Population Matters

A See Change?

September 25th, 2013

Last week Pope Francis shocked the world with comments saying that the Catholic Church had become “obsessed” with abortion, gay marriage and contraception:

“It is not necessary to talk about these issues all the time. The dogmatic and moral teachings of the church are not all equivalent. The church’s pastoral ministry cannot be obsessed with the transmission of a disjointed multitude of doctrines to be imposed insistently.

We have to find a new balance; otherwise even the moral edifice of the church is likely to fall like a house of cards, losing the freshness and fragrance of the Gospel.”

While his comments do not represent a formal change in church policy, they could represent a changing tone on these issues that would be more reflective of the beliefs of its membership, particularly in the United States. Polling has shown that 82% of Catholics believe that birth control is “morally acceptable” and 63% of Catholics opposed overturning Roe v. Wade and support maintaining a woman’s right to choose.  More surprisingly, perhaps, 98% of Catholic women who have had sex have used a contraceptive other than natural family planning.

Unfortunately what the Catholic faithful think and what the church hierarchy thinks are not always the same. This dynamic has played out in the United States in numerous ways with the most recent iteration being the passage of the Affordable Care Act, which among other things would ensure that women have access to birth control with no co-pay. While most Catholics find birth control “morally acceptable,” and have used contraceptives, the Catholic bishops have fought tenaciously to prevent as many women as possible from accessing this benefit.

On an international level the Catholic Church has a huge impact at the United Nations where since 1964 the Holy See, the diplomatic representative of the Catholic Church, has had non-member state status. The Catholic Church is the only religion to be granted this status, with other religions only allowed to participate as non-governmental organizations. This enables the Holy See to have a disproportionate impact at the United Nations. As most policy is adopted by consensus at the U.N., dissent by the Holy See can easily throw a monkey wrench into international deliberations. The Holy See has been particularly intransigent on issues related to reproductive rights and LGBTQ issues. Recently the Holy See almost prevented final approval of a consensus outcome document at the Commission on the Status of Women that focused on violence against women.

While I am sure the Pope’s comments do not mean a change in church doctrine, particularly in light of the comments that he made on Friday to a group of Catholic gynecologists, they may mean the Holy See will be less obstreperous on these issues.  That would be particularly welcome news at the United Nations, where member countries are starting to formulate a post-2015 development agenda. The new development goals must include women’s rights and access to reproductive health services.

So will Pope Francis’s comments represent a real See-change or will we see more of the same? Stay tuned.

Posted by Jennie Wetter, Director of Public Policy

Immigration Bill Means Waiting 15 Years for Family Planning and Reproductive Health Benefits

August 15th, 2013

The immigration reform bill proposed and passed by the Senate in June would offer nearly 11 million people a path to legal status. If enacted into law, long-time residents of the US will gain the right to vote, the chance to seek lawful employment, opportunities for college financial aid, and legal recognition within our communities. But regardless of your opinion on the bill, there is one glaring deficiency: it would do nothing to meet the immediate family planning and reproductive health needs of immigrant women.

While the Senate bill provides a path to citizenship, it would require a wait of 15 years or more before an immigrant would become eligible to receive Medicaid benefits, including family planning and reproductive health. Such a wait would effectively deny many women in this country the kind of reproductive health care that we seek to provide—through international assistance— to women in developing countries.

If the Senate bill passes through the House without change and is signed into law, it would allow undocumented immigrants already living within the US borders to step forward and begin the process of attaining citizenship. People who have been residing in the US prior to December 21st, 2011, would be eligible to apply for citizenship under the law, but it would be a long process. First, they would have to change their status to become a “registered provisional immigrant (RPI).” Then, after a ten year waiting period, an RPI could adjust their status to “lawful permanent resident.”

During the 10-year waiting period as an RPI, immigrants are barred from receiving nonemergency Medicaid and also remain ineligible for assistance from the Affordable Care Act. Private insurance is astronomically expensive for low- and middle- income families without the federal subsidies put in place by the Affordable Care Act. RPIs cannot receive tax credits from the Affordable Care Act, and, thus, they will likely remain uninsured throughout the 10-year waiting period.[1] RPIs can only access limited public programs, such as WIC (supplemental nutrition programs for women and children).1 These programs alone are inadequate because they do not provide preventative care or comprehensive sexual and reproductive health services.

