Senator MOORE (Queensland) (21:09): President Donald Trump's presidential memorandum of 23 January 2017 stated:
I hereby revoke the Presidential Memorandum of January 23, 2009, for the Secretary of State and the Administrator of the United States Agency for International Development (Mexico City Policy and Assistance for Voluntary Population Planning), and reinstate the Presidential Memorandum of January 22, 2001, for the Administrator of the United States Agency for International Development (Restoration of the Mexico City Policy).
In effect, this memorandum reinstates what has become known as the global gag on abortion for family planning using any kind of US aid.
The reaction from the world was not surprise. In fact, this was something that Donald Trump talked about a little during his presidential campaign-not of course in the years before; he actually talked about his support for women's right to choose at that time. When he ran for President, he was clear that he was actually going to revert to the standard Republican policy of ensuring that there would be restriction on US international funding for any aid program that was linked in any way to abortion funding.
When he signed his presidential memorandum, he was surrounded at the time by a group of male advisers. He was overriding the presidential memorandum of 2009, which was signed by then newly elected President Obama. Those of us who are interested in this issue were excited and relieved at that stage to see then President Obama signing this declaration which reinstated USA aid to organisations who were fulfilling their role to look at women's reproductive rights across the world-one element of which was access to abortion or information about abortion around the world. The stark contrast between the images of those two presidential signings was that when President Obama made his decision in 2009, he was surrounded by women. For those of us who are interested in this topic, that iconic image remains with us for hope and also for concern about what the impact will be of the Trump memorandum.
To be clear, no-one at this stage is completely sure of what the impact is going to be of this change of policy. There is information about what could occur, but it will not be clear until we see the rollout and until we see the decisions by a range of organisations that work in this field about whether they will sign on. If they do, the expectation from the US government is that they will cease having any information about abortion in their family planning or in their information on women's reproductive health. Unless they sign a declaration stating that, they will lose any access to US aid funding. We are watching as the organisations are making their decisions and talking to their members, and assessing what the impact will be on their services.
It is clear that what we are seeing now is a reversion to previous policy. The Mexico City policy to which President Trump refers goes to a 1984 decision at a population conference that was held in Mexico City, when the then Reagan administration brought domestic abortion politics into the arena of international aid for the first time. The administration declared:
The United States does not consider abortion an acceptable element of family planning programs and will no longer contribute to those of which it is a part.
The process there was to work with organisations to see what occurred. Since then, we have been able to see the impact on women, the impact on families and the impact on economic survival and poverty across the world by this decision about family planning across the world.
We are not sure how the Trump process will operate because there is a clear expansion of the terms of the Mexico City definition to include 'all health assistance furnished by all departments or agencies' not just family planning assistance. This will include programs ranging from HIV/AIDS, to malaria and children's health. So we will see organisations that have effectively been providing real assistance to families' health and to programs across the world being restricted in the kinds of services that they provide under their commitment to the world. Remember, this declaration was been made at exactly the same time as we, as an international community, have signed up to the Sustainable Development Goals.
President Trump has now taken on the responsibility that his nation signed onto only two years ago in terms of the commitment to a world that is facing issues of poverty and disadvantage. Sustainable development goal No. 5 is actually determined to end all forms of discrimination against women and girls everywhere, eliminating all forms of violence. Element 5.6 clearly states:
Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
This is a clear international statement. The United States and all other nations of the world have agreed to that process. When you look at the program of action, which I always keep by my side, you will see that this wonderful document dated 5-13 September 1994 gives a quite clear indication of ensuring that there will be effective family-planning processes across the world. It states clearly that:
In no case should abortion be promoted as a method of family planning-
and no-one pretends that abortion is an effective method of family planning. However, it goes on to say:
Prevention of unwanted pregnancies must always be given the highest priority and every attempt should be made to eliminate the need for abortion. Women who have unwanted pregnancies should have ready access to reliable information and compassionate counselling. Any measures or changes related to abortion within the health system can only be determined at the national or local level according to the national legislative process. In circumstances where abortion is not against the law-
and this is the local law-
such abortion should be safe. In all cases, women should have access to quality services for the management of complications arising from abortion. Post-abortion counselling, education and family-planning services should be offered promptly, which will also help to avoid repeat abortions.
That is the environment in which these decisions have been made since 1994, but the presidential direction, which the new president has just signed, raises concerns about any of the programs offered to look at safe access, family counselling and the devastating needs of women who have taken up the option of abortion and are now suffering from complications. All of those services could be impacted by this presidential declaration because no agency which offers any of those services will now be allowed to get USAID funding. We know that the consequences will be devastating.
The International Planned Parenthood Federation, the IPPF, was founded in 1952 and has a global network of local partners that deliver more than 300 services every minute of every day. The IPPF have clearly said that, during President Trump's term, they will not sign any declaration that limits the numbers of services and types of services that they provide for women and families across the world. They have said that they will not sign, so they will lose over $100 million in US government funding during this term. In practical terms, that funding could prevent in this time 20,000 maternal deaths, 4.8 million unintended pregnancies and 1.7 million unsafe abortions. It could also provide treatment to 275,000 pregnant women living with HIV to protect their health and help prevent transmission of HIV to their infants; 70 million condoms to prevent unintended pregnancies, HIV and other STIs; and 725,000 HIV tests to enable people to know their HIV status. This funding, which they will lose under this decision, could also treat 525,000 sexually transmitted infections.
