Canadian aid groups are deliberating how to respond to American policies that block U.S. aid for virtually any group in developing countries that provides abortion, science-based sexual health information or LGBTQ+ advocacy.
The rollback of feminist aid has those groups calling on Prime Minister Mark Carney to assemble a coalition of like-minded nations to defend sexual health programming.
“People are more likely to die because they’re not receiving this kind of assistance,” said Erin Kiley, director of international programs at Oxfam Canada.
Since 1985, Republican administrations have implemented what they call the Mexico City policy, which blocks American funding for groups that provide abortion counselling or referrals.
Democrat administrations have repeatedly rescinded the policy, then see Republican administrations reinstate it. Some call it the “global gag rule” because it limits advocacy for decriminalizing or expanding abortion services.
Some studies have suggested the policy leads to a rise in unintended pregnancies and unsafe abortions in various countries.
In 2010, the Conservative government of Stephen Harper took a similar approach by boosting funding for maternal health while blocking those funds from being used for abortion services.
Aid groups found ways to circumnavigate those American and Canadian policies. They used funding from other nations to fund abortion services or dipped into their budgets to construct sexual health facilities adjacent to general clinics.
But U.S. President Donald Trump drastically expanded the policy in February by barring more types of U.S. funding from going to any groups receiving funding from other sources for abortion services. His policy also withholds funds from groups advocating for LGBTQ+ issues or gender-affirming medical care.
The changes came after drastic cuts to American foreign aid and as Trump’s government signed deals with socially conservative governments abroad to fund national health systems in partnership with religious groups opposed to abortion and gay rights.
Kiley said Oxfam’s partners in places like southern Africa are facing some tough choices. Some still champion gender rights, she said, while other groups avoid those topics — including some which don’t receive American aid but might one day apply for it.
“Coalitions that work in this space (are) becoming a bit fragmented, because some are trying to align with U.S. government policy and others are trying to be outspoken,” Kiley said.
“In Zimbabwe in particular, they referred to a chilling effect on rights and advocacy.”
Kiley said her organization takes virtually no U.S. funding, giving Oxfam more ability to speak out than some of its peers. Other charities declined to be interviewed for this article, citing the risk of American blowback.
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The debate within the sector came up at an April conference of aid groups in Ottawa. The Canadian branches of well-known, globally federated charities told the conference their organizations had internal rifts over how to respond.
The conference heard that branches in Canada, Europe and developing countries had different views on whether it was ethical for organizations which don’t work on maternal health or LGBTQ+ rights to take funds from Washington.
Jessica Stern, appointed by former U.S. president Joe Biden as a special envoy on LGBTQ+ rights, told conference participants they should take the money when they are able to comply with the Trump policy.
“U.S. taxpayers are contributing significant dollars and we should make sure that some of that money goes to good work,” she said on April 22.
“I am very afraid of a scenario — which could happen — where the U.S. government is actively funding (anti-gay) conversion therapy and is actively funding programs to get women to stay with their batterers, and all kinds of other ugly, anti-rights initiatives.”
Erica Belanger, the interim Canada head of MSI Reproductive Choices, said her organization has seen a 20 per cent increase in demand for sexual health services since Trump returned to the White House and slashed aid spending.
In Zambia, the charity stepped in to distribute contraceptives in rural areas because no other groups had funding to bring supplies from city depots.
“Canada’s soft power really, really matters in this moment,” Belanger said. “We need strong government leadership that will stand up for these issues.”
The Canadian Partnership for Women and Children’s Health is also urging Canada to assemble a coalition to preserve sexual health services and advocacy for reproductive rights.
“It’s completely trying to break and fragment the global health system to essentially ring-fence partners who do provide access to safe abortion and comprehensive sexual reproductive health and rights programming, and those who do not,” said the coalition’s CEO Caitlin Goggin.
“They are trying to completely change the way in which comprehensive health services are provided around the world and asking partners — all the way down to local small organizations — to make impossible choices about whose money they receive and take in a moment of global scarcity.”
She said Washington is asking Malawi and Zambia to split the work of medical workers, so that those working in sexual health cannot do general medicine, and vice versa.
“This is a health rights issue for women and families. And without full access to the comprehensive slate of services, women don’t have full bodily autonomy around the world,” said Goggin.
Randeep Sarai, secretary of state for international development, was not available for an interview. His office said in a media statement that it’s engaging with Canadian organizations “to assess possible impacts on their operations and service delivery as a result of the U.S. administration’s changes” to foreign aid.
“Gender equality has been a part of Canada’s development programming for decades, and it will remain a core part of our international assistance going forward,” wrote spokeswoman Shanti Cosentino, listing projects Canada has supported on sexual health and gender gaps in labour markets.
“We continue to advocate for and believe in the importance of gender equality and inclusion as core principles for achieving sustainable development outcomes,” Cosentino wrote, adding this includes work through the G7, the G20 and the United Nations.
The aid sector is hoping Canada renews its 10-year commitment to funding health services through a gender lens, which expires in 2030.
