A 14-year-old girl who was a regular patient died after an unsafe abortion, and the doctor who had refused her care never saw her work the same way again. That doctor was Eunice Brookman-Amissah. She went on to spend three decades pushing African governments to change their abortion laws, and the Right Livelihood Award now honours that work.
The award citation credits her “for pioneering discussions on women’s reproductive rights in Africa, paving the way for liberalised abortion laws and improved safe abortion access.” The Ghanaian physician said she was grateful that the prize would bring attention to unsafe abortion, which she called a contentious topic even in the 21st century.
From opponent to advocate
Brookman-Amissah started out as a doctor in the UK and Ghana. Her upbringing was conservative, and she opposed abortion. The death of that teenage patient ended that position.
In the early 1990s the word itself was close to unspeakable in Ghana. She was known to wait for hours outside the Ministry of Health, trying to hand over abortion kits made by Ipas, an international group working on safe abortion access. She later served as Ghana’s Minister of Health from 1996 to 1998, then as ambassador to the Netherlands until 2001. In 2001 she also joined Ipas, becoming its Vice President for Africa. She held that post until she retired from the organisation in 2014 and ran the Ipas Africa Alliance for Women’s Reproductive Health and Rights from Nairobi.
What changed on the ground
Her method was slow persuasion. She spent years briefing government officials, lawyers, judges, health workers, journalists, religious leaders and young people, and from those meetings she assembled a coalition for reform.
The results differ by country. Abortion is now legal up to 12 weeks of gestation in Mozambique and Benin. Sierra Leone overturned a colonial-era law that criminalised it. Eswatini permits abortion to save a woman’s life and protect her health, and Kenya widened the grounds on which it is lawful. In 2006 and 2008 she and Ipas worked with the Ministries of Health in Ghana and Zambia on applying the abortion laws those countries already had. Work with stakeholders in Malawi continues.
She also carried the Maputo Protocol across the continent. The African Union adopted it in 2005, and it was the first human rights document to explicitly recognise a right to abortion. At a 2003 conference she convened for African policymakers, the World Health Organisation released its first technical and policy guidelines on safe abortion. After talks with her, Ipas and African midwives, the International Confederation of Midwives acknowledged in 2014 that midwives have a role in providing safe abortion care.
The cost to her was personal. In 2006 a US-based extremist group, Human Life International, called for her to be eliminated, and she needed security at home, at work and on the road. In 2016 an anonymous caller told her he had been hired to assassinate her.
The numbers behind the work
Sub-Saharan Africa sees 6.2 million unsafe abortions each year, according to the Right Livelihood Foundation, and 92 per cent of women there live in a country that restricts abortion. The region records 185 maternal deaths per 100,000 abortions. More than 75 per cent of abortions there are unsafe, against a global average of 45 per cent. The foundation says her advocacy has contributed to a 40 per cent decline in abortion-related deaths in the region since 2000.
Many health organisations in the region depend on US government money, which is subject to the Global Gag Rule. Conservative US administrations have used it to withhold aid from groups that provide or even discuss abortion. It was not in effect under the Biden administration, but the foundation notes its chilling effect on health ministries lingers.
Brookman-Amissah still consults and trains the next generation of sexual and reproductive health and rights activists.
