WASHINGTON — The Trump administration said on Monday it would vastly expand the so-called global gag rule that withholds American aid from health organizations worldwide that provide or even discuss abortion in family planning. The new policy could disrupt hundreds of clinics in Africa and around the world that fight AIDS and malaria.
It affects about $8.8 billion in global health funding, up from about $600 million during the administration of President George W. Bush.
The rules, issued by the State Department, mean that any foreign nongovernmental group that wants American money for any of its health activities — from AIDS treatment to malaria prevention to safe childbirth practices — must promise not to “promote abortion as a method of family planning.” Already, American taxpayer dollars cannot be used for abortion services abroad.
They are a follow-up to an executive order President Trump signed in January, which froze funding to nongovernmental organizations if they offer abortion counseling or advocate the right to seek abortion. In April, the administration also froze funding to the United Nations agency that promotes family planning efforts.
But public health advocates say that in much of the developing world, there are no high-quality substitutes to these providers.
“It’s not like we have an influx of providers in places like West Africa,” said Jonathan Rucks, the advocacy director of PAI, a global public health group. “Whole communities could be cut off.”
Representative Nita M. Lowey, Democrat of New York, called the new rule “a cruel and unprecedented attack on the world’s most vulnerable women.”
A State Department official told reporters that the administration would review the “expansive nature” of the new policy over the next six months.
The global gag rule was introduced by President Ronald Reagan in 1984 at the International Conference on Population in Mexico City, and is also known as the Mexico City Policy. Since then, Republican administrations have kept or reimposed it, while Democratic ones have rescinded it.
During the Bush administration, it affected about $600 million in aid to nonprofits, the State Department said on Monday. A Kaiser Family Foundation analysis put it lower, at $520 million.
Mr. Bush visited Botswana and Namibia only last month to highlight the need for aid under the President’s Emergency Plan for AIDS Relief, or Pepfar, to treat cervical cancer. He also argued that care for cervical cancer should be provided right along with care for H.I.V.
But under the policy announced Monday, that could be impossible.
The policy “risks undoing years of progress on women’s health in Pepfar countries,” said Asia Russell, executive director of the Health Global Access Project, a public health group.