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Janez Lenarčič European Commissioner for Crisis Management Rue De La Loi / Wetstraat 200 1049 Brussels, Belgium

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Janez Lenarčič European Commissioner for Crisis Management Rue De La Loi / Wetstraat 200 1049 Brussels, Belgium Janez Lenarčič European Commissioner for Crisis Management Rue de la Loi / Wetstraat 200 1049 Brussels, Belgium Brussels, 23 July 2020 Dear Commissioner Lenarčič, We are writing in our capacity as Members of the European Parliament all party parliamentary group for Sexual and Reproductive Rights (“MEPs for SRR”) to follow up on the Commission’s 15 April 2020 answer to the 20 February 2020 Written Parliamentary Question regarding the EU’s support for ensuring the right to safe abortion for war rape victims in accordance with international humanitarian law (IHL). We welcome the Commission’s re-affirmation of its 2015 policy on funding safe abortion care in conflict settings as matter of right. As the policy acknowledges, international humanitarian and human rights law protect the provision of abortion services as non-discriminatory medical care. Survivors of armed conflict face a high risk of unwanted pregnancy due to exposure to frequent, forced, and unprotected sex, and a lack of access to contraception.1 Nearly half of women who become pregnant from sexual violence seek or undergo termination of their pregnancy, often using medications or herbs obtained outside the formal healthcare sector.2 Unsafe abortion is a major factor in maternal morbidity and mortality. Ten percent of maternal deaths globally are the result of unsafe abortion3; 97% of those are in the developing world.4 Pregnant people are entitled to all necessary medical care required to treat their condition.5 While different sexes may require different treatments, all sexes must enjoy equality in medical outcomes.6 For persons who become pregnant from conflict-related sexual violence, the option of a safe abortion is therefore indispensable to guaranteeing equality of care. Moreover, human rights bodies, particularly the Committee Against Torture and the Human Rights Committee, have found that failing to provide access to abortion services may amount to torture or cruel, inhuman, or degrading treatment.7 As a humanitarian donor, the EU has legal obligations to protect and fulfill the rights to non-discriminatory medical care and to be free from torture and inhuman treatment.8 Indeed, the Commission’s budget for Delivery of rapid, effective and needs-based humanitarian aid and food assistance specifically requires that EU humanitarian aid be “granted to victims without discrimination or adverse distinction on the basis of…sex” and “provided in accordance with international humanitarian law.”9 Since the Commission’s policy was first announced in 2015, the importance of abortion services in conflict settings has been reaffirmed in numerous different instruments and campaigns, including the SheDecides Campaign, the Inter-Agency Field Manual on Reproductive Health in Crisis, and the Sphere Handbook. We welcome and applaud former Commissioner Stylianides’s 2019 reiteration the European Union’s commitment to respond to gender-based acts of violence, as well as its active membership of the Call to Action on Protection from Gender-Based Violence in Emergencies. Despite the above EU commitments and advancements, the provision of abortion services is still missing or largely ignored by humanitarian health actors.10 Case-studies in Mali, Lebanon, Burkina Faso, the Democratic Republic of the Congo, and South Sudan all highlight the unavailability of abortion in crisis situations.11 Several studies have found a reluctance or resistance among reproductive health care workers to providing abortion services.12 For example, an analysis of the Médecins Sans Frontières’ experience in implementing safe abortion care determined that the main challenge was actually internal resistance amongst staff.13 Humanitarian aid providers are often unsure of what is permitted by laws and policy and erring on the side of caution—rather than on the side of patients’ rights—makes it easier to dismiss services such as safe abortion which carry stigma and are viewed as controversial.14 In humanitarian aid communications on the Commission website15 stigmatic language when referring to abortion can be found as well, such as in reports addressing neonatal mortality. Notably, one of the most commonly cited reasons that humanitarian organizations use to justify non-provision of safe abortion care is the restrictions imposed by donor funding.16 Other barriers to the provision of abortion services in conflict settings include: lack of awareness of the necessity and types of sexual and reproductive health interventions required during a crisis; a lack of human resources in providing sexual and reproductive health services in the field; poor logistics and stocking of reproductive health supplies; and poor coordination leading gaps in services.17 Accordingly, we write to express our concern that the EU is not doing enough fulfil its obligation under international law to ensure that survivors of armed conflict are able to access the medical care to which