The global chill of Roe’s reversal

The people and politics driving global health.

Jun 30, 2022 View in browser   By Carmen Paun and Daniel Payne THE BIG IDEA The Supreme Court decision is already being felt around the world. | Jose Luis Magana/AP Photo 'RIPPLE EFFECTS' FOR U.S. FOREIGN AID — When the U.S. sneezes, the whole world can catch a cold, an activist with an abortion-rights group in Malawisaid on a recent visit to Washington. The impact of the Supreme Court's decision to overturn Roe v. Wade is quickly spreading across the world, said Bethany Van Kampen, a senior legal and policy adviser at the same organization, Ipas. "When it comes to family planning and reproductive health, the U.S. is the largest government donor. And of course, that is going to create ripple effects," she told Global Pulse. A chill over a freeze: U.S. foreign-aid rules, such as the Helms amendment, prohibit governments from using U.S. assistance to fund abortions as a method of family planning. Another one, the Mexico City Policy, or the Global Gag Rule — which changes depending on which party governs the White House — bars foreign nongovernmental organizations from performing or promoting abortion as a condition of U.S. funding. Those rules already cause "an incredible chilling effect in countries that are receiving U.S. foreign assistance, and so you can imagine that with this decision, that chill will become worse," Van Kampen said. Even before the Roe ruling, countries receiving U.S. aid were afraid of doing anything related to abortion for fear of losing that money, she said. The Mexico City Policy's most recent implementation, under the Trump administration, led to reduced family planning and reproductive health service provisions, less access to trusted providers and a reduced trust in the U.S. government, the Government Accountability Office said in aMay report. Some organizations in countries like Malawi, Mozambique and Zimbabwe didn't even know the rule was revoked by President Joe Biden in January 2021 until researchers from pro-abortion organization Fòs Feminista spoke to themfor a study released in April 2022, said Serra Sippel, the organization's chief global advocacy officer. With Roe's fall, Sippel fears such policies will be harsher. But Brian Clowes, the director of research and training at Human Life International, an anti-abortion group, doesn't believe the Roe decision would impact U.S. foreign funding for sexual and reproductive health, which he would like to see repurposed. "If we really want to save the lives of Africans, we ditch the birth control devices, we ditch the abortion and all the rest of it, and spend all this money on clean drinking water," he told Global Pulse. Being clearer: Sippel and Van Kampen argue that the U.S. Agency for International Development must communicate to the entities it funds how they can use U.S. aid. A USAID spokesperson said the agency routinely communicates with staff managing global health grants and training at USAID and its partners. The Biden administration remains "just as committed as we ever were to sexual rights and health," said Atul Gawande, USAID's assistant administrator for global health, speaking at a Foreign Policy event Tuesday. WELCOME TO GLOBAL PULSE WELCOME BACK TO GLOBAL PULSE, where Carmen is envious that someone is planning to live her dream of sitting at the beach and doing nothing. Send your dreams — and tips — to cpaun@politico.com and dpayne@politico.com.  Global Pulse is a team effort. Thanks to editors Eli Reyes and Barbara Van Tine. Follow us on Twitter: @_daniel_payne and @carmenpaun. IN THE SPOTLIGHT The international movement for abortion rights could find a new front in the U.S. | Natacha Pisarenko/AP Photo 5 GLOBAL IMPACTS OF THE ABORTION DECISION — The fallout from the U.S. decision to overturn Roe will impact similar fights in other countries. Here's what to watch for next. Online abortion pill supplies and demand: Abortions in countries that restrict the procedure are often accessed through pills in the mail — a model that's likely to see dramatically more demand following the court's ruling. Aid Access, a nonprofit that makes pills available via international providers and pharmacies, has prepared for a surge in demand. "Everybody seems ready," Robin Tucker, a nurse practitioner with Aid Access, told Global Pulse just before Roe was overturned. "We've even talked to the manufacturers of the pills to make sure there's not a problem keeping up with supply." Increased international travel for abortions: When abortion rights were rolled back in other countries in the past, it led women to travel internationally for care — something U.S. women may increasingly do after the decision. "It's already started," said Paula Ávila-Guillén, executive director