Global Health Institute

By Maya Gabby

On Tuesday, January 21, 2020, our “Conversations in Global Health” lecture welcomed Keifer Buckingham, Senior Policy Advisor for International Public Health at Open Society Foundations (OSF). Buckingham began with an overview of her path to her current role at OSF. In speaking about critical moments in her educational journey, she cited both her undergraduate and graduate programs as having significant impacts on her career trajectory. 

Buckingham, like many other global health professionals, has worked on a variety of health areas over the course of her career, but has grappled most with the politics of reproductive health rights. When asked about the current state of the Global Gag Rule (GGR), it was obvious that it remains her passion. Under the Trump administration, the GGR – or the Mexico City Policy as it is also known as has been vastly expanded and is now the “Protecting Life in Global Health Assistance. Funding for international health services through USAID and PEPFAR have been drastically impacted. Having lobbied for the Global Health Empowerment and Rights (HER) Act this past summer, which would permanently end the GGR, I was curious if there had been any meaningful improvement. Unfortunately, while global health funding used to be a relatively bipartisan issue, the current administration has caused increasing polarization and the bill has not been moved beyond democratic participation. 

However, hope is not lost -- at least not according to Buckingham. She is a firm believer in “budgets [as] moral documents, even when they don’t pass”. And while the Trump administration has offered very little to improving sexual and reproductive health and rights (SRHR), house democrats have continued to list global health assistance as a top priority in their budgetary considerations. Buckingham is quick to cite the financial return of family planning (for every $1 spent on family planning there is a $7 return on investment) and wealth of positive data as key ways to engage with morally opposed individuals. After all, relationship building has been at the heart of her success in the political world. With the upcoming election in the front of my mind, this brought me great hope for the future of the GGR and my own interest in health policy. As advocates for global health equity, Buckingham’s parting words were meant as inspiration and encouragement to those of us still in the undergraduate portion of our journeys. Facing us, she said “We need more curiosity and empathy in the world.” 

Maya Gabby (NHS ‘21) is a third-year undergraduate at Georgetown studying global health, with specific interests in sexual and reproductive health and rights and health policy.

By Shuait Nair 

The sphere of global health has witnessed an impressive growth in progress over the past few decades. The notion of the right to health has gained familiarity across many societies, though the term itself is still shrouded in ambiguity. Today, many global health activists are working to clearly define the right to health, primarily by identifying the types of health services which fall under this broader umbrella, while ensuring that all populations have access to any essential services. Keifer Buckingham, Senior Policy Advisor for International Public Health at Open Society Foundations, is one such global health advocate who has worked on elucidating the right to health. In particular, she has devoted her career to the advocacy of a form of health which many countries either ignore or are quick to dismiss: reproductive health. Buckingham’s career began with examining the right to HIV care among populations throughout the world. In her freshmen year of college, Buckingham had the opportunity to travel to Rwanda on an exchange program. While there, she visited a PEPFAR-funded clinic– her first-hand experience with seeing international communities and the extent to which health impacted their livelihoods inspired her to create her own major in international development at a time when the now popular field was virtually non-existent. In graduate school, her health focus transitioned from global HIV care to domestic reproductive rights. 

Buckingham claimed that this shift in interest was catalyzed by her discovery of an unsettling irony rooted in the U.S. global health agenda, namely that while the US fought hard to provide HIV treatment for women abroad, the country was all too quick to limit reproductive rights at home. Buckingham began pursuing research on domestic policies that regulated reproductive health, such as the Global Gag Rule (Mexico City policy), which blocked funding to NGOs that directly supported or advocated for access to abortions. With time, Buckingham unearthed the reproductive health paradox in the U.S., noting in her article published in The Hill, how post-Roe v. Wade, U.S. policies like the Global Gag Rule and Helms Amendment restricted a woman’s fundamental right to reproductive health. 

A central part of Buckingham’s career has been to consolidate this concept of reproductive health rights. In our conversation, Buckingham mentioned how reproductive health rights had largely varying associations between countries. For example, Buckingham noted that while reproductive health rights in the U.S. mostly focused on the right to terminate an unwanted pregnancy (abortion), the term often referred to the right to access prenatal care and postnatal in refugee camps across the Middle East and Asia. However, Buckingham argued that the concept of reproductive health was its own umbrella consisting of a spectrum of rights, from the right to survive a pregnancy and have a healthy baby to more nuanced rights, such as the rights to have a child (via fertility treatment), receive sexual education, and exercise gender identity. Buckingham reminded us that even though the U.S. often debated the more complex concepts of reproductive health, it still struggled with the more fundamental rights, noting the disparity in maternal mortality rates between white women and women of color in the country. 

For the past year, Buckingham has worked as a senior policy advisor on international health at the Open Society Foundations, an organization which develops and provides grants to smaller independent groups hoping to tackle global health initiatives. Her work in the Open Society Foundations has given activists the opportunity to open up conversations on the more divisive issues within the realm of global health. It is essential that we these platforms to spread awareness of reproductive health rights despite the efforts of countries to avoid such matters. Whether they are ready or not to recognize this issue should no longer be a ground for delay; it’s about time we address the elephant in the room. 

Shuait Nair is a sophomore in the School of Foreign Service studying Science, Technology, and International Affairs. He is also a researcher on refugee and migrant health rights.