KISUMU, Kenya (AP) 鈥� For decades, U.S. anti-abortion groups have lobbied domestically and abroad for . In the U.S., their biggest success was the reversal of Roe v. Wade. Now, the to the movement exporting 鈥渇amily values鈥� to nations overseas.
At anti-abortion activists鈥� annual March for Life demonstration in Washington, on U.S. funding for nongovernmental organizations, foreign governments and U.N. agencies that promote access to abortion, gender-affirming care and diversity initiatives overseas.
鈥淲e鈥檙e going to start blocking every international NGO that performs or promotes abortion abroad from receiving a dollar of U.S. money,鈥� Vance told the crowd in January.
The expanded restrictions build on the anti-abortion advocacy work carried out by conservative U.S. nonprofits abroad 鈥� especially in Africa, where healthcare is highly dependent on foreign aid. The region has 鈥� including the highest number of maternal deaths per 100,000 abortions.
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This is part of a series on , which has the world鈥檚 fastest-growing population and accounts for 70% of global maternal deaths. Around 180,000 pregnancy deaths are recorded every year across the continent.
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The new rules represent a radical expansion of earlier U.S. policy that cut assistance to overseas groups providing abortion-related services. Experts say at least $30 billion in U.S. aid could be affected, reshaping health policies worldwide.
鈥淲e鈥檙e seeing opportunity here to have a consistently pro-life ethic,鈥� Nicole Hunt of Colorado-based Focus on the Family, a conservative Christian evangelical group, told The Associated Press. 鈥淲e鈥檝e been influencing health policies for a long time with our foreign aid. This is just a new direction.鈥�
In the crosshairs is an international convention signed by African countries two decades ago declaring safe abortion a human right. Known as the Maputo Protocol, it obliges signatory nations to legalize abortion in cases of rape, incest, fetal malformation or risk to a woman鈥檚 health. But , forcing women to seek illicit procedures. Every year, sub-Saharan Africa records over 6 million unsafe abortions, according to the African Institute for Development Policy.
Emboldened by President Donald Trump鈥檚 policies, U.S. anti-abortion groups now aim to overturn even this limited access to safe abortion.
In Nairobi, Nardos Hagos of the International Planned Parenthood Federation said she is deeply worried for the future.
鈥淲e鈥檝e now moved into a new era where we are the ones who are in opposition because the most powerful and influential supporters of reproductive health 鈥� the U.S. and a lot of Europe 鈥� are now more aligned with anti-rights groups,鈥� she said.
鈥淲e鈥檙e gonna see more women dying from unsafe abortions.鈥�
Africa is the focus
It鈥檚 difficult to track the full scope of the funding U.S. anti-abortion charitable groups send to Africa.
Publicly available information from nonprofit tax filings of 17 such groups show money sent to Africa jumped 50% between 2019 and 2022, to over $16 million, according to an analysis by the Institute for Journalism and Social Change, a research group.
And the funding kept growing: The organizations spent almost $9.4 million in Africa during 2023 and 2024, previously unreported data analyzed by the institute shows.
That鈥檚 鈥渏ust the tip of the iceberg,鈥� said the institute鈥檚 Claire Provost.
鈥淲hat we鈥檙e seeing here is just a fraction of what the real investment on the continent is,鈥� Provost said, noting that unlike other tax-exempt charitable organizations, U.S.-based churches and some religious groups are not required to complete annual financial disclosures detailing revenue, contributions and expenses.
It鈥檚 not possible to see 鈥渆ven limited information鈥� about how much money The Church of Jesus Christ of Latter-day Saints, among others, funnel to Africa, she said.
Widely known as the Mormon church, the Salt Lake City-based church is 鈥漣ncreasingly active on the continent, including opposing sexual and reproductive rights issues,鈥� Provost said. With over 1 million followers in Africa, it has held 鈥淪trengthening Families鈥� conferences throughout the continent over the past eight years.
Sean E.R. Donnelly, the church鈥檚 communications manager for Africa, said in an AP interview that about a quarter of the $1.5 billion the church spent overseas last year was in Africa, for development projects 鈥渨ith the goal of helping people, especially families,鈥� including in healthcare, education and emergency relief.
