Africa: Global Gag Rule, 03/26/03

Africa: Global Gag Rule, 03/26/03

AFRICA ACTION Africa Policy E-Journal March 26, 2003 (030326)

Africa: Global Gag Rule (Reposted from sources cited below)

This posting contains a press release and the declaration from a consultation on unsafe abortion held in Addis Ababa from March 5-7, 2003, as well as two short feature stories on the consultation from African Gender and Media. The consultation, the first on the topic held on a continent-wide basis, was sponsored by a number of African and international groups working on women's reproductive rights. Among the resolutions was a strong condemnation of the Bush administration policy called the "global gag rule," which bars U.S. assistance for family planning programs that also provide counseling on abortion.

Additional information about the Addis Ababa consultation can be found on the website of Ipas, at, and at, which has reports from the consultation provided by African Gender and Meida.

Currently there is also uncertainty and internal debate in Washington about the extent to which this rule will also be applied to new U.S. funds promised by President Bush to fight global aids. A large number of U.S. and international groups, including Africa Action, have spoken out against the Global Gag Rule, in a series of recent letters to President Bush. Copies of the letters, and latest news on developments, are available on, the website of Center for Health and Gender Equity (CHANGE), 6930 Carroll Avenue, Suite 910, Takoma Park, MD 20912 USA. tel: 301-270-1182, fax: 301-270-2052, email:

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Saving Women's Lives from Unsafe Abortion

March 18, 2003

African health leaders, lawyers, women's advocates call for action to save women's lives from unsafe abortion

Participants in Africa's first regional consultation on unsafe abortion speak out against the Global Gag Rule, saying it impedes efforts to reduce unwanted pregnancy and unsafe abortion.

For more information, contact: Merrill Wolf Senior Advisor, External Communications, Ipas Email: Website: Phone: 919-960-5612, 800-334-8446 , Fax: 919-929-0258 300 Market Street, Suite 200, Chapel Hill, NC 27516 USA

Ipas Africa Alliance PO Box 1192 Rhapta Road/Mvuli Road Junction, 00200, City Square, Nairobi, Kenya Tel: 254-2-445900 :: Fax: 254-2-449177 e-mail:

March 18, 2003 - More than 100 African leaders from 15 countries who attended the continent's first regional conference on unsafe abortion concluded deliberations in Addis Ababa, Ethiopia, March 7 with a strong call for action to address this global public-health problem. Unsafe abortion results in the deaths of about 30,000 African women every year, according to the World Health Organization.

The multidisciplinary group of experts attending the "Action to Reduce Maternal Mortality in Africa" conference included health ministers, parliamentarians, health-care professionals, women's advocates, lawyers and others. They called on African governments to uphold commitments under numerous international agreements to address unsafe abortion effectively, including by increasing the availability of information and services to help prevent unwanted pregnancy and by making safe abortion available to the full extent of local and national laws.

Participants committed themselves to educate the full spectrum of stakeholders affected by unsafe abortion about its tragic, preventable impact and to work more effectively within existing legislation and health systems to make high-quality, comprehensive reproductive-health care universally available.

"The primary interest of everyone involved in this conference is to save women's lives from unsafe abortion - something we know how to do but for which the global community has lacked political will," said Dr. Eunice Brookman-Amissah, a former Minister of Health of Ghana who now heads the Ipas Africa Alliance for Women's Reproductive Health and Rights. Along with several other organizations, the Ipas Africa Alliance co-sponsored the conference.

"No one wants to promote abortion," she continued. "It's true that liberalization of abortion laws has been shown to reduce maternal mortality, but the immediate priority is not always to legalize abortion. It is instead to make safe services available to the full extent of existing laws."

Brookman-Amissah noted that every African country permits abortion in some circumstances but that women rarely have access to care to which they are legally entitled. "That is why so many women and girls are maimed or die," she said.

Participants also called on African governments and the global community to be accountable to citizens and other stakeholders by opposing the Global Gag Rule imposed in January 2001 by the administration of U.S. President George W. Bush. This policy disqualifies nongovernmental organizations outside the United States from receiving U.S. family planning funding if they provide counseling on abortion, provide legal abortion services except in very narrow circumstances, or participate in political debate surrounding abortion.

"By reducing funds available for preventive family planning, the Global Gag Rule clearly impedes efforts to reduce unsafe abortion," said Brookman-Amissah. "Contrary to its stated intentions, the policy results in more unwanted pregnancies, more unsafe abortions, and more deaths of women and girls. We who have seen those effects first-hand can no longer tolerate silence about the gag rule's tragic effects."

Conference participants decried the lack of attention to reproductive health in general and to unsafe abortion in particular in programs to achieve the Millennium Development Goals, which United Nations member nations adopted in 2000. "Maternal mortality cannot and will not be reduced by 75 percent by 2015, nor will goals related to poverty reduction and economic development be achieved, without attention to unsafe abortion," Brookman-Amissah said.


