Women are dying in Africa as US ramps up its global battle against abortion – Oskaloosa Herald

The Unseen Casualties: How US Policy Shapes Women’s Fates in Africa

In a world grappling with complex global health challenges, the tragic reality of women dying in Africa due to a ramped-up global battle against abortion stands as a stark and urgent humanitarian crisis. Far from being a localized issue, the decisions made in Washington D.C. regarding foreign aid and reproductive health policies ripple across continents, often with devastating, unforeseen consequences for the most vulnerable populations. While ostensibly aimed at upholding certain moral principles, the United States’ long-standing and intermittently enforced “Global Gag Rule” – officially known as the Mexico City Policy – has become a flashpoint for international debate, directly linking American political ideology to the escalating rates of maternal mortality and morbidity in sub-Saharan Africa and beyond.

This comprehensive article delves into the intricate web of policy, public health, and human rights that defines this critical issue. We will explore the historical context of the US’s stance on global abortion funding, particularly the evolution and unprecedented expansion of the Global Gag Rule under recent administrations. We will then meticulously examine the dire impacts of these policies on the already fragile healthcare systems of African nations, highlighting how the withdrawal or redirection of crucial funding has led to a dramatic increase in unsafe abortions, preventable deaths, and a significant undermining of broader reproductive health services. By contextualizing the challenges faced by African women and outlining the perspectives of various stakeholders, this analysis seeks to illuminate the profound human cost of policies that prioritize ideological battles over evidence-based public health imperatives and the fundamental right to life and health.

A Policy with Global Reach: Understanding the Mexico City Policy/Global Gag Rule

At the heart of the crisis in Africa is a US foreign policy tool known colloquially as the “Global Gag Rule,” or officially, the Mexico City Policy. This policy, first introduced by President Ronald Reagan in 1984 at the International Conference on Population in Mexico City, prohibits non-governmental organizations (NGOs) that receive US family planning funds from providing abortion services, counseling, referrals, or advocating for abortion law reform in other countries, even if they use their own non-US funds for these activities. It represents a direct assertion of US domestic anti-abortion politics onto international aid programs.

A Historical Pendulum: Decades of Reinstatement and Repeal

The Global Gag Rule has been a political football, reinstated by Republican administrations and rescinded by Democratic ones since its inception. This on-again, off-again nature has created an environment of instability and unpredictability for international health organizations. Each change in presidential administration brings a dramatic shift in policy, forcing NGOs to repeatedly restructure their operations, services, and partnerships, leading to significant disruptions in healthcare delivery. President George H.W. Bush reinstated it in 1989, President Bill Clinton rescinded it in 1993, President George W. Bush reinstated it in 2001, President Barack Obama rescinded it in 2009, and most significantly, President Donald Trump reinstated and drastically expanded it in 2017. This policy seesaws with political tides, often leaving health providers in recipient countries in a precarious state, unsure of future funding or service delivery parameters.

The Mechanism of Restriction: What the Policy Entails

The core mechanism of the Global Gag Rule is financial coercion. NGOs that rely on US funding for critical health services—ranging from contraception and maternal care to HIV/AIDS prevention and treatment—are faced with an agonizing choice. They must either refuse US funding, potentially crippling their ability to deliver essential services, or comply with the policy, thereby ceasing any activities related to abortion, even if those activities are legal and medically advised in their respective countries. This includes a complete ban on providing information, referrals, or even advocating for safe abortion services, regardless of the legality of abortion in a given country or the source of funding used for those specific services. The policy essentially demands that organizations self-censor and limit their comprehensive health offerings, effectively punishing them for engaging in activities that are considered standard practice for reproductive health organizations globally. The implications extend far beyond direct abortion provision, impacting the entire spectrum of reproductive health care by creating a pervasive chilling effect.

The Trump Era: Unprecedented Expansion and Deepening Impact

While the Global Gag Rule has a contentious history, its reinstatement and expansion under the Trump administration marked a significant escalation, multiplying its reach and deepening its detrimental effects on global health, particularly in Africa.

