Access to abortion is a human right. International development actors must not ignore it.

By Alex le May, Jedidah Maina, Muadi Mukenge, and Mandira Paul

Reproductive rights, including abortion rights, are human rights. Everyone has the right to make informed decisions about their body and health, no matter where they live. It’s a simple statement based on a global principle that all nations should uphold. Yet it’s been tough to go from principle to reality. We think it’s time to change that — and we’re not alone, there’s a growing international movement with us.

At the Generation Equality Forum, we — along with government leaders, activists and advocates from around the world — committed to responsive funding, supporting intersectional and inclusive movements for reproductive justice, and improving access to abortion care for all, particularly in crisis settings.

And at a meeting of actors in the global abortion access movement, World Health Organization Director General Tedros Adhanom Ghebreyesus has also called for action, saying that “achieving universal health coverage built on a foundation of primary healthcare must include access to contraception and safe abortion care, to the full extent of the law, as well other services for sexual and reproductive health.”

We agree. It’s time to see abortion within the context of human rights — the right to live free from discrimination, the right to bodily autonomy, and the right to health. But the truth is, gender, racial and economic inequities, as well as political ideology, make it difficult for young people, women, LGBTIQ+ people and other marginalized groups to get the essential health care they need. And these same structural inequities have long blocked equitable access to abortion care.

As a result, abortion is separated from other health services. It is legislated and restricted, politicized and problematized — even though 73 million abortions occur worldwide every year. So how do we make lasting, sustainable change that builds access to abortion?

Make abortion a component of essential health care. Access to sexual and reproductive health care, including abortion, must be an integral part of universal health care for all who need or want it. Access to abortion still is precarious, or outright limited, in many places in the world, including in the United States. And in some of the most critical spaces, like humanitarian or crisis settings, abortion is routinely left out of emergency health services — even though women and adolescent girls are disproportionately affected by humanitarian and natural disasters and by the lingering stress from such events.

End legal restrictions on abortion. Research has shown that when abortion is restricted, it only drives people to seek abortions under unsafe conditions. Women and girls suffer physical complications and risk death, creating life-long negative consequences for their families and communities. Due to concerted advocacy, there is now real progress to liberalize abortion laws and lift legal barriers; roughly 40 countries have liberalized their laws within the last two decades. Grassroots advocates, like those who were part of the “Green Wave” in Argentina, or those in the Democratic Republic of the Congo, have fought tirelessly to decriminalize abortion, understanding that abortion is about a woman’s agency and place in society, about whether she — or anyone who can become pregnant — can live up to their full potential. They’ve done it because they’ve watched their friends or family members pay the worst price — with their health or even their life.

Foreign policies from some of the world’s richest nations also restrict abortion care — not just for their own citizens but for millions of people around the world through foreign aid funding. And yet in contrast, some governments like Canada, the Netherlands or Sweden provide foreign assistance funds for comprehensive sexual and reproductive health and rights, including abortion services, under their feminist foreign policies — but they can’t possibly fill all the gaps. More donor nations should follow this lead, in the name of gender equality, which surely cannot be achieved without reproductive and economic freedom for women and girls and other groups who remain on the margins.

Integrate abortion into other social justice issues. We can learn from local advocates like those at La Reveulta, a feminist collective in Argentina, that works to increase access by bringing together 58 groups who provide information and accompaniment to people seeking abortion; or SENET, a network in Busia, Uganda, working to improve community health through promoting sexual health and rights, education and economic empowerment for girls. Like SENET, which takes a locally focused, yet expansive view of how abortion access connects with economic security and education, we must all view abortion through an intersectional lens. We can’t separate women’s rights from human rights; reproductive rights from human rights; racial justice or climate justice from reproductive justice.

Finally, let local activists lead. Even when people in power have sought to deny reproductive freedom, tireless advocates keep going and the movement keeps growing. People and grassroots organizations know what is needed for their communities, and they know what works. The Women’s Solidarity Foundation for Humanity and Human Rights (SPEK-HAM), based in Surakarta, Indonesia, works with village, health and religious leaders to ensure that women get the abortion and postabortion care to which they are legally entitled. TICAH, the Trust for Indigenous Culture and Health, works to help communities improve health using local knowledge and resources through programs like the Mama Network, which shares information on sexual health and rights with women in communities, and by doing grassroots advocacy to shift social and legal norms around unwanted pregnancy.

Even now, as we continue to face a global pandemic, and as we grapple with ever-changing geopolitics, there’s passion and momentum to expand abortion rights. Now is the time to normalize abortion, to decriminalize and destigmatize it, to integrate it into primary health care and as an essential part of universal health coverage, to see it as one part of reproductive, economic, gender, and climate justice. It’s also time to fund efforts to do all of these things, both domestically and through foreign aid and philanthropic funding. Governments, health systems, donors and civil society can’t afford to be on the sidelines of this movement. The time is now to stand together for the right to abortion.

Alex le May is deputy fund director for Amplify Change

Muadi Mukenge is chief of development and external relations for Ipas

Jedidah Maina is executive director for Trust for Indigenous Culture and Health (TICAH)

Mandira Paul is senior program specialist for sexual and reproductive health and rights, Swedish International Development Cooperation Agency (Sida)

Ipas is an international reproductive health and rights organization.