Communique from the "Action to Reduce Maternal Mortality in Africa" Regional Consultation on Unsafe Abortion

March 5-7, 2003 Addis Ababa, Ethiopia

Note: Cosponsors of the consultation were the Amanitare African Partnership for Sexual and Reproductive Health and Rights of Women and Girls, the Centre for Gender and Development of the Economic Commission of Africa, the Commonwealth Regional Health Community Secretariat, the Ipas Africa Alliance for Women's Reproductive Health and Rights, the Regional Prevention of Maternal Mortality Network and the UNFPA Country Support Team for East and Central Africa. Representatives of multilateral and bilateral donor and technical support agencies also attended the consultation. Neither cosponsorship nor representation at the consultation implies endorsement by these organizations of the contents of this communique.

Background and Preamble

We, the 112 participants of "Action to Reduce Maternal Mortality in Africa: A Regional Consultation on Unsafe Abortion," which took place March 5 7, 2003, in Addis Ababa, Ethiopia, represent a cross section of African Ministers of Health, parliamentarians, directors of health services, heads of reproductive-health units, heads of academic institutions, youth activists, national and regional women's groups, national networks engaged in promoting women's health, nongovernmental organisations, religious organisations, professional organisations such as obstetrician-gynaecologists and nurse-midwives, lawyers, sociologists and media practitioners.

During the three-day consultation, we reviewed numerous dimensions of the public-health challenge of unsafe abortion, including the sociocultural, legal and policy context in which it occurs. Recognising that abortion has always occurred and will continue to occur in all cultures, we focused on the need to make it safe in order to reduce related deaths and injuries of women. We examined laws, policies and international commitments influencing access to safe abortion in Africa; health-care providers' and public and private health systems' role in meeting women's needs for safe abortion; and strategies for creating an enabling environment that supports women's right to safe abortion and related services.

Based on our own experiences and on presentations and discussions during the consultation, we note with alarm that maternal mortality rates remain unacceptably high and that unsafe abortion accounts for an average of 12 percent of maternal deaths on the African continent. At the national level, experts estimate that unsafe abortion contributes in the range of 10-50 percent of maternal deaths in African countries. Of the 68,000 deaths from complications of unsafe abortion worldwide, 30,000 or nearly half are in sub-Saharan Africa.

In addition to the shocking number of African women whose lives are lost each year, unsafe abortion causes thousands more women to suffer serious illnesses and injuries and renders many infertile. These deaths and injuries are preventable, since safe and effective technologies for contraception, pregnancy termination and postabortion care are available but underutilized. We also know that deaths and injuries from unsafe abortion disproportionately affect adolescents, poor and other marginalised groups of women, depriving Africa of a valuable human resource.

We recognise that, worldwide, restrictive abortion laws and lack of safe abortion services are the major factors contributing to the disproportionately high mortality of women from unsafe abortion. Most African countries operate under archaic laws related to abortion that were imposed by former colonial powers and have long since been changed in those countries. In most countries where abortion laws are liberalised, there are almost no deaths from unsafe abortions.

We note that legislation in most African countries legally permits abortion in limited circumstances such as in cases of rape, incest or to save a woman's life but that the majority of women and health-care providers remain uninformed of their legal rights and obligations. We further recognise that many of the root causes of unsafe abortion including African women's lack of access to comprehensive reproductive-health information services to prevent unwanted pregnancy, and lack of decision-making power related to sex and reproduction are the same as those underlying the HIV/AIDS pandemic.

We note also that all African countries have signed the Programme of Action of the International Conference on Population and Development, the Platform for Action of the Fourth World Conference on Women and other international agreements, compliance with which requires addressing the public-health problem of unsafe abortion, including by making safe abortion available to the full extent of local law.

We stress that unsafe abortion has significant economic implications, including the enormous costs to African health systems associated with managing its complications. Until women can make their own reproductive choices safely, poverty alleviation and economic development cannot be achieved. Policies of Northern governments and international financial institutions such as health-sector reform, debt restructuring and structural adjustment severely constrain health and social spending by African governments and require revisiting.

Commitments and Recommendations

Thus, we the participants commit ourselves to:

* Formulate specific strategies to educate and engage all stakeholders in advocacy to reduce the incidence and impact of unsafe abortion;

* Work more effectively within existing legislation and health systems to ensure that high-quality, comprehensive reproductive-health care is universally available, with special attention to reaching and responding to the needs of especially vulnerable populations.

We the participants call on African governments to:

* Include specific and increased funding for reproductive health and to address unsafe abortion in national and health system budgets;

* Advocate for specific attention to reproductive health and unsafe abortion in programs to achieve the Millennium Development Goals, notably with regard to objectives specified in Goal 5, "Improve Maternal Health;"

* Initiate reviews of existing, and in many cases outdated, laws criminalising abortion, in line with specific commitments under international agreements.

