Access Denied: Nepal
Preliminary Impacts of Trump's Expanded Global Gag Rule in Nepal
In Nepal, the Global Gag Rule provides a stark example of how harmful U.S. policy can risk unraveling country progress on sexual and reproductive health and rights. Not only will the Global Gag Rule make U.S. investments in Nepal less effective by dismantling integrated U.S. global health assistance programs, it will also undermine government initiatives to integrate family planning with other health services and achieve universal health coverage. In all cases, adolescents, migrants, rural and other marginalized communities are most at risk of losing access to reproductive health services and supplies.
Over the past 15 years, Nepal has made important progress in increasing access to and improving the quality of sexual and reproductive health information and services. Significant among these is the legalization of abortion in 2002, which has contributed to sharp reductions in maternal mortality. Other principles guaranteeing the fulfillment of sexual and reproductive health and rights are enshrined in Nepal’s 2015 constitution, underscoring that “[every] woman shall have the right relating to safe motherhood and reproductive health.” The Trump-Pence administration’s expanded Global Gag Rule not only fundamentally contravenes the constitutionally guaranteed rights of Nepal’s citizens and the particular protections afforded to women, but further threatens more than a decade of the country’s progress on health.
The Global Gag Rule prohibits foreign nongovernmental organizations (NGOs) 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 or liberalization of safe abortion services if they want to continue receiving U.S. global health 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 as well as other programming.
To document the preliminary impacts of the Global Gag Rule on women’s sexual and reproductive health and rights, PAI conducted a fact-finding trip to Kathmandu, Nepal, in May 2018. The policy is already having several damaging effects. These impacts include: worsening contraceptive insecurity; dismantling partnerships, especially at the subnational level; inhibiting outreach to hard-to-reach, vulnerable and marginalized populations; increasing donor dependency; exacerbating abortion stigma and emboldening anti-choice opponents; and creating a dearth of implementing partners for U.S. agencies to carry out their own health-related objectives. The policy’s impacts are further compounded by challenges related to the United States defunding the United Nations Population Fund (UNFPA).