At a United Nations meeting in New York this week, the Trump administration declared there’s no “international right to abortion” and called on other countries to join a coalition pushing the elimination of what it calls “ambiguous” terms and expressions, such as sexual and reproductive health, from U.N. documents.

“We remain gravely concerned that aggressive efforts to reinterpret international instruments to create a new international right to abortion and to promote international policies that weaken the family have advanced through some United Nations forums,” Health and Human Services Secretary Alex Azar and Secretary of State Mike Pompeo said in a letter circulated in advance of the gathering.

Earlier this year, HHS officials began meeting with representatives from other countries, urging them to join a new international coalition that would focus on the value of the family, and which would not condone harmful sexual risks for young people, or promote abortion as a means of family planning.

Response from other countries

Other countries, civil society and women’s rights groups have expressed alarm at the efforts, and accused the United States of aligning with countries like Saudi Arabia and Sudan with poor human rights records and, also, of putting unfair pressure on poor countries that depend on U.S. aid.

Numerous country representatives tweeted their objections to U.S. statement under the hashtag #SRHR — sexual and reproductive health and rights — the very language the United States has sought to erase from U.N. documents.

Sweden’s Minister for International Development Cooperation tweeted that the action was “unbelievable news,” and that “women’s rights must be protected at all times.”

The Netherlands’ Sigrid Kaag, minister of foreign trade, spoke out in a competing joint statement issued on behalf of 58 countries. While she did not use the word abortion, she repeatedly stressed the need to uphold the full range of sexual and reproductive rights.

And Françoise Girard, president of the International Women’s Health Coalition, said that “sexual and reproductive rights are human rights, and are enshrined in UN agreements for almost 25 years now.”

“The Trump administration’s position is extreme and its repeated attempts to strip women, girls, and gender- diverse people of their rights at the United Nations have failed,” Girard said.

Antiabortion groups, meanwhile, praised the statement as a sign of the administration’s “strong pro-life leadership on the world stage.”

“From day one, President Trump has worked to restore respect for life as a foundational American value, not only in our domestic policies, but in our international relations as well,” SBA List President Marjorie Dannenfelser said in a statement.

Azar unveiled the results of that work on Monday, announcing 19 states representing 1.3 billion people had agreed to work with the United States on these issues.

Below is the full text of the United States’ joint statement:

We are pleased to speak on behalf of the United States of America, Bahrain, Belarus, Brazil, Democratic Republic of the Congo, Egypt, Guatemala, Haiti, Hungary, Iraq, Libya, Mali, Nigeria, Poland, Russia, Saudi Arabia, Sudan, United Arab Emirates, and Yemen.

We believe that health of women, men, children and adolescents supports and improves the overall health of our families and communities, and that the family is the foundational institution of society and thus should be supported and strengthened.

We commend the United Nations and the Member States on the significant work done on the Universal Health Coverage Political Declaration, and for the high priority placed on expanding access to health care.

We therefore urge Member States to join us in focusing on the important work of expanding health and opportunities for all people, and especially those in situations of risk and/or vulnerability.

To make the most meaningful progress without delay or dissension, we respectfully call upon Member States to join us in concentrating on topics that unite rather than divide on the critical issues surrounding access to health care.

We do not support references to ambiguous terms and expressions, such as sexual and reproductive health and rights in U.N. documents, because they can undermine the critical role of the family and promote practices, like abortion, in circumstances that do not enjoy international consensus and which can be misinterpreted by U.N. agencies.

Such terms do not adequately take into account the key role of the family in health and education, nor the sovereign right of nations to implement health policies according to their national context. There is no international right to an abortion and these terms should not be used to promote pro-abortion policies and measures.

Further, we only support sex education that appreciates the protective role of the family in this education and does not condone harmful sexual risks for young people.

We therefore request that the U.N., including U.N. agencies, focus on concrete efforts that enjoy broad consensus among member states. To that end, only documents that have been adopted by all Member States should be cited in U.N. resolutions.

To this end, we also understand the important role the Sustainable Development Goals play in assisting countries realize their own path to universal health coverage, in accordance with national policies and legislation.

We strongly support the highest attainable health outcomes for women, men, children, and adolescents holistically and throughout their lives.