Following the achievement of lawful permanent residency, there is an additional “five-year bar” that would prevent legal American residents from receiving aid from federal benefit programs such as Medicaid.[2]  That means, in effect, a fifteen-year wait to receive health care. This is especially detrimental for young women of reproductive age who are pregnant or who need access to contraceptives. Currently, the cost of giving birth in a hospital is an average of $32,000 for a vaginal delivery and $51,000 for a C-section.[3] Just for this common medical procedure, the costs are impossibly high. Undocumented immigrants, however, who want to avoid an unplanned pregnancy and the associated costs of bringing a child into this world, would be ineligible for Medicaid family planning services.

The U.S. is a major provider of family planning and reproductive health care services to women in developing countries. The U.S. spends over $600 million a year in support of the UN’s goal of ensuring “universal access to reproductive health care.” If women in developing countries need access to family planning and other reproductive health care services, the same reasoning should apply to women in this country, regardless of their immigration status.  

Posted by Grace Benson, Public Policy Fellow

 


The Unintended Consequences of the War on Women

July 30th, 2013

Wars as a rule are not exercises in critical thinking.  Still, legislators who are busy waging an unrelenting attack on women and their reproductive health should take time to read the latest Guttmacher Report, “Contraceptive Needs and Services, 2010”.  They might discover that their war on abortion and family planning is creating some collateral damage.

State legislators in recent months have been working overtime in their effort to restrict a woman’s access to abortion services. Some states have set a limit on how late in a pregnancy a woman can get an abortion; other states have enacted TRAP laws (targeted regulation of abortion providers) that are designed to put clinics out of business by enacting burdensome laws that single out abortion providers from other medical service providers. The TRAP laws are not just stopping women from accessing abortion services; they are also restricting a woman’s access to pap smears, cancer screenings, and birth control.  At the same time several states have been slashing funding for family planning services, while Congress has been trimming Title X, the federal program that funds family planning services for low-income households.

One of the unintended consequences of these assaults on family planning and reproductive services is an increase in unplanned pregnancies…and the demand for abortions. According to the Guttmacher Institute report in 2010 8.9 million women received publicly funded contraceptives, and they helped prevent 2.2 million unintended pregnancies, which would have resulted in 1.1 million unplanned births and 760,000 abortions. The report estimates that without publicly funded contraceptive services the national levels of unintended pregnancy, unplanned birth and abortion among all women would be 66% higher overall and 73% higher among teens.

That’s not the end of the collateral damage that results from cutting family planning services.  Guttmacher’s report also shows how these cuts actually increase government spending. Publicly-funded family planning services in 2010 produced savings of $10.5 billion.  The return on investment for federal and state governments?  A whopping $5.68 for every $1 spent on family planning services.  

Any way you look at it, the War on Women is producing a lot of unintended casualties.   Maybe it is time for these legislators to call a retreat.

Posted by Jennie Wetter, Director of Public Policy

World Population Day and ‘Failing States’

July 11th, 2013

On July 11, without much public fanfare, the world will observe World Population Day. There will be no celebrations, no fireworks, and no formal ceremonies. Established by the United Nations in 1989 as a means of raising public awareness of global population issues, the observance has largely faded into obscurity. Decades of declining birth rates have assuaged fears of a “population bomb.” Those fears have been replaced, in part, by warnings of an impending “birth dearth.” In reality, however, we keep adding another billion people to the planet every 12-13 years, and the concerns that gave birth to the original World Population Day have not gone away. They are very much with us.

If you think concerns about population today are overblown, you should take a look at the 2013 Failed States Index (FSI) that was formally released by the Fund for Peace and Foreign Policy magazine at a Washington, D.C. press conference on Tuesday. The annual ranking of countries that are struggling against great odds to maintain functioning governments reads like a “Who’s Who” of countries with rapidly growing populations. Large parts of the world have made–in full or in part–the demographic transition from high fertility, high mortality, and rapid population growth rates to low fertility, low mortality, and stable or declining populations. Dozens of countries, however, have failed to make that transition, and, almost without exception, these countries rank very low in contraceptive usage and very high in terms of hunger, poverty, disease, and political instability.

The populations of the 20 countries that had the worst scores in the 2013 Failed States Index currently total 813 million. According to the latest UN population projections, their numbers will more than double in the next 37 years. Unless fertility rates in these countries fall faster than presently anticipated, their populations will total 1.7 billion by 2050. Today these 20 countries constitute 11 percent of world population; by 2050 they could account for 18 percent. And without an increased and sustained commitment on the part of the U.S. and other donor nations to international family planning assistance, the UN’s latest population projection could turn out to be an underestimate.

Expanded access to contraceptives would help to lower fertility in these countries, but unless more girls stay in school and delay marriage to adulthood, the decline in fertility could easily stall. In some countries, it already has. In many countries, the adolescent pregnancy rate is rising. The mere fact that most countries in the world have undergone a demographic transition does not guarantee that all countries will.

