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MEMORANDUM FOR THE SECRETARY OF STATE
THE ADMINISTRATOR OF THE UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT
SUBJECT: Mexico City Policy and Assistance for Voluntary Population Planning
The Foreign Assistance Act of 1961 (22 U. S.C. 2151b(f) (1)), prohibits nongovernmental organizations (NGOs) that receive Federal funds from using those funds "to pay for the performance of abortions as a method of family planning, or to motivate or coerce any person to practice abortions." The August 1984 announcement by President Reagan of what has become known as the "Mexico City Policy" directed the United States Agency for International Development (USAID) to expand this limitation and withhold USAID funds from NGOs that use non-USAID funds to engage in a wide range of activities, including providing advice, counseling, or information regarding abortion, or lobbying a foreign government to legalize or make abortion available. The Mexico City Policy was in effect from 1985 until 1993, when it was rescinded by President Clinton. President George W. Bush reinstated the policy in 2001, implementing it through conditions in USAID grant awards, and subsequently extended the policy to "voluntary population planning" assistance provided by the Department of State.
These excessively broad conditions on grants and assistance awards are unwarranted. Moreover, they have undermined efforts to promote safe and effective voluntary family planning programs in foreign nations. Accordingly, I hereby revoke the Presidential memorandum of January 22, 2001, for the Administrator of USAID (Restoration of the Mexico City Policy), the Presidential memorandum of March 28, 2001, for the Administrator of USAID (Restoration of the Mexico City Policy), and the Presidential memorandum of August 29, 2003, for the Secretary of State (Assistance for Voluntary Population Planning). In addition, I direct the Secretary of State and the Administrator of USAID to take the following actions with respect to conditions in voluntary population planning assistance and USAID grants that were imposed pursuant to either the 2001 or 2003 memoranda and that are not required by the Foreign Assistance Act or any other law: (1) immediately waive such conditions in any current grants, and (2) notify current grantees, as soon as possible, that these conditions have been waived. I further direct that the Department of State and USAID immediately cease imposing these conditions in any future grants.
This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
The Secretary of State is authorized and directed to publish this memorandum in the Federal Register.
BARACK OBAMA
THE WHITE HOUSE, January 23, 2009.
Regarding the Mexico City Policy
I hereby revoke the Presidential Memorandum of January 23, 2009, for the Secretary of State and the Administrator of the United States Agency for International Development (Mexico City Policy and Assistance for Voluntary Population Planning), and reinstate the Presidential Memorandum of January 22, 2001, for the Administrator of the United States Agency for International Development (Restoration of the Mexico City Policy).
I direct the Secretary of State, in coordination with the Secretary of Health and Human Services, to the extent allowable by law, to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies.
I further direct the Secretary of State to take all necessary actions, to the extent permitted by law, to 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.
This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
The Secretary of State is authorized and directed to publish this memorandum in the Federal Register.
Restoration of the US “Mexico City Policy” by President Donald J. Trump
The Mexico City Policy is the name given to a measure promulgated by President Reagan at the time of the International Conference on Population held in Mexico City in 1984 requiring nongovernmental organizations to agree as a condition of receiving Federal funds that they would neither perform nor actively promote abortion as a method of family planning in other nations. This policy was rescinded by President Clinton, restored by President George W. Bush, and again rescinded by President Obama, with the action in each case taken in one of the earliest executive orders of the respective administration. As expected, the policy has again been restored by President Donald J. Trump, through a Memorandum addressed to the Secretary of State, the Secretary of Health and Human Services, and the Administrator of the United States Agency for International Development and signed on January 23, 2017. The text of the Memorandum is reproduced below. The explicit extension of the policy's coverage to all US global health assistance (see paragraph 2) is a novel element. The earlier executive actions on the policy are reported in the Documents sections of the September 1984, March 1993, March 2001, and March 2009 issues of PDR.
SUBJECT: The Mexico City Policy
I hereby revoke the Presidential Memorandum of January 23, 2009, for the Secretary of State and the Administrator of the United States Agency for International Development (Mexico City Policy and Assistance for Voluntary Population Planning), and reinstate the Presidential Memorandum of January 22, 2001, for the Administrator of the United States Agency for International Development (Restoration of the Mexico City Policy).
I direct the Secretary of State, in coordination with the Secretary of Health and Human Services, to the extent allowable by law, to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies.
I further direct the Secretary of State to take all necessary actions, to the extent permitted by law, to 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.
This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
The Secretary of State is authorized and directed to publish this memorandum in the Federal Register.
Contents
The policy requires non-governmental organizations to "agree as a condition of their receipt of [U.S.] federal funds" that they would "neither perform nor actively promote abortion as a method of family planning in other nations". [18] The policy has exceptions for abortions performed in response to rape, incest, or life-threatening conditions. [19]
Named for Mexico City, the venue of the United Nations International Conference on Population and Development where it was announced, the policy was instituted by U.S. President Ronald Reagan in 1984. [20] [21] [22] The final language of the 1984 policy was negotiated by the deputy chairman of the U.S. delegation, Alan Keyes, then an Assistant Secretary of State. [23]
After the establishment of the Mexico City policy, organizations were required to meet its specified conditions in order to be eligible for federal funding from the United States, and as a result, several international abortion agencies no longer received a portion of their funds from this source. The International Planned Parenthood Federation (IPPF) did not alter its operation and lost more than 20% of its total funding. Other family planning organizations, such as the Family Guidance Association of Ethiopia and the Planned Parenthood Association of Zambia, likewise did not make the changes required by the Mexico City policy and had their funding cut. NGOs in Romania and Colombia adapted to the new U.S. guidelines and continued to qualify for federal funding. [24]
In 1987 and 1988, the policy was challenged by two U.S. Appeals court rulings in DKT Memorial Fund Ltd. vs. USAID, involving Phil Harvey and two foreign NGOs, [25] and Planned Parenthood Federation of America, Inc. v. USAID. [26] Ultimately, the two court rulings contributed to the policy being used only against foreign NGOs, while not invoked against U.S. NGOs.
