As we think about what today, International Women’s Day, means for the United States, I am calling for stronger U.S. leadership on women’s international reproductive health and family planning (IRH/FP). Since the 1960s, the United States Government has been a global leader by providing IRH/FP assistance in dozens of countries. But have we done enough?
There are currently an estimated 215 million women around the world who want to delay or prevent pregnancy but who do not have access to modern contraceptives. This unmet need contributes to roughly 75 million unintended pregnancies every year. Reducing the unmet need for contraceptives, and thereby cutting the number of unintended pregnancies, would also reduce the 20 million unsafe abortions and a good number of the 350,000 maternal deaths that take place worldwide each year.
Addressing women’s sexual and reproductive health needs can also contribute to significant improvements in child health. For example, the World Health Organization recommends an optimal spacing between births of at least two years to reduce the risk of premature birth, low birthweight, and infant mortality. Some children in large families may also face heightened risk of malnutrition, poor access to healthcare, and educational and economic disadvantages.
According to the Guttmacher Institute ("Adding it Up” 2009) making investments in comprehensive programs that involve sexual and reproductive health, as well as maternal, newborn and child health would save hundreds of thousands of lives also be highly cost-effective.
Increased investment in and improved access to comprehensive programs like these can also aid in the prevention of sexually transmitted infections, including HIV. Every day, approximately 1,000 infants are infected with HIV worldwide during pregnancy, birth or breastfeeding - around ten percent of all new HIV infections.
Unintended pregnancy prevents many young girls in developing countries from attending school. In fact, 90 percent of all adolescent births worldwide occur in low- and middle-income countries (though the rate of teen pregnancy in the United States also remains stubbornly high). Access and information to contraceptives, and information about the risks of early marriage and pregnancy, help to provide young people with the tools they need to make their own reproductive health decisions and to stay in school.
Although the U.S. committed at the historic 1994 International Conference on Population and Development in Cairo to provide increased investments in sexual and reproductive health, U.S. foreign assistance for IRH/FP has remained stagnant and even declined (in constant dollars) in recent years. If the United States were to provide a fair share of the funding needed to meet the ICPD targets, the contribution would be at least $ 1 billion; and this figure is still less than a third of the $3.2 billion that would be the U.S. fair share to help achieve universal access to sexual and reproductive health care by 2015. In short, we have a long way to go.
The Obama Administration’s budget request for IRH/FP for fiscal year 2013 stands at not even two-thirds of that amount - $643 million. While this does represent a slight increase over 2012 funding, it by no means comes close to what the United States Government could contribute to adequately address the reproductive health needs of women and girls. UNFPA, for example, an agency that plays a vital role in addressing issues like teen pregnancy, saw dramatic cuts in support from the United States last year. For 2013, the Administration has proposed a meager$39 million request (far below the $50 million requested in 2012).
The current political and economic environment makes it hard to pitch spending more money, for any purpose, no matter how compelling. However, the benefits from making investments in comprehensive sexual and reproductive health, are undeniable – more lives saved at a lower total cost, and more women and girls leading productive and healthful lives. So to celebrate International Women’s Day, I am joining a long list of experts and advocates who are calling on the U.S. Government, the world’s leader in global health assistance, to renew its commitment to women and girls by raising the bar for international reproductive health and family planning.