African health activists fear a new crackdown on abortion across Africa after U.S. President Donald Trump reinstated an anti-abortion pact that cuts off U.S. funds to foreign charities that provide or promote abortions.

When Trump signed the Mexico City Policy, or ¡°global gag rule¡°, during his first term some African charities were forced to close, denying women safe abortions. It also emboldened local opposition to women¡¯s reproductive choice.

The policy also hit antenatal care, contraception and HIV testing and treatment, along with tuberculosis and malaria programs run by African health organizations.