The Trump administration has released its first assessment of the impact of the president's decision to reinstate the "Mexico City policy," which cuts off U.S. aid to international groups unless they promise not to provide or promote abortion, even with non-U.S. funding sources.
The review finds that so far practically all grantees have agreed to those conditions. But opponents of the policy caution that the administration's statistics offer too incomplete a picture to draw conclusions about the policy's impact.
Every Republican president since Ronald Reagan has implemented the policy. But Trump's version — which he instituted three days after taking office — goes further. Whereas previous versions only covered U.S. funding of overseas family planning, Trump has extended the policy to funding of virtually all global health programs — potentially more than $7 billion a year, according to an analysis by the Kaiser Family Foundation.
Take the case of a health clinic that uses U.S. dollars to treat children in a poor country for malaria while using other funding to provide information about abortion to female patients. When the clinic's U.S. grant comes up for renewal it will now face a choice: stop offering the abortion-related services or give up U.S. funding for its malaria work.
According to the administration's review, since the policy was put in place just over half of the nearly 1,300 affected global health grants have come up for renewal — and only four organizations have opted to decline the money.
However, it's unclear what share of U.S. aid funding those group represent. (In a phone call briefing for journalists, senior administration officials said they did not have funding data immediately available.)
At least two of the groups that declined funding — Marie Stopes International and International Planned Parenthood Federation — are major providers of health services to poor people worldwide. (The other two were not identified). Marie Stopes, for instance, was getting about $30 million a year in U.S. money — accounting for 17 percent of its donor funding. Officials with the organization say that they have been able to secure short-term replacement funding for the majority of it. But beginning in mid-2018 many of their programs will face losses. And this will likely require the group to close down outreach teams delivering sexual and reproductive services to impoverished women in Madagascar, Uganda and Zimbabwe.
Analysts also caution that many of the grantees covered by the Administration's statistics are essentially U.S.-based pass-through groups — meaning they ultimately pass on their U.S. aid money to foreign partners on the ground. And it remains to be seen how many of those partners will agree to comply with the Mexico City policy. The administration reports that it is aware of at least 12 such sub-grantees that have refused as of last September.
Perhaps most significantly, the review did not include any information about whether or not the policy has led to a reduction in health services for poor people.
Officials said they would continue to monitor the policy's implementation, and issue another review by end of this year.