Q&A: UNFPA's Babatunde Osotimehin on family planning in the face of uncertainty

Last week’s "She Decides" conference drew 400 delegates, including 20 ministerial delegations, to Brussels to discuss the impact of the U.S. government’s “global gag rule” and to raise funds to help tackle the shortfall in family planning aid that has been created. The gag rule prevents non-U.S. nongovernmental organizations that provide services or information relating to abortion from receiving government funding for any of their activities, a move that will likely reduce access to contraceptive services, maternal health care and HIV prevention, among other things. Among those speaking was Dr. Babatunde Osotimehin, executive director of the U.N. Population Fund and former minister of health of Nigeria. He told Devex that the conference and fund was not about abortion: “This is [about] sexual and reproductive health and rights — the whole range of services — and empowering women to take charge of their lives; that is what it was about,” he said. With the future of U.S. contributions to UNFPA also unclear, Dr. Osotimehin spoke to Devex about the role of family planning in achieving the Sustainable Development Goals and how to shore up programs in uncertain times. Here are takeaways from the conversation, edited for length and clarity. What role does family planning play in the Sustainable Development Goals? Family planning is probably the most important intervention that you can introduce into any community because it empowers women. And when you liberate a woman — when she can make choices about her life — you actually empower her children, her family and everybody. That relates to the issue of gender equality, which is also central to the Sustainable Development Goals, but I think we cannot look at family planning in isolation. There is also the issue of the education of girls; the issue of health and universal [health care] coverage; the issues surrounding early and forced marriage, so she can take control of her life … the prevalence of HIV and the utilization of condoms to prevent that. We, in the development community, believe that family planning is one of the most effective human development interventions you can have, because it positions the woman, the family and the community in a totally different way. How does it relate to the goal of ending poverty in all its forms by 2030? It's all part of it. Let me tell you the story of a 10-year-old girl. When a 10-year-old girl goes to school and learns information about her body, and then at a proper time she decides that she doesn't want to get pregnant; she goes through school and university; then she decides about her career prospects and what she wants to do. So the way you do that is you give her agency and you give her opportunity to not only build social capital but also to build financial capital. You take her out of poverty. I'm just using that as an example of the trajectory that family planning information and services give. Look at a woman who's already in a marriage, who actually has a child, and she has the ability to make the choice about when to have the next child because she's trying to build a business. That happens for her with the help of family planning. In recent years, the U.S. has accounted for almost 50 percent of bilateral aid for family planning and it is also one of the world's biggest purchasers and distributors of contraceptives. Given how important family planning is, is there a risk in being reliant on a small group of big donors? There's a risk in looking at a small amount of donors. The message that was passed down [at the conference] was that we should get many more people on board, small and large, and also encourage program countries from the south to be part of this movement. They should be able to put money into programs in their countries so that it's sustainable. They do an assessment of their needs, they put that against what they have, and if they can afford it then they spend it, because it's about the dignity and the lives of their women. If they can't afford it, then there are resources to supplement what they have. But it's crucial that they put money into it too — money in a general way, because it's also about human resources; it's also about supply chain systems; it's also about information; it's also about education. But for all of that to happen, you need a critical sum of money to go forward. U.S. contributions to UNFPA have, in the past, been blocked by Republican governments. Is there a concern that it might happen again, and do you see resistance to family planning aid coming from elsewhere? I don't know what's going to happen. We are waiting for policy and we hope for the best. We try to make sure it doesn't affect us because there are so many urgent things to attend to, so we continue to do our work. What we'll try to do is to catalyze programs on the ground in program countries — to enable them also to come to the table with strategies of their own, because that's the really sustainable thing that should happen. What we have is a total society approach to this. Foundations, civil society organizations, the private sector, high net worth individuals will be crucial for meeting these goals. [But] government has a responsibility to look after the health and the well-being of its people. 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