Broadening the Scope: From Family Planning to Global Health

President Donald Trump not only reinstated the Global Gag Rule but expanded it dramatically through a policy initially titled “Protecting Life in Global Health Assistance” (PLGHA). Unlike previous iterations which primarily targeted family planning funds, Trump’s expanded policy applied to nearly all US global health assistance. This meant that any international NGO receiving funds from any US government agency for global health activities—including programs for HIV/AIDS, tuberculosis, malaria, maternal and child health, nutrition, and water and sanitation—was subject to the gag rule. This expansion dramatically increased the number of organizations affected and the breadth of services impacted, moving far beyond traditional family planning clinics to encompass a vast array of life-saving public health initiatives.

The PLGHA policy extended its tentacles into programs supported by USAID, the Department of State, and the Department of Health and Human Services, among others. This unprecedented scope meant that organizations involved in everything from distributing anti-retroviral drugs to educating communities on malaria prevention could lose their US funding if they also offered or even referred women to abortion services, or engaged in any advocacy related to abortion, regardless of how minor. This created an impossible situation for many NGOs, forcing them to either abandon their commitment to comprehensive reproductive health care or risk losing vital funding for other essential health programs, thereby creating a profound moral and operational dilemma.

Financial Ramifications: Billions at Stake

The financial implications of this expanded policy were staggering. Estimates from organizations like the Guttmacher Institute and Human Rights Watch suggested that the policy affected approximately $12 billion in US global health assistance annually. This represented a colossal sum of money, making the decision for NGOs to comply or forgo funding immensely difficult. For many organizations operating in low-resource settings, US funding is a lifeline, sustaining critical health programs and infrastructure. Losing access to such substantial funding could mean the complete cessation of services, clinic closures, staff layoffs, and the dismantling of years of effort in building health capacity.

The sheer scale of the funds implicated meant that the policy had a far wider and more destructive impact than any previous version. It wasn’t just about limiting access to abortion; it was about undermining the entire public health infrastructure in many countries, particularly those in sub-Saharan Africa that are heavily reliant on US foreign aid. The policy effectively weaponized humanitarian aid, leveraging financial power to enforce a domestic ideological agenda on sovereign nations and their populations.

Africa: At the Epicenter of Vulnerability

The African continent, particularly sub-Saharan Africa, disproportionately bears the brunt of the Global Gag Rule’s impact. This region is characterized by specific vulnerabilities that amplify the policy’s detrimental effects, making it a critical focus for understanding the human cost.

Pre-existing Health Challenges and Dependence on Aid

Many African nations struggle with weak healthcare systems, characterized by insufficient infrastructure, a severe shortage of trained healthcare professionals, and limited access to essential medicines and technologies. Maternal mortality rates in sub-Saharan Africa are among the highest in the world, with women facing a significantly higher lifetime risk of dying from pregnancy-related complications compared to their counterparts in developed nations. Unsafe abortion is recognized by the World Health Organization (WHO) as a leading cause of maternal death and injury globally, and this is particularly true in regions where access to safe, legal abortion is restricted.

Compounding these challenges is a substantial reliance on foreign aid for health services. The United States is one of the largest global health donors, and its funding supports a vast network of health initiatives across Africa, from HIV/AIDS prevention and treatment (through programs like PEPFAR) to family planning, child vaccinations, and maternal care. When a policy like the Global Gag Rule restricts this aid, it directly impacts the ability of these already struggling health systems to provide comprehensive and life-saving care.

Socio-Cultural and Legal Landscapes Regarding Abortion

The legal status of abortion varies widely across Africa, with some countries having highly restrictive laws and others allowing it under certain circumstances, such as to save the woman’s life or in cases of rape or incest. However, even in countries where abortion is legal, access can be severely limited due to stigma, lack of trained providers, and cultural or religious barriers. Unwanted pregnancies remain a pervasive issue, driven by factors such as limited access to contraception, gender inequality, poverty, and sexual violence.

In this complex environment, comprehensive reproductive health services, including access to safe abortion and post-abortion care, are not merely about choice but are fundamental to women’s health and survival. The Global Gag Rule further complicates this landscape by imposing external restrictions that often contradict local health needs and national laws, exacerbating an already dire situation for women facing unintended pregnancies. It effectively undermines local efforts to improve reproductive health outcomes by cutting off funding from organizations that are best positioned to deliver care, often because they are the most trusted and comprehensive providers in their communities.

The Tragic Consequences: Rising Maternal Mortality and Unsafe Abortions

The most devastating and direct consequence of the US’s anti-abortion policies in Africa is the observable increase in unsafe abortions and, subsequently, a rise in maternal mortality and morbidity. This is not merely an ideological debate; it is a matter of life and death for countless women.

