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The Mexico City Policy/Global Gag Rule: Its Impact on Family Planning and Reproductive Health

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The Mexico City Policy/Global Gag Rule: Its Impact on Family Planning and Reproductive Health THE MEXICO CITY POLICY/GLOBAL GAG RULE: ITS IMPACT ON FAMILY PLANNING AND REPRODUCTIVE HEALTH HEARING BEFORE THE COMMITTEE ON FOREIGN AFFAIRS HOUSE OF REPRESENTATIVES ONE HUNDRED TENTH CONGRESS FIRST SESSION OCTOBER 31, 2007 Serial No. 110–121 Printed for the use of the Committee on Foreign Affairs ( Available via the World Wide Web: http://www.foreignaffairs.house.gov/ U.S. GOVERNMENT PRINTING OFFICE 38–605PDF WASHINGTON : 2008 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 COMMITTEE ON FOREIGN AFFAIRS TOM LANTOS, California, Chairman HOWARD L. BERMAN, California ILEANA ROS-LEHTINEN, Florida GARY L. ACKERMAN, New York CHRISTOPHER H. SMITH, New Jersey ENI F.H. FALEOMAVAEGA, American DAN BURTON, Indiana Samoa ELTON GALLEGLY, California DONALD M. PAYNE, New Jersey DANA ROHRABACHER, California BRAD SHERMAN, California DONALD A. MANZULLO, Illinois ROBERT WEXLER, Florida EDWARD R. ROYCE, California ELIOT L. ENGEL, New York STEVE CHABOT, Ohio BILL DELAHUNT, Massachusetts ROY BLUNT, Missouri GREGORY W. MEEKS, New York THOMAS G. TANCREDO, Colorado DIANE E. WATSON, California RON PAUL, Texas ADAM SMITH, Washington JEFF FLAKE, Arizona RUSS CARNAHAN, Missouri MIKE PENCE, Indiana JOHN S. TANNER, Tennessee JOE WILSON, South Carolina GENE GREEN, Texas JOHN BOOZMAN, Arkansas LYNN C. WOOLSEY, California J. GRESHAM BARRETT, South Carolina SHEILA JACKSON LEE, Texas CONNIE MACK, Florida RUBE´ N HINOJOSA, Texas JEFF FORTENBERRY, Nebraska JOSEPH CROWLEY, New York MICHAEL T. MCCAUL, Texas DAVID WU, Oregon TED POE, Texas BRAD MILLER, North Carolina BOB INGLIS, South Carolina LINDA T. SA´ NCHEZ, California LUIS G. FORTUN˜ O, Puerto Rico DAVID SCOTT, Georgia GUS BILIRAKIS, Florida JIM COSTA, California ALBIO SIRES, New Jersey GABRIELLE GIFFORDS, Arizona RON KLEIN, Florida ROBERT R. KING, Staff Director YLEEM POBLETE, Republican Staff Director PEARL ALICE MARSH, Senior Professional Staff Member GENELL BROWN, Full Committee Hearing Coordinator (II) C O N T E N T S Page WITNESSES The Honorable Nita Lowey, a Representative in Congress from the State of New York .......................................................................................................... 9 The Honorable Marilyn Musgrave, a Representative in Congress from the State of Colorado .................................................................................................. 12 Duff G. Gillespie, Ph.D., Professor and Senior Scholar, Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health ........................................................................................................ 16 Ejike Oji, M.B.B.S., Country Director, Ipas Nigeria ............................................. 24 Joana Nerquaye-Tetteh, Ph.D., Former Executive Director, Planned Parent- hood Association of Ghana .................................................................................. 31 Jean Kagia, M.D. (Kenya), Consultant, Obstetrician & Gynecologist ................. 40 LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING The Honorable Nita Lowey: Prepared statement ................................................. 11 The Honorable Marilyn Musgrave: Prepared statement ...................................... 14 Duff G. Gillespie, Ph.D.: Prepared statement ....................................................... 17 Ejike Oji, M.B.B.S.: Prepared statement ............................................................... 26 Joana Nerquaye-Tetteh, Ph.D.: Prepared statement ............................................ 33 Jean Kagia, M.D.: Prepared statement .................................................................. 42 APPENDIX Material Submitted for the Hearing Record .......................................................... 83 (III) THE MEXICO CITY POLICY/GLOBAL GAG RULE: ITS IMPACT ON FAMILY PLANNING AND REPRODUCTIVE HEALTH WEDNESDAY, OCTOBER 31, 2007 HOUSE OF REPRESENTATIVES, COMMITTEE ON FOREIGN AFFAIRS, Washington, DC. The committee met, pursuant to notice, at 10:02 a.m. in room 2172, Rayburn House Office Building, Hon. Thomas Lantos (chair- man of the committee) presiding. Chairman LANTOS. The committee will come to order. Around the globe millions of women are fighting for their repro- ductive rights. They are fighting for the right to control how many children they bring into the world. They are fighting for the right to have ready access to contraceptives, and they are fighting for the right to obtain a safe and legal abortion. In this battle, women are supported by the world’s leading non- governmental organizations specializing in