In many of these struggling countries, forty percent or more of the population is under the age of 15, and these children will soon be entering their reproductive years. The population of Somalia, which topped this year’s FSI, is projected to rise from 10.5 million to 27.1 million by 2050. The population of Democratic Republic of Congo (DRC), which came in second on the index, is projected to rise from 67 million 155.2 over that same time period. Sudan, which came in third, is projected to jump from 38.0 million to 77.1 million. The population of Yemen, already suffering from acute water scarcity, is projected to rise from 24.4 million to 42.5 million. The populations of war-torn Iraq and Afghanistan are also on the rise. Iraq’s population could climb from 33.8 million to 45.9 million by mid-century, while Afghanistan’s population could jump from 30.6 million to 56.6 million. But none of these projections are written in stone. Even small declines in fertility rates could dramatically lower these long range population forecasts. But will they?

By any fair measure, providing contraceptive services is not expensive. What’s really costly is failing to provide women with contraceptives choices and denying them the freedom to choose how many children to have and when. Reproductive freedom, as it turns out, is crucial to the future of failing or potentially failing countries. Without it, many of these countries will never complete the demographic transition to lower fertility and lower mortality, and they will have great difficulty in reducing poverty, eliminating hunger, and maintaining political stability.

When women everywhere enjoy gender equality and access to family planning and reproductive health services, World Population Day will be a cause for universal celebration, but we are not there yet. The UN set 2015 as the target year for achieving universal access to family planning and reproductive health services, but far too little progress has been made. Over 200 million women in the developing world want to avoid or delay a pregnancy, but are not using a modern method of contraception. Empowering these women and giving them access to a range of contraceptive services is crucial to their health and the wellbeing of their families and their country.

Originally posted on The Huffington Post on July 9, 2013.

Time to Make Child Marriage History

May 30th, 2013

Child marriage, a marriage where one or both of the parties are under the age of eighteen, is a violation of human rights, yet it happens every day around the world, across religions and cultures. The numbers are sobering, one in three girls in the developing world will be married before she turns eighteen and one in seven before she turns fifteen.  Everyday 13,000 girls under the age of fifteen are married, some as young as eight or nine. This translates into nearly five million girls under the age of fifteen being married every year. Experts predict that if the current trend continues by 2020 fifty million girls will be married before they turn fifteen. That means fifty million girls will be married against their will and have their childhoods cut short.

According to a new report by the Council on Foreign Relations, not only is child marriage a violation of human rights it also has major implications for U.S. foreign aid and policy. The report argues that “this tradition traps girls and their children in a cycle of poor health, illiteracy, poverty, and violence that has consequences for development, prosperity, and stability. As such, child marriage undermines U.S. aid investments and foreign policy objectives around the world.” The report argues that child marriage undermines U.S. interests and investments in four main areas: health, education, economic development, and stability.

The Obama administration has made global health, including maternal and child health and family planning a priority. Unfortunately investments in these areas are being undermined by the practice of child marriage. When girls marry young they are unable to negotiate safe sexual behaviors and are at an increased risk for HIV and other STIs, and are often unable to access contraception resulting in early childbearing. Bearing children at such an early age puts their lives in danger. Girls between the ages of fifteen to nineteen are twice as likely to die from a pregnancy-related cause as girls in their twenties, and girls under fifteen are five times more likely to die in childbirth. This leads to the shocking fact that complications from pregnancy and childbirth is the leading cause of death for girls between age fifteen and nineteen in the developing world. Not only is the mother’s health in danger; so is the child’s.  Stillbirths and infant mortality are fifty percent more likely when the mother is less than twenty years old.

Child marriage also undermines education and economic development. Girls’ education is one of the most important drivers of economic development. When girls stay in school they tend to marry later and have smaller, healthier families. However when girls are forced to marry early they are often pulled out of school limiting the girl’s economic potential. It perpetuates the cycle of poverty by keeping the girl illiterate and preventing her from competing in the job market later in life.

Finally, the report highlights how child marriage is undermining U.S. investments in health and stability. Girls who are married as child brides are more likely to experience domestic and sexual violence, and research suggests that violence against women and girls is correlated with civil strife and conflict.  Not surprisingly perhaps, child marriage is often prevalent in fragile states.

