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Health , World

A Trump Victory Could Reinvigorate Global Anti-abortion Pact

by Jodi Enda November 1, 2024

Co-published with Foreign Policy


Less than two weeks before his 2020 election defeat, then-President Donald Trump’s administration rolled out a document that purported to promote women’s health and rights while declaring that there was “no international right to abortion.” 

“It’s the first time that a multilateral coalition has been built around the issue of defending life,” then-Secretary of State Mike Pompeo said at a signing ceremony, conducted virtually because of the coronavirus pandemic. Brazil, Egypt, Hungary, Indonesia, and Uganda joined the United States in sponsoring the nonbinding directive, called the Geneva Consensus Declaration on Promoting Women’s Health and Strengthening the Family. Another 28 countries, many with authoritarian governments that repress women’s rights, signed it.

Abortion is one of the most pivotal issues that will determine whether Trump returns to the Oval Office. The Republican nominee routinely brags about his role—via three Supreme Court nominations—in overturning Roe v. Wade in a 2022 ruling that inevitably limited abortion access for millions of people in the United States. Less known is the work that Trump and his appointees did to prevent women in other countries from obtaining the procedure.

The Geneva Consensus Declaration, which encourages governments to improve women’s health care without abortion, is one slice of Trump’s work to impose anti-abortion values on people overseas. It has garnered fewer concrete results than his expansion of the Mexico City Policy, a perennial Republican rule that prevents foreign organizations that accept U.S. assistance from providing abortions or related services. But if Trump is elected, the declaration is expected to have renewed vigor. In fact, it could loom over all U.S. foreign assistance.

While the one-page document—with its emphasis on health and human rights for women—presents as nonthreatening, detractors assert that a Trump victory on Nov. 5 could make it very threatening indeed.

“I mean, sorry—to be brutal about it, women are going to die,” said Swetha Sridhar, a senior global policy research officer for Fòs Feminista, an international alliance that promotes sexual and reproductive health and justice. “That’s what we’re going to see.” 

President Joe Biden withdrew the United States from the declaration upon assuming the presidency in 2021 because, his administration said, it “promotes anti-LGBTQI sentiment and undermines women’s health.” But Washington’s rejection of a document that it produced did not kill it. The declaration has been kept alive largely through the work of one former Trump administration official, Valerie Huber, who is known as its “architect.”

Sridhar and other abortion and gender rights advocates say that the Geneva Consensus Declaration represents a long-term, conservative attempt to create new international standards grounded in faith-based views of abortion and family structures.

“It has a big impact when you have these established global norms,” said Serra Sippel, the executive director of the Brigid Alliance, which provides logistical support for people who need to travel to obtain abortions within the United States. “Anti-gender, anti-rights folks can use this consensus as a tool to try to get countries to pass laws,” Sippel added.

The effort to export anti-abortion policies to other countries did not start under Trump. The Center for Family and Human Rights (C-Fam), an organization with ties to the Catholic Church, worked for 24 years to create a declaration, said its president—Austin Ruse—in a statement issued the day of the signing ceremony. In a summation of the declaration’s principles, Ruse said: “There is no international right to abortion. There is no international obligation to fund abortion. The United Nations has no business interfering in sovereign decisions when it comes to protecting life in the womb.” 

C-Fam did not make anyone available for an interview for this story.

Huber, the declaration’s most visible proponent and a former U.S. special representative for global women’s health in the Trump administration, has spent the past few years traveling the globe, sometimes working with foreign first ladies to bring more countries on board. Huber also founded the Institute for Women’s Health, which “identifies high-impact solutions to promote women’s health and thriving,” according to its website. The institute created a framework called Protego to partner with countries that sign the declaration and provide guidance as they implement “high-impact, low-cost interventions” to meet the needs of women and their families, Huber said in two statements issued in response to an interview request.

“The tenet of the GCD [Geneva Consensus Declaration] regarding abortion points to the sovereignty of nations to chart their own path on this issue—therefore, GCD coalition nations have differing laws regarding abortion,” Huber wrote. “The GCD accurately states that abortion is not an international right, but rather it is up to the country to decide on its own abortion policies—without external pressure.”

Of course, countries already have the ability to pass and enforce their own laws on abortion. Opponents of the Geneva Consensus Declaration, however, argue that the document would allow governments to ignore international accords related to abortion, such as the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa, better known as the Maputo Protocol. That 2003 treaty recognizes abortion rights in cases of sexual assault, rape, incest, life-threatening fetal anomalies, and situations in which continuing a pregnancy would endanger the pregnant woman’s life or her mental and physical health. 

Nevertheless, a handful of the countries that ratified the agreement do not permit abortion under any circumstances.

“The Maputo Protocol is an African instrument for Africans, created by Africans. No external pressure,” said Kemi Akinfaderin, who leads global advocacy work for Fòs Feminista and is based in Lomé, Togo.

