In the global fight for sexual and reproductive health and rights (SRHR) within the current political climate - which includes massive funding cuts from the US Administration, it is increasingly becoming apparent that power rarely lies where we assume it does. Ideological currents, donor politics, judicial decisions, and cultural backlash (all powerful forces shaping this ecosystem) are often beyond the control of service providers, civil society actors, non-profit organizations and even governments (those who do the work). And yet, the expectation remains: deliver, scale, survive, thrive.How?For those of us working at the heart of the SRHR movement, this paradox is familiar. The terrain is political, volatile, and deeply unequal. When major funding decisions can be reversed by a single election, when misinformation campaigns can undo years of work, or when legal restrictions can criminalize healthcare provision suddenly, then the illusion of certainty and control becomes dangerous. Not only are we not governed by conventional market logic, but the unpredictable influence of non-market actors including religious groups, social movements, philanthropies, and international institutions whose priorities can shift overnight, ultimately shape our work. The recent dismantling of USAID is a sobering reminder of just how vulnerable we are as a sector. Unlike the Global Gag Rule, which followed an ideological cycle we had learned to anticipate, this decision came without warning, without precedent, and without the usual window for contingency planning. It exposed the fragility of our sector, not just to political tides, but to a global funding architecture that remains deeply skewed and susceptible to ideological interference. It is in this context that leadership must be reimagined.This moment demands a deeper reckoning: how can we lead when the rules are unpredictable, the playing field is uneven, and the very legitimacy of SRHR is under siege?The SRHR ecosystem sits at a high-stakes intersection of health, human rights, gender politics, and development. It is as much about clinics and commodities as it is about movements and messaging. Success is not only measured in service delivery numbers or program outcomes, but also by how well we navigate ideologically charged environments, how effectively we influence policy debates, and how resilient we are in the face of organized opposition. SRHR work is inherently political - no matter where we position ourselves on the spectrum. And political work demands political strategy, even when we’d rather stay neutral. This time, neutrality didn’t protect us. As we saw with USAID, they came for us all.Are we truly acknowledging that survival can no longer depend on the ‘chop wipe mouth’ mentality, as we say in Pidgin – the notion of silently complying from the sidelines, discreetly signing documents and collecting cheques while the ‘abortion providers’ stand by, waiting for the next four-year cycle? The time for passive acceptance has passed; we must now recognise that survival requires active participation and meaningful change, not just quiet endurance.Are we developing the capacity to collectively anticipate, influence, and position ourselves proactively by strategically engaging with both market and non-market forces? Do we better understand the interplay of these forces and refuse to be caught off guard by predictable surprises? Are we done playing catch up or playing the neutral gatekeeper of the status quo?Too often, our sector becomes fixated solely on programmatic delivery, adopting a market-driven management approach: setting targets, optimizing processes, tracking performance, and demonstrating impact. However, this framework risks overlooking the deeper realities of our ecosystem. What we truly need is a more worldly approach—one that centres context, embraces systems thinking, and recognises the complex interplay of power, policy, and people. This mindset is part of a new wave of thinking I have been exploring thanks to the International Masters Programme for Managers, IMPM, and one which I hope can be integrated more consciously into how we work as organizations in a volatile sector.At the International Planned Parenthood Federation (IPPF), this shift is already underway. In the wake of recent shocks, we are rethinking what it means to be resilient - not just operationally, but politically. We’re asking the tough questions: How can we anticipate change sooner? How do we build influence with non-traditional allies? How can we reimagine our systems to respond more quickly and intelligently to emerging threats, and how do we safeguard against funding losses?Following a Federation-wide survey of our Member Associations and Collaborative Partners, IPPF has set up a Harm Mitigation Taskforce to assess the evolving crisis and fast-track emergency funding to the most severely impacted affiliates. The first round of grants was disbursed in May 2025 to ensure the continued delivery of essential healthcare services and uninterrupted access to life-saving health commodities.While we cannot fully replace the funding losses, we can strategically inject resources to sustain life-saving services during such challenging times. Our partners on the ground are already doing this, delivering services in some of the world’s most challenging contexts. They are adapting their care pathways, diversifying partnerships, and pivoting their advocacy - all because they are deeply committed to their communities and trusted by them.This moment also calls for a new orientation to leadership that moves beyond control and toward systems stewardship, because the leaders who will matter most in the coming decade are not those who can manage efficiently in stable times, but those who can read the landscape, anticipate shifts, build coalitions, and challenge the status quo. They are comfortable working in ambiguity, they ask better questions, and crucially, they understand that reclaiming agency does not mean eliminating uncertainty but rather learning how to lead within it.While the sector often feels like it is in constant crisis mode, there is a deeper truth here: moments of disruption, however painful, also open space for reinvention. Crises expose weak points, surface unspoken dependencies and challenge outdated mental models. But they also present a window, however small, to lead differently. Are we listening?At IPPF, we are using this window to ask ourselves what kind of institution we want to become. Not just one that adapts, but one that influences. Not just one that delivers services, but one that shapes systems. And not just one that survives shocks, but one that helps build a future where such shocks are less likely, less devastating, or more equitably absorbed.This is not easy work. It requires confronting deeply embedded assumptions about what leadership is, how change happens, and who gets to drive it. It demands that we embrace both the visible and invisible forces shaping our context. And above all, it requires that we lead not from a place of fear or reaction, but from a deep, unwavering commitment to the world we are trying to build. We can do more than respond – we can lead.

