With hope and a renewed sense of pride in my country, today I am happy to applaud President Obama for finally repealing the harmful Global Gag Rule, an action that marks a significant step towards combating the global AIDS epidemic, ensuring women’s rights worldwide, and realizing the right to health for all.
Last month, my work at PHR took me to Kenya, where I saw first-hand the damaging effects that the Global Gag Rule had on the delivery of comprehensive care and prevention messaging to women. The health professionals, advocates, and women with whom I met were resolute on the importance of integrating HIV/AIDS services with reproductive health services, including family planning, to address the growing feminization of the AIDS epidemic. But the Global Gag Rule had greatly hindered the scaling up of service integration.
The Global Gag Rule (GGR) prohibited health organizations that received US dollars for family planning from performing abortions, making referrals for safe abortion services, and supporting safe abortion laws and policies, even with funding from other sources. Although the GGR did not apply to PEPFAR HIV services, mixed messages were repeatedly given to recipient organizations, resulting in the lack of integration of HIV and family planning services.
Despite the lack of US funded support, Kenya was able to successfully start integrating services. A theme that came up often during my travels was that integrating family planning and HIV/AIDS services helps to ensure no opportunities are missed.
“Women coming for family planning services are sexually active – they need to know their HIV status,” explained Emma, a nurse and advocate for the integration of services. Furthermore, women who seek prevention, care, and treatment for HIV/AIDS must be provided with reproductive health services, including family planning. The repeal of the Global Gag Rule will now allow programs to expand the integration of these services without fear of reprisal.
The right to health demands that health systems be accessible, available, affordable, and of good quality, yet women in particular face much stigma and many socioeconomic barriers. Integration of these services breaks down barriers to care for the most vulnerable women by providing access to multiple services at multiple entry points, giving them a wider range of opportunities to connect to the health system.
While visiting a clinic outside Nairobi, I spoke with Alice, a young mother who received family planning and HIV testing through a local NGO. Alice was able to access these services because they were made available as a package in one location. If this were not the case, she might not seek the services at all. The repeal of the Global Gag Rule offers hope that the health of more women like Alice will no longer be at the mercy of ideologically driven policies that block the implementation of comprehensive health programs.
Today, President Obama took an important step, but there is much more work ahead to implement integrated services on a global scale. We, as advocates, must remain committed to scientific and evidenced-based policies that promote women’s health rights. While reflecting on the opportunities that lie ahead in a world without the stifling effects of the Global Gag Rule, I think about Anne, a young mother who received comprehensive family planning and HIV testing services in a safe and comfortable environment thanks to Kenya’s initiatives to integrate services. When asked what it meant to be able to receive all these services together, she simply said, it means “I am free. Free to go on with life.”