Additionally, we the participants call on multilateral and bilateral donor agencies, headquarters and regional country offices of international technical support agencies, and the global community to:

* Direct more resources to preventing unsafe abortion and to making safe legal abortion available to the full extent of the law;

* Provide the necessary leadership in addressing issues of unsafe abortion especially in the dissemination and implementation of technical and policy guidance for safe abortion in Africa.

Finally, we the participants vehemently oppose the Global Gag Rule that was reinstituted in January 2001 by U.S. President George W. Bush and which clearly impedes efforts to reduce unsafe abortion. We call on African governments and the global community to be accountable to their citizens and other stakeholders by opposing it.

In conclusion, participants in the "Action to Reduce Maternal Mortality in Africa" consultation reaffirm our commitment to doing whatever is within our power at the national and regional levels to halt the needless deaths and injuries of African women and girls from unsafe abortion. We do this not only in the interest of the girls, women, families and communities affected by unsafe abortion today, but also for Africa's future.


Action to reduce maternal mortality in Africa

Another apartheid on our door steps

By Rosemary Okello

The fact that women in the industrialized world who seek an abortion face almost no risk to their health, while women in Africa face death or are maimed for life, is one of the greatest health tragedies in the world today.

"There is no greater apartheid in the world than what is being experienced in the field of reproductive health," said Prof Fred Sai, consultant chair and Presidential Advisor on Reproductive Health and HIV/ AIDS, Ghana, in his keynote speech to the regional consultation on unsafe abortion.

The fact that by the end of the March 5-7 consultation, 280 women would have died from unsafe abortion complications calls for each individual to take action no matter how small, Sai said. "Nobody is too small to fight for women's right and all of us have a role."

The current scenario in Africa is one where non- governmental organizations and community health providers are at the forefront of service delivery in countries where abortion laws are restrictive, while the governments promote post abortion care.

The key issue for activists pushing for unrestrictive abortion laws and better access to reproductive health care for all is how to close the gap and at what cost.

There is a need to move beyond the "rhetoric and offer women abortion care and ensure that there is access to services," said Prof. O.A. Ladipo, President of the Association for Family Planning and Reproductive Health, Nigeria.

But this cannot be achieved unless there is political will and involvement among governments, policy makers, service providers and everyone in society, experts say. Therefore the question of abortion needs to be placed in the context of women's overall access to health care and their status in the society, experts add.


Action to reduce maternal mortality in Africa

A window of opportunity

By Rosemary Okello

"Can African women count on us?"

This question summed up the call for action which emanated Friday from the first ever Regional Consultation on Unsafe Abortion held in Addis Ababa, Ethiopia. For many participants to the March 5-7 meeting, the sharing of experiences and the learning from one another has made them more determined than ever to address the needless loss of women's lives from unsafe abortion.

"One of the key targets is the community, because abortion is a very emotive subject that is normally looked at from a social- cultural point of view. Life is normally structured around communal roles and responsibility in Africa," said Amb. Dr. Eunice Brookman-Amissah, Ipas Vice-President for Africa.

The Consultation agreed that using the right language and targeting key stakeholders can help shift attitudes about abortion on the continent.

Prof. Oladapo Ladipo, President, Association for Family and Reproductive Health, Nigeria said that as leaders and activists on unsafe abortion, the participants have a critical role to play in mounting a campaign that is able to achieve the goal of saving many women who are dying. " We have to use everything at our disposal, including sharing the lessons learnt during the meeting," Ladipo said.

He said that for the first time, stakeholders in the region were able to go behind the statistics and bring out the magnitude of the problem as it presents itself in the various countries of Africa.

"Advocating for the liberalization of abortion laws or using the same laws to campaign for access to services is one of the ways forward," Ladipo said. Also, he added, advocacy is key, especially when dealing with religious leaders, traditionalists, politicians, and the women's groups which normally lack information on unsafe abortion.

"In African countries, there is no law that absolutely prohibits abortion and it is the same medical people and the society that have not been able to interpret the law correctly. With this window of opportunity, all stakeholders can do something for the African woman.

"This does not mean that we are promoting abortion, because I am yet to see a woman who enjoys terminating a pregnancy, unless it is due to some reason," Ladipo continued.

Echoing the same sentiment, Uche Ekenna, Ipas Acting Regional Director for Africa, added that: "more importantly would be for the providers and health personnel to know what is the limitation of the law, and to be able to provide the services according to the limit of the law."

But he warns that, even in countries where the law has been liberalized, many women still cannot access the reproductive health services, partly because of the lack of adequate resources.

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Date distributed (ymd): 030326 Region: Continent-Wide Issue Areas: +political/rights+ +gender/women+


Message-Id: <> From: "Africa Action" <> Date: Wed, 26 Mar 2003 11:33:39 -0500 Subject: Africa: Global Gag Rule

Editor: Ali B. Ali-Dinar

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