Looking at the way child marriage undercuts U.S. investments in health, education, economic development, and stability the Council on Foreign Relations report concludes that:

“In this time of austerity, policymakers should recognize that addressing child marriage is not only a moral imperative—it is also a cost-effective and strategic imperative to achieve the United States’ diplomatic and development goals. The reach and success of U.S. efforts to improve global health, bolster education, foster economic growth, and promote stability and the rule of law will grow stronger if this persistent practice comes to an end.”

It is time to speak out in defense of the five million girls under fifteen who will otherwise be married this year.  They should be allowed to be girls, not brides. It’s time to make child marriage history.

Posted by Jennie Wetter, Director of Public Policy

Women Deliver. How About Men?

May 24th, 2013

Next week in Kuala Lumpur thousands of people from around the world will gather for the third global Women Deliver conference (May 28-30).  The participants will include government leaders, policymakers, healthcare professionals, reporters, and nonprofit leaders.  Their goal, which is as urgent as it is worthy, is to promote the health, rights, and empowerment of girls and women.

Most of the participants will be women.  That’s not surprising:  Who else knows more about the crucial importance of empowering girls and women than women?  But it is disappointing.  And it is also a reflection of how far we still have to go in achieving full gender equality.

Around the world women are delivering…in every conceivable way.  In addition to delivering children, girls and women are doing more than their fair share to make the world a better place.  And they ‘deliver’ in many cases despite physical abuse and impossible odds.

What many, if not most, girls and women in the world do not have is a fair chance to succeed, and until they are better protected from sexual violence and coercion, they will never have that fair chance.

This week in Malaysia, where the conference is being held, a 40-year old man, who was recently charged with raping a 13-year old girl, told the court this week that he is now married to the girl. The Malaysian Attorney General and Malaysian Ministry of Women, Family and Community Development are urging that the man still be convicted of statutory rape.  It is unclear though whether the prosecutors will proceed with the case.

As shocking as this incident sounds to many of us, marriage by rape or abduction is still a prevalent practice in many developing countries, particularly in rural areas of South Asia and sub-Saharan Africa.  The defendant in the Malaysian case argued in his own defense that, “There are many cases of men marrying underage girls. I do not see why my case should be any different.”

That comment reflects the deeper problem. In some parts of Malaysia and in many parts of the developing world the idea that women should be subservient to men is still deeply engrained in culture and tradition.

The high-profile raping of girls in India has generated virulent protests in recent months and may force prosecutors in India to take rape cases more seriously, but it does not change the fact that child marriage is still prevalent in many parts of India and that girls in many areas do not receive the same schooling as boys.  Yes, the Indian parliament in March passed a more stringent law to guard women against sexual violence, but until India does more to elevate the status of girls, females will continue to suffer from inequitable treatment and high levels of sexual violence.

In the past decade the developing world has made significant progress in enrolling more girls in primary schools, but their enrollment in higher education continues to lag, in part because child marriage is still prevalent in many areas.  In male-dominated societies, where child marriage has been practiced for centuries, leaders often see little need to enforce laws against under-age marriage.  That must change, for whenever girls are deprived of schooling and women are denied their reproductive rights, everyone suffers…women and men.  Gender equality is a moral imperative, but it is also an economic and social imperative.  No country, no society, however industrious or blessed with resources it may be, will ever reach its full potential so long as women are denied theirs.

If you look closely at those countries where respect for girls and women is lowest, you will invariably  find high rates of maternal and infant mortality, hunger, poverty, illiteracy and disease.  That’s not coincidence.  When girls are denied schooling and women are denied access to family planning and reproductive health services, their families and their communities invariably suffer.  The world can—and does—spend an awful lot of time and resources treating the consequences of gender inequality, when it would be far more cost effective to tackle the underlying problem.

Empower girls and women and they will deliver.  That’s the message that the world will hear next week from Kuala Lumpur.  Let’s just hope the men of the world will be listening.

Posted by Robert J. Walker, president

 

 

Celebrating National Women’s Health Week

May 17th, 2013

This week is National Women’s Health Week and given the expanded coverage that is going into effect as a result of the Affordable Care Act there’s lot to celebrate this year.  Not everyone, however, is in a celebratory mood and many are downright unhappy with the expanded coverage.

The House of Representatives celebrated this week by voting for the 37th time to repeal the law.  Yes, that’s right:  the 37th time.  That raises the question, “What is so bad about Obamacare?”  The ACA, after all, has been a huge victory for women’s health.  Prior to the ACA insurance companies could charge women higher premiums than men just because they were women, and could deny women coverage for preexisting conditions like breast cancer or pregnancy.  But thanks to the ACA, they cannot do that any longer.  Today, because of the ACA, 45 million women and counting have received preventative care with no co-pay.

