With human population growth increasing, world leaders at the Family Planning Summit 2020 in London pledged an additional $2.5 billion toward expanding access to contraception and family planning over the next four years. Most leaders, however, indicated that was still not enough funding to meet the need.
Noticeably absent from the global convening was the US government, which has traditionally been the largest funder of global contraception and family planning efforts.
As health ministers, philanthropists and government leaders across Europe, Africa and India pledged funding, they simultaneously criticized President Donald Trump's administration for going in the opposite direction. Earlier this year, his government cut $32 million in funding for the United Nations Population Fund, the UNFPA, and has threatened to cut $600 million more from the State Department’s budget.
"I’m deeply trouble, as I’m sure you are, by the Trump administration’s budget cuts,” said Melinda Gates, co-chair of the Bill and Melinda Gates Foundation. “If empowering women is more than just rhetoric for the president, he’ll prove it by funding family planning.”
The Gates Foundation is a major funder of PRI and its Across Women's Lives effort.
The foundation pledged $375 million over the next three years, with a focus on increasing access to contraception for adolescent girls worldwide.
More than half of the commitments counted so far will come from governments in Asia and Africa, with India committed to spending an additional $1 billion by 2020, while Bangladesh said it will increase its family planning funding by nearly 70 percent to $615 million until 2021, according to Devex.
Most of the efforts to increase access to contraception focused on Africa, where by 2050 the bulk of the world’s population growth is slated to take place. An additional 2.4 billion people are projected to be added worldwide by 2050, with 1.3 billion of them in Africa.
There was a sense of urgency at the summit, which had an initial goal in 2012 of getting modern contraceptives to 120 million more women and girls in 69 target countries by 2020. Current data indicates progress is well short of that target: Only 30 million additional women and girls have been reached since 2012, according to a midway review.
And an estimated 214 million additional women and girls in the global south still want access to contraception but can’t get it.
Funding levels don’t appear to be enough. Even with the commitments that came in at the London summit, this is far short of what the latest data from the Guttmacher Institute, a research group on reproductive issues, says is needed: $11 billion annually to expand services to meet all the women’s needs for contraception in developing regions.
Organizers said that every additional dollar spent on contraceptive services above current levels would save $2.30 on the cost of providing support for unintended pregnancies.
And there are more ways family planning funding pays back. New data indicate that improving girls' education and access to family planning are the single most effective ways to reduce carbon emissions and prevent catastrophic global warming, according to "Drawdown," a new book that ranks solutions to global warming.
Additionally, family planning activists make the case that preventing large families will strengthen economies. Empowering women to control their pregnancies will help keep them out of poverty, encourage them to participate in the economy and improve the chances of the children they do have, advocates say.
In past interviews with Across Women's Lives, Trump administration officials have described family planning efforts like this as "phony" and said that women worldwide don't want contraception.
"We believe contraception is an inherent problem," said Austin Ruse, president of Catholic Families and a member of an advisory board to President Trump. He said access to contraception leads to "an increase in sexual promiscuity and also abortion."
There is no data or evidence available to support this claim.
Melinda Gates argued that family planning could play a part in reducing the refugee crisis that's roiled most of Europe in recent years.
“If you invest in family planning, fewer people in developing countries will risk their families' lives on the high seas to come to Europe," Gates said. "[Contraception] helps women stay in education and get jobs, which helps create peace and stability and means people are more likely to stay where they are,” she said.
All the bad news aside, there have been a number of gains in the family planning landscape since 2012. Perhaps the most significant change is that the Gates Foundation has implemented a system to track access to contraception in at least 30 countries — something that didn’t exist five years ago.
Data trackers can now tell down to individual villages what percentage of women are using contraception, and which kind. For example, in one country in East Africa, the number of women using implants soared from 100,000 to more than 600,000 in just five years, according to Emily Sonneveldt of the international health group Avenir Health.
Additionally, technological developments in birth control were also being hailed as a successful strategy in increasing women’s ability to control their pregnancies. One is Sayana Press, a three-month, progestin-only contraceptive shot that can be self-administered. There are also now implants that last between three and five years.
The summit was co-hosted by the Gates foundation, the UK Department for International Development and the UNFPA.
While the US government was not a participant in the conference, Congress later this summer will appropriate 2018 funding for family planning efforts, and Melinda Gates indicated she would be encouraging members to continue their support.