Nigeria is the single largest recipient of U.S. international development aid and relies heavily on global health assistance to meet the needs of its large and growing population. The Trump-Pence administration policy, “Protecting Life in Global Health Assistance,” (commonly referred to as the Global Gag Rule by opponents) risks overburdening the underfunded public health sector and undermining the reproductive and overall health goals in Nigeria.
To document the preliminary impacts of Trump’s Global Gag Rule on women’s sexual and reproductive health and rights, PAI conducted a fact-finding trip to Abuja, Nigeria, in December 2017. These impacts include: commodity insecurity; the loss of key U.S. health partners; the financial and administrative burden of compliance; the cost of foregoing U.S. global health assistance; and the chilling effects on advocacy with an increasingly hostile domestic environment for sexual and reproductive health and rights.
Nigeria provides a clear example of how the interaction of U.S. policies and funding decisions can have outsized ramifications for sexual and reproductive health and rights in a country. The Global Gag Rule does not apply to multilaterals like the United Nations Population Fund (UNFPA). However, as foreign NGOs lose access to U.S. funding and U.S.-donated contraceptive supplies due to the policy, they have scaled back services, pushing more clients to public sector facilities and increasing demand for commodities procured by UNFPA. Unfortunately, the agency is already experiencing a significant funding shortfall. U.S. government funding has historically supported UNFPA’s core and humanitarian work. The defunding of UNFPA places a strain on the agency and UNFPA Supplies, and has raised alarms among advocates and providers in Nigeria given the agency’s central role in contraceptive security. Any further reductions in UNFPA’s capacity will cascade down, hitting hardest the organizations working with the most vulnerable populations and severely disrupting health supplies. Additionally, despite the fact that the Global Gag Rule does not impact humanitarian funding, there are questions about how organizations who serve displaced populations will continue their work if they no longer receive U.S. funding.