Big questions remain about global contraceptive access

The fundamental right to decide if and when to have a child is presently out of reach to 225 million women worldwide who want to delay or avoid pregnancy through use of a modern method of contraception.                

The evidence is irrefutable: Investments in family planning are essential to the prosperity of developing countries. When a woman can exercise her reproductive rights, she is better equipped to leverage her other rights, such as the right to education. Access to family planning reduces poverty, improves health, promotes gender equality, and increases financial opportunity. The results are overwhelmingly positive: Empowered women lead to healthier families, stronger communities and flourishing societies.

The power and potential of family planning has not gone unnoticed. Four years ago, global health and development leaders convened in London to take a declarative stance on the issue and make a daring promise: to provide voluntary, rights-based family planning to 120 million additional women and girls in the world’s poorest countries by the year 2020. Family Planning 2020, a global partnership to catalyze action on this commitment was born of this promise. Enormous progress has been made over the past four years, and more women and girls than ever before have access to and are able to use contraception.

Yet, as the family planning community marks the midpoint of the FP2020 initiative, big questions about contraceptive security remain unanswered. Simply put: How do we ensure the supplies needed to provide family planning to unprecedented numbers of women and girls are actually available? Can manufacturers keep up with the increasing global demand for family planning products? Will donors increase their spending? How and why should countries prioritize family planning in their domestic budgets? And what additional demand will be placed on countries’ domestic resources, on the private sector, and on women and their partners?

These are questions that 350 contraceptive supplies experts will tackle at the Reproductive Health Supplies Coalition meeting taking place in Seattle this week. The coalition, one of the driving forces behind the 2012 London Summit on Family Planning, and an integral partner in the FP2020 movement, is the world’s largest membership network of reproductive health supplies organizations. Working hand in hand with FP2020, the coalition is committed to ensuring all women and girls have reliable and consistent access to a wide range of high-quality contraceptive options.

A breakthrough analysis — to be launched at this week’s meeting — will provide key data to help address these issues. The new Global Contraceptive Commodity Gap Analysis concludes that the achievement of FP2020’s goal of reaching 120 million additional users of contraception in 69 of the world’s poorest countries would add $510 million to the current annual cost of commodities over the next five years. If the ripple effects of that increased growth in the 69 countries were to spur on higher contraceptive uptake in 66 other middle-income countries, the total additional cost for all 135 countries could reach $550 million.

But it will take much more than funding alone to meet the growing global need for contraceptives. The supply chain that moves family planning products into the hands of the women who want and need them is a lifeline that must be protected and strengthened. Too often, shelves and hands remain empty. And it is incumbent upon us to better understand why. Information is vital — stronger data collection and analysis allows countries and stakeholders to better isolate and analyze trends that can help us reach more women and men, and the most marginalized groups, including young people and rural populations. Cultural and religious taboos must also be addressed in certain communities in order for every woman, man and young person to be able to access the modern contraceptive method of their choice.

No single organization or government can address these critical issues alone. It takes dedicated partnerships between those who have not necessarily worked together in the past; the private and public sectors, innovators and generic manufacturers, and developed and developing countries have to cross traditional divides to find common ground. Indeed, both FP2020 and the coalition must leverage the power of our partnerships to achieve our ambitious goal.

Both FP2020 and the Coalition bring together multilateral and bilateral organizations, private foundations, governments, civil society, and the private sector into collaborative relationships where partners explore the potential of doing more together than they could accomplish alone. FP2020 supports and magnifies the efforts of global and country-level partners, focusing on catalytic actions directly linked to expanding access to contraception through high-quality rights-based programs designed to meet the needs of individual women and girls. The coalition mobilizes the collective strength of its global membership to increase access to a full range of affordable, quality reproductive health supplies in low- and middle-income countries. Through this partnership, the family planning sector is working together in new ways: enhanced collaboration is driving progress at every level, data are increasingly being used to drive decision-making on programs and policies, and commitment to a rights-based framework is growing.

As we embark on the final four years of the FP2020 initiative, and look toward the realization of the Sustainable Development Goals and universal access to contraceptives by 2030, the threats to contraceptive security must be addressed and overcome. The family planning community must reflect urgently on what works well, where course corrections are needed for greater impact, how we can make active interventions to accelerate progress, and ultimately, how we can deliver on the big promise we have made to millions of women and girls.

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