If you’re an American health NGO or an international health organization working with US government-funded assistance programs that include abortion as part of family planning, this is essential reading!
When President-elect Donald Trump steps into office on January 20, 2025, his early actions will have a significant impact on USG-funded assistance programs. Expect to see stricter guidelines regarding abortion services in foreign aid initiatives.
Indeed, the Trump administration plans to bring back the Protecting Life in Global Health Assistance (PLGHA) policy, which restricts the use of US federal funds for any abortion-related services and advocacy. This policy mainly affects foreign NGOs that receive US funding, as they must certify that they won’t use their own resources—or any other funding source—to provide abortion services as part of family planning in order to qualify for assistance. However, it’s worth noting that this rule does not apply to US-based NGOs due to the so-called “unconstitutional conditions doctrine.”
That being said, a lot has shifted since Trump’s first term, particularly in light of the evolving legal landscape after the Dobbs v. Jackson Women’s Health Organization case.
Historical Background
- 1973 – Roe v. Wade marked a pivotal moment in legalizing abortion in the United States.
- 1973 – In response to Roe v. Wade, the US Congress passed the Helms Amendment, modifying the Foreign Assistance Act to prevent U.S. funds from being used for abortion services as a method of family planning, or to coerce individuals into obtaining abortions. However, it did allow for the use of U.S. funds for post-abortion care.
- 1984 – The Reagan administration introduced the “Mexico City Policy,” also known as the “global gag rule.” This policy sought to impose further restrictions on abortion by limiting foreign NGOs from providing or promoting abortion services, even with their own financial resources.
- Since then, both Democratic and Republican administrations have alternately rescinded and reinstated this policy.
- January 23, 2017 – President Trump reinstated the Mexico City Policy. On May 15, 2017, the State Department announced the PLGHA: a broader application of the Mexico City Policy, extending its requirements to global health assistance provided by all departments and agencies. This included not just family planning assistance from USAID, but also support for initiatives related to HIV/AIDS, maternal and child health, infectious disease prevention, global health security, and reproductive health.
What can you expect from the new Trump administration?
Scenario 1 (the softer approach): If the Trump-era policy known as PLGHA is brought back in its most recent version, it will simply require NGOs that use federal funds for assistance programs to commit to not offering health support from a U.S. grant to any foreign NGO that either performs or actively promotes abortion as a method of family planning.
Scenario 2 (this seems pretty likely) – In light of the recent overturning of Roe v. Wade, which stripped away the constitutional protections for abortion rights in the U.S., and with Republicans now in control of both Congress and the Supreme Court, the second Trump administration might seize the chance to blur the lines between the restrictions placed on domestic and foreign NGOs. This means that ALL NGOs (whether U.S. based or not) that receive US federal funding for their assistance programs could be required to promise not to provide health assistance from U.S. grants to any NGO (regardless of their origin) that either performs or actively promotes abortion as a method of family planning— even if they’re using their own funds.
Scenario 3 (Expansion to ALL Foreign Assistance) – They might not only impose restrictions on domestic NGOs that no longer enjoy protections, but also broaden the PLGHA to include all contracts (not just grants and cooperative agreements), and extend the limitations beyond global health assistance to cover other forms of aid. They could also impose stricter rules on NGOs when it comes to funding other NGOs involved in abortion-related activities, whether it’s their own cash or contributions from other donors. The reach of PLGHA might not just affect non-governmental organizations; it could also extend to public international organizations and government-affiliated entities. Additionally, there’s a chance that the rules permitting U.S. funds to be used for post-abortion care could be scrapped.