President Bill Clinton rescinded the Mexico City policy on January 22, 1993. He referred to the policy as being "excessively broad" and stated that it had "undermined efforts to promote safe and efficacious family planning programs in foreign nations". [4] On January 22, 2001, President George W. Bush reinstated the policy, stating, "It is my conviction that taxpayer funds should not be used to pay for abortions or advocate or actively promote abortion, either here or abroad. It is therefore my belief that the Mexico City Policy should be restored". [27] In September 2007, Barbara Boxer, a Senator from California, created an amendment designed to lift the funding conditions put in place by the Mexico City policy. It passed by a vote of 53–41. President Bush promised to veto any legislation which would eliminate the Mexico City policy. [28] The policy was rescinded again by President Barack Obama on January 23, 2009, [7] and further reinstated on January 23, 2017 by President Donald Trump. [10] Trump not only reinstated the policy but expanded it, making it cover all global health organizations that receive U.S. government funding, rather than only family planning organizations that do, as was previously the case. This includes offices such as USAID, the Department of State, Global Aids Coordinator, Center of Disease Control and Prevention, National Institute of Health, and Department of Defense. [29]
The nature of the policy has implications for organizations in certain countries such as South Africa. Even if these organizations support the policy itself, it is illegal for them not to inform a woman seeking an abortion of her rights, and/or refer her to a facility where she may have an abortion. The President's Emergency Plan for AIDS Relief (PEPFAR) was excluded from the Mexico City policy under the George W. Bush administration, but was not excluded since the Mexico City policy was reinstated on January 23, 2017. [30]
In May 2017, Rex Tillerson announced an expansion of the policy originally a ban covering roughly $600 million in family planning money, the Trump policy since then applied to all international health care aid doled out by the U.S. government — nearly $9 billion. [31]
In 2021 President Biden rescinded the Mexico City policy. [32]
Impact Edit
According to a 2019 study in the journal Lancet, the implementation of the Mexico City Policy during the Bush administration (2001-2009) unintentionally led to more abortions. By limiting funding for family planning organizations, which use abortion as one of many methods of family planning, use of contraceptives reduced and pregnancies increased. When the Mexico City Policy was in effect under the G.W. Bush administration, the abortion rate was 64% higher in thirteen countries highly affected by the policy than in other comparable countries. Under the immediately preceding Clinton administration, when the policy was not in effect, the abortion rate in the thirteen countries was 8% lower than in the other comparable countries. The authors of the study estimate that Bush's imposition of the Mexico City Policy increased the abortion rate in the thirteen countries by 40%, and the rest of the increase had other causes. [15]
A 2015 study of Ghana found that the policy increased unintended pregnancies and abortions. [17] A 2011 study which examined Sub-Saharan Africa found that the Mexico City Policy likewise had the unintended consequence of increasing the number of abortions, with the authors suggesting that the reduction in financial support for family planning organizations led to a greater number of accidental pregnancies. [16]
Rutgers University economist Yana van der Meulen Rodgers concluded in her 2019 book The Global Gag Rule and Women's Reproductive Health that Mexico City policy had not reduced abortions, likely increased unsafe abortions, and adversely affected health outcomes for men, women and children. [1] In a 2017 editorial for the New England Journal of Medicine, Stanford University health experts Nathan Lo and Michele Barry noted that research showed the policy increases unintended pregnancies and abortions. They write, "the reinstatement of the Mexico City Policy is a stark example of “evidence-free” policymaking that ignores the best scientific data, resulting in a policy that harms global health and, ultimately, the American people." [33] 2017 editorials in The BMJ by University of Michigan Medical School health experts, [34] and The Lancet by University of Toronto, Columbia University and Guttmacher Institute health experts concluded the same. [35] [36]
The policy originally enacted from 1984 to 1993 spoke to abortion only, not family planning in general. However, in 2001, the policy was re-implemented and expanded to cover all voluntary family planning activities, and critics began to refer to it as the "global gag rule." These critics argue that the policy not only reduces the overall funding provided to particular NGOs, it closes off their access to USAID-supplied condoms and other forms of contraception. [37] This, they argue, negatively impacts the ability of these NGOs to distribute birth control, leading to a downturn in contraceptive use and from there to an increase in the rates of unintended pregnancies and abortion. [37] A study of nations in sub-Saharan Africa suggests that unintended pregnancies increased and abortions approximately doubled while the policy was in effect. [38] Critics also argue that the ban promotes restrictions on free speech as well as restrictions on accurate medical information. [39] [40] [41] [42] The European Parliamentary Forum on Population and Development presented a petition to the United States Congress signed by 233 members condemning the policy. The forum has stated that the policy "undermines internationally agreed consensus and goals". [43]
Supporters of the policy have argued, using the example of the Philippines, that the ban prevents overseas health organizations from using U.S. government funds to contravene the contraception and abortion laws of the countries in which they operate. [44] Supporters also argue that the policy prevents the health agencies from promoting abortion at the expense of other birth control methods. [45] [46]
The Vatican supports the Mexico City policy. [47]
The Sandbæk Report of the European Union, which calls for the funding of the United Nations Population Fund (UNFPA), was seen by some Catholic commentators as a contrast to the Mexico City policy. [48] The European commissioner Poul Nielson said that the European Union wished to "fill the decency gap" left by the Mexico City policy. [49] [50]
The UNFPA states that it does not "provide support for abortion services". [51] Pro-life individuals and organizations have accused the UNFPA of supporting forced abortions by the Chinese government. [52] [53] The Bush administration withheld funding from the agency due to concerns about its alleged involvement. A 2002 U.S. State Department investigation found "no evidence" that UNFPA knowingly took part in forced abortions. [54] The organization has stated that it "has never, and will never, be involved in coercion in China or any part of the world". [51]
In 2010, the Harper government in Canada announced a maternal health development aid plan for the upcoming G8 summit which did not include financial support for abortion or contraception, drawing comparisons to the Mexico City policy. [55]
An episode of the television series Boston Legal, "Squid Pro Quo", which originally aired on May 9, 2006, featured a case involving USAID's withdrawal of funding to an overseas non-profit organization. [56]
An episode of the American television series The West Wing, entitled "Privateers", featured a "gag rule" amendment of a law for overseas aid. [57]
Pro-life, pro-abortion leaders respond to Biden revoking Mexico City Policy
WASHINGTON, D.C., January 28, 2021 (LifeSiteNews) &ndash The Biden administration made good Thursday afternoon on its declaration that it was about to resume sending foreign aid dollars to commit and promote abortions worldwide, provoking strong reactions from both friends and foes of the abortion industry.
