every time the global gag rule has been imposed since then, foreign governments were exempt for diplomatic reasons, as were US-based NGOs on constitutional grounds.
To be clear, legislation was already in place in 1984, and is still in place now, that bans the use of US funds under the Foreign Assistance Act from paying “for the performance of abortion as a method of family planning”.
Under Trump’s order, the gag rule now applies not only to US bilateral family planning assistance (US$575 million for fiscal year 2016), but also to all “global health assistance furnished by all departments or agencies encompassing an estimated $9┬À5 billion in foreign aid. Foreign NGOs that receive US funding to work on a broad range of health programmes in about 60 low-income and middle-income countriesÔÇöincluding on HIV/AIDS, maternal and child health, among other will potentially be subject to the same ideological restrictions that have hampered family planning aid at points in the past. Thus, President Trump’s version of the global gag rule represents a wider attack on global health aid writ large.
Adding to the widespread concern among US government agencies, global health NGOs, and advocates is the Trump administration’s failure to provide any guidance on the interpretation or application of the new policy. Those details may emerge in the coming weeks and months. But we already know that, when last in effect, the gag rule crippled family planning programmes. Many foreign NGOs, as a matter of principle and out of dedication to the patients they serve, refused to let the US Government muzzle their abortion advocacy efforts or dictate what services or counselling they provided using their non-US funds. These health providers were forced to reduce staff and services, or even shut clinics. As a result, many thousands of women no longer had access to family planning and reproductive health services from these clinics, sometimes the only provider of such services in the local community. Various actors, including the governments of Canada and the Netherlands, are mobilising to compensate for at least some of the damage that will be done by the gag rule. But the US is the largest funder of global health programmes worldwide, and the disruption this aid effort will suffer is massive.
The unprecedented scope of the Trump global gag rule validates the fears of many observers: reproductive health and rights worldwide will face a sustained attack in the next 4 years of the Trump Administration. This assault will almost certainly include defunding the United Nations Population Fund (UNFPA), as well as potentially drastic cuts to US overseas family planning aid.
So one may ask the Assistant Minister Tshireletso to please stand up and tell us what is next for Botswana in putting un-safe abortion in the policy agenda, one that is detached from Global Health Initiative agenda. Whether or not abortion is permitted or prohibited by law, women will seek abortion services and obtain abortion. They will seek them because of their social, economic, health or other personal circumstances. If safe services are not available, they will turn to unsafe ones more especially under the prevailing circumstances where there is a lot of youth un-employment, retrenchments, general immoral practices and the commercialization of the girl child in marriage where some families use their daughters as washa washa ponze schemes by way of collecting lobola, thus turning it into transactional marriage / sex scam. At times just dumping them into mere spaza husbands at times coming from familes where passion killings and alcoholism are a norm and practice.
Thabo Lucas Seleke is a Researcher & Scholar in Health Policy & Health Systems Strengthening