During a fiery hearing with the Senate foreign relations committee last month, Andrew Bremberg, President Trump’s controversial nominee for US representative to the United Nations office in Geneva, declared that victims of rape and sexual violence should not be allowed to terminate their pregnancies. Bremberg pledged that, if confirmed, he would vote against any UN resolution outlining fundamental rights for survivors of sexual violence if they include abortion.

Bremberg also took credit for driving the Trump administration’s massive expansion of the global gag rule, or “Mexico City Policy”, an international anti-abortion policy that prevents foreign organizations from receiving US global health assistance if they provide information, referrals or services for legal abortion as a method of family planning, or advocate for the liberalization of abortion in their country.

To be clear, Bremberg is taking credit for cutting off access to life-saving HIV prevention, treatment and care; cervical cancer screening; voluntary male medical circumcision; and gender-based violence screening. The ripple effects of the Trump administration’s global gag rule are killing women around the world, and Bremberg wants to keep it that way.

The history of the global gag rule is a long, heavily partisan journey. First implemented by Ronald Reagan in 1984, the global gag rule was enacted to stop foreign NGOs from providing abortion or abortion-related services. Yet even Reagan, a conservative deity, made exceptions for abortions in response to rape, incest or the life of the pregnant person.

In 1993, Bill Clinton rescinded the global gag rule, calling the policy “excessively broad”. In 2001, George W Bush reinstated the rule via presidential memorandum. In 2009, shortly after taking office, Barack Obama swiftly rescinded the rule. But then came Donald Trump.

Just two days after taking office, Trump reinstated the global gag rule via presidential memorandum and instructed the then secretary of state, Rex Tillerson, to expand the policy to the fullest extent of the law. In May 2017, Tillerson issued a new global gag rule, renamed “Protecting Life in Global Health Assistance”, which expanded the reach of this policy to nearly all global health assistance from the US Department of State, Department of Defense, Department of Health and Human Services (including the Centers for Disease Control and Prevention), USAid, and the Peace Corps.

Unlike previous iterations, Trump’s global gag rule targets nearly all global health assistance funds, and has already cut funding for programs targeting issues such as HIV/Aids, maternal and child health, malaria, tuberculosis, family planning and reproductive health, nutrition, non-communicable diseases, water, sanitation and hygiene at the household and community levels, and the Zika virus. A policy that once affected millions of dollars now affects billions.

Research has shown that Trump’s global gag rule is associated with an increase in abortion and unintended pregnancies

In 2019, the Trump administration continued to expand the already catastrophic policy, restricting “gagged” organizations from funding groups that provide abortion services and information, even if those organizations don’t get any US global health funding. Illogically, organizations, donor governments and funders are bound by a US government policy even if they don’t receive US government funding.

This has been catastrophic. Research has shown that Trump’s global gag rule is associated with an increase in abortion and unintended pregnancies, is harming HIV prevention efforts, and will harm women and girls’ empowerment efforts around the world. In fact, curbing US assistance to family planning organizations, especially those that consider abortion a method of family planning, increased abortion rates in sub-Saharan Africa, where abortion rates among women in countries highly exposed to the policy rose by 40%.

While many of the affected areas are similar to those affected in past iterations of the gag rule, the scope of the harm of Trump’s policy is likely to be broader because all global health assistance partners are gagged. A 2018 Change report, Prescribing Chaos in Global Health: The Global Gag Rule from 1984-2018, anticipates that the new protocol will affect a broader range of health areas than ever before, such as nutrition, malaria, tuberculosis and gender-based violence, which are all subject to the policy.

Given all that we know about Trump’s contributions to the global gag rule, it’s clear that matters will only get worse with Andrew Bremberg in charge.

While Bremberg boasts about this expansion of the global gag rule, it is absolutely critical to note Bremberg’s past support for extremist, anti-choice conservatives. As co-chair of the Department of Health and Human Services transition team, Bremberg stocked the agency with anti-choicers before serving as chief of the White House’s Domestic Policy Council.

Bremberg will probably continue to brag about his expansions to the global gag rule. But we should not forget that the policy he is promoting is one that leaves the US with bloods on its hands.

Trump’s expansion of the global gag rule is a disastrous policy has already made a resounding impact on poor women, people with HIV and Aids, and the LGBTQI community throughout the world. But there is still hope – there is legislation moving in Congress that would end this presidential nightmare. As people like Bremberg take credit for this catastrophic policy, it is critical that the American public understand that he has absolutely nothing to be proud of.