In Tigray, Ethiopia, this vast secondary school once echoed with the sounds of students shuffling between classes and teachers giving lessons. Now it has been transformed into a crowded camp, sheltering more than 10,000 internally displaced people – most of them women and children. The rooms are divided up by large sheets to house multiple families. When night falls, they share thin mats and try to get some sleep. For two years, between November 2002 and November 2004, Tigray was in conflict, cut off from adequate food, medicine, and outside aid. Schools, hospitals, and essential services collapsed, shattering communities that once thrived on agriculture and trade. For International Women’s Day we collaborated with Ethiopian photographer Maheder Haileselassie to help tell the stories of women attending clinics and sheltering in displacement camps like this with their families. After fleeing the Tigray conflict and enduring immense hardship they continue to push forward with determination. Today and every day – despite devastating cuts to international aid – we are united in solidarity with them.     Zenebu (above left) lived in her home town for more than forty years before fleeing four years ago: "We used to be wealthy. We owned cows, donkeys, and farmed several hectares. Militias stormed the town one day after midnight, and we had to flee empty-handed to save our lives. We want to go back home because there’s nothing to do here. The food and the sleeping situation are horrible, and I now have high blood pressure. I’m a very hardworking woman. My husband passed away more than thirty years ago, and I was the ‘man’ of the house, raising my children. I was a strong woman back home." For Wubalech (above right), the meaning of home has been upended:  "We used to farm up to five hectares of land and had cattle,” she says. “Milk and butter were abundant. We left our good life." The Tigray War Report estimates that more than 500,000 people were killed in the conflict between various armed groups. According to Tigray's interim regional administration, one million internally displaced people remain scattered across the region.  Women bore the brunt of widespread sexual violence, and many became the sole providers at home after losing family members in the war. Without identification papers, securing employment remains nearly impossible.   Tirhas, pictured above, fled with her mother and siblings after her father was killed in the conflict. She stopped her studies and now works part-time as a house helper to support her family: "I can't continue my studies because I have to support my family. I'm the only one who brings in income. But I’m strong because I'm the one supporting my family, I’m carrying all the burden. Supporting each other is what makes women powerful." Research across 52 out of 84 districts of Tigray showed that 43% of women in Tigray experienced some form of gender-based violence during the conflict, with 29.2% of young women (aged 15–24 years) affected by sexual violence (Fisseha G et al, 2003). The brutality of sexual and gender-based violence during the conflict has left deep physical and psychological wounds, with survivors struggling to access justice and medical care.   Mehret* 42, pictured above, was displaced five years ago and her story contains a graphic description of sexual violence. Mehret arrived at the camp with five of her children. Her husband and one of her children died fighting in the war and her eight-year-old daughter was kidnapped. Mehret endured unimaginable sexual violence: fighting forces put nails and stones in her vagina. At night, in the school, Mehret sleeps beside her own mother. They borrow bed mats when the pain Mehret still experiences after the violence is too bad for her to lie on the floor. "Just staying alive and being able to stand up again despite what I endured makes me know that I am resilient… As a woman, I have the right to proper nutrition, better medication and justice to return to my homeland." Mehret, who is now attending a college course, has found reserves of resilience that no-one should have to, and she is not alone in doing so. Despite many hardships, women in Tigray continue to push forward with determination. In the overcrowded shelters, they lean on one another, preparing communal meals, sharing scarce supplies, and caring for children who have seen too much. Twenty-three-year-old Rahwa was displaced four years ago. Her father was killed, and she fled with her mother and sisters. She had been studying in college, but first the COVID-19 pandemic and then the war interrupted her education. She started working for a private company but couldn’t afford rent outside the camp and had to return. Now, she only works part-time: “Standing still is good enough. I go out and work. It may not be enough, but it’s enough to get us through the day. If a woman has a job, she can become stronger than anyone. We don’t have our documents to get hired here, and we also get sexual requests to get employed. That makes it difficult to reach a better place."  Amid the fragile situation, the International Planned Parenthood Federation (IPPF), through its partners, worked to restore essential sexual and reproductive healthcare under the IPPF humanitarian SPRINT response funded by the Australian Government's Department of Foreign Affairs and Trade (DFAT). Their efforts include mobile clinics and community outreach, providing maternal care, contraception, and sexual violence care. Between the camps and rural areas, more than 45,000 displaced people received clinical care, counselling, and sexual and reproductive education.   Throughout the response, 483 women safely delivered their babies, including Adey, 33 (pictured left), who delivered her baby the night before this photo was taken. When her contractions started, an ambulance was sent to her home, and she later gave birth at the clinic. The women of Tigray have shown extraordinary resilience. But resilience alone does not solve health emergencies, feed families, or heal trauma. When healthcare systems collapse and funding disappears, it is women who bear the greatest burden physically, emotionally, and economically.  Just weeks after these stories were captured, USAID funding cuts forced the closure and scaling down of critical services supported by IPPF partners. Some supported outreach projects have been shut down, and critical services such as ultrasounds, once free, are now forced to carry fees many cannot afford in order to keep the service open. The health, education and training programs for young people were affected, staff lost their jobs, and women who had begun to rebuild their lives now face new obstacles in accessing care. Their stories are far from over. “The USAID cuts came with very little notice. The women and girls will suffer the most, as they now face impossible choices between accessing healthcare, feeding their families, or securing even the most basic necessities for survival. These cuts don’t just reduce services, they strip away hope and force women in Tigray into even more precarious situations.” Said Valerie Dourdin, Global Humanitarian Director, IPPF. As International Women’s Day comes and goes, the displaced women of Tigray will remain – still strong, still determined, and still in urgent need of consistent, meaningful support.  

