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JOHANNESBURG — President Trump’s dramatic expansion of a ban on U.S. funding to foreign organizations that promote or provide abortions has left impoverished women around the world without treatment for HIV, malaria, and other diseases, health groups say, calling it “devastating” because Trump went where no administration had gone before.

Trump in his first working day in office revived the so-called global gag rule. He expanded on previous versions so that for the first time foreign NGOs that even discuss abortion as an option are barred not only from about $575 million in U.S. family planning funds but also an estimated $8.8 billion in U.S. global health aid. And they must certify that none of their non-U.S. funding goes for abortion-related activities.

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Tuesday marks one year since Trump’s decision, and health organizations are sharing the first effects of the shift by the United States, the world’s largest health donor. The Trump administration, cheered by anti-abortion groups such as the Susan B. Anthony List for no longer “exporting abortion,” is expected to release its own assessment.

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