Asked about women鈥檚 reproductive rights and abortion, he said the church was 鈥渘ot really active鈥� in those areas, but noted the issues may be discussed by its African partners during church-sponsored conferences.
鈥淲e have the deputy prime minister, we have the ministries of gender, we have all the ministers who are relevant to family, and we鈥檙e helping them … as they craft policy and strategy to make sure that we protect the family,鈥� Donnelly said of the conferences.
Asked about the church鈥檚 position on abortion, he sent a statement outlining that it generally opposes elective abortion in most cases but allows exceptions for rape, incest or danger to a woman鈥檚 health in counseling its members. He said via email that the church conducts no activities related to abortion and reproductive rights.
Last year’s church-sponsored conference took place in Sierra Leone at a time when the country was close to decriminalizing abortion. But pressure from local religious lobbies stalled the process, local rights groups said. Activists and rights groups have raised the alarm over the influence of local religious groups, whose strategies mirror those of some conservative U.S. Christian groups. In response to AP鈥檚 questions about the conference and any pressures around abortion and other reproductive rights issues, Donnelly said, 鈥淭his is not how the church operates in Africa or globally.鈥�
He also referred AP to the church鈥檚 Caring Report, which outlines its humanitarian work globally and does not mention the conference.
It鈥檚 tricky to determine how the U.S. money is spent once it reaches Africa because of loose requirements on disclosing financial data in African countries.
Focus on the Family spent $370,000 in Africa between 2019 and 2023, according to the Institute for Journalism and Social Change, which says that likely does not fully capture the scope of the group鈥檚 influence or work. Focus on the Family鈥檚 Hunt said its mission is 鈥渢o change hearts and minds on abortion鈥� globally, but she declined to provide details of activities in Africa.
Funding emboldens harassment of reproductive-rights groups
Hannah Ruguru vowed to help women get abortions safely after losing her sister to a backstreet procedure. But her work at a reproductive health clinic in Kisumu in rural western Kenya has proven increasingly hazardous.
She鈥檚 been screamed at by protesters and encountered so much abuse on Facebook that she deleted her account, she said.
鈥淪ometimes you can get scared,鈥� Ruguru said. But 鈥渁t the end of the day, I鈥檓 helping women.鈥�
Marie Stopes International, which runs the clinic where Ruguru works, said in a 2024 report that staff in several African countries described online and legal attacks from U.S.-based groups and U.S.-funded local organizations. In Congo, it said, health workers have been detained for days for providing legally permissible services before being released without charge.
鈥淭he extent of the opposition has made abortion providers fearful of coming into work,鈥� the report said.
In Ethiopia, the group said, the head of the local office of U.S.-based Family Watch International has 鈥渢argeted and trolled members of our senior leadership team on social media,” and released YouTube videos promoting anti-abortion misinformation.
In Kenya, the names and addresses of staff at reproductive rights organizations have been published online, accusing them of murder.
The owner of a private abortion clinic in Nairobi said staff members have been harassed by police and detained. Officials demand bribes, threatening charges if they don鈥檛 pay up, the owner said, speaking on condition of anonymity for fear of repercussions.
Musoba Kitui, regional director of Ipas Africa Alliance, which promotes reproductive rights and access to safe abortion care, said the changes in U.S. foreign aid policy combined with 鈥渢his advancing American interest in ideology in Africa is really concerning.鈥�
鈥淲e think the consequences are going to be dire,鈥� Kitui said, especially for women and marginalized communities such as LGBTQ+ people.
鈥業t鈥檚 a culture war鈥�
Last year, anti-abortion Christian groups from the U.S., Europe and Africa and high-ranking Kenyan officials gathered in Nairobi for a conference on 鈥淧romoting and Protecting Family Values in Challenging Times.鈥� Poland-based anti-abortion group Ordo Iuris handed out a guide in four languages, including Swahili, with tips on lobbying international organizations, including the United Nations, European Union and African Union.