As announced earlier today, President Joe Biden&rsquos presidential memorandum revokes predecessor Donald Trump&rsquos 2017 policy, which not only reinstated the Mexico City Policy&rsquos ban on foreign aid to groups that committed abortions, but took the additional step of expanding it to groups that promote or discuss abortion and directs the Secretary of Health and Human Services to &ldquoreview the Title X Rule and any other regulations governing the Title X program that impose undue restrictions on the use of Federal funds or women&rsquos access to complete medical information.&rdquo
In his memorandum, Biden also withdrew the United States&rsquo signature from the Geneva Consensus Declaration, which reaffirmed &ldquothat there is no international right to abortion, nor any international obligation on the part of States to finance or facilitate abortion, consistent with the long-standing international consensus that each nation has the sovereign right to implement programs and activities consistent with their laws and policies.&rdquo
Before signing the executive order, Biden said he was not &ldquoinitiating any new law, any new aspect of the law. This is going back to what the situation was prior to the (former) president&rsquos executive order.&rdquo
President Biden: "Today, I'm about to sign two executive orders. to undo the damage Trump has done." pic.twitter.com/xKoc2uGrBP
&mdash CSPAN (@cspan) January 28, 2021
&ldquoNo one requires me to do anything,&rdquo Biden added before reporters were asked to leave the Oval Office, in spite of strong support for the president from pro-abortion organizations that want easier access federal funding for their abortion procedures.
Trump&rsquos expansion of the Mexico City Policy resulted in international abortion providers Planned Parenthood and Marie Stopes losing millions because they refused to drop abortion in order to qualify for the money. Marie Stopes also had to close hundreds of operations across Africa. At the same time, reviews by the State Department found that most recipients have complied with the new rules without issue, leaving the distribution of legitimate foreign aid unharmed. His Title X rule required &ldquoclear financial and physical separation between Title X-funded projects and programs or facilities where abortion is a method of family planning&rdquo and bans &ldquoreferral for abortion as a method of family planning.&rdquo It was projected to cut almost $60 million from the $616 million Planned Parenthood received during the most recent fiscal year.
The abortion lobby is celebrating the development:
Today, we celebrate these initial steps on the path towards reclaiming full ownership over our bodies, our health, and our futures. We're grateful @POTUS & @VP have begun to right the wrongs of the last four years &mdash but this is only the beginning. #ReproBlueprint #BuildBackBetter https://t.co/7ULDo6OXam
&mdash Alexis McGill Johnson (@alexismcgill) January 28, 2021
What&rsquos the global gag rule? Glad you asked. It's foreign policy, first introduced by Reagan, that prohibits foreign NGOs that get global health funding from the U.S. from using their own separate resources to engage in abortion related work. And its days are numbered.
&mdash NARAL (@NARAL) January 28, 2021
THIS is why we fought so hard. Thank you @POTUS for ending the #GlobalGagRule and starting to undo the harm and damage done in the last 4 years. This is only the beginning of what we hope we can do together: https://t.co/cOpIIlw1AS #ReproBlueprint https://t.co/gTJDiX9k3O pic.twitter.com/VqBvHMvrET
&mdash NAF (@NatAbortionFed) January 28, 2021
&ldquoI&rsquom proud to see the Biden-Harris administration re-establish U.S. leadership on reproductive rights by immediately addressing an archaic ban that was weaponized by the Trump administration,&rdquo said EMILY&rsquos List president Stephanie Schriock. &ldquoPlain and simple, rescinding the global gag rule will save thousands of lives. Under the Trump administration, the ban constrained our global health partners who faced threats to foreign assistance to roll back global sexual and reproductive health rights. As a result, many clinics were forced to shut down, contributing to deaths from childbirth complications and unsafe abortion.&rdquo
Pro-life activists, meanwhile, are lamenting it as a tragedy.
