Andrew Leigh (Fenner, Australian Labor Party, Shadow Assistant Treasurer) Share this | Link to this | Hansard source

I move:

That this House:

(1) notes that:

(a) the Global Gag Rule (GGR), as implemented by the United States, will prove detrimental to millions of women and girls around the world;

(b) the GGR has expanded to an unprecedented degree, applying to 15 times more funding as a consequence of its extension into all global health funding, which will result in roughly $9.5 billion dollars in global health funding being affected;

(c) the GGR will result in the targeting of some of the most effective health organisations in the world, operating in 60 low and middle income countries;

(d) a study by researchers at Stanford University found that after the GGR came into effect in 2001, the abortion rate increased sharply in sub-Saharan African countries that had been dependent on such funding;

(e) the funding cuts will likely prevent many global health organisations from offering HIV prevention and treatment services, maternal health care and even Zika virus prevention; and

(f) it is possible that as many as 21,700 maternal deaths could occur in the next four years as a consequence of this executive order, which is in addition to 6.5 million unintended pregnancies and 2.1 million unsafe abortions from 2017 to 2020, according to Marie Stopes International;

(2) recognises that:

(a) when Labor was in government, overseas development assistance increased from 0.28 per cent of Gross National Income in 2007-08 to 0.37 per cent in 2013-14, and was on track to reach 0.50 per cent in 2017-18; and

(b) under the Coalition, development assistance is now just 0.23 per cent of national income, the lowest level since comparable records began in the 1970s, and well below the OECD average of 0.30 per cent; and

(3) calls on the Australian Government to join the Dutch, Belgian, Swedish and Canadian governments in filling the gap in development assistance funding left by the United States Government's imposition of the GGR.

Madagascar is not a country that gets many speaking minutes devoted to it in this House, and it is unlikely many of the women in Madagascar remember when Donald Trump described himself as 'very pro-choice'. I do.

It is also unlikely that many of the women in Madagascar gave much attention to the photo of President Trump, flanked by White House aides, signing his global gag rule. But women and girls, in Madagascar and around the world, will suffer mightily from its implementation.

Previous versions of the rule prohibited non-government organisations that receive US funding for family planning from having any involvement with abortion. The rule meant that an organisation could not even use its own money—not only in providing abortions but also for a physician, counselling a patient as to the best course of care or referring a patient to another source of treatment. It meant that patients would not have condoms to reduce HIV transmission.

President Trump's version of the global gag rule extends it to all global health funding for any aid program that was linked in any way to abortion funding, not just family planning. It now applies to 15 times more funding, which will result in roughly $9.5 billion dollars in global health funding being affected.

Lalaina Razafinirinasoa, the country director of Marie Stopes Madagascar, has said that her organisation provides family planning services to approximately 800,000 women and men and is the largest provider of family planning services in Madagascar. In 2015, Marie Stopes Madagascar received US$3.7 million from USAID and, in 2016, they received US$3.5 million. Half of Marie Stopes Madagascar's service delivery methods are funded by USAID—the mobile clinic working in outreach areas for 400,000 people; and the voucher program for around 35,000 young people and poor women a year.

According to Ms Razafinirinasoa, all of the funding Marie Stopes Madagascar receives from the US government will be lost, starting in October. This is because the global mission of Marie Stopes is to give women the right to have children by choice, not by chance. Even though Marie Stopes Madagascar provides birth control, not abortion, it is guided by this broader mission and is caught by President Trump's global gag rule.

According to Marie Stopes Madagascar, in 2016 it helped avoid approximately 165,000 unwanted births. If it had kept its funding until 2020, it could have prevented over one million unintended pregnancies, more than 2,000 maternal deaths and approximately 340,000 abortions. They estimate the savings to the Madagascan government would be around 39 million pounds in direct healthcare costs over that period. And this is just one organisation, in one country. The healthcare of women and girls will be affected in at least 60 low- and middle-income countries.

