Let’s Not Sugar Coat It—A Quick First Take on the Implications for International Family Planning Programs in a Second Trump Term

Let’s Not Sugar Coat It—A Quick First Take on the Implications for International Family Planning Programs in a Second Trump Term

Thursday, November 7, 2024

President-elect Trump’s election night statement, “We’re going to help our country heal,” is as improbable as George W. Bush’s pledge to be “a uniter, not a divider” when it comes to the issue of abortion. The task of further undermining reproductive rights at home and abroad is one with a high probability of fulfillment during the second Trump administration, contrary to American public opinion. Let’s not sugar coat it—the implications of Trump’s re-election for continued U.S. leadership on international family planning and reproductive health (FP/RH) programs will be bad. The only questions that remain—are just how bad and how fast.

This election cycle has been unprecedented in many ways, not the least of which is the degree to which reproductive rights and freedom have been at the forefront of campaigns, ballot initiatives and public discourse. After the Dobbs decision in 2022 overturned five decades of legal precedent establishing a constitutional right to abortion, how could reproductive rights not be a central issue in this November’s presidential and congressional races?

In many ways, 2025 harkens back to 2017 when the first Trump administration enjoyed Republican majorities in both the House and Senate. In many other ways, however, things are vastly different. A number of the individuals in the first Trump administration—both political appointees and civil servants—who deserve credit for moderating some of the more extreme anti-sexual and reproductive health and rights (SRHR) policy proposals are gone or will leave, to be replaced by MAGA loyalists and Trump acolytes.

This time, the GOP has fundamentally shifted on abortion and contraception and will align closely with Trump, meaning that the few responsible Republicans left in Congress, to the extent they still exist, will be less likely to be able to temper the ambitions of their more extreme caucus colleagues. In fact, many already share the same radical opposition to global SRHR advancement. Last year’s  PEPFAR reauthorization debacle, during which Republican legislators refused to sign off on a continuation of global HIV/AIDS programs for the next five years without first attempting to use the vast popularity of the programs to extract a reimposition of the Global Gag Rule (GGR) on them as the price, is the most damning recent example of this trend.

While the first Trump administration took quite some time to get up and running after its unexpected victory in 2016 and fill key positions, this administration has the backing of organizations like the Heritage Foundation, which has published a 922-page policy manifesto, the infamous Project 2025, for the new administration to follow and teed up mechanisms to train and vet Trump loyalists to join the federal government replacing career civil servants. It leaves nothing to the imagination about how unapologetic the Trump administration would likely be in restricting women’s access to health care—specifically, as it pertains to the GGR—among other threats to global SRHR, most notably defunding the United Nations Population Fund (UNFPA).

Reinstatement of the GGR was one of the first official acts by Republican presidents George W. Bush and Trump after their inaugurations on January 20. A similar “day-one” timing of the issuance of a presidential memorandum reinstating the GGR in some form—most likely a more all-encompassing version of the GGR in place during the Trump first term—and conveying his intention to withhold all U.S. financial support to UNFPA is expected.

Project 2025 would take the already draconian GGR restrictions a step further by proposing that, upon reinstating the GGR, the rule should not only apply to foreign nongovernmental organizations accepting U.S. global health funding but those taking any U.S. foreign assistance funding at all, including humanitarian aid. It proposes a further dramatic expansion of the GGR by applying the rule to American nongovernmental organizations, the United Nations, other multilateral organizations and even foreign governments, jeopardizing these entities’ eligibility to receive U.S. foreign assistance.

As the Biden-Harris administration and the 118th Congress draw to a close, there is still much work to be done when the House and Senate return next week for a lame-duck session—most urgently, finalizing the fiscal year (FY) 2025 appropriations process before the current continuing resolution (CR) keeping the federal government open expires on December 20.

Republican House leaders are consulting with Trump transition aides on how to proceed—whether to try to complete an omnibus spending package before adjourning for the holidays to give the newly-inaugurated president a clean start in January or passing a short-term CR kicking final decisions on FY 2025 appropriations into the new year and a new Congress. The decision on timing could significantly impact whether the status quo on international FP/RH funding and policy that has existed for the last 14 years can be maintained. Such an outcome would constitute a significant achievement in the current political moment in which we find ourselves.

Only time will tell, but true healing for this country—and for the millions of people who rely on foreign assistance and American leadership for their survival—should include continuing support for U.S. leadership and investments in international FP/RH programs.

At the time of publication, it is already clear that the new Senate will have a Republican majority, but of a still uncertain size. Party control of the House will be determined by the outcome of several close, contested races that remain to be called. Stay tuned for more in-depth analyses of election results and their implications for international FP/RH programs in the coming days and weeks.