&ldquoPresident Biden is returning to the pro-abortion policies of Barack Obama and forcing taxpayers back into a partnership with the overseas abortion industry,&rdquo said Family Research Council president Tony Perkins. &ldquoThe abortion industry is well known for relentlessly pursuing taxpayer dollars &mdash and will exploit any opportunity to grab U.S. taxpayer money. With this action, President Biden is throwing aside any notion of uniting or &lsquohealing&rsquo America&rsquos political division and is demonstrating that &lsquounity&rsquo means conformity to the goals and priorities of the Left.&rdquo
&ldquoPresident Biden has unmasked his intention to be an abortion extremist and to promote abortion as a centerpiece of his &lsquohealthcare&rsquo agenda, proving his claim to be a unifier is nothing but a farce,&rdquo said Concerned Women for America president Penny Nance. &ldquoBiden&rsquos pro-abortion agenda breaks with the vast majority of Americans, including a majority who identify as pro-choice, who oppose this agenda.&rdquo
&ldquoFunneling U.S. tax dollars to abortion groups overseas is an abhorrent practice that flies in the face of the &lsquounity&rsquo Joe Biden and Kamala Harris promised to inspire,&rdquo said Susan B. Anthony List president Marjorie Dannenfelser. &ldquoRather than rally the nation around common ground policies to affirm and promote life, today they force taxpayers to bankroll abortion businesses overseas, opening up a slush fund for groups like Marie Stopes International and the International Planned Parenthood Federation. These abortion industry giants shamefully push their agenda on deeply pro-life nations and cultures. Americans across the political spectrum oppose the use of taxpayer funding to promote abortion and abortion businesses. Despite this, the new administration is moving forward with a payout to the abortion industry that backed their political campaign.&rdquo
Biden rescinds the Mexico City Policy, which restricts US tax dollars from funding abortions overseas.
Do not tell me that Biden is a man of faith.
Do not tell me he cares about the vulnerable.
Do not tell me that he listens to &ldquoscience.&rdquo
The full text of Biden&rsquos and Trump&rsquos memoranda on the Mexico City Policy is printed below:
Presidential Memorandum Regarding the Mexico City Policy
MEMORANDUM FOR THE SECRETARY OF STATE
THE SECRETARY OF HEALTH AND HUMAN SERVICES
THE ADMINISTRATOR OF THE UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT
SUBJECT: The Mexico City Policy
I hereby revoke the Presidential Memorandum of January 23, 2009, for the Secretary of State and the Administrator of the United States Agency for International Development (Mexico City Policy and Assistance for Voluntary Population Planning), and reinstate the Presidential Memorandum of January 22, 2001, for the Administrator of the United States Agency for International Development (Restoration of the Mexico City Policy).
I direct the Secretary of State, in coordination with the Secretary of Health and Human Services, to the extent allowable by law, to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies.
I further direct the Secretary of State to take all necessary actions, to the extent permitted by law, to 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.
This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
The Secretary of State is authorized and directed to publish this memorandum in the Federal Register.
Memorandum on Protecting Women&rsquos Health at Home and Abroad
MEMORANDUM FOR THE SECRETARY OF STATE, THE SECRETARY OF DEFENSE, THE SECRETARY OF HEALTH AND HUMAN SERVICES, THE ADMINISTRATOR OF THE UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT
Section 1. Policy. Women should have access to the healthcare they need. For too many women today, both at home and abroad, that is not possible. Undue restrictions on the use of Federal funds have made it harder for women to obtain necessary healthcare. The Federal Government must take action to ensure that women at home and around the world are able to access complete medical information, including with respect to their reproductive health.
In the United States, Title X of the Public Health Services Act (42 U.S.C. 300 to 300a-6) provides Federal funding for family planning services that primarily benefit low-income patients. The Act specifies that Title X funds may not be used in programs where abortion is a method of family planning, but places no further abortion-related restrictions on recipients of Title X funds. See 42 U.S.C. 300a-6. In 2019, the Secretary of Health and Human Services finalized changes to regulations governing the Title X program and issued a final rule entitled &ldquoCompliance With Statutory Program Integrity Requirements,&rdquo 84 Fed. Reg. 7714 (Mar. 4, 2019) (Title X Rule), which prohibits recipients of Title X funds from referring patients to abortion providers and imposes other onerous requirements on abortion providers. The Title X Rule has caused the termination of Federal family planning funding for many women&rsquos healthcare providers and puts women&rsquos health at risk by making it harder for women to receive complete medical information.
It is the policy of my Administration to support women&rsquos and girls&rsquo sexual and reproductive health and rights in the United States, as well as globally. The Foreign Assistance Act of 1961 (22 U.S.C. 2151b(f)(1)), prohibits nongovernmental organizations (NGOs) that receive Federal funds from using those funds &ldquoto pay for the performance of abortions as a method of family planning, or to motivate or coerce any person to practice abortions.&rdquo The August 1984 announcement by President Reagan of what has become known as the &ldquoMexico City Policy&rdquo directed the United States Agency for International Development (USAID) to expand this limitation and withhold USAID family planning funds from NGOs that use non-USAID funds to perform abortions, provide advice, counseling, or information regarding abortion, or lobby a foreign government to legalize abortion or make abortion services more easily available. These restrictions were rescinded by President Clinton in 1993, reinstated by President George W. Bush in 2001, and rescinded by President Obama in 2009. President Trump substantially expanded these restrictions by applying the policy to global health assistance provided by all executive departments and agencies (agencies). These excessive conditions on foreign and development assistance undermine the United States&rsquo efforts to advance gender equality globally by restricting our ability to support women&rsquos health and programs that prevent and respond to gender-based violence. The expansion of the policy has also affected all other areas of global health assistance, limiting the United States&rsquo ability to work with local partners around the world and inhibiting their efforts to confront serious health challenges such as HIV/AIDS, tuberculosis, and malaria, among others. Such restrictions on global health assistance are particularly harmful in light of the coronavirus disease 2019 (COVID-19) pandemic. Accordingly, I hereby order as follows:
Sec. 2. Revocations and Other Actions. (a) The Secretary of Health and Human Services shall review the Title X Rule and any other regulations governing the Title X program that impose undue restrictions on the use of Federal funds or women&rsquos access to complete medical information and shall consider, as soon as practicable, whether to suspend, revise, or rescind, or publish for notice and comment proposed rules suspending, revising, or rescinding, those regulations, consistent with applicable law, including the Administrative Procedure Act.
