On his first day in office in 2001, President George W. Bush  reinstated the so-called Mexico City Policy — known to critics as the global gag rule. It prevents the US government from giving money to organizations that provide counseling and referral for abortion, lobby to make abortion legal or more available in their country, or perform abortions except in cases of a threat to the woman’s life, rape or incest (even if those activities are funded by somebody else).

On Development Drums this week, we heard about the impact of the global gag rule on women in Africa, in an interview with Dana Hovig from Marie Stopes International. (Full disclosure: my partner works for MSI.)  My expert guests were sceptical that Barack Obama would give priority to reversing the global gag rule any time soon.

But this weekend, we have heard that Obama is preparing to reverse some key decisions that President Bush took using executive authority, including on stem cell research, oil and gas drilling and - according to the Washington Post, the New York Times and Bloomberg - the global gag rule:

President-elect Barack Obama will reverse U.S. family-planning and AIDS-prevention strategies that have long linked global funding to anti-abortion and abstinence education, a public-health adviser said. Obama “is committed to looking at all this and changing the policies so that family-planning services — both in the U.S. and the developing world — reflect what works, what helps prevent unintended pregnancy, reduce maternal and infant mortality, prevent the spread of disease,” Wood said.

These seems like a good time to raise the profile of this important issue, to make sure that reversing the global gag rule is on the list of decisions for President Obama to take in his first day in office.  The Center for Reproductive Rights has written to Barack Obama calling for the repeal of the global gag rule.  Now is the time to make as much noise as possible about this to generate political support for an early decision to reverse this policy.

For more information about the global gag rule, listen to the interview with Dana Hovig in Episode 6 of Development Drums (about 30 minutes in to the podcast).

I’m impressed by the idea of the Welbodi Partnership, a charity supporting the Ministry of Health and Sanitation in Sierra Leone:

The Welbodi Partnership was established to support the provision of paediatric care in Sierra Leone, where child health statistics are the worst in the world.

The cool thing - as Tristan points out - is that:

they work directly with the Ministry of Health and Sanitation to improve the hospital, instead of running their own hospital, as many NGOs like to do. This way, they deliver services and build capacity in the country’s health system.

There are far too many NGOs who, for respectable reasons, set up parallel services. The result is duplication and waste, and foreign-funded NGOs often deplete capacity from already hard-pressed government systems. The Welbody partnership approach seems to combine the best of both worlds.

Does anyone know of other NGOs taking this approach?

Bill Clinton has finally been persuaded that investment in health systems is more important than funding “vertical” initiatives for particular diseases:

“That’s increasingly in the last few years what our foundation has been focused on - what is the most cost-effective way to mobilise a national health system,” Mr Clinton said.

“You can get the universal treatment - the money’s there now, if we spend it most effectively.”

“But we don’t have the health care systems to reach out to people, get them tested and diagnosed in a timely fashion, get them on treatment and do the regular follow-ups.”

Well good. This is what the aid experts have been saying for years. It is why many of us opposed the establishment of funds like the Global Fund for AIDS, TB and Malaria and PEPFAR in the first place. But politicians like to announce things that they think their public will understand, and big disease-specific initiatives are the kind of thing that seems to fit the bill.

According to Hugh Williamson in the FT the 8 richest countries are stepping back from the commitment they gave in Gleneagles to increase aid:

Leaders of the Group of Eight rich nations are set to backtrack on their landmark pledge at the Gleneagles summit in 2005 to increase development aid to Africa to $25bn a year. A draft communiqué obtained by the Financial Times, due to be issued at the group’s July summit in Hokkaido, Japan, shows leaders will commit to fulfilling “our commitments on [development aid] made at Gleneagles” – but fails to cite the target of $25bn annually by 2010.

To be fair, the only evidence for this given by the FT is that the draft G8 summit makes no reference to the figure. In some ways this may seem pedantic - failing to repeat the number is not the sane thing as renouncing it - but for those of us who watch summit language carefully, this is a significant ommission. If the countries meant to to keep their promises, they would make a virtue of it by restating the commitment. The only possible reason for dropping the language is that they no longer believe they will live up to it.

In some ways, however, this is more worrying:

In a further retreat, the G8 is set to abandon its Gleneagles promise to provide universal access to Aids treatment and prevention by 2010. The pledge has been a benchmark around which health campaigners and others have been organising their work, especially in Africa.

Universal access to AIDS treatment is a much better target than the aid target. In principle, we should be setting targets for what we plan to achieve, not targets for how much we plan to spend (which creates perverse incentives to spend more, rather than achieve more value for money).