On 24 January 2025, President Trump signed an executive order reinstating the Global Gag Rule (GGR).   The International Planned Parenthood Federation (IPPF) - a federation of members and partners in 153 countries - fights for the right of every individual to decide about their own health, well-being and life. IPPF will never support policies which actively restrict or violate an individual’s right to bodily autonomy, including the right to safe abortion. The GGR - also known as the Mexico City Policy - violates human rights by forcing women to continue with an unwanted pregnancy or into unsafe abortion, and IPPF will not tolerate it. The GGR is a far-reaching, destructive American foreign policy, one that is deeply unpopular with the American people. It denies U.S. funding to organisations like IPPF if they use money from other donors to provide safe abortion services, counselling or referrals. It blocks critical funding for health services like contraception, maternal health, abortion care, and HIV/AIDS prevention and treatment for organisations that refuse to sign it. When it has been enacted by previous Republican Presidents, evidence has shown that the GGR has led to an increase in maternal deaths, in unplanned pregnancies and unsafe abortions. It blocks access to health care for women and the most vulnerable people, silences SRHR advocates, reduces coverage of community health workers, and infringes on a country’s sovereignty. The Global Gag Rule’s reinstatement will result in an escalation in avoidable health crises, needless physical and emotional harm, a loss of dignity for women, and death. IPPF anticipates it will lose $61 million USD for programs that provide sexual and reproductive health services for millions of women and youth. 13 countries and 16 healthcare projects worldwide are affected by the Global Gag Rule. Without funding, the people we serve will otherwise go without these vital services, including women suffering the burden of health and humanitarian crises.  Donald Makwakwa, Executive Director, Family Planning Association of Malawi (FPAM): "The reinstatement of the global gag rule will have devastating consequences for women and girls in Malawi, where access to sexual and reproductive health services is already limited. Projected funding cuts to FPAM will disproportionately harm women and young girls in Malawi, many of whom rely on these services to avoid unplanned pregnancies, unsafe abortions, and maternal deaths. It is a cruel policy that sacrifices lives and bodily autonomy." The global gag is further insult to injury on top of other U.S. foreign policies that have a catastrophic impact on the communities in which our MAs work. Just yesterday, the State Department’s Office of Foreign Assistance sent a global cable that ordered an immediate pause on new foreign aid spending, as well as a stop-work order for existing grants and contracts. The new executive action targeting transgender, non-binary and intersex individuals has resulted in great fear for our communities. We have already seen funding cut as a result of its new anti-DEI executive action. The US also announced it plans to renew its membership of the Geneva Consensus Declaration, an anti-abortion joint statement initially cosponsored by persons claiming to represent the governments of Brazil, Egypt, Hungary, Indonesia, Uganda, and the United States. It was signed by persons from 34 countries on October 22, 2020.   It is clear foreign aid has become a political weapon, used to enforce hateful ideologies at the expense of women in all their diversity, and against LGBTQI+, poor and immigrant communities.    We cannot—and will not—deny life-saving services to the people we serve.  We urge other governments and donors to step forward and call out the damage and destruction of these destructive actions. We stand in solidarity with our community.  Now is the time for our movement to unite, to come together and to fight for a world of sexual and reproductive health, rights and justice for ALL. Learn more about Global Gag Rule here: The Global Gag Rule | IPPF  For more information, please contact media@ippf.org or +44 7918 845 944. About the International Planned Parenthood Federation  IPPF is a global healthcare provider and a leading advocate of sexual and reproductive health and rights (SRHR) for all. Led by a courageous and determined group of women, IPPF was founded in 1952 at the Third International Planned Parenthood Conference. Today, we are a movement of 158 Member Associations and Collaborative Partners with a presence in over 153 countries.  Our work is wide-ranging, including comprehensive sex education, provision of contraceptive, safe abortion, and maternal care and responding to humanitarian crises. We pride ourselves on being local through our members and global through our network. At the heart of our mission is the provision of – and advocacy in support of – integrated healthcare to anyone who needs it regardless of race, gender, sex, income, and crucially no matter how remote.