The Desperate Choice: Why Unsafe Abortions Persist

When legal and safe abortion services become inaccessible, whether due to restrictive laws or the withdrawal of funding for comprehensive care, women do not stop seeking abortions. Instead, they are driven to clandestine, often life-threatening methods. The root causes of unintended pregnancies—such as lack of access to effective contraception, sexual violence, and socio-economic pressures—remain. Faced with an unwanted pregnancy, many women, particularly those in vulnerable circumstances, feel they have no other option but to resort to unsafe procedures performed by untrained individuals using crude and dangerous methods. This includes self-inducing abortions with toxic substances, sharp objects, or relying on unqualified practitioners in unhygienic conditions.

The Global Gag Rule directly contributes to this tragic phenomenon. By forcing organizations to abandon abortion-related services or forgo funding for critical family planning, it inadvertently reduces access to contraception and comprehensive sexual education. This leads to more unintended pregnancies. Simultaneously, by restricting information and referral services, it ensures that women who do become pregnant and seek an abortion have fewer legitimate avenues to turn to, pushing them further into the shadows of unsafe practices.

Medical Complications and the Human Cost

The medical complications resulting from unsafe abortions are severe and often irreversible. These include:

• Hemorrhage: Excessive bleeding, often leading to shock and death.
• Infection: Sepsis, peritonitis, and generalized infections from unsterile instruments and environments.
• Perforation: Punctures of the uterus, intestines, or other organs.
• Organ Damage: Injury to the bladder, bowel, or cervix.
• Infertility: Long-term consequences, often leading to social stigma and distress.
• Chronic Pain: Persistent pelvic pain and other health issues.
• Psychological Trauma: Severe emotional and mental health impacts.

For every woman who dies from an unsafe abortion, many more suffer debilitating injuries and lifelong health complications. These women often require extensive and costly post-abortion care, which places further strain on already overburdened health systems. The human cost extends beyond the individual woman to her family and community, who lose a mother, a caregiver, or a productive member of society.

The Statistical Grim Reality

Numerous studies and reports from international health organizations, including the World Health Organization (WHO) and the Guttmacher Institute, consistently highlight the link between restrictive abortion policies and higher rates of unsafe abortions and maternal mortality. Data indicates that regions with highly restrictive abortion laws also tend to have the highest rates of unsafe abortions. While quantifying the exact direct statistical impact of a policy like the Global Gag Rule can be complex due to data limitations, evidence points to:

• Reduced access to contraception and family planning services, leading to increased unintended pregnancies.
• A rise in the proportion of unsafe abortions as women lose access to comprehensive health information and safe services.
• Increased admissions to hospitals for complications from unsafe abortions, straining emergency services.
• A direct correlation between the application of such policies and a backslide in progress towards reducing maternal mortality in affected countries.

The consensus among public health experts is clear: policies that restrict comprehensive reproductive health care do not reduce abortion rates; they merely make abortions less safe, leading to preventable deaths and disabilities.

The “Chilling Effect”: Impacts Beyond Abortion Services

One of the most insidious consequences of the Global Gag Rule is its far-reaching “chilling effect,” which extends its negative influence well beyond direct abortion services to impact the entire spectrum of public health and development in affected regions.

Disruption of Comprehensive Health Care Networks

The expanded Global Gag Rule under the Trump administration, affecting billions of dollars in global health aid, forced many international and local NGOs to make an impossible choice: either cut their comprehensive reproductive health services (including vital family planning, contraception, and maternal care) or lose essential US funding for all their other health programs. Many organizations, recognizing the desperate need for services like HIV/AIDS prevention, malaria treatment, or child nutrition, reluctantly opted to comply. This compliance, however, came at a steep price.

When organizations cut services or referrals related to abortion, even if using non-US funds, they often had to dismantle integrated health programs. This meant that a woman visiting a clinic for family planning might no longer receive comprehensive information about all her reproductive options, or a clinic providing HIV testing might no longer have a robust referral system for pregnant women needing safe maternity care if the primary provider also offered or discussed abortion. The fragmentation of services created by the policy undermined the very principle of holistic, patient-centered care, leading to reduced efficiency, diminished quality of care, and confusion among beneficiaries.

