Statement from Global Health Council on the Interim Final Rules (IFRs) Expanding the Mexico City Policy and Restricting DEI and Gender Related Programming
Global Health Council (GHC) is deeply concerned by the Trump administration’s release of three Interim Final Rules (IFRs) that, together, significantly reshape the scope and conditions of U.S. foreign assistance. Taken as a package, these rules (1) expand the Mexico City Policy (colloquially referred to as the “Global Gag Rule”), (2) impose new restrictions related to diversity, equity, and inclusion (DEI), and (3) introduce a “gender ideology” rule that limits how gender, inclusion, and health are addressed in U.S.-funded programs throughout the world. These rules represent a broader shift toward the use of political and ideological conditions in U.S. foreign assistance.
“The combined effects of these policies on health systems and service delivery in low- and middle-income countries are particularly alarming,” said Global Health Council President and CEO, Elisha Dunn-Georgiou. “Placing restrictions on speech, advocacy, and the use of non-U.S. funds undermines efforts to address maternal mortality, strengthen health workforces, reduce discrimination, and advance health equity. The demand for care, however, will remain the same or even increase, making it impossible for health systems and providers to respond effectively.”
The expansion of the Mexico City Policy dramatically broadens its reach beyond prior iterations. For the first time, provisions apply across nearly all non-military U.S. foreign assistance, including humanitarian programs and activities carried out by U.S.-based organizations, multilateral partners, and other governments. Past experience shows that the Mexico City Policy disrupts health systems, fractures referral networks, and reduces access to essential services without reducing need, placing additional strain on already fragile health systems. This expansion will exacerbate those harms.
The anti-DEI and gender ideology rules are troubling for what they signal about the treatment of equity, inclusion, and evidence-based care within U.S. foreign assistance. Health programs are most effective when they address inequities and allow partners to respond to documented needs. Restrictions that limit information, services, or advocacy related to gender and marginalized populations undermine care delivery and silences expertise. Such exclusions weaken the effectiveness of health programs and increase risk across all communities. Diseases spread by way of exposure and are not inhibited by ideology.
“Health programs are most effective when they are grounded in evidence, responsive to local needs, and respectful of the dignity and rights of all people,” said Dunn-Georgiou. “Policies that force organizations to choose between funding and their core missions risk making U.S. assistance less efficient, less effective, and less aligned with longstanding, bipartisan global health goals.”
GHC will continue to assess the implications of the IFRs and advocate for U.S. global health policies that center people’s health, dignity, and well-being.