Forty-three years ago today, the Supreme Court deemed abortion a constitutionally protected right for women in the United States in Roe v. Wade, taking a huge step forward for women’s equality. Since then, anti-choice lawmakers at the federal and state-level have been working concertedly to render this right meaningless by restricting access to abortion.

The Guttmacher Institute recently found that states have enacted 1,074 abortion restrictions since 1973.  One of the longest-standing restrictions is the Helms Amendments, which has been in place since December 1973 and prevents the use of U.S. foreign aid to pay for abortion services, even in the case of rape, incest or life endangerment.

Shutting down federal funding for abortion services exacerbates one of the longest-standing barriers to abortion access: the cost. As anti-choice lawmakers have known for the past four decades, if the right to abortion can’t be eliminated, the next best thing is to make abortion access practically impossible.

The Helms Amendment impacts some of the most vulnerable women and girls in the world; those raped in war. Through the continued imposition of the Helms Amendment without exceptions, the U.S. is denying abortion access to women enslaved and raped by groups like ISIS and Boko Haram, and to girls as young as 12 raped in the Democratic Republic of Congo.

The U.S. is laudably the world’s largest provider of development and humanitarian aid. Through this aid, the U.S. funds a variety of initiatives around the world, including health care services in conflict zones. But when girls and women present at these U.S. funded health centers for medical care, while they may have access to a wide range of services, safe abortion is not one of them. Insultingly, if these women seek out an unsafe abortion and have medical consequences, they can go to a U.S. funded health care provider for post-abortion care, but only after they have put their own life in danger. Not only is this policy illegal under international law, its consequences are dire and often deadly.

Yesterday, in a receiving line at a town hall in Iowa, Hillary Clinton was asked by an activist whether she would “help fix the Helms Amendment” as president, to which she gave a resounding yes.   There has been no stronger advocate of women’s rights and abortion rights in the current presidential campaign than Clinton. Rightly framing abortion as a class and racial issue, she’s drawn attention to the fact that making abortion unaffordable essentially renders the right to it meaningless, in particular for low-income women.  However, Ms. Clinton, as a part of the Obama Administration, had ample opportunity to act on the Helms Amendment but failed to do so.

During her tenure as Secretary of State, the Helms Amendment’s impact of women raped in war was raised with the Obama Administration multiple times, including during the 2010 Universal Periodic Review of the United States. However, despite the fact that President Obama can take steps through executive action to limit the impact of the Helms Amendment, he and his Administration have continually failed to take any action—to the detriment of countless women around the world.

Like Roe & the U.S. Constitution, a variety of international instruments, including the Convention on the Elimination of All Forms of Discrimination against Women, the Geneva Conventions, the Convention against Torture, and the International Covenant on Civil and Political Rights, enshrine and protect rights to abortion for women around the world. However, as long as the U.S. remains the world’s largest donor of development and humanitarian aid, abortion restrictions on foreign assistance, such as the Helms Amendment, will continue to impede the ability of women around the world to exercise their right to abortion services.

Today, as we reflect on the legacy of Roe, and sit on pins and needles as we anticipate the arguments and Supreme Court decision in Whole Women’s Health v. Cole, let us also reflect on the idea that the right to abortion is nothing without the protection of actual access to these services, including through public funding. And that policymakers in Washington D.C. shouldn’t be the reason that women are unable to exercise their rights around the world.

Akila Radhakrishnan is the Legal Director at the Global Justice Center. She has published articles in The Atlantic, Women Under Siege, RH Reality Check, Ms. Magazine, the Denver Journal of International Law and Policy and Reproductive Laws for the Twenty-First Century.