The U.S. government has historically been an important development partner in Ethiopia. However, harmful U.S. foreign policy has the potential to roll back reproductive health gains made in the last decade. In 2005, when the Mexico City Policy was in effect, Ethiopian advocates and health providers prevailed in securing a more liberal abortion law. The government’s widespread implementation of the law and the expansive guidelines it issued have been instrumental in reducing maternal deaths due to unsafe abortion. The expanded Global Gag Rule imposed by the Trump-Pence administration in 2017—entitled “Protecting Life in Global Health Assistance”—flies in the face of what the Ethiopian government, public health experts and civil society know: legal, safe abortion care is critical to saving lives.

The Global Gag Rule effectively prohibits foreign nongovernmental organizations from using their private, non-U.S. funds to provide comprehensive, safe abortion services; information or referrals for abortions; or to advocate for the legalization of safe abortion services for reasons other than life endangerment, rape or incest if they want to continue receiving U.S. assistance. Importantly, the expanded Global Gag Rule applies to all U.S. global health assistance, impacting not just reproductive health and family planning, but maternal and child health, HIV/AIDS prevention and treatment, and other programming. The Trump-Pence administration’s hostility toward sexual and reproductive health and rights, combined with the expanded Global Gag Rule and the defunding of the United Nations Population Fund (UNFPA), risk undermining not only the effectiveness and efficiency of U.S. health investments in Ethiopia, but also harming vulnerable populations dependent on U.S.-supported programs and services.

In February 2018, PAI conducted a fact-finding trip to Addis Ababa, Ethiopia to document the preliminary impact of Trump’s Global Gag Rule on women’s sexual and reproductive health and rights. At the time of publication, key populations who rely on the private sector—such as adolescents and youth, people living with HIV/AIDS and sex workers—are directly being affected by the closure of previously U.S.-supported health clinics. Additional impacts include: the loss of key U.S. partners for service delivery; the dismantling of partnerships between compliant and noncompliant organizations; the undermining of other donors’ health programs and projects; and the uncertainty of securing future funding for sexual and reproductive health commodities.

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