Do you remember when Donald Trump described himself as "very pro-choice".
I also vividly remember the photo of President Trump in the White House -- surrounded by men -- signing the Global Gag Rule he supercharged this year.
While some Madagascan women and girls may have missed that photo, many of them will suffer mightily from this Global Gag Rule's implementation.
This is because President Trump signed into existence a much more extreme and destructive Global Gag Rule. Previous versions of the rule prohibited any non-governmental organisation from having any involvement with abortion in order for it to receive any funding from the US for family planning activities.
The rule meant that an organisation couldn't even use its own money to provide abortions, or to assist a doctor to provide or counsel a patient as to her best care, or refer that patient to another place for necessary medical care. It meant that patients couldn't be given condoms to reduce HIV transmission.
The President aggravated this directive by extending it to all global health funding for any aid program that was linked in any way to abortion funding, not just family planning. The rule now applies to 15 times more funding, which will result in over US$9 billion in global health funding being affected.
Lalaina Razafinirinasoa, the country director of Marie Stopes Madagascar, has said that her organisation provides family planning services to approximately 800,000 women and men and is the largest provider of family planning in Madagascar. In 2015, Marie Stopes Madagascar received US$4 million from the United States government, and in 2016 they received US$3.5 million.
Half of Marie Stopes Madagascar's service delivery methods are funded by the United States government -- like the mobile clinic working in outreach areas for 400,000 people and the voucher program for around 35,000 young people and poor women a year. According to Razafinirinasoa, all of the funding Marie Stopes Madagascar receives from the US government will be lost, starting in October.
The healthcare of women and girls will be affected in at least 60 low and middle-income countries.
This is because the mission of Marie Stopes is to give women the right to have children by choice, not by chance. So even though they provide birth control, not abortion, Marie Stopes Madagascar is guided by this broader mission and so is caught by President Trump's Global Gag Rule.
According to Marie Stopes Madagascar, in 2016 it helped avoid approximately 165,000 unwanted births. If it could keep its funding, it could prevent over 1 million unintended pregnancies, more than 2,000 maternal deaths, and approximately 340,000 abortions by 2020. They estimate the healthcare savings to the Madagascan government would be $50 million.
And this is just one organisation, in one country. The healthcare of women and girls will be affected in at least 60 low and middle-income countries.
A study by researchers at Stanford University found that, after President George W. Bush's comparatively weaker version of the Global Gag Rule came into effect in 2001, the abortion rate increased sharply in sub-Saharan African countries that had been dependent on such funding. You read that right: past implementation of the Global Gag Rule led to an increase in the abortion rate.
As my colleague Claire Moore pointed out in the Senate, the International Planned Parenthood Federation 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 won't sign, so they will lose more than $100 million in US government funding during this term. In practical terms, this means that between 2017 and 2020, 21,700 mothers will lose their lives, 6.5 million unintended pregnancies will not be prevented and 2.1 million abortions will be unsafe. In addition, we can expect 300,000 more pregnancy related deaths. The Global Gag Rule means the withdrawal of treatment to 275,000 pregnant women living with HIV, whose children may miss out on crucial antiretroviral drugs at the moment of birth -- a treatment shown to be extremely effective at preventing transmission of HIV from mothers to their infants.
The Global Gag Rule also means that 70 million condoms will not be distributed to prevent unintended pregnancies, HIV and other STIs, while 725,000 HIV tests will not be provided to enable people to know their HIV status.
These are catastrophic statistics, but they are not yet manifest. They are actually entirely preventable -- which is why a number of countries have refused to sit back and wait until they are reported. The governments of the Netherlands, Belgium, Sweden, Canada, Denmark and Norway have all increased their contributions to an international pool attempting to ensure that family planning funding across the developing world can be maintained.
We can do our part where the United States has fallen short.
Australia is still waiting. Under the Coalition, development assistance is now just 0.23 percent of national income, the lowest level since comparable records began in the 1970s, and well below the OECD average of 0.30 percent. By contrast, when Labor was in government, overseas development assistance increased from 0.28 percent of Gross National Income in 2007-08 to 0.37 percent in 2013-14. It was on track to reach 0.50 percent in 2017-18.
The Turnbull Government needs to step up and participate in the urgent international financial response to the funding gap left by President Trump for vital women's health programs. We can do our part where the United States has fallen short.
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