(b) The Presidential Memorandum of January 23, 2017 (The Mexico City Policy), is revoked.
(c) The Secretary of State, the Secretary of Defense, the Secretary of Health and Human Services, the Administrator of USAID, and appropriate officials at all other agencies involved in foreign assistance shall take all steps necessary to implement this memorandum, as appropriate and consistent with applicable law. This shall include the following actions with respect to conditions in assistance awards that were imposed pursuant to the January 2017 Presidential Memorandum and that are not required by the Foreign Assistance Act or any other law:
(i) immediately waive such conditions in any current grants
(ii) notify current grantees, as soon as possible, that these conditions have been waived and
(iii) immediately cease imposing these conditions in any future assistance awards.
(d) The Secretary of State, the Secretary of Defense, the Secretary of Health and Human Services, and the Administrator of USAID, as appropriate and consistent with applicable law, shall suspend, revise, or rescind any regulations, orders, guidance documents, policies, and any other similar agency actions that were issued pursuant to the January 2017 Presidential Memorandum.
(e) The Secretary of State and the Secretary of Health and Human Services, in a timely and appropriate manner, shall withdraw co-sponsorship and signature from the Geneva Consensus Declaration (Declaration) and notify other co-sponsors and signatories to the Declaration and other appropriate parties of the United States&rsquo withdrawal.
(f) The Secretary of State, consistent with applicable law and subject to the availability of appropriations, shall:
(i) take the steps necessary to resume funding to the United Nations Population Fund and
(ii) work with the Administrator of USAID and across United States Government foreign assistance programs to ensure that adequate funds are being directed to support women&rsquos health needs globally, including sexual and reproductive health and reproductive rights.
(g) The Secretary of State, in coordination with the Secretary of Health and Human Services, shall provide guidance to agencies consistent with this memorandum.
Sec. 3. General Provisions. (a) Nothing in this memorandum shall be construed to impair or otherwise affect:
(i) the authority granted by law to an executive department or agency, or the head thereof or
(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This memorandum shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
(d) The Secretary of State is authorized and directed to publish this memorandum in the Federal Register.
Barack Obama signed more executive actions in his first 12 days than Donald Trump
United States president Donald Trump signed 18 executive orders and memos in his first 12 days in office, for an average of 1.5 executive actions per day. While that may seem like an unprecedented bombardment of policy, the number of actions signed by Trump is actually one short of his predecessor. In his first 12 days in office in 2009, Barack Obama signed 19 executive actions.
These figures include both executive orders and presidential memos. Both are powerful directives issued by the executive branch a main difference between them is that presidents typically cite their legal authority in executive orders, but not in presidential memos (other subtle differences between the actions are laid out here). Between Inauguration Day and Jan. 31, Trump signed seven executive orders and 11 memos in the same time frame, Obama signed nine orders and 10 memos.
Some executive actions are controversial, some are procedural, and some simply reverse orders signed by prior presidents. Each of the past four presidents, for example, have signed an executive action either repealing (Democrats) or reinstating (Republicans) what’s known as the “Mexico City Policy,” a Reagan-era rule that withholds US funds from global organizations that provide abortion services. Trump reinstated the rule with a memo almost immediately after taking office.
Although Trump has signed fewer executive actions than Obama did in his first 12 days, Trump’s have been more varied and impactful. He’s signed an order to build a wall along the US-Mexico border, put in place a temporary ban on all refugees and restrictions on immigration from seven Muslim-majority countries, inked an order that paves the way for the repeal of the Affordable Care Act, green-lit two controversial oil pipelines, and signed an order that dramatically restructures the National Security Council.
By contrast, Obama’s most scrutinized early orders sought to ban the use of torture in enemy interrogations, shut down the Central Intelligence Agency’s overseas prisons, and close Guantanamo Bay within a year. And the idea of closing Guantanamo Bay created enough controversy that, by 2011, Obama had essentially given it up. Today a few dozen detainees still remain at the prison.
Below is a list of executive orders signed by each president since Bill Clinton in their first 12 days in office:
Trump brought back the "Mexico City Policy." Here's what it means for U.S. foreign aid and abortion.
Reinstatement of the "Mexico City Policy," as provided for in President Donald Trump's Jan. 23 executive memorandum, took effect on May 15.
"(It) ensures that U.S. taxpayers will no longer subsidize foreign nongovernmental organizations that perform or promote abortion on demand," said the co-chair of the Congressional Pro-Life Caucus.
Trump's memorandum also expanded the policy, now called "Protecting Life in Global Health Assistance," according to Rep. Chris Smith, R-New Jersey, who is the caucus co-chair.
"This humane policy seeks to respect and protect the precious lives of unborn girls and boys from the violence of abortion," Smith, a Catholic, said in a statement. "The new policy doesn't cut global health assistance by so much as a penny."
The policy was first put in place by President Ronald Reagan in 1984. It was named for the city that hosted the U.N. International Conference on Population that year and where Reagan, then in his first term as president, unveiled it.
