How the U.S. Can Still Lead with Humility on Global Sexual and Reproductive Health, Rights and Justice
By Seema Jalan
The decision of the Supreme Court of the United States in Dobbs v. Jackson Women’s Health Organization, which overturns Roe v. Wade and reverses the constitutional right to abortion, is undeniably a violation of human rights and autonomy and sends a signal to the rest of the world that the United States does not support women, girls and all people being afforded the opportunity to direct the course of their own lives.
This is a decision that first and foremost impacts the law and the health and rights of people in the U.S.; but it also threatens global progress on sexual and reproductive health, rights and justice (SRHRJ). For better or worse, the U.S. as the largest global health funder has an outsized influence on the world. By moving against the global tide that is liberalizing abortion, it is emboldening an already organized and well-resourced opposition, potentially causing a “chilling effect” for global health care providers that may rely on U.S. funding, and harming its own credibility and influence on the global stage. Countries that have relied on U.S. leadership, including the precedent of Roe v. Wade, to advance reproductive health and rights domestically may now see their progress threatened, and countries that have sought to restrict rights may now point to the U.S. in regress as an example to emulate.
But even as we move backwards at home, the U.S. can and must continue to lead with humility and renewed urgency to fulfill its commitments to advance SRHRJ, including through foreign policy, by:
1. Advancing funding for global SRHRJ and permanently ending harmful policies. The U.S. is the largest funder of reproductive health globally. Even and especially in a post-Roe world, we must continue to robustly fund this work in our federal budget, including full support for the critical work of UNFPA, the UN agency on sexual and reproductive health. We must also ensure that this funding is maximized and not stymied by harmful and regressive policies like the global gag rule or the Helms amendment. While the global gag rule was rescinded as an early action by the Biden-Harris Administration, it has yet to be permanently repealed by Congress, which is essential in preventing the policy from being reinstated on the whim of a future conservative administration.
Progress here has begun: for the second year in a row, the U.S. House of Representative’s State, Foreign Operations, and Related Programs spending bill increases funding for international family planning and reproductive health programming and for UNFPA; and addresses longstanding and harmful foreign policy restrictions by removing the Helms amendment and permanently repealing the global gag rule. Thanks to the leadership of Reps. Barbara Lee and Rosa DeLauro, this is a strong step in the right direction as federal appropriations season gets underway.
2. Combatting the “chilling effect”: The fall of Roe v. Wade could exacerbate the chilling effect that still lingers from the global gag rule, causing NGOs receiving U.S. global health funding to potentially become skittish about providing comprehensive health care due to lack of clarity on what is permitted and for fear of losing significant donor funding. A recent Fòs Feminista report found that even though the global gag rule was officially reversed as an early action of the Biden Administration, there were months of delays and roadblocks in effectively communicating this to on-the-ground partners causing comprehensive care, including abortion care, to remain out of reach for those who needed it; even though legally, it was no longer restricted by the gag rule. The report found: “Organizations needed urgent and immediate guidance from the [U.S. government] in January 2021 that clearly instructed them to cease implementing the [global gag rule] and explain how to modify ongoing programs to align with the policy change as well as mitigate harmful impacts on communities around the world.”
The U.S. can learn from these findings and act swiftly and clearly to communicate to international partners that its own domestic abortion restrictions are not, in fact, restricting the work of global health funding recipients — and that these partners should continue to provide rights-based and comprehensive care that is needed in their communities. This can happen on multiple fronts. Leaders across the administration, including at the Department of State and its U.S. embassies around the world, USAID and its global missions, and Health and Human Services, can all make clear that the U.S. unequivocally supports SRHRJ and can clarify what is permitted under current law through foreign assistance, including allowances for foreign aid to support abortion in the cases of rape, incest and life endangerment.
3. Advocating for SRHRJ in global fora. Undoubtedly, the U.S.’s role as a global leader on SRHRJ has been dealt a blow by the fall of Roe v. Wade. It has lost credibility on health and human rights and, as the aftermath of the decision continues to roll out, it is likely this credibility will fall further. But the U.S. must still show up in force — again, with humility and recognizing the reality on our home front — to champion SRHRJ as an expectation in diplomatic relations, global negotiations, and multilateral convenings. This includes continuing to counter harmful regressive efforts like the so-called Geneva Consensus, and pro-actively harnessing the solidarity expressed by political leaders around the world to coalition-build to continue global momentum for reproductive freedom.
4. Doubling down on equity. In the U.S., Roe v. Wade has always been the floor, not the ceiling, and an insufficient one at that — legality has not equated to accessibility for abortion care in the U.S., especially for BIPOC communities. Similarly, it has not equated to support for abortion in U.S. foreign policy. Despite regression domestically, the U.S. can and must move forward a progressive and transformative foreign policy agenda that goes beyond legality with an eye toward justice and equitable access, including the asks from the Blueprint for Sexual and Reproductive Health, Rights, and Justice, a comprehensive policy agenda endorsed by more than 90 organizations; and the framework of a Feminist Foreign Policy that puts gender equality, bodily autonomy, and human rights at its core. It can also center SRHRJ in the implementation of the first-ever National Strategy on Gender Equity and Equality. To do this meaningfully, the U.S. must engage BIPOC and LGBTQIA+ justice movement leaders in visioning, strategy, priority-setting and resource decision-making; and, indeed, shift foreign assistance to support BIPOC-led and LGBTQIA+-led organizations, feminist movement leaders, and human rights defenders in local contexts around the world who have the deep knowledge of what their communities want and need — the strongest path to countering opposition and driving systemic and enduring change.
The overturning of Roe v. Wade is a devastating regression in human rights and autonomy here in the U.S., with significant impacts globally. But we cannot let the regression seep into our foreign policy, too. The U.S. has ample opportunities to stay true to its commitments on SRHRJ. It must not delay on seizing them.
Learn more about the Universal Access Project and get involved at www.universalaccessproject.org.
