By Michael Igoe

The U.S. global health security agenda is running out of options, Abraaj pushes back against allegations of misused health funds, and the U.S. State Department assesses the first months of anti-abortion policy.

This week in development.

The U.S. State Department released its first review of implementation and challenges associated with the expansion of the Mexico City Policy early last year. The so-called “Protecting Life in Global Health Assistance” policy requires any organization receiving U.S. global health funding — as a prime or subcontractor — to agree not to perform, or provide any information about abortion as a method of family planning. While previous Republican administrations have attached this policy to U.S. family planning funds, the Trump administration expanded it to the much larger pool of U.S. global health funding.

This first review reported that, “it is too early to assess the full range of benefits and challenges of the PLGHA policy for global health assistance,” but sought to address some of the concerns groups have raised about the policy so far.

The review included a number of “action” items the State Department intends to take as increasing numbers of organizations fall under the new policy’s purview. Most of these involve clarifying some aspect of the policy — for example, that “immediate termination” is the “presumptive sanction for egregious or recurrent violations of the PLGHA policy,” but that the U.S. government has discretion to demand corrective action instead.

The review argues that relatively few prime and subcontractors declined to comply with the PLGHA policy.

The Planned Parenthood Federation of America described this finding — and the review in general — as “misleading,” pointing out that two of the prime contractors who refused to comply are the International Planned Parenthood Federation and Marie Stopes International, which are both major health service providers.

“USAID is working to transition the activities of those organizations that have not agreed to the PLGHA standard provision to other partners, while minimizing disruption of services,” the review states.

British Conservative MP Jacob Rees-Mogg delivered a petition to Downing Street on Thursday, calling on the government to scrap its commitment of spending 0.7 percent of GNI on aid. Rees-Mogg delivered the petition on behalf of the tabloid Daily Express newspaper, which has been leading a campaign against what it describes as Britain’s “foreign aid madness,” arguing the money could be better spent at home.

The newspaper claimed the petition had gathered more than 100,000 signatures — a number high enough to guarantee the issue a debate in parliament if it had been submitted through the government’s formal e-petition channel, although most of the petition’s signatures were not. Currently a backbench MP, many observers see Rees-Mogg as a potential future contender for the Conservative Party leadership, and his views are often considered representative of the pro-Brexit right of the party, where aid skepticism is increasingly rife. However, the 0.7 percent commitment has been embedded in U.K. law since 2015, and Secretary of State for International Development Penny Mordaunt recently confirmed it will remain in place.

The Centers for Disease Control and Prevention is planning to cut back activities associated with the “global health security agenda,” a network of technical assistance efforts launched after the Ebola virus outbreak aimed at preparing countries around the world to better detect and respond to emerging pandemics.

The roughly $500 million originally allocated for this effort only runs through fiscal year 2019, and in anticipation that it may not be replenished — or funded through the CDC’s core budget — the U.S. health agency is already planning to wind down many of its country activities, the Wall Street Journal reported. Without additional funding, the CDC will focus its global health security efforts in 10 priority countries — India, Thailand, Vietnam, Kenya, Uganda, Liberia, Nigeria, Senegal, Jordan and Guatemala, according to an email obtained by the journal. Former CDC director Tom Frieden, who now leads Resolve to Save Lives, criticized the failure to fund the effort. “Not only would this set back scientific, technical, and diplomatic relationships that have taken years to develop, it would significantly increase the chance an epidemic will spread without our knowledge and endanger lives in our country and around the world,” he wrote to Devex.