On January 23, 2017, President Trump reinstated the Mexico City Policy (MCP), a Reagan-era set of guidelines intended to restrict United States funding for abortion. The Policy withholds US funding, delivered in large part through USAID and the Department of Health and Human Services, from non-US groups that advocate for abortion as a method of family planning and provide abortion services, except in cases of rape, incest, or danger to the mother’s life. In May, Secretary of State Rex Tillerson announced an expansion of the guidelines: the ban would pertain not only to family planning funds, but also to all US funding for international healthcare. Furthermore, to offset the interchangeability of funds, the expanded MCP withholds US funding from groups that use non-US funds to promote or perform abortions. As the Washington Times reports, this expansion caused the funding pool covered by the expansion to swell by $8.4 billion.

Media frenzy ensued, as healthcare providers and media outlets united to condemn the move and to lament its deleterious effects on vulnerable groups, especially women, around the world. Most of the hysteria stems from concern that health clinics that provide services beyond abortion, such as vaccination and the containment of diseases such as HIV/AIDS, will no longer receive the support necessary to continue those operations. However, the US will only withdraw funding from these programs in the event that clinics insist on advancing abortion as a means of family planning, rather than as a life-saving last resort. That does not happen by accident; only those clinics that pursue aggressive promotion of abortion services will stand to lose funding. This condition for US support signals the Trump administration’s view that a community must protect the life of its most vulnerable members before it can promote health for any others. In fact, groups that follow the example of Marie Stopes International and the International Planned Parenthood Federation in insisting on the continued provision of abortions—as many as 1 million each year, according to CNN—knowing that they will lose American funding for other programs they describe as essential, suggests that they care more for politics than for the health of the communities they claim to champion.

As some non-governmental organizations defy the Trump administration’s stance on abortion as an illegitimate method of family planning, others marshal their resources to undermine the expanded MCP by making up the losses in funding for pro-abortion groups. Both Susie Buffett, the late wife of Warren Buffett and former chair of the Susan Thompson Buffett Foundation, and Melinda Gates, co-chair of the Bill and Melinda Gates Foundation, have named birth control as their primary philanthropic interest. Today, their foundations are the world’s first and fifth largest funders of family planning services, respectively, through Planned Parenthood and its international affiliates. This copious funding allows prominent pro-abortion groups, e.g. Ipas, to operate independently of US funding and so insulate themselves from fluctuations in US health policy.

Unlike the Bill and Melinda Gates Foundation, which maintains a searchable online database of its charitable activity, the Susan Thompson Buffett Foundation shrouds its activities in secrecy. Its website only features information on its college scholarships, along with a disclaimer that “The Foundation does not respond to other inquiries.” The foundation limits its support to organizations that it has sought out and deemed worthy of its aid. Foremost amongst these rank Planned Parenthood and Ipas, a group dedicated to perfecting abortion procedures. Warren Buffett has pledged $3 billion over the course of his life to the Susie Buffett Foundation, in addition to 85% of his current $74.6 billion net worth to the Gates Foundation. That foundation has an existing endowment of $44.6 billion, along with a further pledge of 95% of Gates’s $89.8 billion net worth. Although Melinda, a Roman Catholic, refuses to fund abortion, her support for contraception and the fungibility of funding makes her foundation a de facto bastion of the global pro-abortion cabal.

Melinda Gates thus faces the same problem as the Trump administration: how to enforce a policy with only limited control over its funding. There exist two obstacles to recognizing the misappropriation of charitable funds, regardless of whether USAID or the Gates Foundation supply them. First, as the New York Times reports, the charitable sector enjoys substantive protections for the anonymity of donors, meaning that organizations, such as the Susie Buffett Foundation or Ipas, can make donations to allied organizations without donor or recipient having to report the transaction’s details on their IRS forms 990. This inhibits Melinda Gates and the State Department from tracing their funding and enforcing the guidelines for it, and allows organizations to exchange money amongst themselves to ensure asset liquidity and to buoy donation programs. Second, these protections extend to metrics of progress: charitable organizations do not have to reveal how they measure success or assess the efficacy of their activities. This shields organizations, especially those taking advantage of donor anonymity and fund fungibility, from having to answer for their charitable activities, unless they had previously submitted estimates for the costs and effects of their activities and their donors have the will to check these estimates against the reality.

The Mexico City Policy’s reinstatement and expansion send a powerful message to the international community about the Trump administration’s principles. However, providers of abortion and family planning services will continue to flout its provisions until prominent non-profits, such as the Gates Foundation, affirm human dignity from conception and rally behind the policy that champions it. Those groups must persist in that affirmation until even the hardened opposition renounces its shameful practice.