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On Monday, as an executive order President Trump signed in January prohibiting U.S. foreign aid for groups that discuss abortion went into effect, senior U.S. officials said the "gag order" will affect $8.8 billion in State Department programs, much more than the roughly $600 million in family planning funds covered by the so-called Mexico City Rule under the George W. Bush administration. Trump's order will block funding for any nongovernmental organization that doesn't pledge to not "promote abortion as a method of family planning" through abortion counseling or referrals, lobbying, or information campaigns, and its impact is expected to be felt hardest in Africa.

The bulk of the funds, $6 billion, are from the President's Emergency Plan for AIDS Relief, established by Bush in 2003; other hard-hit programs are the anti-malaria initiative started by Bush and expanded by former President Barack Obama, and the United Nations Population Fund, which operates in more than 150 countries and says it doesn't promote abortion. Trump officials say that overall funding won't be cut, but women's health advocates and family planning groups said the expanded order will lead to crucial health centers closing around the world. "It's not like we have an influx of providers in places like West Africa," PAI advocacy director Jonathan Rucks tells The New York Times. "Whole communities could be cut off."

Trump's order is officially called "Protecting Life in Global Health Assistance," and abortion opponents cheered the expansion. A 2011 study by Stanford researchers, cited by women's health experts, suggests that the policies Trump is enacting actually increased abortion rates in sub-Saharan Africa, The Washington Post notes. A State Department official said the "expansive nature" of the new order will be reviewed over the next six months.