Melinda & Bill Gates Sound Alarm Around Devastating Impact of Mexico City Plan's New Restrictions

Bill and Melinda Gates are notoriously discreet in avoiding political arguments that could impact their work at The Gates Foundation.  They don't endorse candidates and try to work with every White House administration on getting US support in solving some of the world's  most challenging problems. 

This week, the Gateses felt compelled to express concern about the impact of Donald Trump's 'America First' stance on US development aid. They also expressed grave concerns about Trump proudly signing an executive order that reinstitutes the Mexico City policy.  The global gag rule states that the U.S. “does not consider abortion an acceptable element of family planning programs,” and that it will “no longer contribute to separate nongovernmental organizations which perform or actively promote abortion as a method of family planning in other nations.”

Trump’s reinstatement of the rule takes it a step further and disqualifies foreign NGOs from receiving any other U.S. global health funding if they do not certify that their own funds—no matter the source—will not be used to perform or actively promote abortions. Now, if an NGO even talks about abortion, it cannot receive funding from any U.S. department or agency for any global health program. The full text of the memorandum can be found here.

This expansion of restrictions in the name of religious liberty caught many NGOs and foundations -- including the Gates Foundation -- by surprise. 

A Pro-Life Policy That Has Deadly Impact

Inside Philanthropy reviews Melinda Gates' February 14, 2017 interview with Bloomberg Television, writing that Melinda spoke with "barely controlled rage."  Like so many of us she cannot make peace with an official US pro-life policy that threatens to kill so many people in easily quantifiable analyses. 

Melinda Gates said: "I'm personally concerned about the Mexico City Policy." And it isn't just continued access to contraception that worries Gates, who's been a champion of greater investments in family planning. She also noted that the expanded rule could affect health organizations that provide drugs to combat HIV, malaria, and other diseases. She pointed to its possible effects on the work of the Global Fund, supported by a wide range of governments (including the U.S.) and many private donors, which she said had saved 20 million lives, in part by setting up health clinics around poor countries that distributed HIV/AIDS drugs. "And because we're implementing a policy, all of sudden a clinic's going to be shut down?" Gates asked, in disbelief. She slammed the new policy as out of step both with America values (including a belief in "life") and its national security. 

Pathfinder International, a global health initiative working to expand access to contraception, promote healthy pregnancies, and halt the spread of HIV, called the global gag rule a "punitive policy that risks women's lives around the world."

To date, the Gates Foundation has awarded $43 million in grants to Pathfinder. The Susan Thomson Buffett Foundation, the largest overall player in global family planning, gave Pathfinder over $20 million in 2015 alone. Even though abortion is legal in most of the countries in which it operates, Pathfinder stands to lose all funding from USAID, for even directing a woman to another facility for information. In 2015, USAID funding was $70 million.

All of these cuts and new restrictions will put intense pressure on Gates, Buffett and other funders to do more. This reality is particularly challenging to Melinda Gates, who in 2012 launched Family Planning 2020 (FP2020), a global campaign for the rights of women and girls globally to plan and control their fertility. The FP2020's goal of providing 120 million women and girls with access to modern contraceptives by 2020, no matter their circumstances and no matter where they live, is seriously imperiled by the expanded restrictions on the Mexico City Policy. 

“I believe in universal voluntary access to contraception. Full stop,” Melinda Gates said in an interview. “I’ve seen it transform millions of women’s lives around the world.” Over 300 million women in developing countries now have access to modern contraception, while an estimated 225 million more want it but don’t have adequate access.  Melinda Gates' FP2020 goal would more than cut that need in half, but meeting it is now very much in peril. 

Bill and Melinda Gates receive medals from Obama at presidential medal of freedom ceremony in November 2016. Photograph: Carlos Barria/Reuters

Dear Warren From The Gateses

In the annual Gates Foundation letter to Warren Buffett, who a decade ago pledged 10m shares in his company Berkshire. Donated in annual installments -- the gift was worth about $31 billion at the time -- Bill Gates himself borrowed a term from U2s Bono and called poverty sexist in his progress letter.

“You cannot go out and be in the developing world and then come back and look at the data and turn away from the importance of women in the developing world,” said Melinda Gates.

Whether they breastfeed and take their children to be vaccinated makes a profound difference to how the child grows and his or her life chances, and men are not always there, she added. “So you have to look at the woman’s role and when you look at it you realise it can be an accelerator to every single thing you want to have happen in the world for global health and global development and social change.”

“The poorer the society, the less power women have. Men decide if a woman is allowed to go outside, talk to other women, earn income. Men decide if it’s acceptable to strike a woman. The male dominance in the poorest societies is mind-blowing.”

In the letter, Melinda Gates adds: “It’s also crippling. Limiting women’s power keeps everyone poor.”

“Warren, if Melinda and I could take you anywhere in the world so you could see your investment at work, we probably would take you to meet sex workers. I met with a group in Bangalore, and when they talked about their lives, they had me in tears,” writes Bill Gates.

“One woman told us she turned to sex work after her husband left her – it was the only way to feed her children. When people in the community found out, they forced her daughter out of school, which made the girl turn against her mother and threaten to commit suicide.

“That mother faced the scorn of society, the resentment of her daughter, the risks of sex work, and the humiliation of going to the hospital for an HIV test and finding that no one would look at her, touch her, or talk to her. Yet there she was, telling me her story with dignity.”