Access and Barriers

Highs and Lows at The London Family Planning Summit:

Starting at 2p.m. last afternoon, I watched a live streaming of the London Family Planning Summit from Bangalore, India. On Twitter, several international organizations and individual tweeters joined in to comment on the announcements. There were many reasons to cheer, but also several to groan about.

Below are my lists of the several highs and lows of yesterday’s summit:

5 Key Points From the Summit:

  1. How Much: Developing nations will receive 2.6 billion USD for the next eight years to provide over 120 million women and children with access to family planning. Donors included developed nations and various private philanthropies like the Hewlett Foundation, the Packard Foundation, Bloomberg Philanthropies, and of course, the Gates Foundation. Melinda pledged 560 million to the cause, and said it was an easy decision for Bill and her to make.  View full list of donors here.
  1. Who will benefit: Asian and African nations will receive funds based on their needs. According to studies, Chad in Africa has a contraceptive prevalence of 2.8% and has come up bottom of the list. Some of the poorest Asian countries that will benefit include Pakistan, Bangladesh, Burma, Laos, and Cambodia. 
  1. What will be used: Five drug companies, including Merck for Mothers, Pfizer, Shanghai Dahua, Famy Care and Female Health Company presented their statements at the summit. They plan to introduce modern injectable contraceptive, long-acting implants and highly-efficient pills at low costs for the period of the project, and hopefully beyond. 
  1. How it will be implemented: Most nations from Asia and Africa, notably India, Indonesia, and Bangladesh, plan to formulate policies that weave together public and private sectors, and distribute contraceptives at very affordable costs to all girls and women without discrimination. All nations addressed the need to address cultural and social barriers, through policy change at the national level, and counseling at an individual level. 
  1. Civil Society Involvement: The International Planned Parenthood Federation scripted a declaration that was signed by 1350 civil societies from 177 countries. These organizations will work with local governments and private sectors to implement family planning programmes. Mr. Tewodros Melesse, Director General, International Planned Parenthood, spoke at the summit, and said that the declaration was a bond meant to remind all these organizations of their commitments. It would also serve as a means of networking in all these countries, and will help monitoring progress, he said.

5 Speakers who Stood Out:

There were several great statistics recounted at the summit, but these speakers struck a chord by faithfully keeping the rights based approach at the heart of the discussion, or for discussing key points that might not have been adequately discussed by the agenda.

  1. Theo Sowa, the Interim CEO, African Women’s Development Fund: She acknowledged the need to include men in the conversation, but also stressed that women have to be the core of it. Inclusion of men is particularly important in developing countries, where men make decisions for their wives, and often deny them the right to use birth control and other family planning services. It is important to address this patriarchal point of view, and to help men learn to respect and support the women in their families. But at the end of the day, women are at the core of this issue: they have to be able to make decisions about their own bodies, and must learn to be self-reliant, and independent.
  1. Bience Gawanas, Commissioner for Social Affairs, African Union: She was the first, and probably one of the only leaders who framed family planning within the broader framework of sexual and reproductive rights. She was preceded by world leaders who stressed on population control measures, and so it was inspiring to hear Ms. Gawanas put the rights-based approach back on the table, when she reminded world leaders not to forget to frame their programs in the context of reproductive rights.
  1. Heikki Holmås, Minister of International Development, Norway: He claimed to have grown up in his mother’s office, and said women’s rights were close to his heart.  He urged the world to feel a sense of obligation to stand up against conservative and religious regimes that suppress women, and oppose their rights to make decisions over their own bodies. He also urged finance ministers in his country and in others to budget generously for family planning, and to empower women to make their own decisions. He also had a message from his mother – “Listen to your heart, and think with your brain.” He urged world leaders to weigh the outcomes of barring family planning before implementing laws based on religion, and traditional views.
  1. Maria Eitel, Nike Foundation: She was not scheduled to speak at the conference, but asked to make a cameo shortly before lunch break. But what Eitel said stunned the audience. 90% of childbirths among adolescents in Asia and Africa are results of child marriage, not premarital sex, she said. Speaking for the Nike Foundation and the Girl Effect, an organization that works against child marriage, Eitel urged the government to include girls between 13 and 19 in their family planning programs and to integrate these with policies against child marriage.
  1. Mr. Andris Piebalgs, European Commissioner for Development, EU: Once again one of the only speakers who mentioned that women’s rights, gender equality and reproductive justice should be at the hear of this project. He asked countries to plan for a future where women are empowered through family planning, and capable of making political and economic contributions. The EU pledged 23 million Euros toward the project.

5 Causes for Concern: 

  1. Rights-based approach was missing: Apart from the few leaders mentioned above any talk of a rights-based approached, came from expected corners: Melinda Gates, David Cameron speaking for the United Kingdom, Hilary Clinton in a video message, and representatives of the United Nations and of various civil societies. Unfortunately, the Asian leaders failed to frame their plans under the broader context of sexual and reproductive rights. India announced that its plans were central to its health programs, while speakers from Philippines, Indonesia and Bangladesh simply announced statistics and numbers. Their talks were a little reminiscent of the final outcome of Rio+20, where women’s health and family planning were discussed as welfare programs, and not as a matter of reproductive rights or social justice. This passive approach to family planning immediately provoked comments on Twitter, including one from Jodi Jacobson, Editor-in-chief of Reality check, who wondered if the Indian scheme had the power to translate into reality if gender discrimination, and empowerment of women were not more openly discussed. The same could be said of other Asian and African countries.
  1. Wasted Opportunity for Safe Abortions: As Dana Hovig of Marie Stopes International wrote for the Huffington Post, everyone knew that safe abortions would not be discussed at the meeting. And despite a few mentions by leaders from the African continent, no one really took up the cause. It was a missed opportunity for safe abortions, and any discussion would have made a difference to women in Asia and Africa. One particular Tweet feed that stood out was from Sunny Hundal, who shared this article on why the exclusion of abortions was a disappointment.
  1. Should drug companies compete: During the panel discussions with five drug companies (all represented by men), the moderator picked up the competitive tone to their statements. She raised the question if the race to provide the best contraceptives would be beneficial to the project as a whole. While this might initially create a competitive market, in the long run it might be better if these companies worked together at providing methods at very low and affordable costs in all project areas. 
  1. Better than my neighbor is not good enough: There was also a bit of competition between some of the African nations on doubling or tripling the use of contraception use. Unfortunately the rates in these countries are very low with Chad averaging at 2.8 % (lowest on the list) to Senegal at 12%. Any completion between nations is likely to create some complacency that might deter them from their real goals: contraception for all. 
  1. Monitoring could cause concerns: The International Planned Parenthood Federation and other civil societies were hoping to use their newly established global network for monitoring the programs. The representatives from WHO  also spoke of the need to constantly track the programs and to monitor for changes. But national governments lacked comprehensive plans for monitoring. This is an urgent need and will have to be legislated.

While the experience was great for me, and my fellow tweeters, we would all love to see these promises translate into action. Hopefully most of them, will.



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