Moreover, some organizations, unable to compromise their ethical commitments to comprehensive care, refused US funding altogether. While principled, this often led to their closure, staff layoffs, or a drastic reduction in the scale of their operations, leaving significant gaps in healthcare provision in communities that critically needed them. This reduced operational capacity meant fewer people reached with essential health services, regardless of whether those services were abortion-related or not.

Setbacks in HIV/AIDS Prevention and Maternal/Child Health

The expansion of the Global Gag Rule to cover all global health assistance had particularly severe implications for programs combatting HIV/AIDS, tuberculosis, and malaria, as well as those focused on maternal and child health. Organizations that traditionally integrated family planning and reproductive health services into their broader HIV/AIDS prevention programs, for instance, found themselves constrained. Preventing unintended pregnancies among women living with HIV is crucial for preventing mother-to-child transmission and ensuring the health of both mother and child. By limiting access to comprehensive family planning and counseling, the policy inadvertently created barriers to effective HIV prevention and care.

Similarly, maternal and child health programs suffered. If an organization providing antenatal care or child immunizations also provided contraception or referred women for safe abortion services when needed (e.g., in cases of medical necessity or rape, where legal), it could lose all its US funding. This led to a narrowing of services and a reduction in the overall quality and accessibility of care for mothers and children, exacerbating existing health disparities and jeopardizing years of progress in these critical public health areas.

Eroding Trust and Local Capacity Building

The Global Gag Rule also had a corrosive effect on trust between healthcare providers and their communities. When trusted local NGOs are forced to suddenly alter or withdraw services due to external policy changes, it can lead to confusion, suspicion, and a loss of confidence in the healthcare system. Patients may become wary of seeking care, fearing that vital information or services will be withheld. This erosion of trust can have long-term negative impacts on public health campaigns, including vaccination drives and disease prevention initiatives.

Furthermore, the policy undermined efforts to build sustainable local health capacity. By imposing external restrictions on how local organizations could operate, it hindered their ability to develop comprehensive, locally relevant health solutions. It effectively dictated what types of care could be provided, rather than empowering local health leaders and communities to address their unique health challenges in a holistic manner. This top-down imposition weakened the very NGOs that are often the most effective and culturally competent providers of care in their regions.

Voices from the Ground: NGOs and Health Workers on the Frontlines

The real-world implications of the Global Gag Rule are most acutely felt by the non-governmental organizations (NGOs) and healthcare workers on the frontlines of service delivery in African communities. These dedicated professionals and organizations often serve as the sole source of medical care and health information for millions, operating under challenging circumstances and now facing additional ethical and operational dilemmas imposed by foreign policy.

Ethical Dilemmas and Operational Challenges

For doctors, nurses, and community health workers in Africa, the Global Gag Rule presents a profound ethical quandary. Bound by professional oaths to provide the best possible care, they are simultaneously constrained by a policy that dictates what information and services they can offer. Imagine a healthcare provider faced with a woman suffering from a life-threatening ectopic pregnancy, a victim of sexual violence seeking emergency care, or a young girl desperate to avoid an unintended pregnancy. Under the Global Gag Rule, if their organization receives US funding, they might be prevented from discussing all legal and medically appropriate options, including safe abortion referral or advocacy for less restrictive laws, even if their professional judgment deems it necessary.

Operationally, NGOs have reported significant disruptions. Some have been forced to cease specific services, such as comprehensive sexuality education or post-abortion care, entirely. Others have had to separate their services into “gagged” and “ungagged” branches, leading to administrative inefficiencies, increased costs, and fragmentation of care. The policy often requires organizations to sign “attestation clauses,” legally binding documents that ensure compliance, creating an environment of fear and self-censorship. Staff training programs have been curtailed, outreach efforts scaled back, and critical supply chains for contraceptives and other medical supplies have been interrupted, all contributing to a decline in service quality and reach.

The policy’s “no foreign funds” clause, which prohibits NGOs from using even their *own* non-US funds for abortion-related activities if they accept US global health assistance, is particularly punitive. This aspect effectively dictates how foreign NGOs spend their entire budget, not just the portion funded by the US, creating an unprecedented level of external control over their operations.

Advocacy and Resilience in the Face of Adversity

Despite these immense challenges, many NGOs and health advocates in Africa and globally have demonstrated remarkable resilience. They continue to raise awareness, document the policy’s impacts, and advocate for its permanent repeal. African civil society organizations, alongside international partners, have become vocal critics of the Global Gag Rule, arguing that it infringes upon national sovereignty and undermines locally driven health solutions.

