On January 23, 2017, President Trump reinstated and significantly expanded the Mexico City Policy (MCP), which prohibits non- U.S.-based nongovernmental organizations (NGOs) from receiving U.S. global health funding if they perform, counsel on, or refer for abortion, or advocate for its liberalization outside of limited exceptions. Whereas the MCP historically only implicated family planning funding, the expanded MCP (EMCP) now applies to all federal global health assistance funding. As such, the EMCP now applies to HIV funding through the President’s Emergency Plan for AIDS Relief (PEPFAR), implicating hundreds of new implementing partners (IPs) that were previously exempt. While the EMCP’s impact on PEPFAR IPs is not yet known, previous iterations of the MCP prompted service reductions and clinic closures among family planning providers. In order to understand if and how PEPFAR IPs may be affected, amfAR, in collaboration with Johns Hopkins University, launched a confidential electronic survey and key-informant interviews with PEPFAR IPs to document any changes in organizational operations and service delivery prompted by the EMCP.
Background on the Mexico City Policy
• Since the 1970s, the Helms Amendment has prevented any U.S. foreign assistance funding from being used for abortion services, even during the Clinton and Obama administration years when the MCP was not in effect. In contrast to the Helms Amendment, however, the MCP extends restrictions to organizational activities as a whole, even those supported by non-U.S. funding. Specifically, the EMCP restricts a nonU.S.-based NGO from engaging in the following activities while receiving U.S. global health assistance: 1) abortion services; 2) counseling on abortion; 3) referring for abortion; and 4) advocating for the liberalization of abortion access. Limited exceptions in the cases of rape, incest, or if carrying the pregnancy to term would endanger a woman’s
life, are allowed in the EMCP language.