they are entitled. While we appreciate that providing medical care in conflict settings presents myriad technical and security challenges, the EU is legally and morally responsible to dispense aid in a way that protects and fulfills the rights of people affected by conflict. Consistent with the recent EU Gender Action Plan II (GAP II) evaluation findings, we are witnessing a mismatch between the EU policy ambitions in Gender Equality and Women’s Empowerment (GEWE) and the resources aligned to achieve them.18 Thus, we reiterate the February questions posed to the Commission: Can the Commission provide an overview of the concrete actions undertaken to implement its policy on abortion services in conflict settings? What proactive steps has the Commission taken to communicate this policy to humanitarian partners, both on the ground and at their respective headquarters? We further request that the European Commission make clear to ECHO partners that international law – not subjective decisions – determines the right to medical care of women and girls affected by armed conflict, and take the following steps: Issue a memorandum to EU humanitarian partners and grantees to inform them of the EU’s policy concerning safe abortions for war rape victims, IHL’s protections for medical personnel, and the primacy of IHL in armed conflict settings. Develop a monitoring and reporting framework together with your humanitarian partners and grantees to ensure IHL obligations are met, and specifically that women and girls receive appropriate care, including the provision of safe abortion under the conditions set out in your policy. Ensure EU funds are kept separate from US humanitarian funds in all accounts, and separate from any other donor funds that may prevent EU aid from being administered in full compliance with IHL. These actions will help the European Commission fulfil its obligations under IHL and respond to specific GAP II evaluation findings that call for the Commission to address gender stereotypes and discriminatory social norms; promote freedom from SGBV and its consequences; promote the rights of girls and women; and advance sexual and reproductive health and rights for all. We kindly request the Commission to provide a copy of the proffered 8 January 2018 letter from former HR/VP Mogherini and Commissioner Stylianides to several non-governmental organizations stating that humanitarian partners are free, and have always been free, to choose the most appropriate treatment for their patients in light of the given contextual factors. We urge you to take decisive action and thank you for your attention to this important matter. We welcome the opportunity to discuss these issues and how we can work together to ensure that the humanitarian aid policy both fulfills the legal standards and protects the rights of survivors of conflict. Yours sincerely, Sophie in ‘t Veld Petra De Sutter Maria Arena Robert Biedroń Malin Björk Olivier Chastel Gwendoline Delbos-Corfield Sylvie Guillaume Heidi Hautala Pierrette Herzberger-Fofana Miapetra Kumpula-Natri Frances Fitzgerald Predrag Fred Matić Karen Melchior Terry Reintke Philippe Lamberts Maria Eugenia Rodríguez Palop Massimiliano Smeriglio Sylwia Spurek Vera Tax Irène Tolleret Hilde Vautmans Chrysoula Zacharopoulou Samira Rafaela Members of the European Parliaments 1 Oladeji, O., et al, Sexual Violence–Related Pregnancy Among Internally Displaced Women in an Internally Displaced Persons Camp in Northeast Nigeria, Journal of Interpersonal Violence, 1-13, (2018) doi:10.1177/0886260518792252. 2 Rouhani, S. et al, A Quantitative Assessment of Termination of Sexual Violence-Related Pregnancies in Eastern Democratic Republic of Congo, Conflict and Health, 10(1), 1-9 (2016) doi:10.1186/s13031-016-0073-x. 3 Special tabulations of data from Say et al., Global causes of maternal death: a WHO systematic analysis, Lancet Global Health, 2014, 2(6):e323–e333, http://dx.doi.org/10.1016/S2214-109X(14)70227-X. 4 Singh, S. et al, Abortion Worldwide: Uneven Progress and Uneven Access, Guttmacher Institute (2017), https://www.guttmacher.org/report/abortion-worldwide-2017. 5 ICRC, 2016 Commentaries to Geneva Convention I, Art. 3 ¶ 387; Protocol Additional (II) to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of Armed Conflicts, art. 8(a), Jun. 8, 1977, 1125 U.N.T.S. 302. 6 International Committee of the Red Cross, ‘Women Facing War: ICRC study on the impact of armed conflict on women’ (October 2001), at 20; Geneva Convention (III) Relative to the Treatment of Prisoners of War, (1950) 75 UNTS 135, art. 14; Commentaries to Geneva Convention (IV) Relative to the Treatment of Civilians in War art. 13, para. 2. 7 See UN Human Rights Committee, KL v. Peru, ¶ 6.6, U.N. Doc. CCPR/C/85/1153/2003 (Nov. 22, 2005); Human Rights Committee, Concluding Observations on Nicaragua, U.N. Doc. CCPR/C/NIC/CO/3 (2008), ¶ 13; UN Committee against Torture (CAT Committee), Concluding Observations: El Salvador, para. 23, U.N. Doc. CAT/C/SLV/CO/2 (2009). 8 See Court of Justice of the European Union Judgment in Case T-561/14 European Citizens' Initiative One of Us and others v Commission (23 April 2018); Judgment in Case C-266/16 Western Sahara Campaign UK v.
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