According to a fact sheet posted on the website of the U.S. State Department, Trump's memorandum directed the U.S. secretary of state "to implement a plan to extend the Mexico City Policy to 'global health assistance furnished by all departments or agencies.'"
It said Secretary of State Rex Tillerson approved a plan, giving the policy its new name and outlining how U.S. government departments and agencies will apply its provisions to foreign nongovernmental organizations that receive U.S. funding for global health assistance.
Under the expanded policy, "global health assistance" includes funding for international health programs, such as those for HIV/AIDS, maternal and child health, malaria, global health security, and family planning and reproductive health.
"The new policy establishes pro-child safeguards—benign, humane conditions—on about $8.8 billion in annual global health assistance funding appropriated to the U.S. Agency for International Development (USAID) and the Departments of State and Defense," Smith explained in a May 17 opinion piece published by The Daily Signal, a news website.
"The new pro-child, pro-woman safeguards do not reduce funding for global health assistance by so much as a dollar," Smith said, adding that Trump included three abortion exceptions in his memorandum for the policy—for rape, incest and to save the life of the mother.
"Nothing in the policy prevents foreign NGOs from treating injuries or illnesses that were caused by any abortion," the congressman added.
"For years, pro-abortion organizations have used U.S. taxpayer funds to weaken, undermine, or reverse pro-life laws in other nations and systematically destroy the precious lives of unborn children," Smith wrote. "Scores of countries throughout the world have been besieged by aggressive and well-funded campaigns to overturn their pro-life laws and policies."
"The Protecting Life in Global Health Assistance Policy will significantly mitigate U.S. taxpayer complicity in global abortion," he said.
U.S. foreign policy "should consistently affirm, care for and tangibly assist women and children," Smith said, calling for increased access to maternal and prenatal care, safe blood and better nutrition, and the expansion of essential obstetrical services, "including skilled birth attendants, while improving transportation to emergency care facilities to significantly reduce maternal mortality and morbidity."
He urged there be "a priority for programs that ensure adequate nutrition and supplementation for moms and children during the all-important first 1,000 days of life."
"No one is expendable or a throwaway. Every human life has infinite value. Birth is merely an event, not the beginning of the life of a child," Smith added.
Prioritizing Sexual and Reproductive Health and Reproductive Rights in U.S. Foreign Policy
Today, President Biden signed a Presidential Memorandum revoking the January 23, 2017 Presidential Memorandum on the Mexico City Policy. Pursuant to President Biden’s memorandum, the previous administration’s Protecting Life in Global Health Assistance policy has also been rescinded.
In the Biden-Harris administration, the empowerment and protection of women and girls, including promoting their sexual and reproductive health and rights, is a central part of U.S. foreign policy and national security. Today’s action by President Biden will help improve the lives of women and children around the world by expanding the base of partners implementing U.S. health assistance and increasing access to critical health services, including HIV/AIDS care for key populations, family planning information and services, and effective tuberculosis diagnosis and treatment.
Pursuant to President Biden’s memorandum, and consistent with applicable law, the State Department is also taking the necessary steps to make $32.5 million appropriated by Congress available in 2021 to support the United Nations Population Fund (UNFPA). UNFPA’s work is essential to the health and well-being of women around the world and directly supports the safety and prosperity of communities around the globe, especially in the context of the global COVID-19 pandemic.
As the largest donor to both maternal health and voluntary family planning programs, including the provision of life-saving health care services in crisis settings, the United States will continue its efforts to make pregnancy and childbirth safer by strengthening health systems to provide women with integral health services, including increased access to maternal health care and voluntary family planning. The United States will also partner with governments, the private sector, and international and non-governmental organizations to improve health outcomes and empower women and girls so that they can realize their full potential and help drive social and economic development.
Finally, the United States will withdraw co-sponsorship and signature from the Geneva Consensus Declaration in a timely and appropriate manner. Under President Biden’s leadership, the United States is re-engaging multilaterally to protect and promote the human rights of all women and girls, consistent with the long-standing global consensus on gender equality and sexual and reproductive health and reproductive rights.
Key Facts
- On January 23, 2017, President Trump reinstated and expanded the Mexico City Policy requiring foreign NGOs to certify that they will not “perform or actively promote abortion as a method of family planning,” using any funds (including non-U.S. funds), as a condition for receiving U.S. government global health assistance. The U.S. government issued initial guidance related to U.S. global family planning assistance on March 2, and further guidance on other U.S. global health assistance is expected soon.
- This data note assesses how the Mexico City Policy affects the provision of legal abortion services in U.S. assisted countries.
- It finds that the majority of countries that received U.S. bilateral global health assistance in FY 2016 (37 of 64), allow for legal abortion in at least one case not permissible by the MCP. These countries accounted for 53% of bilateral global health assistance. In all other countries, abortion is not legal beyond what is permissible by the MCP, although other activities are prohibited by the policy.
- While foreign NGO recipients of U.S. global health assistance will be required to certify that they are in compliance with the MCP regardless of where they work, where countries’ laws allow for abortion in cases not permitted by the MCP, they will be prohibited from providing legal services with non-U.S. funds as a condition of receiving U.S. assistance.