reproductive health care, but the United States refuses to work with these world health leaders, thanks to the mindless Global Gag Rule first instituted by President Reagan, and reimposed after the Clinton years by our current President. This policy places restrictions on health care workers overseas that they would never have to face if they were based in the United States. If these overseas groups spend even a dime of their own money advocating for changes in their own nation’s abortion laws, they are ineligible to receive family planning funds from our own coun- try. They can’t spend their own money to do what they think is right for women without losing U.S. support. These same hard working NGOs are not just sidelined in the pol- icy debate, they cannot even counsel women about abortion. If a pregnant woman shows up at a family planning clinic in South Af- rica, the doctor cannot even tell her that abortion is an option with- out jeopardizing the clinic’s financial support. Without that support, many of these facilities would have to close their doors forever, depriving women of essential health care serv- ices, including screenings for HIV and cervical cancer, and espe- cially the provision of contraceptives for the prevention of un- wanted pregnancies and abortion. By gagging the world’s most ef- fective reproductive health care organizations, the President is hop- ing to reduce the rate of abortion, but that is not happening. The Global Gag Rule is just making abortion more unsafe. (1) 2 Earlier this month the Lancet, the highly-respected British med- ical journal, published a major study of worldwide abortion rates conducted jointly by the U.N.’s World Health Organization and New York’s Guttmacher Institute. The results of the study are as eye-opening as a jolt of caffeine in the morning. The study found that in countries in which abortion is legal and countries in which it is illegal, abortion rates are pretty much the same, but there is a shocking difference. Where abortion is legal, it is provided in a safe manner. Where it is illegal, abortion is often performed under unsafe conditions by poorly trained providers. In fact, an estimated 20 million unsafe abortions are performed every year, almost all of them in countries where abortion is illegal under most circumstances. An estimated 67,000 women die each year as a result of complications from these unsafe procedures. Let me repeat that. Sixty-seven thousand women dead from unsafe abortions each year, often leaving many children behind. Given these staggering statistics, the United States should be ac- tively supporting NGOs which are fighting to get rid of unjust laws banning or severely limiting abortion, not shunning them. We should be working with organizations like the Family Planning As- sociation of Kenya, the Family Guidance Association of Ethiopia, the Planned Parenthood Association of Ghana, and the Inter- national Planned Parenthood Federation. All of these organizations have been barred from getting U.S. family planning funds. If banning abortion doesn’t lower the abortion rate, what does? The answer is clear—ready access to contraception. In Eastern Europe, a place I know a little bit about, where the availability of effective contraception has greatly expanded since the fall of the Communist regimes, the abortion rate has dropped by more than 50 percent, but because of the punitive provisions of the Global Gag Rule, since 2001 the United States has stopped shipping contraceptives to 20 developing countries in Africa, Asia, and the Middle East, and many leading NGO family planning pro- viders in other countries have stopped receiving contraceptives. While the Global Gag Rule is being promoted as anti-abortion, it remains at its core anti-family planning. These are important issues and they demand from us a construc- tive response. My good friend from New York, the distinguished chairwoman of the House Foreign Operations Appropriations Sub- committee, Nita Lowey had done just that. I strongly endorse the contraceptives language in her bill that begins to unravel the Glob- al Gag Rule and I hope that by the end of the legislative process it will become completely repealed. The Global Gag Rule is bad policy, and it is doing enormous harm to women around the globe. The sooner we change it the bet- ter for everyone concerned. I now turn to my friend, the distinguished ranking member of our committee, my colleague from Florida, Congresswoman Ileana Ros-Lehtinen, for any comments she may wish to make. Ms. ROS-LEHTINEN. Thank you so much, Mr. Chairman, my friend. Welcome to our wonderful panelists today, and today as you said, Mr. Chairman, we will be discussing the Mexico City Policy which prohibits the provision of United States tax dollars to foreign 3 non-governmental
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