The London Family Planning Summit held in the United Kingdom on Tuesday has been heralded a major success — raising at least $2.5 billion in new funding commitments for reproductive health services, signing up new partners and countries to its 2020 targets, and delivering a renewed sense of momentum to a sector that feels under threat.
However, translating that energy into action — especially as the funding gap remains unbridged — will be the real challenge, experts warned.
More than 400 donors, senior government leaders — including from a number of developing countries — activists, NGOs and businesses came together in London for the summit this week, featuring high-level speakers such as Dr. Tedros Adhanom Ghebreyesus, the new director-general of the World Health Organization, who said he would “personally champion” the issue of sexual and reproductive health as a “top priority;” and Kristalina Georgieva, chief executive officer of the World Bank.
It was billed as a progress check on the first London Family Planning Summit, held five years ago in 2012, where participants committed to ensuring that 120 million more women and girls would have access to family planning by 2020. Many individual pledges were renewed and revised on Tuesday.
The original summit saw the formation of the FP2020 secretariat to drive progress toward this target by focusing on increasing access to family planning in 69 priority countries with the most unmet need. The latest data from the Guttmacher Institute suggests there are 214 million women and girls worldwide who want to avoid or delay pregnancy but do not have access to contraception.
Read more Devex coverage of the Family Planning Summit:
Uncertainty was cast over whether this year’s summit would go ahead as planned, following the surprise result of the recent U.K. election, and considering a climate of skepticism toward foreign aid among the British public, Devex learned. But the U.K. not only hosted the summit, it also emerged as the most generous bilateral donor, pledging an additional 45 million British pounds ($58 million) toward family planning every year until 2022. Tanya Barron, chief executive officer of Plan International U.K., described the decision to host the summit as a “very bold thing to do,” and praised the U.K.’s Department for International Development for “once again putting big sums of money on the table.”
The meeting also saw new funding commitments from a number of other countries, including Norway, Denmark, Australia, Belgium and the Netherlands, as well as the European Commission. Specific funding pledges were made to the United Nations Population Fund and the She Decides movement.
The summit comes at a time when pressure on the family planning community is high. The Sustainable Development Goals have upped the ante, so that reaching 120 million people by 2020 — already proving more of a challenge than expected — is now “only the first stepping stone on the pathway to universal access” by 2030, Natalia Kanem, acting head of UNFPA, said during the opening plenary.
There are also huge population shifts underway, and additional challenges from the record numbers of displaced people around the world, many of whom have a “fierce need” for family planning which implementers have been struggling to meet.
The sector is also reeling from the loss of financial support and leadership from the world’s largest bilateral funder, the United States, following President Donald Trump’s decision to reinstate the global gag rule and defund UNFPA, with proposals also on the table to zero out the U.S. Agency for International Development’s family planning budget.
While the summit’s co-hosts — the U.K. government, UNFPA, and the Bill & Melinda Gates Foundation — were clear that the event was not a reaction to this, developments in the U.S. nonetheless cast a shadow over the proceedings, with an awareness that, no matter how many other donors stepped up their contributions, the funding gap would remain.
“There is nothing anyone can do to fill the bucket of money the U.S. had committed to family planning,” said Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, which pledged an extra $375 million.
Still, participants were keen to discuss how progress could be made from here. Devex rounds up four key highlights.
1. A more diverse set of players at the table
In the face of diminishing U.S. support and slow progress on meeting the FP2020 targets — only 30.2 million additional women have been reached since 2012 so far — attendees said they were pleased to see new partners, countries and donors joining the partnership.
New member countries included Chad, Haiti, and South Sudan, as well as statements of support from Bolivia, Egypt and Kyrgyzstan; as well as 19 civil society and private sector partners; and one new donor — Canada.
“It’s really exciting to see we are continuing to bring new countries and new partners in — it's about creating that global movement,” according to Julia Bunting, CEO of Population Council.
While most of these new nations stopped short of allocating funds, their political commitments will pave the way for donors and implementers to increase their presence in those countries, Ugochi Daniels, head of UNFPA's humanitarian response, explained.
