In February 2006, the UK government made a historic decision: in response to the erosion of funds available for work on safe abortion worldwide, it announced the creation of the Global Safe Abortion Fund (now known as the Safe Abortion Action Fund). Administered by the International Planned Parenthood Federation, the Fund offers nongovernmental organizations worldwide up to 2-year, $350 million grants for safe abortion advocacy, service provision, or operations research. Fund administrators have pledged to place a particular emphasis on reaching the most marginalized, vulnerable women in the world, many of them in developing countries.

Just under a year after it put out a call for proposals, the Fund has recently announced that it has received 222 requests for funding, totaling $43 million. This number is a powerful reminder of the staggering lack of funding available for safe abortion worldwide, despite enormous global need. For the countless local, national, and international groups working to address the public health crisis of unsafe abortion, the creation of the Fund was a kind of reproductive health Deus ex Machina. Recent years have seen a steep decline in the availability of funds for organizations and projects that even mention the "A" word, no matter how comprehensive the projects are, and no matter how wide the range of community needs served by the organization.

It's amazing that the need for funding is so great, especially since countries of the world have recently reaffirmed their commitment to reducing current maternal mortality rates by three-quarters by 2015 (through the Millennium Development Goals), and achieving universal access to reproductive health services by the same year (through the reaffirmation of the Cairo Programme of Action). Thirteen percent of the over half a million pregnancy- and childbirth-related deaths worldwide are attributable to unsafe abortion (19 million women worldwide seek unsafe abortions annually, and 70,000 women die from the consequences of these procedures, 96 percent of them in developing countries) – so we really cannot hope to achieve our global goals on reproductive health without expanding women's access to safe abortion and working to increase women's control over the decision to become pregnant.

Yet somehow, the United States is vigorously pursuing the opposite strategy: eliminating or dramatically reducing funding for reproductive health (most especially abortion), and as a consequence, significantly contributing to the reduction of women's control over their sexual and reproductive decision-making power. The trend has reached new heights in recent years under the Bush administration, but its history stretches back decades.

In 1984, Ronald Reagan's Mexico City Policy (more commonly known as the Global Gag Rule, for the censoring effect it had on healthcare providers overseas) cut off U.S. family planning funding to any and all organizations providing safe abortion services, counseling, or information, even if abortion was legal in their countries. Bill Clinton overturned the Gag Rule in 1992, but George Bush Jr. swiftly reinstated it on the first full day of his presidency in 2001. Under the new Gag Rule, it's not only illegal to provide services or referrals related to abortion – it's also illegal to engage in any kind of advocacy that might expand access to safe abortion. That goes for anything your organization does – so, if you get any family planning money from USAID, your organization is strictly forbidden from helping women access safe abortion or speaking out about the public heath crisis of unsafe abortion, even if the USAID funds are for a completely different aspect of your work.

The Gag Rule dealt a harsh blow to countless overseas organizations that were unlucky enough to be dependent on USAID funding for their survival (the United States is often the largest bilateral donor in developing countries worldwide). These organizations were providing a range of reproductive health services to women in need, but with the advent of the Global Gag Rule, they had to either shut their doors to the entire community, or shut their mouths when dealing with women in desperate need of information and advice.

When it comes to U.S. funding policies that stigmatize abortion, the Gag Rule is only the tip of the iceberg. In 2002, President Bush froze the traditional annual $34 million U.S. contribution to UNFPA, the world's largest multilateral provider of reproductive health services to the developing world, based on false claims about that agency's work in China that were leveled by an extreme anti-abortion fringe group. The U.S. contribution to UNFPA has now been withheld for five years running, over the protests of Congress and the U.S. public. Funding for international and domestic family planning has flatlined and dwindled under the Bush administration. And at countless international conferences over the past six years, Bush administration officials have attempted to use comprehensive action plans on population, development, and women's health and rights as platforms for a little ad hoc anti-abortion advocacy, much to the dismay of every other country present. Nice behavior from the world's premier promoter of democracy.

To read more about the realities addressed by the Safe Abortion Action Fund, download "Death and Denial: Unsafe Abortion and Poverty," published by in January 2006 by IPPF.