We support equal access to health care, which includes, but is not limited to reproductive concerns, maternal health, voluntary and informed family planning, HIV, elimination of violence against women and girls, and empowerment to reach the highest standard of health.

We support programs to improve the health, life, dignity, and well-being of women, men, children, and families, and we will continue to be their stalwart defender.

Let us focus on concrete issues and challenges to accelerate access to health for all.

To this end, international solidarity has a key role to play, in order to the build broad consensus by member states.

The Netherlands joint statement is below:

Mr. President,

It is my pleasure to deliver this statement on behalf of the governments and peoples of Albania, Antigua and Barbuda, Argentina, Armenia, Australia, Austria, Belgium, Bolivia, Bosnia and Herzegovina, Bulgaria, Cap Verde, Chile, Colombia, Costa Rica, Croatia, Cyprus, Czech Republic, Denmark, Dominican Republic, El Salvador, Estonia, Fiji, Finland, France, Germany, Greece, Guinea, Iceland, Ireland, Italy, Latvia, Lebanon, Liberia, Liechtenstein, Lithuania, Luxembourg, Malta, Mexico,

Montenegro, Nepal, New Zealand, North Macedonia, Norway, Panama, Peru, Portugal, Romania, Serbia, Slovenia, South Africa, Spain, Sweden, Switzerland, Togo, Tunisia, United Kingdom and Uruguay, as well as my own country, The Kingdom of the Netherlands.

Mr. President, I would like to join previous speakers in congratulating you on your election and wishing you a successful tenure. We wish to express our appreciation and give thanks to Ambassador Imnadze of Georgia and Ambassador Srivihok of Thailand, for steering the negotiations on the Political Declaration on Universal Health Coverage (UHC) to success. We thank Director-General Tedros Adhanom Ghebreyesus of WHO for his support and look forward to his continued leadership in advancing UHC. We also acknowledge the outstanding contributions of civil society to this process.

Mr. President, today, the adoption of the Political Declaration and this historic High-Level Meeting on Universal Health Coverage constitute a defining moment for the benefit and the well-being of millions of people around the world. UHC is fundamental for achieving all sustainable development goals. We believe that the implementation of this Political Declaration will be a major contribution to a world i which every person’s right to health is protected. As we celebrate this milestone, I would like to addressthe importance of sexual and reproductive health and rights to realize UHC and achieve the SDGs, in four points:

First, we strongly believe that SRHR is an integral part of Universal Health Coverage and the SDGs. For UHC to be genuinely universal, it must embrace all health services, including sexual and reproductive health and rights (SRHR). Sexual and reproductive health services in UHC programs need to be of good quality, available, accessible and acceptable to all women and girls across the life course, free of stigma, discrimination, coercion and violence. Many examples of national UHC schemes encompassing SRHR, around the world, have demonstrated the significant difference such programs can make in preventing risks, reducing harm, and ultimately saving lives.

Second, investing in SRHR has proven to be affordable, cost-effective, and cost saving. Such investments significantly contribute to reducing financial risk, decrease the burden on health systems, and hence foster economic development, poverty reduction and sustainable development. Around sixty-two percent of sexual and reproductive health services are financed out-of-pocket by patients, with alarming implications for equitable access to these preventable and life-saving services. With a limited investment of nine US dollars per person, per year, these essential services can be available to all.

Third, gender-related barriers to accessing UHC must be addressed, including by direct involvement of women, adolescents and marginalized groups in policy and program design. Gender inequalities are a barrier to the realization of the right to health and universal and equitable access to quality health services. They are also a barrier to achieving the SDG targets of reducing maternal mortality, ensuring universal access to SRHR, addressing gender-based violence as well as harmful practices.

Lastly, Mr. President, investing in comprehensive sexual and reproductive health services in UHC is necessary to address the needs of women, girls, adolescents and people in the most marginalized situations who need these the most. According to the recent Guttmacher-Lancet report on SRHR, more than half of the world population will have limited or no access to sexual and reproductive health services over their reproductive years. Focusing on the needs of the poorest and most vulnerable women, adolescent girls and young people in UHC programs is necessary to close the gap in access, equity and gender equality, to empower women and girls tangibly, and achieve universality, leaving no one behind.

In closing Mr. President, we wish to reassure you of our full commitment and support to the implementation of the Political Declaration on Universal Health Coverage in our respective countries and abroad.

I thank you.

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