As my colleague Senator Claire Moore pointed out in the other place, the International Planned Parenthood Federation will not sign any declaration that limits the numbers of services and types of services that they provide for women and families across the world. They will not sign, so they will lose more than $100 million in US government funding during this term. In practical terms the effect of the global gag rule could lead to as many as 21,700 more maternal deaths over the next four years, in addition to 6½ million unintended pregnancies and 2.1 million unsafe abortions from 2017 to 2020.

A study by researchers at Stanford University found that, after the global gag rule came into effect in 2001, the abortion rate increased sharply in sub-Saharan African countries that had been dependent on such funding. That is right—the past implementation of the global gag rule has led to an increase in the abortion rate. The funding cuts will likely prevent many global health organisations from offering HIV prevention and treatment services, maternal health care and even Zika virus prevention. Treatment will not be provided to millions of people with sexually transmitted diseases, including treatments that would prevent the transmission of HIV to infants. A number of countries refuse to sit back—the Netherlands, Belgium, Sweden and Canada have all increased their contributions to an international pool aimed at ensuring reproductive health services across the developing world are maintained.

In Australia we have cut aid to the lowest level since comparable records began in the 1970s. We need to step up and fill this gap, and we need to do so with increased funding rather than simply the reannouncement of previous funding. Australia needs to do its part where the United States has failed.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

Is there a seconder for the motion?

Terri Butler (Griffith, Australian Labor Party) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

Andrew Laming (Bowman, Liberal Party) Share this | Link to this | Hansard source

There is no doubt that in Australia we hold the importance of maternal and child health very dear, and I commend the member from the opposition for raising this issue. Looking at sexual and reproductive health and the importance of universal access to it has been well understood in bilateral agreements, in Bretton Woods institutions and in most of the aid organisations around the world. I have worked in Madagascar and, although glaucoma is a far cry from maternal health, there is no doubt that we take a major and multilateral approach towards making sure that maternal and child health is as good as possible, for economic reasons as much as for social reasons.

We know that if modern contraception and the type of services that we enjoy here in wealthy countries were accessible, there would be massive falls in maternal and child deaths. We would expect that global maternal deaths would fall from 290,000 to around 90,000, and we know that infant deaths would fall by around 75 per cent from 2.9 million down to around 660,000—still startling numbers, but massive improvements are achieved by the interventions of wealthy economies. Australia holds its head high in this area, and that is why we are very keen to align ourselves with some of the concerns expressed by the opposition member, but we also note that the decision of the US is one for them to decide upon domestically.

In my role with donor coordination, having worked with major agencies in East Timor and other areas, I saw that most of these agencies simply move around to fill the gaps that are evident in-country and on the ground. While I am not commenting on the US policy, I would say to the member opposite that, fundamentally, in each of these areas—Madagascar included—agencies will simply respond to the need and shift their priorities if they identify that a deficit in maternal and child health needs to be filled. I have confidence that other agencies, other bilateral arrangements and other governments will fill that need. I am very confident that, even though it is an unmet need, there will be a significant move to do that, and I think that those providers are mature enough to do that.

Australia's record on sexual and reproductive health is very significant. In the last financial year we provided just over $9 million in core funding to the United Nations Population Fund under a four-year partnership, which is commendable. We also provided $4.6 million in core funding to the International Planned Parenthood Federation and another $3.5 million to the IPPF for its sexual and reproductive health program for crisis and post-crisis situations, as well as $2.5 million to UNFPA for essential child and maternal commodities. Australia also funds bilateral and regional partnerships to strengthen sexual and reproductive health services to a range of countries—Cambodia, which will be familiar to many; Timor-Leste; PNG, our northern neighbour; Vietnam and Pacific island economies. You cannot say that Australia does not have a significant footprint in this area already, but I would also have to concede that the withdrawal of a major donor economy like the US presents significant threats, which are going to have to be addressed by other bilateral agreements and other nations.

