President George W. Bush still calls himself "a uniter, not a divider." But he used his first full workday in office last week to tilt toward his supporters on the religious right. His order banning U.S. aid to international organizations that conduct or "actively promote" abortions was apparently intended as a small gesture, issued during a week devoted to a high-profile plan for education reform. But U.S. pro-choice activists, caught off guard, reacted with anger--and the impact of the Bush rules could spread far overseas.
The measure had been in effect under Ronald Reagan but was repealed by Bill Clinton in 1993. Though no more than a handful of the 450 groups that receive funding from the United States Agency for International Development (USAID) are likely to be directly affected, many more worry that they will feel the pain.
Some accused the U.S. government of promoting a double standard. "What the Bush administration is saying is, 'It's fine for us American women to have safe, legal abortions, but you women in the developing world, thou shalt not have safe abortions'," said Pramilla Senanayake, assistant director general of International Planned Parenthood Federation in London. IPPF, one of the world's largest family-planning organizations, was one of two groups to lose funding under Reagan and believes its aid is once again in jeopardy. Eight of IPPF's 100-some branch offices in developing countries perform abortions or are involved in abortion advocacy. The organization had been counting on $5 million from USAID, or about 8 percent of its budget. Losing the aid under Reagan "was really tough," said Senanayake, whose organization was forced to cut several programs.
The Johannesburg-based Planned Parenthood of South Africa is also bracing for cutbacks. The group, which makes information about abortion readily available, was expecting to receive one quarter of its budget, or about $2 million, from the USAID-funded organizations Pathfinder and VSC International. Director Motsomi Senee says the cuts won't bite until the summer and hopes to make up the shortfall by applying for more help from some of the group's private funders, including the Bill & Melinda Gates Foundation and the Henry J. Kaiser Family Foundation. But even so, she expects to have to halt several programs, including an effort to distribute contraceptives in the country's most rural regions.
No one will know the full effects of the new policy until the guidelines come out in mid-February. One official knowledgeable about the regulations said he expects them to be virtually identical to Reagan's, implemented in 1984. Under Reagan, referrals for abortion were allowed in cases of rape or incest, or if the life of the mother was in danger. But U.S.-government-funded agencies were explicitly forbidden to "provide advice that abortion is an available option" unless specifically questioned by a pregnant woman who had "already decided to have a legal abortion."
Though a limited number of agencies seem in danger of losing funds, family-planning organizations say the effects of the new policy will be widespread. "In the other countries, we're going to be confronted with a problem which we saw in the Reagan era," says Kate Bourne of Boston-based Pathfinder International. "Clinics start to shy away from providing lifesaving care for women who come in from botched illegal abortions, even though that's exempted from the policy."
Others suggest that Bush's policies may be more liberal than Reagan's. The new administration, says a knowledgeable U.S. government official, appears more supportive of family-planning programs as a whole. For one thing, it did not reduce the aid budget of $425 million approved by the previous Congress. And a press release issued by the White House last week underlined the importance of "providing quality voluntary family-planning services" and of "not limit[ing] organizations from treating injuries or illnesses caused by legal or illegal abortions." The confusion will clear up only after Bush issues the new U.S. regulations--and people far beyond the United States are waiting to see what he has in mind.