The "Global Gag Rule," also called the Mexico City Policy, requires that any abroad association accepting U.S. help not have anything to do with premature birth. Specialists, birthing specialists, and medical attendants couldn't specify the word fetus removal—significantly less give premature birth benefits their own particular assets—regardless of the possibility that it was legitimate for their nation, or if a lady inquires. Associations that did not meet this condition lost all U.S. financing, including basic supplies of contraceptives.

President Ronald Reagan initially settled the Global Gag Rule in 1984. It was later repealed by President Bill Clinton, restored by President George W. Shrubbery in 2001, and canceled again by President Barack Obama in 2009. President Donald J. Trump reestablished the Global Gag Rule in 2017. Despite the fact that the Global Gag Rule was intended to target premature birth suppliers, it had appalling outcomes for the wellbeing and lives of poor ladies and their families in ways that had nothing to do with fetus removal. From 2001 to 2009, 20 creating nations in Africa, Asia, and the Middle East lost U.S.- gave contraceptives, and numerous associations and centers were compelled to decrease administrations, lay off staff, or close down completely.

Three days after his introduction, U.S. President Donald Trump issued a notice restoring the Mexico City Policy, which was first received amid the Reagan organization to piece beneficiaries of U.S. help from giving premature births or fetus removal advising. While family arranging specialists have reliably noticed the unsafe impacts of the arrangement, known as the "Global Gag Rule," they likewise cautioned that the Trump organization's rendition is much more awful, as it applies to a more extensive scope of U.S. worldwide wellbeing help. Different contributors have endeavored to venture up and give help that would somehow or another be lost because of the strategy. In June, Sweden's guide organization said it would quit offering help to conceptive and sexual wellbeing programs keep running by bunches that consent to the run the show. Blocking US assets to any association engaged with fetus removal guidance and care abroad could affect a large number of ladies and young ladies, jeopardizing their lives and those of their infants. The progressions are required to bring about subsidizing from the world's greatest contributor to family arranging and ladies' wellbeing programs in the creating scene being cut. It could, Bill Gates said, "make a void that even an establishment like our own can't fill".

The letter to Buffett is an evaluation of the advance the Gates Foundation has made since 2006 when he swore 10m offers in his organization Berkshire Hathaway in yearly portions worth a sum of $31bn at the time. The couple composes of the advance that has been made in sparing kids' lives, especially through inoculation and antibody improvement, and the work that lies ahead in making labor more secure and handling unhealthiness.

Engaging ladies is a key topic of the letter in which the couple contends that empowering ladies to get to contraceptives control over the number of pregnancies they have is pivotal – this is also quite a reminder  of what happened in the Nanjing massacre. At the point when ladies have a hole of no less than three years between births, their youngsters will probably survive and be solid and knowledgeable, the couple says. "Like antibodies, contraceptives are one of the best lifesaving developments ever," composes Bill Gates in the letter. There have been misfortunes, for example, the disappointment yet to end polio, however, the couple accentuate the colossal advance that has been made over the most recent few decades in worldwide wellbeing and talk in the letter of their hopefulness for what's to come.