We also need to note that significant cuts were made by the previous speaker's side of politics prior to the 2013 election, and these have had significant impacts that have not been made up for by commitments since. After unsustainable and unaffordable increases under that government, the foreign aid budget has now found a more settled position where the focus is absolutely on value for money, delivery and a quality outcomes framework, not just how much money, in a raw sense, is dispersed.

During the 2016 campaign, Labor did announce that it would be increasing its aid budget by $800 million over four years if elected, and this was their first instalment. It is very important to remember—of course we will never allow them to forget, either—that this was in the context of massive cuts that had been delivered by the Labor government when they were in office by diverting $750 million from the aid budget. Ironically, it was to address the people-moving challenge. We found, paradoxically, that the Gillard government became one of the largest recipients of its own foreign aid budget, which was quite ironic if not tragic. What we did see were significant cuts from that side of politics—some commitments more recently to increase, but they are easy to make when you are in opposition. What we had was a government that could not hold its head high on foreign aid. It has since made some empty promises about increasing funding, but it is where the rubber hits the road that matters. When you are in government, it is how you spend it and how you raise the revenue that really matters, and I do not think Australia will let them forget.

In closing, the US has made this decision, but—as someone who has worked in this field of donor coordination, in East Timor in particular—I know that there are solutions and that providers will find a way to fill this vacuum.

Terri Butler (Griffith, Australian Labor Party) Share this | Link to this | Hansard source

This is a very important motion, and I thank the Member for Fenner for drafting and proposing this motion that we are debating here today, because it is about the question of access to reproductive health services and abortion for women in developing countries. Pregnancy, childbirth and termination of pregnancy complications are one of the leading causes of death for women in developing countries. In fact, complications arising from pregnancy, childbirth and terminations of pregnancy result in around 830 maternal deaths per day in developing countries. As a nation that is well-off and in a position to influence what happens globally in relation to access to reproductive health services, we should take a very strong interest in an area that is killing 830 women every day.

Accordingly, I think that it is both within our rights to be concerned about the global gag rule, and it is also incumbent upon us to be concerned about the global gag rule. In January this year President Trump reinstated the global gag rule but expanded its scope. Instead of just applying to reproductive health organisations, it applies to all health organisations and all American overseas aid so that any organisation that has any arm undertaking assistance with abortions, with terminations of pregnancy, is affected. That is greatly concerning because what it means is that, no matter what an organisation is doing in a particular country, if any part of their international operation is providing terminations, is providing counselling in relation to terminations, is referring women for terminations or is advocating for abortion services, then they are affected by this global gag rule.

Marie Stopes International has estimated that this is going to have a significant effect on the ability of women worldwide to get access to the services they need. Without US funding, the loss of services during President Trump's first term—between 2017 and 2020—will mean there will be 6½ million more unintended pregnancies, 2.2 million abortions, 2.1 million unsafe abortions and 21,700 maternal deaths. As the Member for Fenner pointed out, taking away access to reproductive health services has, in at least one example, led to more terminations of pregnancy not fewer, and of course that makes sense intuitively. If you cannot get access to contraception, counselling, education and the services provided, then that is likely to contribute to there being more unplanned pregnancies not fewer. Restricting access to safe, legal termination does not reduce abortions. It just means that women have unsafe abortions instead of safe abortions. It is something that people who are concerned about abortion would do well to consider when they support the global gag rule, because, if in fact the effect of the rule is to give rise to more unplanned pregnancies and more unsafe abortions, that would be a very poor outcome of the reinstatement of this rule.

It is disappointing to me that we have to have this debate and that a US President in 2017, surrounded by an all-male cohort, decided to reinstate a global gag rule purportedly aimed at trying to reduce abortion, although, of course, as I have just said, it does not have that effect today, when we should be really focused on what is best for reproductive health and what is best for women and their children in developing countries.

