Amid uncertainty, Packard forges ahead on reproductive health
Giselle Carino, the director and chief executive officer of the international alliance Fòs Feminista, expected the Trump administration to sign a global gag rule, which has effectively shut off the U.S. funding spigot to global health organizations that provide abortions or referrals. It’s a repeat of what happened in President Donald Trump’s first term, and generally anytime the GOP regains the White House.
Carino’s organization supports more than 200 women’s organizations and health clinics worldwide that provide sexual and reproductive healthcare access and fight for reproductive health and rights. What’s different from Trump’s first term is that many of those clinics are also reeling from the administration’s 90-day freeze on foreign aid. And Trump’s latest move, attempting to dissolve USAID, promises to further upend the situation.
“Organizations are now faced with a decision of firing staff or going bankrupt, because who can sustain their work without three months of funding?” Carino said of the foreign aid funding freeze.
Nonetheless, Carino said, Fòs Feminista has been able to expand its work protecting reproductive health even in countries with authoritarian governments. “Our collective resolve will not be deterred by this very aggressive agenda against what we consider to be human rights.”
Through its partners, the organization has contributed to legalizing abortion in 2020 in Argentina, decriminalizing abortion in the majority of states in Mexico and passing laws in Africa to combat gender-based violence.
According to Carino, Fòs Feminista’s ability to flourish is strongly tied to long-term support from the David and Lucile Packard Foundation, which, between its global reproductive health funding and its domestic grants supporting women’s right to choose and abortion access, has a more than 50-year history of supporting reproductive health and rights. “At nearly every step of the way, there has been progress despite ever-present and evolving challenges,” said Packard’s Global Reproductive Health Director Lana Dakan.
As we’ve written, Packard isn’t the largest U.S.-based funder of abortion rights — that would be the Susan Thompson Buffett Foundation — but it has provided more than $1 billion in support over the years, filling gaps as funding from other sources, public and private, slips away or never materializes.
With the current outlook for reproductive rights seeming increasingly grim — in the U.S., at least — here’s an update on how this steadfast grantmaker is tackling ongoing and newly arisen challenges, both abroad and at home.
How Packard’s global reproductive health strategy is evolving
Drawing on feedback from health leaders, the Packard Foundation’s global reproductive health strategy has recently shifted focus from a country-focused approach to a regional one that encourages cross-border collaboration, according to Dakan.
The foundation has also been expanding its work in East Africa and French-speaking Africa. One new grantee is the Senegal-based Ouagadougou Partnership, which has worked since 2011 to increase access to family planning services in 10 West African countries, opening contraception services to 1.18 million women, according to its website.
Another part of Packard’s global reproductive health strategy is bolstering the resilience of reproductive health efforts against climate change and other shocks through grantees such as Panorama Global. Part of its work involves strengthening evidence and support for initiatives highlighting how climate change creates obstacles to women and girls seeking sexual and reproductive healthcare.
“Reproductive healthcare delivery must evolve to respond to the needs of young people and be more resilient to external shocks, such as disruptions due to climate change or conflict,” Dakan said. Though the regular imposition of the global gag rule by Republican administrations provides some precedent, it remains to be seen how organizations will respond to the potentially permanent loss of aid support from the U.S.
If that happens, it will have a devastating impact on the availability of contraceptive products, especially in Africa, according to Beth Schlachter, the U.S. senior director of external relations for Packard grantee MSI Reproductive Choices, which works with groups globally.
“If contraceptives are no longer available to women, including condoms, which are critical to preventing sexually transmitted infections, then what we have is a global health crisis, because already, issues related to pregnancy and STIs, particularly HIV, are the No. 1 killers of adolescent girls in South Africa.”
How Packard backs abortion rights in the U.S.
On the domestic front, the Packard Foundation further ramped up its support for abortion rights following the 2022 Dobbs decision that overturned the landmark Roe v. Wade case that legalized abortion in 1973.
