The British government will today publicly defy the United States by giving money for safe abortion services in developing countries to organisations that have been cut off from American funding.
Nearly 70,000 women and girls died last year because they went to back-street abortionists. Hundreds of thousands of others suffered serious injuries.
Critics of America's aid policy say some might have lived if the US had not withdrawn funding from clinics that provide safe services - or that simply tell women where to find them.
What I've never been able to figure out about American policy is why they persist in cutting down funding to organisations that are about preventing unwanted pregnancies.
Steven Sinding, director general , International Planned Parenthood Federation
The "global gag" rule, as it has become known, was imposed by President George Bush in 2001. It requires any organisation applying for US funds to sign an undertaking not to counsel women on abortion - other than advising against it - or provide abortion services.
The UK will today become the founder donor of a fund set up specifically to attempt to replace the lost dollars and increase safe abortion services.
The Department for International Development will contribute £3m over two years. DFID and the International Planned Parenthood Federation (IPPF) - whose clinics across the world have suffered badly - hope that others, particularly the Scandinavians, Dutch and Canadians, will be emboldened to put money in too.
"I think the UK is being very brave and very progressive in making this commitment," said Steven Sinding, director general of the IPPF. "We're deeply grateful for this gesture not only financially but also politically.
"Tens of thousands of women who depend on our services are not able to get them. We're committed to the expansion of safe abortion because in any society no matter how efficiently contraception is made available there will be unplanned and unwanted pregnancies."
The "global gag", he said, had increased the number of unsafe abortions by stopping funding to clinics that primarily provide contraception. "What I've never been able to figure out about American policy is why they persist in cutting down funding to organisations that are about preventing unwanted pregnancies."
International development minister Gareth Thomas said the government hoped the US position would change: "We work very closely with the Americans but we have a very different view from them on abortion. Friends can disagree.
"I recognise that the Americans are not going to want to contribute at the moment. We obviously continue to hope that the position will change. It is a position that has been decided by Congress so we're very aware of it and they know that."
DFID asked IPPF to produce a report on the scale of the damage caused by unsafe abortion. Death and Denial: Unsafe Abortion and Poverty, is published today. It reveals that an estimated 19 million women will risk the consequences of an unsafe abortion this year, of whom 70,000 will die. This accounts for 13% of the 500,000 maternal deaths each year. Reducing unsafe abortions is critical to reaching the UN's Millennium Development Goal on cutting maternal mortality, said Mr Thomas.
Women's low status in many poor countries makes them vulnerable to sexual coercion, abuse and exploitation, says the report. Almost 50% of sexual assaults worldwide are against girls aged 15 or less.
The death and injury toll is highest in countries where abortion is illegal or severely restricted, as in Kenya, where some 30% to 50% of maternal deaths are a result of unsafe abortion.
The Family Planning Association of Kenya, an IPPF member, chose to forfeit US funds rather than sign the "global gag" clause. It was forced to close three reproductive health clinics, scale back others and slash outreach programmes.
Many other organisations are affected by the global gag, including Marie Stopes, which is bigger in some countries than IPPF. The money from the new fund will be equitably shared among all those who have lost US funds. IPPF, which has itself lost $15m
(£9m) a year for the past five years, together with the provision of contraceptives worth $2m to $4m, hopes the fund may eventually raise up to $35m.
© Copyright 2006 Guardian Newspapers Limited