In the first year of the Trump administration, Christian social conservatives placed in high-level jobs focused mostly on U.S. policy. They were highly successful, pushing through a religious exemption to the Affordable Care Act’s birth-control mandate, prioritizing abstinence-only sex education and imposing what critics call “gag rules” on family planning groups receiving $286 million in the United States and up to $7.4 billion around the world that prohibit them from referring for abortions.

Now, they are seeking to spread those views to the rest of the world by building a coalition of nations that would wield clout beyond the Trump administration.

Valerie Huber, a top Health and Human Services Department official, was the special guest at a New York City event Tuesday that included representatives of dozens of nations in town for a key women’s rights conference.

The gathering featured a screening of the film “Strings Attached,” which takes aim at the West’s “ideological colonization” of Africa through interviews with women who experienced side effects from contraception or who regretted having abortions, according to two attendees. Huber used her spotlight to emphasize the Trump administration’s commitment to “protecting life” in global health assistance.

Huber’s appearance at the event — sponsored by C-Fam, a think tank with Catholic ties whose mission is “to defend life and family at international institutions,” and Nigeria, which generally supports comprehensive family planning — is part of a bold new effort by the Trump administration to build an international coalition to restrict access to abortion and promote traditional values about the family.

Over the past few months, Huber and other U.S. officials have traveled the world inviting other nations to join the cause. In meetings, according to people privy to the discussions who asked not to be identified because of the sensitivity of the negotiations, Huber, who previously founded an abstinence-only sex education group, has explained that “health and rights mean different things to different people.”

Attempts to influence global resolutions

The first test of the coalition comes this week as U.S. negotiators seek to excise references to “universal access to sexual and reproductive health and rights” — which they argue promotes abortion and normalizes sexual activity among youth — in an annual document about empowering women by the U.N.’s Commission on the Status of Women. They also want to replace “gender-responsive” with “family-centered” in calls for more-inclusive public services.

And they’re pushing to add a section recognizing that “women’s contribution to the home, including through unpaid care and domestic work, which is not adequately recognized, generates human and social capital.”

U.S. representatives have indicated that a declaration without their proposed changes is “unacceptable,” according to participants at the meetings.

Their position has the backing of nontraditional allies such as Bahrain, Malaysia, Saudi Arabia and possibly Russia but has drawn strong opposition by many European countries.

The United States sought to influence global resolutions on reproductive rights on several occasions last year, according to country representatives and civil society advocates, but had stumbled on its own. In December, U.S. officials drew scorn for holding up important negotiations on refugees and forced marriage while they tried and failed to get support for removing references to sexual and reproductive health. And earlier in 2018, U.S. Agency for International Development (USAID) representative Bethany Kozma, who has been vocal in opposing access to bathrooms of their choice for transgender children, alienated some foreign diplomats. This year, observers say, the U.S. group has come back better prepared, more knowledgeable about the players and more sophisticated — and more likely to be effective.

Critics are dismayed

Civil society groups focused on women’s rights expressed dismay at the efforts. They accused the United States of putting unfair pressure on poor countries that depend on U.S. foreign aid, and also of aligning with countries with poor human rights records.

Serra Sippel, president of the Center for Health and Gender Equity, a Washington-based advocacy group, said the U.S. plan amounts to “bullying.” Elisha Dunn-Georgiou, vice president of programs for PAI, which works on universal access to reproductive health care globally, said such a coalition would allow countries “with more draconian laws about women’s rights or sexual minorities to skirt their obligations under international mechanisms.”

“The U.S. stance this time enables other bad actors at the U.N. negotiation table,” Dunn-Georgiou said.

HHS spokeswoman Caitlin Oakley said that the United States under President Trump “unequivocally supports the empowerment of women and girls, including health promotion for women and girls across the life course.” However, she said the meaning of sexual and reproductive health “has unfortunately evolved in the multilateral setting to include abortion.”

"As a pro-life administration, the Trump administration does not support abortion,” Oakley said.

The State Department said that it does not comment on ongoing negotiations but that it considers Saudi Arabia an important strategic partner and has relayed the United States’ concerns about its “human rights situation” publicly, as well as in private diplomatic engagements.

Language tweaks could affect billions of people

Similar to its strategy within the United States — where officials opposed to abortion rights use bureaucratic levers to achieve their goals — the Trump administration emissaries to international organizations have focused on language tweaks in multinational discussions, agreements, declarations and trade deals that may appear obscure but have the potential to affect billions of people.

In the November trade agreement between the United States, Mexico and Canada, for example, U.S. representatives changed an initial draft that prohibited the signatories from engaging in LGBT employment discrimination to say that every country should proceed as it “considers appropriate.” Late last year, according to a State Department memo obtained by Foreign Policy, the United States urged diplomats to avoid phrases such as “sexual and reproductive health” or “comprehensive sexuality education."

Huber, who shifted from a domestic role at HHS to global affairs in January, is perhaps the most high-profile new face of the United States at international meetings.

Revered by the religious right, she spearheaded some of the most controversial domestic U.S. initiatives on sexual and reproductive health over the past year. She is a key architect of efforts (later reversed after court challenges) to terminate $220 million in Teen Pregnancy Prevention Program grants used to study approaches to lower teen pregnancy rates and redirect some of those funds to abstinence-only initiatives.

‘Do we have a deal?’

At a meeting of the World Health Organization at its headquarters in Geneva in late January that drew leaders from 34 countries to discuss pandemic influenza and how to protect refugees, observers said U.S. representatives were more focused on speaking about women and families.

Country delegates and others briefed on the conversations said U.S. representatives talked about how the millions spent on contraceptives have not always been effective in lowering the rate of unwanted pregnancies and suggested this money could be put to better use for “sexual risk avoidance” (or abstinence) education and other programs.

During one side meeting in a lounge adjacent to the main conference hall, Huber and Garrett Grigsby, director of HHS’s global affairs office who previously led Christian Connections for International Health, pitched their plan to representatives from an African country. The U.S. officials mentioned they had already spoken to South Africa’s Princess Nothemba Simelela, WHO’s assistant director-general for sexual and reproductive health and rights, and noted that Russia appeared to be engaged, according to a conference participant’s notes.

Several times in the conversation, the pair emphasized how big a priority the conservative coalition is for the United States.

“This is important to us,” Huber said.

“This is important,” Grigsby echoed.

“It does not matter who is in the White House. This will last,” Grigsby said at a different point.

“So,” he asked, “do we have a deal?”

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