Travis Weber, vice president of the Family Research Council, a Washington-based evangelical group active in anti-abortion advocacy, said he traveled to Nairobi to 鈥渄efend the family as God designed it.鈥�
Charles Kanjama, vice chairman of African Christian Professionals Forum, the conference organizer, said that previously international aid often supported reproductive rights 鈥� but times have changed.
鈥淲e are hoping that … we can start attracting money from people who think like us,鈥� said Kanjama, among Africa鈥檚 most prominent anti-abortion figures. 鈥淚t鈥檚 a culture war, really.鈥�
Indeed, the anti-abortion agenda is gaining momentum. In June, representatives of 20 African countries finalized a draft charter at a conference in Ghana that calls for rejecting sexual and reproductive health rights. It will be voted on by the African Union next year. Family Watch International’s co-founder, Sharon Slater, was among those fundraising for the charter’s passage at the European Parliament in Brussels this year.
Legal gray area
In Kenya, one of Africa鈥檚 richest countries, seven women die every day on average from complications of unsafe abortions, according to the African Population and Health Research Center.
The 2010 Kenyan Constitution permits abortion when a woman’s health or life is threatened. Subsequent court decisions have also allowed abortions in cases of rape, incest or serious threat to a woman鈥檚 mental health.
But there’s a major legal gray area. Kenya鈥檚 penal code, which dates to the colonial era, continues to criminalize abortion providers and women seeking the procedure, who can face up to 14 years in prison.
Most public hospitals don鈥檛 perform abortions, leaving women the option of pricey private clinic procedures or risky illicit methods, healthcare officials said.
In May, an appeals court in Kenya overturned a ruling that affirmed access to abortion is a fundamental right 鈥� a case led by Kanjama, who said the decision 鈥渞estored constitutional balance.鈥�
The Kenyan Health Ministry, Justice Ministry and the government spokesperson鈥檚 office did not reply to repeated AP requests for comment, including detailed questions sent via email.
The U.S. State Department, in response to an AP request for comment on the Trump administration鈥檚 new rules governing American aid overseas, said: 鈥淭he American people expect their tax dollars to support programs that save lives … and reflect American values, not fund abortion-related activities, left-wing social agendas, or wasteful overseas bureaucracies.鈥�
鈥淯.S. assistance continues to support a wide range of maternal and child health services as part of the America First Global Health Strategy,鈥� it said in a statement.
On the ground, women are dying from unsafe abortions
In Kenya, doctors are obligated to treat women suffering from post-abortion complications, often from underground procedures, including bleeding, infections and the loss of their wombs 鈥� and it鈥檚 those cases that often end up in public hospitals.
鈥淏y the time the women come, we are often dealing with a life-threatening situation,鈥� said Dominic Omollo, the reproductive health coordinator in Bondo, western Kenya.
Even as the stated aim of U.S., international and Africa-based anti-abortion groups is to protect life, activists and healthcare providers say that on the ground, the result is more unsafe abortions and more women dying.
In Karabok, a village in rural Kenya, two trees were planted at the site where Mary Olouch is buried, just feet (meters) from where the 25-year-old bled to death after an illicit abortion.
鈥淪he did not open up to anyone,鈥� said Loice Ochieng, a community health volunteer in charge of family planning in the village.
Olouch already had a young child when she realized she was pregnant. She didn鈥檛 tell her husband. When he came home one evening, he found her bleeding and rushed her to the hospital, but it was too late.
Olouch did not qualify for an abortion in a public hospital and couldn鈥檛 afford a private clinic on her meager income selling fish. Abortion carries enormous stigma in rural communities, and husbands often don鈥檛 allow women to use contraceptives, Ochieng said.
After Olouch鈥檚 death, women started to talk more openly about abortion in Karabok, where for many even uttering the word had been taboo, Ochieng said.
Now, she said, if women 鈥渉ave a problem, they come to me, they ask. Because they have seen that this thing can cause death.鈥�
鈥斺赌�
Beaty reported from New York. AP writers Evelyne Musambi in Nairobi and Caitlin Kelly in Freetown, Sierra Leone, contributed to this report.
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