Getting family planning to women in the poorest countries - are we failing?
New commitments are made at the Family Planning Summit to bolster access to modern contraceptives for the world’s poorest women – but is it enough to the bridge the gap?
Both the UK government and the Bill & Melinda Gates Foundation have made new pledges to reach 214 million women and girls who want family planning services but are unable to access them because of cost and availability.
The commitments were made at the Family Planning Summit held in London today (11 July) on World Population Day – in an event co-hosted by the UK, the Gates Foundation and the UN Population Fund (UNFPA).
Giving women and girls the power to decide when they want to have a family is not only a basic human right, but a vital intervention to break cycles of poverty across lower income countries, by giving women the opportunity to stay in school and pursue better economic opportunities.
Promoting the sexual and reproductive health rights of young women and girls is also a major pillar of reducing new HIV infections in this group – who carry the largest burden of HIV, and particularly in sub-Saharan Africa. UN projections about population growth also predict a ‘youth bulge’ on the continent – with the population expected to at least double by 2050 because of high fertility rates and low access to contraceptives.
In a landmark decision earlier this year, US President Trump decided to completely defund UNFPA, and reinstate an enhanced ‘Global Gag’ policy. The policy bans US funding of any international organisation that also performs, or even provides advice and referrals on abortions, even when they do not use US money to do so.
This particular ban was expanded to include not only family planning programmes, but all programming relating to nutrition, maternal and child health, HIV, malaria, tuberculosis, neglected tropical diseases, and global health security, amounting to around US $8 billion.
The US is the largest funder of family planning, and their retreat at this stage comes at a time when funding for sexual and reproductive rights and health should be bolstered. Without adequate funding, the African youth bulge has the potential to exacerbate HIV in countries already highly impacted by the epidemic.
Philanthropist Melinda Gates, who spoke at the summit, said that contraceptives are “one of the greatest anti-poverty innovations the world has ever known.” She continued, “Contraceptives empower women. And empowered women ... well, they transform societies." The Gates Foundation announced that they will invest an extra US $375 million over the next four years to increase access to family planning in sub-Saharan Africa and southern Asia.
The UK Secretary of State for International Development, Priti Patel, increased the UK’s pledge by £45 million a year for five years, from £180 million per year on family planning until 2020, to an average of £225 million per year until 2022.
“This new UK aid support will provide 20 million women with voluntary contraception, change the lives of 6 million women by allowing them to avoid unintended pregnancies, and prevent the trauma of 75,000 still births.”
The original pledge was made at the inaugural Family Planning Summit in 2012 – in an agreement to reach 120 million girls with contraceptives by 2020, dubbed the FP2020 initiative. In a half-way report released last year, it was revealed that 30 million women were newly able to access contraceptives to prevent unwanted pregnancies – but they fell 19 million users short of their original goal at that point.
A study released last week by the Guttmacher Institute found that nearly 214 million girls had an unmet need for modern contraceptives. The large majority of these people live in sub-Saharan Africa and southern Asia – accounting for 59% of the women globally who want contraceptives. In these countries, around 43% of pregnancies are either unwanted, or have come too soon.
The summit provides a vital opportunity to highlight the need for health systems in which women are active, where care is provided in a way that respects women’s autonomy in decision-making about their health, and which provides information and support to allow women to make informed choices.