These organizations highlight that the policy is fundamentally anti-poor and anti-women. It disproportionately affects women in rural and impoverished areas who have limited access to alternative healthcare options. They emphasize that access to comprehensive reproductive health, including safe abortion care, is a human right and a public health imperative. Their advocacy efforts, often carried out with limited resources, are crucial in bringing the human stories behind the statistics to the attention of policymakers and the global public, tirelessly working to ensure that the voices of African women are heard in the corridors of power.

The Global Debate: Ethical, Humanitarian, and Sovereignty Concerns

The Global Gag Rule remains one of the most contentious policies in international development and public health. Its existence fuels a fierce global debate centered on ethics, humanitarian principles, and national sovereignty.

Supporters’ Arguments: Moral Stance and Taxpayer Funds

Proponents of the Global Gag Rule, primarily conservative and anti-abortion groups in the United States, argue that the policy is a necessary measure to prevent US taxpayer dollars from being used to fund abortions in other countries. Their arguments are often rooted in moral and ethical opposition to abortion, viewing it as the termination of human life. They contend that American citizens should not be complicit, through their taxes, in funding practices that they find morally objectionable. From this perspective, the policy is seen as a consistent application of domestic anti-abortion principles to foreign aid, aiming to protect the unborn globally.

Furthermore, some supporters argue that foreign aid should prioritize maternal and child health initiatives that do not include abortion, such as prenatal care, safe delivery services, and postnatal care. They believe that resources should be directed towards supporting alternatives to abortion, such as adoption, and empowering women through other means. The policy, in their view, aligns with a broader pro-life agenda and ensures that US funding promotes what they consider to be life-affirming healthcare options.

Critics’ Counterarguments: Public Health, Human Rights, and Sovereignty

Conversely, critics of the Global Gag Rule, including a wide array of public health experts, medical associations, human rights organizations, and international development agencies, vehemently oppose the policy on several grounds:

1. Public Health Imperative: They argue that the policy is detrimental to public health. By restricting access to comprehensive reproductive health services, including contraception and safe abortion care, it leads to an increase in unintended pregnancies and unsafe abortions, directly contributing to higher rates of maternal mortality and morbidity. Public health evidence overwhelmingly demonstrates that restricting safe, legal abortion does not reduce the number of abortions but rather pushes them underground, making them dangerous.
2. Human Rights Violation: Critics contend that the policy infringes upon the human rights of women and girls, specifically their rights to health, life, privacy, and non-discrimination. Access to comprehensive sexual and reproductive health information and services, including safe abortion, is recognized as a fundamental human right by numerous international conventions and organizations. The Global Gag Rule effectively denies women the autonomy to make informed decisions about their own bodies and health.
3. Undermining National Sovereignty: A significant point of contention is the issue of national sovereignty. The policy dictates to sovereign nations and their local NGOs how they can manage their own healthcare systems and how they can spend even non-US funds. This is seen as an imperialistic imposition of US domestic political agendas on other countries, irrespective of their local laws, cultural contexts, or health needs. It bypasses the democratic processes and public health priorities of recipient nations.
4. Ineffectiveness and Counterproductiveness: Far from achieving its stated goal, critics argue the policy is counterproductive. By dismantling established health networks and reducing access to contraception, it can paradoxically lead to more unintended pregnancies and therefore more abortions (albeit unsafe ones). It also diverts resources from crucial public health initiatives, weakening overall health systems.
5. Medical Ethics: For healthcare providers, the policy creates an ethical dilemma, forcing them to choose between adhering to professional medical standards (which include providing comprehensive information and care) and maintaining vital funding for their organizations.

The debate thus pits moral viewpoints against evidence-based public health principles, fundamental human rights, and respect for international cooperation, with the lives of vulnerable women often caught in the crossfire.

Looking Forward: The Biden Administration and the Path Ahead

The cycle of the Global Gag Rule dictates that a change in US presidential administration often brings a shift in policy. The current administration has indeed taken steps to reverse the previous expansion, but the long-term impact and the future stability of global reproductive health funding remain uncertain.

