Policies and actions undertaken in the United States reverberate across the world and have far-reaching consequences. Take, for example, sexual and reproductive health. Decisions taken in the United States have harmed and may continue to harm, progress in developing nations' access to essential services.
The worldwide gag rule, initially imposed by Ronald Reagan in 1984, was the first US policy with repercussions for healthcare in other nations. Non-US organizations that receive US government funds are prohibited from providing, referring for, or promoting abortion as a method of family planning under this policy. The policy has been enacted or revoked by successive US presidents. When President Joe Biden assumed office in 2021, he put it on hold.
The second is the US Supreme Court's judgment on women's right to choose abortion. According to recently released documents, the court may overrule Roe v Wade, the famous 1973 decision that granted American women this choice. In a few months, the final decision will be made.
The ramifications for countries that look to the United States for leadership and money will go beyond abortion. The repeal of Roe v Wade, along with the reinstatement of the worldwide gag rule (if and when a Republican government does so), enables national and international resistance to sexual and reproductive health services including family planning, abortion, and comprehensive sexuality education.
This would be a catastrophic blow to African countries, whose modest advances are beginning to emerge in improved legislation and policies as a result of decades of work and lobbying. In Kenya, for example, we investigated the impact of the worldwide gag rule in 2020. Our findings suggested that government officials were abusing the US government's position to keep abortion discussions out of official meetings.
What occurs in the United States may essentially deny women their rights, putting the Sustainable Development Goal of lowering maternal, neonatal, and child morbidity and death back on track.