Health
Trump Reinstates Global Gag Rule, Redrawing Global Health Funding Landscape
President Donald Trump has reinstated the Mexico City Policy, commonly known as the “global gag rule,” sparking concerns about significant ripple effects on global health services, particularly in developing countries.
The policy prohibits U.S. funding for international non-governmental organizations (NGOs) that perform, promote, or provide information about abortions, even with non-U.S. funds. The reinstatement marks a continuation of Trump’s expansion of the rule, first introduced in the 1980s and traditionally toggled depending on the political party of the sitting U.S. president.
Broader Scope and Consequences
Trump’s version of the policy goes beyond its original scope, applying the funding ban to all U.S. global health assistance programs, including those addressing HIV, malaria, tuberculosis, and maternal and child health. This has raised alarm among NGOs and health experts about a potential “chilling effect” on sexual and reproductive health services.
Michael Jennings, a professor of global development at SOAS University of London, warned that organizations adhering to the rule may scale back services out of caution, leading to a “cascading” impact on healthcare delivery.
Impact on Global Health Funding
As the largest funder of global health programs, the U.S. plays a pivotal role in shaping international health initiatives. In 2022 alone, the U.S. allocated €15.1 billion to global health programs, dwarfing contributions from Germany, Japan, and the U.K. Combined, these three nations contributed less than €10 billion.
The policy’s reinstatement is expected to create funding shortfalls, particularly in reproductive health and family planning programs. NGOs like MSI Reproductive Choices, which refused to comply with the gag rule, anticipate losing millions in U.S. funding. MSI, which provides 20% of Zimbabwe’s contraception services, has already signaled potential service cuts in five African countries.
Human and Health Costs
Health experts warn of dire consequences. Studies indicate that previous implementations of the gag rule led to reduced contraceptive use, increased unintended pregnancies, and higher abortion rates. A recent review estimates that the 2017–2021 enforcement resulted in 108,000 additional maternal and child deaths and 360,000 new HIV infections across 30 countries.
Frances Longley, head of the International Federation of Gynecology and Obstetrics (FIGO), emphasized the interconnected nature of services provided by affected clinics, including contraception, prenatal care, and HIV treatment. “Doctors will face preventable crises they cannot address due to punitive restrictions,” she said.
European Response
European governments and donors may face heightened pressure to mitigate the funding gap. In 2017, EU countries raised €460 million to offset the policy’s effects. However, current financial strains, including the war in Ukraine and NATO obligations, may limit Europe’s ability to respond similarly.
“While some donors, including Japan and South Korea, may step up, the shortfall is unlikely to be fully addressed,” said Jennings.
The reinstated policy not only reshapes global health funding but also challenges international cooperation in addressing critical healthcare needs.
Health
World Cup Emotion Can Strain the Heart, Cardiologists Warn Fans at Risk
As the World Cup begins, medical experts are cautioning football fans with underlying heart conditions that the emotional intensity of matches can place unexpected strain on the cardiovascular system.
Cardiologists say that the excitement, tension, and anxiety generated during high-stakes games can trigger physical reactions similar to intense exercise, raising heart rate, blood pressure, and stress hormones.
“Intense emotions, whether positive or negative, can act as ‘precipitating risk factors’ for cardiovascular events such as heart attack,” said Paola Santalucia, a cardiologist and board member of the European Heart Network.
She explained that moments of extreme excitement, such as a decisive penalty shootout or a last-minute goal, may pose risks for people already living with heart disease. Those with additional risk factors, including hypertension, obesity, or smoking habits, are also advised to be cautious during emotionally charged matches.
Research using wearable devices has shown that during major football events, some fans experience heart rates climbing as high as 150 beats per minute. That level is comparable to sprinting and reflects how strongly the body reacts to emotional stress.
A study examining supporters during the 2025 German Cup final found that even watching from home can significantly affect physiological responses. “They still had an increase in heart rate that compares to walking, even though they didn’t walk,” said Christian Deutscher, professor of sports economics at Bielefeld University and co-author of the study.
He noted that the most intense reactions often occur not during goals themselves, but during moments of uncertainty such as VAR checks, penalty shootouts, or shots striking the post. These unpredictable situations, he said, are what drive the strongest emotional and physical responses among fans.
Deutscher also pointed out that stadium spectators may experience even greater strain due to environmental factors such as heat and alcohol consumption.
However, experts emphasize that football itself is not inherently dangerous. Instead, it is the body’s natural response to excitement that can create temporary stress.
“The adrenergic stimulation is at its max: extreme high blood pressure, high heart rate, and adrenaline, cortisol, skyrocketing,” said Dan Atar, professor of cardiology at Oslo University Hospital. In rare cases, he added, this surge can contribute to the rupture of arterial plaque in vulnerable individuals, potentially leading to a heart attack.
Atar stressed that such events can occur in everyday situations as well, including physical exertion like shoveling snow. “It is in no way dangerous to watch a football game,” he said. “All this is physiologic. It’s not dangerous to be excited.”
Still, he acknowledged that combining emotional stress with alcohol, heat, and pre-existing conditions can increase risk for some viewers.
Doctors advise those at higher risk to continue prescribed medications, limit alcohol intake, avoid smoking, and watch for warning signs such as chest pain or irregular heartbeat.
“The key message is not to avoid enjoying the match, but to do so with moderation and awareness,” Santalucia said.
Health
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Health
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