United States President Donald Trump’s administration has been accused of undermining global health through its plan to extend funding restrictions to foreign governments, NGOs, and international bodies that support diversity, equity and inclusion (DEI) initiatives.

The administration intends to expand the Mexico City policy, also known as the global gag rule, to cover organisations that promote what it calls “gender ideology” or DEI programmes. The move could affect key health services, including those supporting women, young people, and marginalised groups.

Health experts say the expanded rule would pressure governments and international partners to abandon anti-discrimination policies or risk losing a major source of US aid. Programmes such as HIV prevention for young women in Africa and vaccination drives led by female health workers could be among those affected.

Beth Schlachter, MSI’s senior director for US external relations, called the reports “deeply concerning”.

She said: “Such a move, which goes far beyond previous restrictions, would be an insidious encroachment on sovereignty, pressuring governments to change their own laws and policies in exchange for US funding, despite repeated claims to respect national autonomy.

“It risks causing real human suffering, undermining global health and destabilising decades of partnerships and progress.”

A senior state department official confirmed the policy direction, saying: “The state department continues to advance President Trump’s American First foreign policy. The department will soon take additional steps to close loopholes that allowed taxpayer funding for promotion of abortion in previous iterations of the Mexico City policy and expand the scope of the policy to ensure every penny of US foreign assistance prioritises American values, not the woke agenda.”

Rajat Khosla, director of the Partnership of Maternal, Newborn and Child Health, said the new policy could have “unimaginable effects”.

“The interventions have already created a chilling effect,” he said, warning that countries reliant on aid would face “very hard choices” if the rule expands.

Beirne Roose-Snyder, senior policy fellow at the Council for Global Equality, said DEI initiatives were essential to reaching vulnerable communities. She added that the proposed restrictions appeared designed to control how organisations operate even outside US-funded projects.

“The administration wants to be able to do ‘ideological purity’ testing before helping after a tsunami,” she said.

Yumnah Hattas, gender justice lead at Frontline Aids, described the plan as part of a “rising transnational anti-rights movement”.

She warned: “Human rights will be violated at a large scale.” Hattas said the gag rule had previously pushed abortions underground and could now threaten access to contraception, HIV prevention and gender-based violence services.

She urged affected countries to reject US funding tied to the new conditions.

“If you ignore the US government, then it doesn’t matter any more,” she said. “Then the global impact of the global gag rule no longer exists because it was rejected by the globe.” (The Guardian UK)