Advocates have welcomed the news that an estimated $5 billion was pledged to improve and expand reproductive health services in developing countries at the London Family Planning Summit earlier this month — double the figure cited in initial reports — but say it still falls far short of the sums needed, and that better monitoring systems are required to ensure the commitments materialize.
The summit, held in the United Kingdom on July 11, saw a number of developing countries and donors come together to make multibillion dollar commitments to extend the availability of family planning services, products and education to women and girls around the world.
According to a current estimate from co-host the Bill & Melinda Gates Foundation, shared in an email with Devex, roughly $4 billion of the total came from recipient countries — with Indonesia and India committing the lion’s share. This is good news, say family planning advocates, who have long argued that greater domestic resource mobilization is needed to address the needs of 214 million women and girls worldwide who want to avoid or delay pregnancy but do not have access to contraception.
The bulk of the remaining $1 billion was pledged by the U.K., the Gates Foundation and Canada.
The summit was held five years after the first London Family Planning Summit in 2012, when participants agreed to an ambitious target of extending access to contraception to an additional 120 million women and girls by 2020. The Family Planning 2020, or FP2020, secretariat was formed to measure and monitor progress towards this goal.
“The overall outcome appears to still fall below the $8 billion … needed to expedite and scale up progress to support all women’s and adolescent girls’ access to lifesaving family planning services.”— Nicola Jones, principal research fellow at ODI
The new commitments come after significant cuts to family planning funding from the United States, where politicians voted last week to endorse President Donald Trump’s expanded “global gag rule,” and to cut the U.S. Agency for International Development’s family planning budget by $146 million — less than feared, but nonetheless devastating to the sector, advocates say.
While the pledges are undeniably positive and point to growing momentum among some donors and developing countries towards supporting family planning, experts pointed out that the $5 billion pledged is nowhere near the $8 billion that the London-based think tank the Overseas Development Institute estimates will be needed annually to meet the challenge.
Some have also questioned whether all of the commitments will materialize, and say it is difficult to tell if it all represents new and additional funding.
Nicola Jones, principal research fellow at ODI, said: “The large number of new commitments and in particular the very significant commitments by a number of developing country governments … is very encouraging.”
“However, the overall outcome appears to still fall below the $8 billion … needed to expedite and scale up progress to support all women’s and adolescent girls’ access to lifesaving family planning services,” she added.
The bulk of southern commitments came from just three countries
Rachel Silverman, assistant director of global health policy at the Washington, D.C.- based Center for Global Development, also applauded “notable” commitments from India, which committed to spend an additional $1 billion by 2020 and increase modern contraceptive usage from 53.1 percent to 54.3 percent, and satisfy 74 percent of the demand by 2020.
Bangladesh said it will increase its family planning funding by nearly 70 percent to $615 million until 2021; and Indonesia pledged $1.6 billion for family planning between 2015 and 2019, which will maintain services to existing users and provide contraception to 2.8 million additional women and girls.
See Devex’s coverage of the Family Planning Summit:
However, the fact that the commitments of these three countries represent the lion’s share of the $4 billion pledged by developing countries at the London summit tempers the narrative about developing countries starting to champion family planning, she said.
“We see three countries making up the bulk of the $4 billion — that’s great for those countries but it skews the [perception of] overall momentum,” she said.
Furthermore, the fact that Brazil and Mexico, both countries which have high adolescent pregnancy rates, were not at the conference, along with Vietnam and the Philippines, where adolescent pregnancy rates have increased over the last decade, was “very disappointing,” Silverman said.
While she was pleased by the scale with which two of the summit’s co-hosts — the U.K. government and the Bill & Melinda Gates Foundation — increased their commitments, she was surprised that foundations that had appeared at the 2012 conference, such as the William and Flora Hewlett Foundation and the David and Lucile Packard Foundation, did not recommit.
However, Jonathan Rucks, advocacy director at PAI, an organization that advocates for family planning programs, said he was “pleasantly surprised and hopeful” about the extent of commitments coming from private sector companies, which he described as a “very important step and something which should be championed.” The summit saw 13 new private sector companies announcing partnerships and commitments, including tea company Twinings, pharmaceutical company Shanghai Dahua, Swedish fashion chain Lindex, and microfinance institute CARD-MRI.
Pledges are easy to make but harder to keep
Despite good intentions, it can be hard for countries to fulfil funding pledges spread over five or more years due to political and economic challenges, Silverman said.
“It is relatively easy to pledge at an international conference, but governments change, finance ministers and health ministers have different opinions, or there could be a crisis, and so it’s very hard for any country to make a commitment that far out,” she said.
For example, Nigeria has struggled to meet its initial 2012 commitments when it promised to contribute $8.35 million annually to the United Nations Population Fund until 2016 for the procurement of reproductive health commodities. According to a 2015 update, only $1.8 million of that was dispersed.
At last week’s event, Nigeria’s health minister, Professor Isaac Folorunso Adewole, did not address the shortcomings but instead outlined new, lower commitments — promising $4 million in new funding for UNFPA.
Rucks also noted that the devil is in the detail when it comes to assessing the scope of new commitments. Close attention needs to be paid to the language used for each, including whether government commitments actually represent new investments. “Those are important distinctions if we are to really achieve the goal of reaching 120 million more women and girls by 2020,” he said. FP2020 said that “more detailed financial information” about the commitments will be available in August.
“A clearer system to monitor and ensure accountability for the implementation of the summit's outcomes is urgently needed.”— Nicola Jones, principal research fellow at ODI
A more transparent and robust monitoring system is needed to ensure that countries and donors stay on track and meet their commitments, according to Jones.
FP2020 commitments are currently tracked by the secretariat and published online based on self-reported information from donors and country governments. “[We ask] commitment makers to report annually on their progress in meeting their commitments, and we publish these responses (along with a range of other information) on our website where we maintain a separate page for each commitment maker,” said Tamar Abrams, FP2020’s director of communications.
But this is insufficient, according to Jones. “A clearer system to monitor and ensure accountability for the implementation of the summit's outcomes is urgently needed,” she said, suggesting the ideal platform would be an “accessible database that publishes funding by year, by donor and by type of program funding.”
Furthermore, the platform would apply “systematized indicators” to commitments, without which it is difficult to ascertain whether committed money is new or whether it has been “double-counted” by donors, she explained. Better tracking systems would also help pinpoint the “most urgent resourcing gaps.”
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