Today, there are over 200 million women in the developing world who want to prevent or delay pregnancy, but are not using any means of modern contraception. This is, without a doubt, a horrifying figure. But the greatest tragedy for us—those of us who have dedicated our professional lives to ensuring global access to family planning—is that this figure has not budged in nearly two decades.
The gap was 200 million in the 1990s; it was 200 million in at the beginning of this decade; and it remains roughly 200 million today. Yes, contraceptive prevalence around the world is increasing — as is the number of new family planning users. But each step forward is more than matched by comparable increases in demand in new users. Therefore, despite our best efforts, we are caught in a deadlock.
We need to find a way to meet the family planning needs of a growing number of women so can we see these numbers fall.
Funding is key. By the year 2020, an estimated $424 million will be required in commodity support to satisfy total demand for contraceptives in donor-dependent countries. If donor funding were to remain at or near current levels, the shortfall would be almost $200 million annually, with a cumulative shortfall of about $1.4 billion over the 2008 to 2020 period. Data on other essential reproductive health (RH) commodities are less available, but it is clear that the need and demand for sexually transmitted infection diagnosis and treatment—as well as antenatal and emergency obstetric supplies—are also rapidly increasing.
What we need now is a reinvigorated effort to ensure RH commodity security. True contraceptive security exists when every person is able to choose, obtain and use quality contraceptives and condoms for family planning and for the prevention of HIV and AIDS and other sexually transmitted infections.
Ten years ago, 127 participants representing 41 organizations and governments came together for a global conference, Meeting the Challenge, in Istanbul to address the “looming crises” of the donor funding gap. Many credit this event as having given birth to today’s RH commodity supply movement.
Since the conference, contraceptive prevalence around the world has increased and there has been a coordinated effort to strengthen family planning commodities. The Reproductive Health Supplies Coalition (RHSC), a global partnership dedicated to ensuring that all people in low- and middle-income countries can access and use affordable, high-quality supplies to ensure their better reproductive health, was born from the Istanbul conference.
In June, RHSC will gather reproductive health leaders at the highest levels in Addis Ababa, Ethiopia at the Access for All conference. While 10 years ago we were focused on the donor gap, we are now looking at what country ownership means for achieving commodity security. The coalition will use this time to continue advocating for and supporting public health agencies in developing countries and the donor community to act together to make sure that programs can rationally forecast, finance, procure and distribute the products they need—now, and into the future.
During the gathering leaders will formulate a “Global Call for Action” that encompasses high-impact action steps for the next decade.
For example, RHSC will continue to secure commitments to achieve 100 million new modern contraceptive users in the next five years through the Coalition’s HANDtoHAND Campaign. This will meet the family planning needs of almost 80 percent of women in low-income countries.
Meeting this challenge means 96 million fewer unintended pregnancies, 54 million fewer abortions, 110,000 fewer mothers dying in childbirth and 1.4 million fewer infant deaths.
Women and girls should have the option to choose, obtain and use the supplies they need to ensure their reproductive health. A world without these options translates into millions of unwanted pregnancies, tens of thousands of maternal deaths and untold unsafe abortions. Now is the time for countries to come together and make RH supplies and commodities available to everyone.