I come from Queensland. Queensland, of course, needs to acknowledge its own poor track record when it comes to pregnancy termination legalisation. This year there was some proposed legislation to decriminalise abortion in Queensland. It was unable to be successfully put before the parliament. It is very disappointing to me that my own state still makes abortion a crime. It has effects for women and doctors and allied health services providers. At the same time, I should acknowledge the progress made by Natasha Fyles and her colleagues in the Northern Territory parliament who very recently were able to successfully fulfil an election promise to make abortion legal in the Northern Territory. The Northern Territory Criminal Code and the Queensland Criminal Code are effectively the same criminal code, so it would be very useful if the Queensland parliament would follow the Northern Territory's lead and make abortion legal in Queensland.

Gai Brodtmann (Canberra, Australian Labor Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

As a former diplomat, I do not normally comment on matters internal to a particular country, but I felt compelled to do so today when I saw the motion that was put up by the member for Fenner. I commend him for putting this motion up because it is an issue that I know many Canberrans feel very strongly about, many Canberra women feel very strongly about, so I felt compelled to speak on this matter today. It is a matter I feel very strongly about too. I commend the member for Fenner for putting the motion forward.

I feel very strongly about this motion because the bulk ignorance of this global gag rule, or the Mexico City policy, which was signed off with such fanfare, with such sense of urgency in an all-male signing ceremony, is absolutely breathtaking. It is regressive and it is life-threatening. Women in developing countries will pay the price for this policy. They will pay with their health, they will pay with their children's health and with their babies' health. They will pay with their lack of opportunity, their lack of education and their lack of choice, and some will pay with their lives.

The Mexico City policy, re-enacted on President Trump's first day in office—the sense of urgency on this was just breathtaking—demands that all non-US NGOs who receive US aid cannot perform, nor actively promote, abortion. NGOs will forfeit all US aid if they so much as tell a woman that abortion is a legal option for them or refer them to a provider or advocate for abortion rights.

All the medical evidence is clear. If you take safe abortion services out of the reproductive healthcare package, it exposes women to risk—significant risk; sometimes a risk to their lives. Every year 21.6 million women are so desperate to end their pregnancy that they put their lives on the line by risking an unsafe abortion, and 18.5 million of those 21.6 million women are from developing countries. Forty-seven thousand of them die from complications through unsafe abortions and millions more are left with the life-altering injuries that you get from having an unsafe abortion—an abortion that is done in often putrid conditions by someone who does not know what they are doing. We have all read stories about the impact of unsafe abortions saying that, if you do not die in the process, essentially you can have your reproductive ability significantly compromised, if not ended.

Deaths due to unsafe abortion remain close to 13 per cent of all maternal deaths. This policy will not just stop women having abortions; it will also force them to have unsafe ones, because, as Marjorie Newman-Williams from Marie Stopes International says, attempts to stop abortion through restrictive laws or by withholding family planning aid will never work because they do not eliminate women's need for abortion. This policy only exacerbates the already significant challenge of ensuring that people in the developing world who want to time and space their children can obtain the contraception they need to do so. And therein lies the rub with this policy: it not only targets the abortion; it also targets family planning services.

As we have heard from my colleagues, USAID is currently the world's largest bilateral donor in family planning and, as a result, has transformed the lives of women and girls in developing countries by expanding access to voluntary contraception. Take those billions out of the system and it is going to have a devastating impact on so many lives.

Tragically, the policy will have the opposite effect to the one intended. A 2011 study found that abortion rates in sub-Saharan African countries actually increased while the Mexico City policy was in force under President Bush.

Three hundred thousand women die from pregnancy or childbirth related complications each year, leaving about one million children motherless—children that are more likely to die within one to two years of their mother's death. And, for every woman who dies in childbirth, dozens more suffer injury, infection or disease. The policy denies women the right to make choices that could improve their living conditions, from the girl who could have avoided an unwanted pregnancy and continued her education to the mother of five who could have averted a life-threatening risk of an unsafe abortion. The impact of this policy will be catastrophic, and it is women in developing countries who will pay the price.

Debate adjourned.