Opinion: Upholding women’s rights and choices during a pandemic

When future generations look back at the COVID-19 pandemic and the changes it has brought to societies across the globe, what will they see? Of course, resilience, digital change, and innovative breakthroughs will be part of the discussion, but are we doing all we can for those who need help the most?

The honest answer is: No.

During this pandemic, women and girls have been living with an increased risk of domestic violence, child marriage, and unintended pregnancies, with high numbers of maternal and infant deaths. All of these challenges on top of COVID-19.

In July 2020, we, at Bayer and UNFPA, wrote an article, The power of choice — ensuring access to family planning in the COVID-19 era, on the importance of partnerships across institutions and sectors to meet the neglected needs of women and girls. Where do we stand one year on?

Let’s start with the facts

Gender inequality remains high, and teenage pregnancy and maternal death are serious health concerns, especially in low- and middle-income countries. Around 218 million women in LMIC economies have an unmet need for modern family planning. This can have devastating impacts on their health and well-being, while also impacting opportunities for education and employment.

Pregnancy and complications in childbirth are the leading cause of death in girls aged 15 to 19. Family planning is not only a human right: It is also central to women’s empowerment, the reduction of poverty, the protection of maternal and child health, and the key to driving economic development and achieving sustainable development.

From an economic standpoint, investing in family planning is also a highly effective form of development aid. The Copenhagen Consensus Center estimated that every dollar invested in family planning has the potential to generate long-term benefits worth $120.

The pandemic comes on top of these grim facts. Its added challenges are clear: supply-chains have been disrupted, health care spending has moved away from family planning, and governments are focusing their attention elsewhere. Some policymakers have even considered the provision of contraception services to be “nonessential."

During the first — nearly — four months of the pandemic, approximately 12 million women in 115 countries lost access to family planning services, when clinics were ordered to halt or reduce “nonessential services.”

Addressing the challenges

UNFPA — with support from partners including Bayer — has helped to maintain supply-chains and services to ensure some women are reconnected to family planning services.

The UNFPA Supplies Partnership is the organization’s flagship family planning program, requiring $250 million annually over five years from 2021-2025. The program will use the fund to cover gaps in contraceptives and maternal health medicines, and to provide technical assistance that will strengthen health systems in LMICs. This will help ensure the medicines reach those who need them.

While some donor and partner governments have faced challenges in keeping the promise of financial support to the program, in recent months countries such as France, Belgium, Denmark, Norway, Luxembourg, as well as other governments have stepped up to the plate.

France, for instance, has announced its intention to contribute about €90 million ($105.4 million) to the partnership.

Bayer has also contributed $4.3 million. Additionally, a group of philanthropic organizations are planning to provide up to $50 million in emergency funding to cover recent foreign aid cuts.

But there is still a 50% funding gap.

Unless additional resources are urgently channeled to ensuring supplies of contraceptives, there will be stock-outs. Choices of contraception will no longer be available or affordable for many and the consequences will be unintended pregnancies, with increases in maternal and newborn death and ill health. Families and countries may then get caught in a cycle of poverty.

Public and private sector partners have a key role and responsibility to drive this much-needed funding and other activities to support girls and women.

UNFPA and Bayer have core competencies that complement each other in many ways.

One example is the strong local presence that UNFPA has in LMICs, which can build on the equally broad regulatory footprint of Bayer’s contraceptive products. During the pandemic, UNFPA has been tackling challenges — such as bottlenecks in logistics and transport — and ensuring these are not amplified by supply disruptions, a situation Bayer was luckily able to avoid.

Additionally, Bayer’s strategy of expanding supply and method choice for long-acting reversible methods has helped stabilize the situation. Offering choice in products addresses actual demand, provides great efficacy at low costs, and reduces efforts along the supply chain to ensure every product reaches the end user. In many areas, like product tracking, or forecasting and planning, joint solutions are key to make access to family planning products efficient and resilient, and this means organizations have to go beyond a limited supplier-purchaser mindset.

The call to action going forward

Access to family planning cannot be reached by one organization alone.

We need to continue to develop partnerships that will create sustainable progress and make use of the skills, products, and capabilities each can each bring to the table. There are no negative outcomes of this — only benefits for everyone.

Direct financing of contraceptive initiatives also needs to be an ongoing priority while global health leaders must prioritize sexual and reproductive health services, and better integrate such services in primary health care. They also need to advocate for more innovation and telemedicine to help fill gaps in the health system.

There are little more than 100 months left until the 2030 Sustainable Development Goals need to be fulfilled. We have to focus, month by month, with all hands on deck.