Introduction
| Table 1: Mexico City Policy Conditions – Key Definitions 4 |
| The Mexico City Policy requires foreign NGOs to certify, as a condition of receiving U.S. global health assistance, that they will not “perform or actively promote abortion as a method of family planning” with any funds, including non-U.S. funds. The following definitions apply: 5 ABORTION IS A METHOD OF FAMILY PLANNING WHEN used for the purpose of spacing births (including, for example, abortion to preserve a woman’s physical or mental health). TO PERFORM ABORTION means to operate a facility where abortions are performed as a method of family planning. TO ACTIVELY PROMOTE ABORTION means for an organization to commit resources to increase the availability or use of abortion as a method of family planning by: |
- operating a family planning counseling service that provides advice and information regarding the benefits and availability of abortion as a method of family planning
- providing advice that abortion is an available option in the event that other methods of family planning are not used or are not successful or encouraging women to consider abortion
- lobbying a foreign government to legalize (or continue legality of) or make available abortion as a method of family planning and
- conducting a public information campaign regarding the benefits and/or availability of abortion as a method of family planning.
Excluded from these definitions are the following EXCEPTIONS (allowable activities):
- abortion in cases where the pregnancy either poses a risk to a woman’s life or is the result of incest or rape 6
- treatment of injuries or illnesses caused by legal or illegal abortions (e.g., post-abortion care) and
- responding to a question regarding where a safe, legal abortion may be obtained if the question is specifically asked by a woman who is already pregnant, she clearly states that she has already decided to have a legal abortion, and the family planning counselor reasonably believes that the ethics of the medical profession in the country requires a response regarding where it may be obtained safely.
Analysis
- In FY16, the U.S. provided bilateral global health assistance to 64 countries. More than half (34) were countries in Africa. The next largest region was East Asia and the Pacific (9). Funding for PEPFAR was directed to the greatest number of countries (41), followed by MCH (35) and FP/RH (34). Together, bilateral global health assistance in these 64 countries totaled just over $6.1 billion in FY16. 9
- Among these 64 countries, 37 allow for legal abortion in at least one case not permissible under the MCP. 10 Most (22) were in Africa the next largest region was South/Central Asia (6). In nearly all of these countries (35), abortion is legal to preserve a woman’s physical health. In 28 countries, abortion is legal in the case of fetal impairment. PEPFAR reached the greatest number of countries (25) in this group, followed by MCH (18), NTDs/other public health threats (17), and FP/RH (16) (see Tables 2 & 3). Together, these 37 countries accounted for 53% of bilateral global health assistance in FY16.
- In 27 countries, abortion is not legal in any case beyond the MCP exceptions. Almost half of these countries were in Africa (12), followed by Latin America/Caribbean (5) and East Asia and the Pacific (5). Most of these countries (25) have abortion laws that are more restrictive than the MCP, allowing abortion only to save a woman’s life only 2 also allow abortion in the cases of rape or incest. FP/RH reached the greatest number of countries (18) in this group, followed by MCH (17), PEPFAR (16), water supply/sanitation (16), and NTDs/other public health threats (16) (see Tables 2 & 3). Together, these 27 countries accounted for 47% of U.S. bilateral global health assistance in FY16.
- The MCP affects these two groups of countries differently. Where a country’s laws allow for abortion in cases not permissible under the MCP, foreign NGOs would be prohibited from providing legal services with non-U.S. funds as a condition of receiving U.S. global health assistance. Where a country’s laws do not allow for abortion beyond what is permissible by the MCP, the policy would not curtail legal abortion services, although it would still prohibit other activities, such as providing counseling about abortion as a method of family planning (see Table 1). In all cases, foreign NGO recipients of U.S. global health assistance will be required to certify that they are in compliance with the MCP. 11 In addition, any U.S. NGO recipient of global health assistance who in turn provides a sub-award to a foreign NGO will be required to ensure that the foreign NGO certified its compliance with MCP.
Figure 1: Abortion Laws in Countries Receiving Bilateral U.S. Global Health Assistance, FY 2016
Figure 2: Map of Abortion Laws in Countries Receiving Bilateral U.S. Global Health Assistance, FY 2016
| Table 2: Abortion Laws in Countries Receiving Bilateral U.S. Global Health Assistance, by Program Area, FY 2016 12 | ||
| Program Area | Abortion Legal in at Least One Case Not Permissible by MCP (# of Countries) | Abortion Not Legal Beyond What Is Permissible by MCP (# of Countries) |
| FP/RH | 16 | 18 |
| PEPFAR (HIV) | 25 | 16 |
| Malaria | 13 | 11 |
| MCH | 18 | 17 |
| Nutrition | 13 | 13 |
| TB | 13 | 10 |
| Water Supply & Sanitation | 14 | 16 |
| NTDs/Other Public Health Threats | 17 | 16 |
| NOTES: MCP means Mexico City Policy. FP/RH means family planning/reproductive health. MCH means maternal and child health. TB means tuberculosis. NTDs means neglected tropical diseases. Analysis assumes that the final guidance on the MCP will include the same abortion-related provisions as the guidance released on March 2, 2017. | ||
Endnotes
White House, “The Mexico City Policy,” Memorandum for the Secretary of State, the Secretary of Health and Human Services, the Administrator of the Agency for International Development, Jan. 23, 2017, https://www.whitehouse.gov/the-press-office/2017/01/23/presidential-memorandum-regarding-mexico-city-policy.