To date, the Geneva Consensus Declaration does not appear to have many real-world consequences for women, according to abortion rights advocates in the United States and abroad. It is not an official treaty and, therefore, has no teeth. It also has had no consistent overseer, the secretariat having been passed from the United States to Brazil and then, after new leaders emerged in those countries, to Hungary.

But its trajectory—and implications for women worldwide—could change rapidly if Trump wins a second presidential term in the Nov. 5 election, abortion rights advocates told The Fuller Project and Foreign Policy

Trump, who has courted abortion opponents in his three presidential runs, has pledged to rejoin the coalition that signed the declaration, now numbering 39 countries (despite withdrawals from Brazil, Colombia, and the United States). In addition, Project 2025, a document seen by many in the United States as the blueprint for a new conservative presidency, proposes that U.S. foreign policy should align with the declaration’s tenets on abortion and the family. 

“As soon as the next president is elected, we will reveal our priorities for the next four years,” Huber said in her statement.

For women in some of the world’s poorest countries, a return of Trump could signal real danger, according to abortion rights advocates in the U.S. and abroad.

Sridhar, who is based in Mumbai, might sound hyperbolic when she predicts an increase in deaths, but her fear is based on Trump’s track record. During his four-year term, he greatly expanded the Mexico City Policy, forcing medical providers that received U.S. money to make a choice: Either they stopped providing abortions and related services, such as counseling or referrals—even if they were subsidized by non-U.S. money—or they lost what was often the bulk of their funding. Many clinics that provided a full array of services, including HIV/AIDS testing and treatment, closed.

A report in the Proceedings of the National Academy of Sciences estimated that Trump’s reinstatement and expansion of the policy between 2017 and 2021 led to 108,000 maternal and child deaths and 360,000 new HIV infections.

Project 2025, which was drafted by the conservative Heritage Foundation think tank with the help of Trump administration alumni, including Huber, would expand the Mexico City Policy considerably further. Starting with former President Ronald Reagan in 1984, every Republican president has invoked the policy, dubbed the “global gag rule” by opponents, and applied it to foreign assistance for family planning services. (Every Democratic president has rescinded the policy.) 

Trump extended it to all health care aid and changed the policy’s name to the “Protecting Life in Global Health Assistance.” Project 2025 would extend the practice to apply it to all foreign assistance, including humanitarian aid.

Layered on top of that would be the Geneva Consensus Declaration. Project 2025 proposes applying the anti-abortion, pro-family doctrine not only to foreign nongovernmental organizations and governments, but also to large international organizations such as the United Nations and the World Health Organization (WHO), which have programs that support reproductive rights and health.

Lynn Morgan, a professor emeritus of anthropology at Mount Holyoke College and an expert on the declaration, said that Trump could use it to undermine the work of U.N. agencies and the WHO, which sets international standards for health care.

“It’s going to empower a coalition of countries who might want to say, ‘We don’t want to participate in the World Health Organization anymore. We’re going to stop funding the World Health Organization because of their advocacy around abortion,’” Morgan said.

The declaration would gain potency if Trump made it a condition of foreign assistance, said Gillian Kane, the director of policy and advocacy at Ipas, an international organization that supports access to contraception and abortion. “I think what the Trump administration could do is say, ‘Hey, if you don’t sign onto this, or if you sign off of this, you’re not going to get foreign aid,’” Kane said. “I think this can be a real cudgel and sort of force people to align to this ideology.”

Huber said in her statement that no matter who becomes president, the Institute of Women’s Health seeks to build consensus. “We don’t want anything to stand in the way of improved health and wellbeing for women and families,” she wrote.

But it’s difficult to fathom Vice President Kamala Harris, the Democratic nominee, working with Huber and other proponents of the declaration. Harris has been outspoken in her support of abortion rights, and advocates say that they hope she will go further than Biden has to promote access abroad. 

Although Biden rescinded Trump’s version of the Mexico City Policy and withdrew from the Geneva Consensus Declaration, abortion rights advocates said his administration was slow to communicate with foreign aid recipients. Akinfaderin, of Fòs Feminista, said that some U.S. agencies were implementing Trump’s restrictions well into Biden’s term.

Akinfaderin said that she would like a Harris administration to view reproductive rights and justice “more holistically” to include such issues as infertility, comprehensive sex education, and maternal mortality. And, she said, Harris should stop conservatives from “rolling back everything that we’ve done—every single thing that we’ve done.”

Beirne Roose-Snyder, the director of the Preclusion Project, an independent legal organization that supports gender rights, said that supporters of abortion and gender rights would relish working with a President Harris, whom she described as “a very public advocate on reproductive rights and sexual orientation and gender identity.”

“This is not someone who is going to take to the creation of fake documents particularly well,” Roose-Snyder said in reference to the declaration. “So I think we would expect to see continued distance and maybe even further engagement with other countries about diminishing the role and power of the future of the Geneva Consensus Declaration. I think we’d expect to see that.”