US aid restrictions reduce delivery of key health services for PEPFAR beneficiaries

September 08, 2020

In 2017, the Trump administration reinstated and expanded the Mexico City Policy, officially titled Protecting Life In Global Health Assistance. This policy prohibits any US-based or foreign nongovernmental organization from receiving US government global health assistance unless the organization certifies that it does not provide abortion services or counseling or referrals for abortion or advocate for changes in abortion laws. To study the impact of this policy on implementing partners of US-funded HIV programming by the President's Emergency Plan for AIDS Relief (PEPFAR), Jennifer Sherwood of amfAR, the Foundation for AIDS Research, and coauthors conducted an online survey during 2018 in all recipient countries. The survey results show that 28 percent of organizations reported stopping or reducing at least one service in response to the policy and note that a broad range of services and initiatives unrelated to abortion were reduced. The integration of HIV and reproductive health services is considered best practice by PEPFAR; many of the disrupted services were reproductive health services that were also provided at PEPFAR sites. The authors conclude that the current policy reduces the delivery of health services by PEPFAR's implementing partners, which has the potential to negatively affect many vulnerable PEPFAR beneficiaries, including youth and pregnant women.
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