Falling family planning funding threatens poverty fight

A dramatic plunge in international donor funding for family planning is threatening to undermine other humanitarian goals such as fighting poverty and hunger, as well as efforts to counter global warming, according to the UN and other specialists.

An estimated 200 million women lack contraception; the potential surge in the world's population could well reverse humanitarian gains, experts say.

The largest amount earmarked for family planning since the 1994 International Conference on Population and Development in Cairo was in 1995, with US$723 million committed, remaining above $600 million for all but one year to 1999. The latest estimate, for 2007, is about $338 million.

"That's a hell of a decline," UN Population Fund (UNFPA) senior demographer Stan Bernstein told IRIN. Nor does it take account of inflation, making the drop even sharper in 1994 dollars. The word disaster is "entirely appropriate", he said, noting that the issue seemed to have been pushed to the backburner by donors and media alike.

Akinrinola Bankole, director of international research at the US-based Guttmacher Institute, an NGO focused on reproductive health research and policy analysis, said:

"Unless there is a renewed attention on population and funding for family planning, high fertility, especially in sub-Saharan Africa, in spite of desires for smaller families and high unmet need for contraception will aggravate the negative consequences, some of which are already horrendous."

UNFPA executive director Thoraya A Obaid is calling for an increase in funding regardless of the financial crisis. "We have to protect the gains made and ensure that these gains do not slip back as more and more people are slipping back to poverty."

Photo: Parwin Faiz/IRIN
Afghan women on average have 6-7 children, according to UNFPA. Funding issues hit the poorest most (file photo)

World Population Day

In an effort to push the issue up the development agenda ahead of World Population Day on 11 July, UNFPA convened 30 leading family planning experts in New York at the end of June, including representatives from Bangladesh, Colombia, Guatemala, Kenya, India, Senegal, Tanzania, Uganda, the UK and USA.

"In one sense the issue is a victim of its own success," Carmen Barroso, western hemisphere director at the International Planned Parenthood Federation, told IRIN, adding that "enormous progress in certain countries, regions, and segments of the population" had blinded people to the problems in other regions where the poor continue to be neglected.

"This is like declaring the marathon is over when the fastest runners have crossed the finishing line; people don't appreciate the level of unmet demand in poorer countries," Bernstein said, citing Kenya and Pakistan as examples of countries where fertility rates that had been falling are now stalled.

"There are a growing number of countries where there has not been the progress that there was in the past and some of that was because the expectation was that things were on the right track and so you could start putting money elsewhere," he said.

"The difficulty of course is that every year more young women are ageing into their reproductive years and they would not have heard information campaigns that were done 10 years ago... It used to be that when you arrived in a developing country you would see billboards or hear radio spots advocating family planning; now all you see are HIV/AIDS billboards. That's where all the money went."

Bankole also said a decline in fertility in regions other than sub-Saharan Africa had nurtured the belief that a decline in all regions was inevitable.

Conservative policies

"The issue of family planning has been demonized by the extreme conservatives who have [made] it ... a taboo issue," Barroso said.

Bernstein cited the link some people made between family planning and abortion.

"And they are linked," he added. "The link is family planning services reduce recourse to abortion, it's as simple as that, but some people put family planning and abortion in the same category of wrong choices."

He also noted that reproductive health in general and family planning in particular were not originally in the Millennium Development Goals because reproductive health and issues about women's rights were felt to be too controversial. Universal access to family planning by 2015 is now included under the MDG of improved maternal health, but its absence at the start slowed things down, he added.

Finally there is the fatigue resulting from the very long-standing persistence of the issue. "There's a little bit of 'this is an old story, didn't we talk about population growth and its impact in the 70s and the 80s,' and it sort of doesn't have the grab of the new,"

Bernstein said. "It's not that there have been that many new contraceptive technologies invented since; it's always the new thing, the new invention that gets attention."

Photo: Contributor/IRIN
A mobile clinic offering reproductive healthcare in Sri Lanka (file photo)

Climate change links

A recent meeting in London on climate change and population noted that while the links were complex, population growth was clearly one of the drivers, particularly on a local scale, with regard to such issues as deforestation and water sustainability.

"It's not a very simple relationship but it's certainly one of the important factors in climate change," Barroso said.

As with most such issues, it is the poor, especially in Africa, who bear the brunt of the funding shortfall.

"Many African countries are going to double or even triple in size between now and mid-century. And that I think poses huge problems for development. We need to debate population issues openly and honestly in a way that we haven't been prepared to do in the last 10 to 15 years," John Cleland, professor of demography at the London School of Hygiene & Tropical Medicine, told a news conference in June.

Obaid agreed: "I would like to stress that investments in women and reproductive health are not only decisive for overcoming poverty, managing the speed of population growth and achieving the MDGs; they are also cost-effective," she told IRIN.

"An investment in contraceptive services can be recouped four times over - and sometimes dramatically more over the long term - by reducing the need for public spending on health, education, housing, sanitation and other social services."

She called on decision-makers, now more than ever, to increase resources for family planning. "I do not think that any of the crises we are facing today - whether it is the food crisis, the water crisis, the financial crisis or the crisis of climate change - can be managed unless greater attention is paid to population issues," she said.