In advance of this week’s United Nations General Assembly, the Trump administration circulated a letter to UN member states calling for a “coalition” to oppose policies advancing reproductive rights and health. At the time, the news barely registered on the list of offenses against diplomacy and good governance meted out daily by the Trump administration. But it should have.
Signed by Secretary of State Mike Pompeo and Health and Human Services Secretary Alex Azar, the letter invited UN members to direct their diplomats to issue a joint statement at this Monday’s UN General Assembly high-level meeting on universal health coverage in New York City.
The secretaries said they were concerned about the advancement, within the UN, of what they called “aggressive efforts to reinterpret international instruments to create a new international right to abortion and to promote international policies that weaken the family.” The letter also argued that using terms such as “comprehensive sexuality education” and “sexual and reproductive health and rights” takes away from parental rights, weakens the family, diminishes national sovereignty, and forces countries to abandon their religious principles.
The so-called harmful policies listed by Pompeo and Azar are, of course, nothing of the sort. Increasing access to sexual and reproductive health care—including abortion—and informing youth and adolescents how to best manage their sexual well-being does not negatively impact the family, national independence, or religious freedom. If adequately funded and backed by political will, these policies improve women and adolescents’ access to quality health care, reduce unwanted pregnancies, reduce maternal mortality and morbidity, and support people in making informed personal decisions about their health and sexuality.
Sex. Abortion. Parenthood. Power.
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The letter appears to have worked: Speaking on behalf of the U.S. government at the opening of the UN meeting Monday morning, Azar presented a joint statement on behalf of 19 countries. Generously lifted from the original letter, the coalition rejected inclusion of the term “sexual and reproductive health and rights,” in UN documents, while only supporting sexuality education that considers “the protective role of the family in this education.”
This mendacious reading of well-established health policy undermines the very goal of this week’s UN debate: how to provide all people with quality health-care services without financial hardship. And it builds on a long right-wing history of intentional, politically-motivated misinterpretation of these policies.
In 1994, 179 governments gathered in Cairo at the United Nations International Conference on Population and Development (ICPD) to adopt the landmark Programme of Action, a blueprint to advance women’s reproductive health and rights. ICPD was designed to galvanize governments to advance reproductive health and rights, individual rights, and women’s empowerment.
This year marks the 25th anniversary of the Cairo Declaration. But what are we celebrating? According to the United Nations Population Fund, access to modern contraception has increased by 25 percent, preventable maternal deaths have declined by 40 percent, and awareness of and efforts to end harmful practices like child marriage and female genital mutilation have increased. Twenty-five years after the promise of ICPD, a lot has been accomplished, but we should be doing much more. Worldwide, an estimated 44 percent of pregnancies are unintended; an estimated 25 million unsafe abortions occur annually; and approximately 2.5 million girls under the age of 16 give birth each year.
Not only has progress on many issues stalled, there has also been serious backlash. Religiously motivated conservative groups are pushing their governments to turn back the clock to pre-1994 standards. The letter from Pompeo and Azar is remarkable not only for its ridiculous allegations (for example, that countries will be pressured “to abandon religious principles and cultural norms”), but because the U.S. government is attempting to create a groundswell of support within the United Nations for rejecting standard operating language and policy on women’s issues.
The Trump administration has been seeding this ground for some time. Last year, around the time of the 2018 UN General Assembly, internal memos from the State Department advised U.S. diplomats to push back against UN resolutions that address women’s issues, specifically striking language on sexual and reproductive health and comprehensive sexuality education, as well as the word gender—the latter in a pointed attempt to erase transgender people from the debate.
By May of this year, at the World Health Assembly in Geneva, the United States was working to bring others into the fold. The U.S. government, with support from countries like Saudi Arabia, Nigeria, Egypt, Brazil, and Iraq, issued a joint statement rebuking the World Health Organization, the preeminent UN authority on global health, for using the term “right to sexual and reproductive health,” which they insisted is associated with pro-abortion policies.
It’s heartening, however, to remember that beyond this battle on language, feminist and human rights activists around the world are doing the actual work to move the vision of ICPD forward: A galvanized human rights movement in Ireland set the stage for a referendum that repealed the country’s abortion ban in a landslide. And the grassroots women’s movement in Mexico created the Maria Fund to provide financial, emotional, and logistical support to women traveling to the capital for legal abortion services.
While ICPD has made progress, it has yet to live up to its full promise. Pompeo, who has said that the Bible “informs everything I do,” wants to make it irrelevant.
For now, the UN space is valuable. Until governments come together to make a stronger promise than ICPD, this is what we must work with.
Yesterday, in a pointed rebuke to the Trump Administration’s call to action, 58 member states came together to issue a strongly worded defense of sexual and reproductive health and rights. This bodes well, and advocates hope that the meeting this week will end with a political declaration that incorporates sexual and reproductive health and rights, including abortion, as an integral part of universal health coverage.