Reversal and the Long Road to Recovery

Upon taking office in January 2021, President Joe Biden swiftly moved to rescind the expanded Global Gag Rule (PLGHA), fulfilling a campaign promise. This reversal was widely welcomed by global health organizations, human rights advocates, and many international partners who had witnessed the devastating effects of the policy over the previous four years. The rescission meant that international NGOs receiving US global health assistance could once again provide comprehensive reproductive health information and services, including abortion-related care and advocacy, using non-US funds, without fear of losing critical funding for other health programs.

However, rescinding the policy does not immediately undo the damage. The “gag” rule often leaves a lasting legacy of disruption. Health clinics that closed may not reopen, trained staff who were laid off may not return, and trust that was eroded takes considerable time to rebuild. Supply chains for contraceptives and other essential medical supplies, once interrupted, require re-establishment. Partnerships that were severed need to be rekindled. The four years of expanded restrictions created significant gaps in service delivery, led to a brain drain of healthcare professionals, and forced organizations to reallocate resources away from their core missions. The process of recovery is lengthy and requires sustained investment and strategic planning to rebuild the capacity and networks that were dismantled.

The Imperative of Sustainable and Rights-Based Solutions

The repeated reinstatement and rescission of the Global Gag Rule highlight the urgent need for more stable and rights-based approaches to global health funding. The unpredictability inherent in the policy’s pendulum swing creates an unstable environment for long-term health planning and investment. To truly safeguard women’s health and advance global development, several imperatives emerge:

1. Permanent Repeal and Legislation: Advocates call for a permanent legislative repeal of the Global Gag Rule to prevent future administrations from unilaterally reinstating it. This would provide the necessary stability for NGOs to plan and deliver comprehensive health services without political interference.
2. Increased Funding for Comprehensive Reproductive Health: Beyond mere rescission, there is a need for increased and sustained US investment in comprehensive sexual and reproductive health and rights (SRHR) programs, including family planning, maternal health, and safe abortion care where legal.
3. Support for Local Ownership and Capacity: International aid should prioritize strengthening local healthcare systems and empowering local NGOs, allowing them to define and implement health priorities based on their community’s needs, rather than external ideological dictates. This involves supporting training, infrastructure development, and policy frameworks that respect national sovereignty and local contexts.
4. Evidence-Based Policy Making: Decisions regarding global health funding should be guided by public health evidence and expert consensus, not by political ideology. The overwhelming scientific and medical evidence supports access to comprehensive reproductive health care as a cornerstone of women’s health and development.
5. Global Collaboration and Advocacy: Continued international cooperation and advocacy are essential to pressure governments to uphold SRHR commitments and to ensure that global health initiatives are resilient against political whims.

The journey towards full recovery and sustainable health outcomes in Africa, free from the shadow of politically motivated funding restrictions, is long. It demands unwavering commitment from the international community and a fundamental shift towards policies that prioritize human lives and dignity over divisive political agendas.

Conclusion: Prioritizing Lives Over Politics

The narrative of women dying in Africa as the US ramps up its global battle against abortion is not merely a headline; it is a profound indictment of policies that fail to prioritize human life and well-being. The Global Gag Rule, in its various iterations, has demonstrated a consistent and devastating impact: it does not reduce abortion rates, but rather forces women into the dangerous realm of unsafe procedures, leading to preventable deaths and debilitating injuries. This policy weaponizes foreign aid, transforming essential health funding into a tool for imposing ideological stances, with African women and fragile health systems bearing the brunt of the consequences.

The expansion of the rule under the Trump administration amplified this tragedy, reaching into virtually all global health sectors and disrupting critical programs from HIV/AIDS prevention to maternal and child health. While the Biden administration’s reversal offers a sigh of relief, the cycle of reinstatement and repeal underscores a fundamental instability that continues to threaten global health progress. The urgent call from public health experts, human rights advocates, and local communities in Africa is clear: global health policies must be grounded in evidence, respect for human rights, and the principle of national sovereignty.

Ultimately, the imperative is to move beyond political posturing and focus on what truly saves lives and empowers women: comprehensive, accessible, and rights-based reproductive health care, including access to contraception, family planning, and safe abortion services where legal. The lives of millions of women across Africa depend on a global commitment to public health that transcends political divides and puts human dignity at its undisputed core. Only then can the international community truly work towards a future where no woman dies from preventable causes, and every individual has the right to control their own health and future.