of the Women's Equality Center, an abortion-rights advocacy group — adding that activists in Mexico City have seen an increase in international demand. "I can only imagine that the numbers are going to go higher." Some trips are supported by donations — and the cash on hand in travel funds will be a key metric in the coming months. Few options for those who can't travel: In some circumstances — whether related to money, health or immigration status — people seeking abortions will be left behind when restrictions increase. "There is a large population of Latinas that don't feel comfortable traveling because they don't have a regular immigration status," Ávila-Guillén said. "So they cannot go across the border, but they might not even be able to go across the state." Financial barriers are also a key point of focus for the future. "What the Supreme Court just did is divide the country into two: not only two in terms of states, but into two in terms of money," she said. An anti-abortion movement gaining momentum: Anti-abortion advocates in Europe are inspired by the decision in the U.S. , POLITICO's Carlo Martuscelli reports — a boost for organizations that could see growing budgets in the coming months. The Roe decision could offer a legal strategy for future challenges in Europe or at least signal that the decision might not be settled in many countries. And that impact is being felt beyond Europe — with U.S. influence and funding sending shockwaves to Asia, Africa and South America, too. An advocacy wave heading for America: The Green Wave, a worldwide movement to expand abortion rights, might see America as its next battleground. Amid concerns that the women's movement faces fatigue and infighting, Ávila-Guillén has advocated for a common front similar to that used to secure abortion rights in Latin America. "The beauty of the Green Wave was that we had a symbol that united us, that it didn't mean we can't have differences internally," she said.   INTRODUCING POWER SWITCH: The energy landscape is profoundly transforming. Power Switch is a daily newsletter that unlocks the most important stories driving the energy sector and the political forces shaping critical decisions about your energy future, from production to storage, distribution to consumption. Don't miss out on Power Switch, your guide to the politics of energy transformation in America and around the world. SUBSCRIBE TODAY.     THE NEW NORMAL As monkeypox cases continue to grow, some countries are taking more aggressive measures to stop transmission. HOW MONKEYPOX COULD BECOME MORE CONCERNING — Sustained transmission of monkeypox, which has now reached more than 50 countries, "would suggest that the virus is establishing itself and it could move into high-risk groups, including children, immunocompromised and pregnant women," World Health Organization Director-General Tedros Adhanom Ghebreyesus told reporters Wednesday. The U.K. has reported two cases in children. The WHO didn't specify their age. The vaccine approved in the U.S. against the virus, Jynneos, could be used to prevent infections in these groups but under some form of clinical study, said Mike Ryan, the WHO's executive director for health emergencies. "We would have to exercise a higher level of caution" in comparison to Covid-19 vaccines, he said. For example, pregnant people could be vaccinated against monkeypox if they've been exposed to the virus but shouldn't be vaccinated preemptively, Ryan said. "It's about assessing risk versus benefit, and national regulatory authorities have to be able to do that in each and every case," he said. Not an official global health emergency yet: The WHO's emergency committee stopped short of declaring the monkeypox outbreak a public health emergency of international concern in a meeting last week. Meanwhile, the U.S. will expand vaccination against the virus to more at-risk people, such as those who were at a party or a venue where monkeypox spread,Biden administration officials said Tuesday. The federal government's initial guidance directed states to vaccinate individuals with monkeypox and their immediate close contacts, an approach that failed to contain the outbreak.   STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president's ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.     WHAT WE'RE CLICKING The Financial Times: The new buzzword used to describe Chinese people being sick of lockdowns under the country's zero-Covid policy is 'runxue': the study of leaving the country completely. POLITICO : Not-so-emergency aid: Billions in U.S. funding to avert mass hunger is still waiting to be spent. The New York Times: When Brazil banned abortion pills, women turned to drug traffickers.   Follow us

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