In the year following the Dobbs decision, the foundation gave out an additional $14.1 million beyond its initial budget in reproductive health grants domestically for a total of $26 million, and $28.8 million for global reproductive health. From 2023 through 2025, its grantmaking for U.S. reproductive health totaled approximately $40 million while its global reproductive health giving was around $65 million.
Last October, the foundation launched a safety and security pilot program to support reproductive health grantees in the trenches who are facing an onslaught of threats. “In reproductive health, safety and security has always been an issue,” said Packard’s U.S. Reproductive Health Director Elizabeth Arndorfer. “But incidents of things like doxxing and incidents around digital security and physical security seem to have increased.”
While those instances are hard to quantify, there has been a 229% increase in stalking of staff working at abortion clinics, a 231% increase in burglaries and a 25% increase in invasions of abortion clinics since the end of Roe, according to the National Abortion Federation. To support grantees, Arndorfer said, the foundation created “on-demand” resources for those under attack, including rapid-response grants for legal and mental health support as well as access to security experts and crisis communication teams.
Beyond security and safety, since Dobbs landed, Packard shifted focus to protecting reproductive rights and choice at the state level, supporting 501c3 grantees working on state-based abortion rights advocacy, including in Colorado, Florida, Maryland, Missouri, Montana, Nebraska, Nevada, New York and South Dakota last year alone.
The Packard Foundation is also continuing what has been a decade-long commitment to supporting reproductive rights and justice groups in Louisiana and Mississippi, where there’s been a total ban on abortions.
“For people in Louisiana and Mississippi, the closest abortion clinic is in Carbondale, Illinois, which is more than 600 miles from New Orleans and 400 miles from Jackson,” wrote Arndorfer in a 2023 blog post. “The impact of these bans falls heaviest on pregnant people who are struggling to make ends meet and who are Black, Indigenous, and other people of color.” Packard, she wrote, provides support for out-of-state travel to access abortion care and legal support for those criminalized for accessing care.
Support for contraception in the U.S.
In addition to backing abortion care in the U.S., the foundation’s support also extends to groups pushing back against moves to limit women’s freedom over choosing when they conceive and have children.
When 195 House Republicans voted against the Right to Contraception Act in 2022, Liz Jaff thought the vote was crazy and clearly at odds with the views of the majority of Americans. It spurred her to found Americans for Contraception that year to raise awareness and build a movement that now, she said, includes everyone from evangelical Latino Christians to 20-something white guys and beyond.
The group, another Packard Foundation grantee, witnessed the death knell of the Right to Contraception Act last June, a rash of state challenges to contraception last year and anticipates new attempts to thwart contraception by the Trump administration. “We know where this is going. It is control of women and control of their bodies,” Jaff said.
From the overturning of Roe v. Wade, “Americans for Contraception recognized, and we recognized, that contraception was also really important to people’s autonomy and making decisions around their reproductive health,” Arndorfer said.
Americans for Contraception’s public education and organizing efforts often stray from the conventional. It sent a 61-foot IUD around to 61 cities in 20 states. It also ran ads about threats to contraception on platforms from ESPN to Christian radio, with the latter reaching 9.7 million listeners, according to its annual report. From such efforts, the group says it drew in 500,000 evangelical Christians to do advocacy work and raise awareness to counter legislative attempts to thwart contraception.
Packard’s work around increasing access to contraceptives goes back decades. According to a 2004 foundation blog post, some 19 million people in the United States were living in “contraceptive deserts,” because they did not have transportation to a clinic or the insurance coverage to get prescription birth control pills. The foundation’s support of a “Free the Pill” campaign began that year — a broad coalition led by Ibis Reproductive Health, which resulted in the FDA’s approval of an over-the-counter birth control pill, Opill, in 2023.
Going forward, Arndorfer said, “It is a scary time, because there are a lot of unknowns… And I think the best thing that we can do is remain flexible and nimble and understand that there is so much that we can do to protect and expand access for the people who need it most.”