Three days after his inauguration, Donald Trump reinstated the “global gag” rule, which prohibits the use of US aid money for abortions, prevents NGOs from using private funds for abortion services, from referring women to groups that provide abortions, and even from offering information on services.

We asked NGOs around the world to tell us how the policy impacted them in the past, and what it means for their work today.

‘The policy constitutes bullying and blackmail’

Sally Griffin, director, ICRH-Mozambique

Mozambique is at a crucial turning point. Abortion was recently decriminalised and the government and its partners are preparing to roll out services. We fear this policy could derail the process, either through its impact on funding for services, or through the climate of fear and restraint it creates.

We receive US funding to provide HIV, sexual and reproductive health (SRH) services to sex workers. The ‘global gag’ rule pushes us into a corner: abandon our efforts to support access to safe abortion or close down our programme providing essential SRH services to marginalised people. Either way, vulnerable women will have their reproductive and sexual rights compromised.

The policy constitutes bullying and blackmail, particularly of local organisations that are heavily dependent on US funding to provide services and to survive, and are therefore effectively powerless to turn it down.

‘Impoverished women may not be able to afford quality abortion care’

Rani Jha, obstetrician and gynaecologist, Nepal

I work to provide free or subsidised safe abortions and contraceptive services to marginalised women. The services are funded by international donations and we are afraid that we may not be able to secure more funds in the future. Then, we may have to curtail our services or start charging patients. But Nepal is a poor country and impoverished women may not be able to afford quality abortion care. We can expect a rise in the rate of unsafe abortions, and subsequent mortality and morbidity. This is going to undermine the reproductive health of our women.

‘The rule will reduce our work to near zero’

Claudia Dides, executive director, Miles Chile

In the past, the implementation of the policy meant that only government funding was available to support the promotion of sexual and reproductive rights. There was an increase in the number of girls aged 11–14 having unwanted pregnancies, and an increase in the prevalence of HIV/Aids.

The global gag rule will reduce our work to near zero as we depend almost 100% on external support to promote the sexual and reproductive rights of women and teenagers in Chile. They would be left without information on the latest contraceptive methods, they would have limited access to sex education (government programmes are limited or non-existent), and there would be restrictions on advocating preventive actions around HIV/Aids and other sexually-transmitted diseases.

‘Mothers will visit the clinic with problems they might have avoided’

Heloise, Ghana

In northern Ghana, it is common for poor young women to receive financial support from their boyfriend in exchange for sex. But without SRH and rights education, they often don’t know how to prevent pregnancy. If a woman does get pregnant, she will often rely on her boyfriend and his family to support her. And if she goes to school, she may have to drop out. After the baby is born, the man’s family is considered free of responsibility and this can leave the woman without financial or family support. In this region, girls and women are often so poor they have no money to get treatment for any pregnancy or newborn complications, resulting in extremely high rates of maternal and child mortality.

With the reinstatement of the ‘global gag’ rule, mothers will visit the clinic with gynaecological problems they might have avoided had they received preventative SRHR education. There will be more deaths, our clinics and health professionals will be burdened by higher caseloads of complications, and maternal and child mortality, and an already overburdened and under-financed health system will face yet more problems.

‘The policy violates human rights to information, bodily integrity and autonomy’

Kathy Mulville, executive director, Women’s Global Network of Reproductive Rights, Philippines

In countries where abortion is decriminalised, and comprehensive safe abortion information and services and contraceptives are widely accessible, we have seen that unsafe abortions and maternal mortality and morbidity are effectively eradicated. This has significant ripple effects for economic and social development; increased school attendance among girls, reduced levels of household poverty and hunger, reduced inter-generational transfers of poverty, mitigated socioeconomic impact of HIV/Aids, and improved environmental sustainability.

In addition to putting much-needed funding in jeopardy, the ‘global gag’ rule will only worsen the already challenging context in which we, our members and local partners work, further stigmatizing efforts to advocate for safe and legal abortions. The policy will feed the already rampant stigma around abortion and will prevent millions from making free and informed decisions about their sexuality and their own bodies, while also violating their human rights to information, bodily integrity, and autonomy in reproductive decision-making.

‘It will weaken evidence-based services for the poorest and most vulnerable women and girls’

Suzanne Petroni, senior director – global health, youth and development, International Center for Research on Women, US

The International Centre for Research on Women is not subject to the gag rule, but our local partners around the world would have to sign it – several have already indicated they are not willing to do so. This may constrain our ability to conduct efficient research, used to improve the design and implementation of policies and programmes that reach thousands, if not millions, worldwide.

For example, our US–funded work to understand how to improve the wellbeing of girls in Zambia who are HIV-positive, to ensure adherence to anti-retroviral therapy services by problem drinkers in India, and to expand access to voluntary family planning in numerous countries, may all be affected by the imposition of this new and expanded “global gag” rule. As well as restricting services directly, the rule is likely to diminish the availability and use of solid evidence, and will weaken the design and delivery of evidence-based services for the poorest and most vulnerable women and girls – and men and boys – globally.

‘Women should determine the care they receive, not the US government’

Sera Bonds, CEO, Circle of Health International, US

Too many organisations dependent on big government funds lose funding in times such as these and are no longer able to provide life-saving services like safe deliveries. We have not taken US government funding for this exact reason; women and their trusted healthcare providers should determine the care they receive, not the US government or a donor.

However, the governor of Texas, where we are based, has pledged to stop funding going to women’s health initiatives, and federal and state aid going to refugees in the state. This doubly impacts our work in the Rio Grande valley where we staff a clinic for refugees. I am sure that, together, we can figure a way through this. This is not our first global gag rule rodeo – nor, sadly, is it likely to be our last.

Do you work for a global health organisation funded by US aid? We want to know how the global gag rule will affect your work. Tell us in the comments below.

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