I am using those figures to show the real impact of this decision. Since 1984, when this Mexico gag was first introduced, there has been no evidence to prove that the global gag rule actually reduces women making the decision to terminate their pregnancy; however, we do know, by those figures I have just read into the record, that the lost funding, which allows access to contraception for more than 225 million women globally, greatly increases the need or the probability of women making the choice to abort. It would also increase pregnancy-related deaths by about 289,000. Marie Stopes International, another international organisation that does provide a full range of women's reproductive information and services, including access to safe medical abortions in nations where abortion is legal, has said:
All the medical evidence, as well as everything we know from our daily interactions with women, is unequivocal: if you take safe abortion services out of the reproductive healthcare package, it exposes women to risk.
We are not prepared to do that. Marie Stopes International, along with IPPF, have refused to sign the statement that they will limit their services, so by nature of the declaration signed by President Trump they will lose all access to USAID.
As I pointed out, this philosophical political approach changes according to the president of the day. We have had over the years from the time of Reagan a series of Republican presidents who have instituted similar programs. With Democratic presidents Clinton and Obama we saw revisions, so the USAID limitation was no longer in place. But through that process there has been significant research done about the impact of the reductions. I will concentrate on Africa, because the data from the African countries was most clear.
I was lucky enough to be in Ethiopia a few years ago and to visit some of the facilities that have been funded by Marie Stopes International. Up until this declaration, Marie Stopes International had received funds from USAID that enabled workers to work in Ethiopian villages. For six or seven hours they visit local villages, where they call together local meetings and work with women and their partners to look at the best way of contraception. They also provided services in tubal ligations and vasectomies for those who chose that process. In Ethiopia, Marie Stopes International run extremely well-regarded, professional and welcoming maternity services where they are able to work with families to ensure that they have safe births, particularly for women who come from regional areas and would not have that safety normally. Alongside those services, they run particularly effective clinics which offer practical advice and termination processes in their natural services, and all of these services work cooperatively on providing education services for women and families and, most particularly, providing informed choice for women and their families about what they want to do in their own pregnancies. That will now cause more trouble. There will not be those services through USAID, and they will be looking at trying to find alternative funding or see how they are able to maintain these extraordinarily well-documented services that are in place.
Ms Marjorie Newman-Williams, the vice-president and director of international operations for Marie Stopes International, has said:
Every year, 21.6 million women are so desperate to end their pregnancy they put their lives on the line by risking an unsafe abortion. Thousands of them die and millions more are left with life altering injuries. Agreeing to the Mexico City Policy-
which now is the Trump policy-
would mean accepting their fate and turning our backs on the very women who need us most.
She went on to say:
Attempts to stop abortion through restrictive laws-or by withholding family planning aid-will never work, because they do not eliminate women's need for abortion. This policy only exacerbates the already significant challenge of ensuring that people in the developing world who want to time and space their children can obtain the contraception they need to do so.
It denies people the right to make choices that could improve their living conditions, from the girl who could have avoided an unwanted pregnancy and continued her education, to the mother of five who could have averted the life-threatening risk of an unsafe abortion. The impact of the Mexico City Policy will be catastrophic and it is women in developing countries who will pay the price.
One of the positive elements of this information that is being shared across the world at the moment is that recently there was a special conference convened in Europe, the Women Deliver conference, where ministers from countries across Europe gathered together to consider what the impact will be from this massive reduction of US aid funding to the people who, as we have said, are most vulnerable. Through that process, there have been commitments by a number of countries. Most particularly, the Dutch government have increased the amount of money that they are putting into an international pool to try to ensure that funding to these areas across the developing world will be able to be maintained. Australia has not taken up the opportunity to increase its funding in this pool, but I know that we are watching and seeing how this is going to develop. Basically, we are watching and waiting to see what the impact will be on these families through international aid and to ensure that these services will be able to continue.
At the same time, there has been a strong advocacy program being run by organisations within Australia who have been writing to our minister, Minister Julie Bishop, stating:
We stand united in opposition to the U.S.-imposed Global Gag Rule, which undermines women's health, rights and autonomy … The Global Gag Rule further hurts an already-dire situation by weakening the effectiveness of U.S. foreign assistance funding by making capable and effective partners ineligible for funds. As you know-
this is directed to Minister Bishop-
complications arising from pregnancy, childbirth and unsafe abortions are leading killers of women and girls in developing countries, killing 830 women a day.
This knowledge is understood, and Australia is talking about what role, if any, our government will play in ensuring that we will have access to safe family planning, including, where legal, abortion services, through our international program. We as a nation have signed up to the Sustainable Development Goals, which clearly indicate that this is an absolutely integral part of looking at women's health and safety and ensuring that all discrimination against women and girls is eliminated, wherever in the world they live.
This is a challenge for all of us. I think it is important that we understand the implications. When a previous national government in the US cut funding to the UNFPA, which is the UN agency that looks at these issues, there was a spontaneous rising up of women across the world, started by a woman in the US who felt that this program should be protected. She called on women of the world to donate $1 for women who could to go into a program. That led to an extraordinary engagement and passion to ensure that our sisters everywhere would have access to effective health programs.
This could well be what we need to do again. I think the challenge is clear. The threat has returned. As I said at the beginning of my contribution, there is no surprise that the government has signed this order. What we have is a challenge to all of us that, again, the most vulnerable women, children and families will not be victims of a President driven by a philosophy which I believe is opposed to women's safety.