November 6, 2024 (Washington, DC) – With the election of President Donald Trump, we are on the cusp of watching the US undo decades of progress in global health and human rights. President Trump’s efforts during his previous term, and the proposals presented by Project 2025 and championed by conservative forces aligned with the incoming administration, will almost certainly roll back reproductive rights and dismantle the global health and development infrastructure that has been in place for decades. This stark reality is especially sobering when juxtaposed with what could have been—a historic moment of leadership under Vice President Kamala Harris, who represents the promise of advancing reproductive rights on a global scale. Instead, we find ourselves at a critical crossroads, facing policies that could deepen disparities and curtail freedoms. 

For the past year, we have been fielding questions—often tinged with skepticism—about the potential consequences of a second Trump administration: 

Aren’t you overreacting? It wasn’t that bad last time, was it? Can they really implement everything you are worried about? 

Since the release of the Project 2025 playbook, we and other global health organizations have been carefully assessing the potential impact of its proposals. Specifically, we have looked at the proposed expansion of the Global Gag Rule (GGR), which under past Republican administrations has limited foreign organizations who receive US family planning funding (or, under Trump, health funding) from providing abortion advocacy or services with other (non-US government) funding. The proposed expansions would apply this “gag” to US-based organizations, and to all foreign assistance funding. In the same breath, the playbook explains their plans for defunding and de-engaging with UN agencies including the World Health Organization and UNFPA, among others. 

Unfortunately, the answer to the above questions appears to be: we are not overreacting. In fact, it was bad last time and will become worse. And while we don’t know if this new administration will be able to enact their full agenda, each piece they implement will negatively impact the health and rights of people around the world, and each part of the Project 2025 agenda we have to fight will take time and attention away from our work. 

Our collective work around the world is lifesaving and life changing. We support health systems to provide critical care to local communities by addressing the needs of children, adolescents, and youth, holistically, so they can grow and thrive. We facilitate the availability and accessibility of contraceptives, so people can control if and when they have children. We help doctors and nurses learn skills for safe surgery, so no woman suffers complications from a necessary caesarean delivery. And we expand access to safe abortion, because it is a human right and a critical health care service. 

Of course, our work on safe abortion is not – and is never – funded by the US Government. Existing legislation including the Helms Amendment assures that. But the Global Gag Rule, if expanded according to Project 2025’s designs, would limit us from using US government foreign assistance money to provide lifesaving care in humanitarian settings, for example, if we also support safe abortion care with funds from other sources, such as European governments or private foundations.  

The proposed expansion to all foreign assistance funding will increase the affected funding from about $7.3B to about $51B. And other proposals, such as defunding and de-engaging from UN agencies, mean that US experts won’t be at the table to engage with the World Health Organization and other agencies that work to protect and promote health across the globe. 

During past Republican administrations, the effects of the Global Gag Rule have been enormous. People lost access to their contraceptive methods. Survivors did not receive the care they needed after experiencing rape and sexual violence. Clinics that provide services to people living with HIV testing, treatment and care closed. People died. 

Expanding the Global Gag Rule will expand its devastating impacts. Each of our organizations is dedicated to supporting the health and rights of people around the world, and our job will get much, much harder. We aren’t afraid of the difficult work ahead, but we are angry and outraged. Angry that, despite data showing that the Global Gag Rule does not meet its intended anti-choice purpose and instead harms people’s health and lives, the incoming Trump administration will inevitably reinstate the GGR by executive order in January. Angry that the conservative forces behind Project 2025 have designed a draconian suite of expanded efforts that will increase the damage wrought by the GGR many times over. And outraged that women and girls, who disproportionately (but not exclusively) suffer the impacts of the GGR, mean so little to the incoming administration and their backers that suffering will increase, and the US government will look the other way. 

President Trump, you have stated that abortion rights should be decided by individual states. Why shouldn’t the same principle apply to the sovereign nations where we work, allowing them to make their own decisions without restrictions imposed by the Global Gag Rule? Voters were clear about their priorities at ballot boxes in Arizona, Colorado, Maryland, Missouri, Montana, Nevada, and New York – not to mention in the states that passed ballot measures protecting abortion access prior to this election. If you truly intend to support and protect the rights of women, demonstrate it by allowing them – and the nations they live in – the autonomy to make their own reproductive health choices, free from government intrusion, financial coercion, and restrictive policies. While we hope that what is outlined in the Project 2025 playbook does not come to fruition, we are anticipating that your administration will embrace its anti-choice and anti-rights plans and roll back women’s fundamental freedoms. We will channel our energy into countering these expansions and navigating the next four years, in solidarity with our global health and civil society partners, to mitigate harm and advance health and rights wherever and whenever possible. 

Traci L. Baird, President & CEO, EngenderHealth 
Dr. Alvaro Bermejo, Director General, International Planned Parenthood Federation 
Simon Cooke, CEO, MSI Reproductive Choices