New and unusual collaborations also emerged — for example, between environmental group Blue Ventures and the family planning community, with a commitment to increase reproductive services to people living in areas of high biodiversity. UNFPA’s Kanem spoke of the necessity for “strange bedfellows” to work together and collaborate more effectively in her speech.
2. The need for new tools and approaches to drive progress
“It’s not just about money” was a common refrain throughout the summit: Innovative ways of working as well as new and adapted tools and products are needed to drive progress, delegates said.
According to Melinda Gates, progress toward the FP2020 targets has been slow to-date because of a huge lack of data along with “completely and totally broken” supply chains, which have caused “stock-outs” of contraceptives in many developing countries.
The Gates Foundation is working on solutions to these problems through investment in building new data systems, alongside efforts to “smoothe” funding to UNFPA to ensure a more consistent supply of contraceptives, she said. The foundation has also been funding the development of new contraceptive options, notably the much-hyped Sayana Press injectible, which remains popular despite recent concerns.
Providing women and girls with a wider choice of contraceptives — both as a rights issue and because evidence shows that increasing the number of options leads to spike in take up — was another common theme.
C. K. Mishra, India’s health secretary, said that “increasing the basket of choice” of contraceptives for women would be a game-changer for the country and announced that contraceptive injectables were being rolled out in many states for the first time. He also said that better data meant the government was now able to start focusing its family planning efforts on the worst performing districts.
UNFPA also announced it would be updating its contraceptive “kits” to be used in refugee camps and emergency settings, and promised to deliver them within 48 hours of an acute emergency arising.
UNFPA, the Gates Foundation and the U.K. government also announced the development of a “bridge-funding mechanism” — an $80 million revolving financing pool to speed up the procurement process, lower the cost of contraceptives and reduce the chance of stock-outs.
3. Local country leadership
Many delegates emphasized that progress will only be made with political and financial commitment from the countries with the most need themselves. Uganda’s health minister, Jane Aceng, said during a press conference that there “has to be leadership and commitment to investing in family planning,” but admitted that “sometimes our African countries” don’t see reproductive health as an investment because “it takes time to see the results.” A strong economic case needs to be made, she said.
“How the energy and promises are canalized into action and impact will be the true testament of the summit.”— Katja Iversen, CEO of Women Deliver
That a number of ministers of finance attended was seen as a sign that attitudes are finally shifting. The World Bank hosted a roundtable which included eight finance ministers from developing countries the day before the summit.
“To a person, they made strong economic arguments that these investments are not just the right thing to do but the smart thing to do,” vice president for human development at the World Bank, Keith Hansen, said.
However, Aceng said the case for family planning also needs to be made to Africa’s many religious and cultural leaders in order to “bring them on board … so they come to realize certain things need to be done if we are to encourage our youth to thrive and our women to reach their full potential,” she said.
This was echoed by Lois Quam, CEO of Pathfinder, who noted that the voices of religious and tribal leaders were somewhat absent from the summit.
4. Translating energy into action will be key
Considering buy-in from countries and donors, the availability of new products and approaches, and a greater understanding of the barriers to progress, Bunting and others told Devex they expect to see accelerated progress going forward, especially in countries such as India.
However, others pointed to a lack of discussion and concrete planning around how to implement the bold statements made at the summit.
“I wish there had been more time for debate, integration discussions, and for a solid talk about where we go from here. How the energy and promises are canalized into action and impact will be the true testament of the summit,” CEO of Women Deliver, Katja Iversen, said.
As UNFPA’s Daniels said, “the hard part is implementing,” and even though we now “know what to do, how to do it and we know the cost,” the biggest barrier is still “attitudes,” especially among governments and community leaders, the majority of whom are still men.
A number of attendees told Devex they felt discussion about how to change attitudes among men and boys deserved higher priority at the summit. Their input is crucial because they often control access to family planning, they said, and because they are the users of one of the most in-demand methods of contraception — the male condom.
Plan International U.K.’s Barron also described the need to talk about pleasure, as many discussions of unprotected sex focus on gender-based violence. Such a focus is “understandable,” she said, given that gender-based violence remains a “horrendous problem,” but there is a danger of putting family planning discussions in “an abstinence corner,” she warned.
Instead, family planning needs to include discussion about “pleasure” and “consensual, happy sex” experienced by both women and adolescent girls, Barron said.
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