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Explainer: Important update to the Protecting Life in Global Health Assistance Policy

On Aug. 18, the Department of State, Department of Health and Human Services (HHS), and United States Agency for International Development (USAID) released the second review of the implementation of the Protecting Life in Global Health Assistance Policy (PLGHA). The purpose of PLGHA is to “prevent American taxpayers from subsidizing abortion through global health assistance provided for populations in need.” This policy ensures that any foreign aid funding to international nongovernmental organizations (NGOs) agree to neither perform nor actively promote abortion as a method of family planning overseas.

PLGHA expands the Mexico City Policy to “global health assistance furnished by all departments or agencies” to the extent allowable by law. The Mexico City policy only applied to voluntary family planning assistance funded by USAID and assistance for certain voluntary population planning furnished by the Department of State. 

In January 2017, the Administration reinstated and expanded PLGHA, and in February of 2018, the State Department released a six-month review of PLGHA. At that time, not all existing agreements had received new funding grants, and not all grantees had been required to agree to the terms of PLGHA. 

USAID Acting Administrator John Barsa stated that “this second review examined the PLGHA Policy’s benefits and execution. As such, this review of the PLGHA Policy provides detailed information on the small number of awards affected by organizations that declined to agree to the policy, including how the declinations affected awards and ongoing assistance, as well as USAID’s efforts to transition activities to new partners as quickly as possible to prevent or resolve any delays or gaps in care.”

Highlights of the report

Below are some of the key findings of the report:

The majority of grantees that receive U.S. global health assistance funding have chosen to comply with the terms of PLGHA, and that implementation of PLGHA has caused minimal disruption in healthcare delivery. The report noted, “When organizations declined the terms of PLGHA, the transitions to alternative health providers have been, for the most part, smooth.”

Out of 1,340 prime grantees, only eight declined to comply with the terms of PLGHA, in addition to a small number of sub-awardees.

Two of the prime grantees that declined the PLGHA terms were International Planned Parenthood Federation (IPPF) and Marie Stopes International (MSI), both of which, as the report notes, “are two of the largest and most-vocal organizations that have attempted to assert a global right to abortion on demand.” Both awards began in 2014. The total estimated award for IPPF was $71.8 million; the total estimated award for MSI was $74 million. When IPPF and MSI declined the terms of PLGHA, USAID redirected some funding to another prime grantee and began partnering with other organizations capable of taking over the nonabortion related health care work done by these two entities.

The report concludes by stating that “the vast majority of the U.S. Government’s implementing partners accepted the PLGHA standard provision when presented with it. When organizations declined the terms of PLGHA, the transitions to alternative health providers have been, for the most part, smooth. In some cases, other donors or the host government have stepped in to fill gaps that occurred because of a declination of PLGHA. Only in limited instances has the Agency struggled to identify new partners or sub-awardees with comparable skill sets, networks, or capacity for outreach as those who declined the terms of PLGHA.”

The ERLC is committed to protecting life, both domestically and abroad, and we’re encouraged by this implementation report and grateful for the effectiveness of PLGHA.

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