“Policy Statement of the United States of America at the United Nations International Conference on Population (Second Session), Mexico City, Mexico, August 6-14, 1984,” undated Bill Clinton Administration, “Subject: AID Family Planning Grants/Mexico City Policy,” Memorandum for the Acting Administrator of the Agency for International Development, January 22, 1993, National Archives and Records Administration’s Clinton Presidential Materials Project, https://clinton6.nara.gov/1993/01/1993-01-22-aid-family-planning-grants-mexico-city-policy.html FY 2000 Consolidated Appropriations Act, P.L. 106-113 George W. Bush Administration, “Subject: Restoration of the Mexico City Policy,” Memorandum for the Administrator of the United States Agency for International Development, January 22, 2001, Bush Administration White House Archives, https://georgewbush-whitehouse.archives.gov/news/releases/20010123-5.html “Subject: Restoration of the Mexico City Policy,” Memorandum for the Administrator of the United States Agency for International Development, March 28, 2001, Federal Register, https://www.federalregister.gov/documents/2001/03/29/01-8011/restoration-of-the-mexico-city-policy George W. Bush Administration, “Subject: Assistance for Voluntary Population Planning,” Memorandum for the Secretary of State, August 29, 2003, Bush Administration White House Archives, http://georgewbush-whitehouse.archives.gov/news/releases/2003/08/20030829-3.html Barack Obama Administration, “Mexico City Policy and Assistance for Voluntary Population Planning,” Memorandum for the Secretary of State, the Administrator of the United States Agency for International Development, January 23, 2009, https://www.whitehouse.gov/the-press-office/mexico-city-policy-and-assistance-voluntary-population-planning White House, “The Mexico City Policy,” Memorandum for the Secretary of State, the Secretary of Health and Human Services, the Administrator of the Agency for International Development, Jan. 23, 2017, https://www.whitehouse.gov/the-press-office/2017/01/23/presidential-memorandum-regarding-mexico-city-policy.
USAID, “Standard Provisions for U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303maa, partial revision March 2, 2017, https://www.usaid.gov/ads/policy/300/303maa USAID, “Standard Provisions for Non-U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303mab, partial revision March 2, 2017, https://www.usaid.gov/ads/policy/300/303mab.
USAID, “Standard Provisions for U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303maa, partial revision March 2, 2017, https://www.usaid.gov/ads/policy/300/303maa USAID, “Standard Provisions for Non-U.S. Nongovernmental Organizations: A Mandatory Reference for ADS Chapter 303,” ADS Reference 303mab, partial revision March 2, 2017, https://www.usaid.gov/ads/policy/300/303mab.
Assumes that the final guidance on the MCP will include the same abortion-related provisions as the guidance released on March 2.
Kaiser Family Foundation analysis of data from the U.S. Foreign Assistance Dashboard (http://beta.foreignassistance.gov/) and USAID NTD Program website (NeglectedDiseases.gov). The U.S. Foreign Assistance Dashboard includes global health funding provided to countries by USAID and the Department of State only, but not funding provided by the CDC. Our analysis includes all bilateral global health assistance provided to countries but not assistance designated as regional or worldwide, which may in turn be provided to countries but is not identifiable by country (estimated to be approximately $1.1 billion in FY16). It also does not include global health assistance provided to multilateral institutions, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, GAVI, and others, which totaled approximately $2 billion in FY16, and are expected to be exempt from MCP requirements.
Kaiser Family Foundation analysis of data from the United Nations, World Population Policies Database (http://esa.un.org/poppolicy/about_database.aspx), and the Center for Reproductive Rights, The World’s Abortion Laws Database (http://worldabortionlaws.com/), for 2015.
FY16 funding amount does not include $100 million that was provided for NTDs, which is not identifiable by country.
These 37 countries include 9 countries that, while allowing for legal abortion in at least one case not permitted by the MCP, do not allow abortion in all MCP excepted cases (e.g., allow abortion to preserve a woman’s physical health but not in the cases of rape or incest).
While all foreign NGOs will be required to certify that they are in compliance with the MCP, not all foreign NGOs provide services that are prohibited by the MCP. Such an assessment was beyond the scope of this analysis.
Presidential Memrandum: Mexico City Policy and Assistance for Voluntary Population Planning - History
THE ADMINISTRATOR OF THE UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT
SUBJECT: Mexico City Policy and Assistance for Voluntary Population Planning
The Foreign Assistance Act of 1961 (22 U.S.C. 2151b(f)(1)), prohibits nongovernmental organizations (NGOs) that receive Federal funds from using those funds "to pay for the performance of abortions as a method of family planning, or to motivate or coerce any person to practice abortions." The August 1984 announcement by President Reagan of what has become known as the "Mexico City Policy" directed the United States Agency for International Development (USAID) to expand this limitation and withhold USAID funds from NGOs that use non-USAID funds to engage in a wide range of activities, including providing advice, counseling, or information regarding abortion, or lobbying a foreign government to legalize or make abortion available. The Mexico City Policy was in effect from 1985 until 1993, when it was rescinded by President Clinton. President George W. Bush reinstated the policy in 2001, implementing it through conditions in USAID grant awards, and subsequently extended the policy to "voluntary population planning" assistance provided by the Department of State.
These excessively broad conditions on grants and assistance awards are unwarranted. Moreover, they have undermined efforts to promote safe and effective voluntary family planning programs in foreign nations. Accordingly, I hereby revoke the Presidential memorandum of January 22, 2001, for the Administrator of USAID (Restoration of the Mexico City Policy), the Presidential memorandum of March 28, 2001, for the Administrator of USAID (Restoration of the Mexico City Policy), and the Presidential memorandum of August 29, 2003, for the Secretary of State (Assistance for Voluntary Population Planning). In addition, I direct the Secretary of State and the Administrator of USAID to take the following actions with respect to conditions in voluntary population planning assistance and USAID grants that were imposed pursuant to either the 2001 or 2003 memoranda and that are not required by the Foreign Assistance Act or any other law: (1) immediately waive such conditions in any current grants, and (2) notify current grantees, as soon as possible, that these conditions have been waived. I further direct that the Department of State and USAID immediately cease imposing these conditions in any future grants.
This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.
The Secretary of State is authorized and directed to publish this memorandum in the Federal Register.
