Global Family Planning Enjoys A Surge In Backing
A major battle is underway in the United States over covering the costs of family planning.
But in international circles, support for contraception is gaining momentum, boosted by two recent studies and billions in fresh funding pledges.
By Deena Shanker
The United States is hosting a huge battle over affordable contraception.
Last week, House Republicans advanced a bill through an appropriations process that would roll back compulsory coverage of contraception under the Affordable Care Act, cut funding to family planning and health programs and allocate more money to abstinence-only education programs that have been widely discredited.
But globally, the momentum appears to be going in the opposite direction, fueled by money and research and the general philosophical context of the U.N.'s Millennium Development Goals, a global antipoverty initiative that includes ambitious national targets for improving maternal health. Governments and charities committed billions in pledges for global family planning at a London conference earlier this month. Meanwhile, two recent studies underscore the life-saving importance of contraception and the unmet need for it.
The current use of contraceptives saves 272,000 lives every year by averting maternal deaths during childbirth, researchers at the Johns Hopkins Bloomberg School of Public Health found in a July 10 study.
Their findings also indicated that meeting global demand could reduce these deaths by an additional 30 percent. In developing countries, unsafe abortions result in 10 to 15 percent of pregnancies ending with the death of the mother.
The report's lead author, Saifuddin Ahmed, compared the importance of contraception to women's health to that of inoculations for preventing childhood diseases. "Vaccination prevents child mortality; contraception prevents maternal mortality," Ahmed wrote.
A month earlier, a report indicated that the number of women using contraceptives globally has increased in the 69 poorest countries. The findings were released jointly by the United Nations Population Fund and the Guttmacher Institute.
Rising Unmet Demand
But the number of women who want contraceptives and lack access to it is growing; 162 million in 2012, up from 153 million in 2008, the study reported.
"The desire to have smaller families is increasing in many parts of the world, yet many women are still unable to have the number of children they want when they want them," said Dr. Sharon Camp, president of the Guttmacher Institute. "The gains that would result from providing quality contraceptive services to all women would more than outweigh the cost, but the current investment falls far short of what is needed to make this a reality."
The June report put the price tag for meeting the developing world's contraceptive needs at $8.1 billion. But the $11.3 billion in saved health costs for mothers and their newborn babies would more than outweigh the money spent, the report estimated.
Providing appropriate forms of contraception would reduce abortions by 26 million, miscarriages by 7 million and infant deaths by 1.1 million, the report argued.
Dr. Babatunde Osotimehin, executive director of U.N. fund, noted that providing access to voluntary family planning resources "will not only save and improve the lives of women and children; it will empower women, reduce poverty and ultimately build stronger nations."
Earlier this month the Bill and Melinda Gates Foundation, U.N. fund and the British government drummed up more than $4.6 billion in pledges at a major conference in London to raise awareness of the need for family planning and to raise money to provide services to 120 million women around the world by the year 2020.
Pledges came in from industrialized nations and developing countries alike and attendees included Chantal Compaoré, the first lady of Burkina Faso, and David Cameron, Britain's prime minister.
Cameron announced plans to double his country's commitment to reproductive health to $800 million over eight years. New York City Mayor Michael Bloomberg donated $50 million and the Bill and Melinda Gates Foundation pledged an additional $560 million over the next eight years, bringing its total commitment up to $1.12 billion.
Adding to the Global Agenda
In the past few years, the Bill and Melinda Gates Foundation has spent millions of dollars in grants for projects developing new contraceptive methods and identifying and meeting the most urgent family planning needs around the world.
As Melinda Gates told The Guardian, "The whole idea is to put this back on the global health agenda."
She emphasized the desire of women in developing countries to be able to control the size and growth of their families. "It's a universal theme when I go out: I want to be able to feed my children and … educate my children. The only way I can do that is if I don't have so many. And so we're finally going to give them the tools to make sure they can do that."
New strategies and partnerships were announced in London, including a plan to deliver up to 12 million doses of an injectable contraceptive in sub-Saharan Africa and South Asia from 2013-2016. The effort will be supported by Britain's Department for International Development, the U.S. Agency for International Development, the U.N. fund, Pfizer, PATH and the Bill and Melinda Gates Foundation.
A vocal Catholic opposition has taken to the blogosphere to discredit the London gathering. The National Catholic Register, for example, reported on the summit under the headline "Melinda Gates and Her Extreme Makeover Population Control," with the caption, "Wife of billionaire Bill Gates launches a concerted campaign against Catholic teaching on contraception."
Gates, herself a practicing Catholic, has responded to these criticisms by pointing to the widespread support she is getting from other Catholics, including nuns. "A church is made up of its members, and one of the things this campaign might do is help women speak out. I've had thousands of women come on to websites and say" 'I'm a Catholic, but I believe in contraception.' It's going to be women voting with their feet." She has also noted that her efforts fall in line with the Catholic Church's commitment to social justice.
Deena Shanker is a journalist and attorney living in San Francisco. Follow her on Twitter @deenashanker.