Ungagging Women’s Human Rights

Yifat Susskind

The global gag rule actually condemned more women to illegal, unsafe abortion by cutting funding for the very family planning programs needed to avoid unwanted pregnancies in the first place.

Of the
many crises President Barack Obama faces, few are more urgent than
preventing the needless deaths of half a million people this year. This
is the number of women who die annually from a lack of basic
reproductive health services. Unlike the global recession, climate
change, and other disasters compounded by George W. Bush, the crisis of
maternal mortality is easily resolved. Last week, Obama took an
important first step by rescinding the "global gag rule."

Formally known as the Mexico City Policy for the place where it was
first announced, the gag rule cut U.S. funding to foreign healthcare
organizations that provide abortions or abortion counseling, or
advocate legalizing abortion in their own countries (though in true
Bush-era fashion, anti-abortion advocacy was permitted).

The policy was nicknamed the "global gag rule" because it stifles free
speech and public debate, violating healthcare workers’ right to press
to change the laws that lead to nearly 70,000 abortion-related deaths each year.
The gag rule was thus an attack on women’s health, democratic process,
and free speech. Rescinding it is a fitting farewell to the Bush era,
but it’s only the first step in a needed overhaul of U.S. reproductive
health policy.

An Attack on Poor Women

For decades, the United States was the single biggest funder of
family planning programs in the Global South. When the Bush
administration imposed the gag rule, clinics there faced a stark
choice: lose their biggest stream of funding or compromise patients’
care by denying them the option of terminating a pregnancy.

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But the gag rule didn’t just target abortion providers. Many of the
clinics that lost funding provided crucial primary health care to some
of the world’s poorest women and their families. In Kenya, at least eight clinics were forced to close
when they refused to submit to the gag rule. Thousands of poor women
relied on these clinics for Pap smears, vaccinations for their
children, malaria screening, HIV/AIDS services, and other basic health
care. 

Three of the Kenyan clinics were affiliates of the International
Planned Parenthood Federation. In total, Federation clinics in 100 poor
countries lost over $100 million because of the gag rule. The
Federation estimates this sum could have prevented 36 million
unintended pregnancies and 15 million abortions. And the life-saving
health services denied by the gag rule could have prevented the deaths of more than 80,000 women and 2.5 million infants and children in the areas covered by their grassroots national affiliates.

In fact, the gag rule actually condemned more women to illegal,
unsafe abortion by cutting funding for the very family planning
programs needed to avoid unwanted pregnancies in the first place. In
Ghana, after the national Planned Parenthood Association lost U.S.
funding, its condom distribution dropped by 40%,
impacting family planning and HI/AIDS prevention programs. In some
areas formerly served by the Association, incidence of unsafe abortions
rose 50%.

A New Agenda

The gag rule’s repeal is welcome news. So is Obama’s announcement
that he will restore funding to the UN Population Fund and join "180
other donor nations working collaboratively to reduce poverty, improve
the health of women and children, prevent HIV/AIDS and provide family
planning assistance to women in 154 countries."

But these are only the first of many changes needed in U.S.
reproductive health policy. Remember, the Bush administration set the
bar extremely low, denying emergency contraception to girls raped
during the war in Kosovo and barring access to condoms and sexual
education in AIDS-ravaged Africa. Here are a few starting points for
undoing the damage:

  • Advance women’s human rights. Poverty and
    gender discrimination are the root causes of most maternal deaths.
    Protecting women’s social and economic rights, therefore, goes a long
    way toward reducing maternal mortality. As a start, the United States
    should ratify the Convention on the Elimination of All Forms of
    Discrimination against Women (CEDAW) and the Convention on the Rights
    of the Child, and honor its commitments to the 1994 International Conference on Population and Development, where governments first recognized reproductive choice as a human right.
  • Promote science and respect for democratic process over dogma, and repeal the Loyalty Oath
    requiring organizations receiving U.S. HIV/AIDS funds to state their
    opposition to prostitution. This totalitarian-minded provision goes
    even further than the gag rule in dictating not just what organizations
    can say and do, but what they can believe. U.S. policy should recognize
    sex workers as a key constituency in HIV/AIDS prevention strategies,
    and work to protect their human rights. The United States should also stop privileging sexual abstinence as a form of HIV prevention and base AIDS prevention strategies on what we know works: comprehensive education and condom distribution.
  • Restore
    U.S. investment in reproductive health services. In real terms, U.S.
    funding for international family planning services has fallen by 40% since 1995.
    Money is needed to ensure safe pregnancy and childbirth – not just in
    the Global North, but around the world. And money is needed to meet an
    urgent need for voluntary contraception, which could prevent 52 million unwanted pregnancies, 22 million abortions, and 1.4 million infant deaths each year.
    That last staggering figure represents children who die simply because
    the burden of unplanned births on their families means less food,
    health care, and other necessary resources for each child.

Reproductive Rights as Development

Funding women’s reproductive health initiatives isn’t an act of charity; it’s a cornerstone of global economic development. According to the UN Population Fund,
family planning "has the potential to reduce poverty and hunger, and
avert 25-35% of all maternal deaths and nearly 10% of all childhood
deaths. It would also contribute substantially to women’s empowerment,
achievement of universal primary schooling and long-term environmental
sustainability."

That’s because women’s ability to control their fertility is a
precondition for exercising autonomy in other realms of life. When
women can decide when to have children, they generally choose to have
smaller families. They participate more productively in their
countries’ economies and political processes, are healthier, and raise and educate healthier children.
These are the foundations of a more peaceful and prosperous world.
Despite the serious challenges we face, that more peaceful and
prosperous world is within reach. Lifting the global gag rule and
implementing human-rights-based policy in reproductive health and
universally is a good start.

This article was first published on Foreign Policy in Focus.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (R-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.