By: Rupal Ramesh Shah

Last month, the U.S. Supreme Court reversed Roe v. Wade. stating that the constitutional right to abortion no longer exists. As an American, I believe everyone should have a choice to make decisions over their bodies, and I also believe every life is precious and worthwhile, and deserves respect. Frankly, I do not believe this is a matter where we have to choose between being pro-life and pro-choice. We can be both, because they are not mutually exclusive.
As a public health professional, for me the repercussions of making abortions illegal are too great. As a Tanzanian, I have experienced a healthcare system that has strict antiabortion laws and does not have ample resources. Data indicates that for most countries across sub-Saharan Africa, abortions are illegal and approximately 62% of 47,000 women who seek abortions annually die due to unsafe abortions. This number could be reduced by the legalization of abortions as well as the development of safe spaces and methods to undergo abortions.
Unfortunately, the current reversal in the U.S. may have a devastating impact on the African continent and elsewhere. Former President Donald Trump, who adopted the so-called global gag rule in 2017, prohibited foreign nongovernmental organizations that received U.S. funding from providing abortion services. That policy only allows abortion in cases of rape, incest, or when a woman’s life is at risk. At the time of the enactment of that rule, countries such as Malawi, Senegal, and Kenya ceased to provide contraception services. In a study by The Lancet published in 2019, researchers documented that the global gag rule contributed to a 40% increase in abortions on the African continent.

Though the gag rule has been in effect since 2017, many African healthcare champions advocated for and promoted abortion rights for their people. This new decision made by the U.S. Supreme Court may undermine those advocacy campaigns across the continent. In fact, over the past decade several African countries such as Mali, Togo, Chad, Niger, Mauritius, Somalia, and São Tomé and Príncipe, worked hard to relax the punitive laws concerning abortion. All the work and time that was spent by activists to ensure women have a choice about the decisions over their bodies will now be questioned because of the overturning of Roe v. Wade in the U.S.
I believe all of us have a role to play on the international stage. We need to ensure that every life is valued and respected, including those of women who make choices about their own bodies.

While there are many ways to engage, here are my suggestions:
1. Discuss this topic openly with family and friends – women and men alike. Statistics show that one in four women have received abortion services in the U.S. However, most people do not talk about it. In order to break down the stigma about this topic, thoughtful and candid conversations are necessary.
2. Support organizations such as Planned Parenthood, which work in local communities to provide healthcare services to all people, with or without insurance. Such organizations need resources such as funding and trained staff.
3. Join activists who are advocating for healthcare services, whether by writing about it, calling government officials, or marching on the streets. Encourage and support members of the community who are part of these advocacy groups.
While the decision to overturn Roe vs. Wade is difficult to understand and perhaps accept, I continue to believe in American democracy. This decision is not permanent, and over time, as more data is released and more stories are told, there will be changes and improvement.
Until then, I believe our work as global health professionals and social justice activists must continue. We must continue to promote pro-life and pro-choice – because truthfully, we can be both.