Under the regulations approved by the Department of Health and Human Services, preventative care includes well woman exams, pap smears, mammograms, and birth control.  So what’s wrong with that?  A lot apparently, particularly the part about access to contraceptives.  In the past two years, there has been a firestorm of protest from social conservatives who insist that birth control should not be classified as preventative care.  Excuse me?  By what screwed up logic is the prevention of pregnancy not a preventative measure?  Birth control is an essential part of women’s health care and having birth control available with no co-pay takes women’s health care decisions out of the hands of politicians and insurance companies, and puts the power where it belongs: with women.

On another controversial front, the U.S. Justice Department is celebrating by appealing a federal judge’s ruling that would make Plan B, the most popular form of emergency contraception, available for anyone without a prescription. After the judge’s ruling, the Department of Health and Human Services lowered the age at which a female could obtain emergency contraception without a prescription from 17 to 15. The judge, however, insists that the age restriction should be eliminated altogether, and the Administration is appealing the decision.

Is that how we should be celebrating National Women’s Health Week?  I don’t think so.  Emergency contraception reduces the risk of pregnancy after contraceptive failure or unprotected sex up to 120 hours after, but is most effective in the first 24 hours.  It is important, therefore, that women obtain access to emergency contraception in a timely manner.  The current restrictions can lead to confusion and human error, effectively denying many women access to emergency contraception, particularly young women and those without any government- issued identification.  By making emergency contraception available over the counter to all women regardless of age it would ensure that women have better access to emergency contraception.

When it comes to women’s health, there’s a lot to celebrate this year…but the battle over women’s health rages on. Too bad.

Posted by Jennie Wetter, Director of Public Policy

Politics, Pakistan and Population

May 1st, 2013

On May 11th, voters in Pakistan will go to the polls for one of the country’s most important elections in decades.  With many experts warning that Pakistan’s economy could be headed for collapse, two issues related to population have emerged.  The first is population growth.  Many observers warn that Pakistan’s population growth rate, which has increased in recent years, is economically unsustainable.  The second issue, and it is related, is the status of women.  A lack of gender equity is hindering female participation in the workforce and it is also contributing to stubbornly high birth rates.

Zubeida Mustafa, a two-time winner of our Global Media Awards, has written extensively on both topics.  She is a freelance journalist who writes a weekly column for Dawn, the paper with which she worked as an assistant editor from 1975 to 2008. Dawn is Pakistan’s most widely circulated and influential English language newspaper that was founded in 1947.

In addressing the issue of population as it relates to the upcoming election, she writes, “It doesn’t take rocket science to realise that a rapidly growing population strains the resources of a country and poses a serious hurdle in the way of development strategies.”

She notes, however, that:

There are parties which do not even see a link between a fast-growing population and the failure of the government to provide health and education facilities to the people. The demographic factor drags down economic growth and resource expansion. They are the Awami National Party (quite surprising given its people-centric approach), the Jamaat-i-Islami, the PML-Q and the Jamiat Ulema-i-Islam-Fazl. The last-mentioned party’s spokesman orally confirmed the party’s lack of commitment to population issues.

Mercifully, four major parties, the PPP, the PML-N, the Pakistan Tehreek-i-Insaf (PTI) and the Muttahida Qaumi Movement (MQM) are more progressive on the population question. The first three spell out categorically why an effective family planning programme is closely linked to the country’s development in the economic and social sectors….

The PPP and PTI are quite comprehensive in spelling out their strategy. The PTI promises to make the population welfare programme an integral part of the health policy and make quality education and modern contraceptive services available to women.

Mustafa, who has been a long-time champion of women’s rights in Pakistan, warns, however, that all the parties, as part of their population platform, need to make a clearer and stronger commitment to women’s rights, and not just for improved access to contraceptive services.  She writes that:

Some speak of educating women because educated women have fewer children on account of their better understanding of contraceptive choices. But that by itself does not change the gender priorities of parents who have a preference for sons. That will change only when women gain social acceptance and recognition.

Issues other than population will no doubt determine the final outcome of the upcoming elections, but the future of Pakistan will be determined in no small part by what future Pakistani governments do to improve contraceptive services and promote gender equity.  Let’s hope that the election results will point in the right direction.

Posted by Robert J. Walker, President

 

 

Victory for Women

April 8th, 2013

 

In a victory for women and women’s health, a federal judge last Friday ordered the Food and Drug Administration (FDA) to remove restrictions on women’s access to emergency contraception. U.S. District Court Judge Edward Korman ruled that the FDA must make the most popular forms of emergency contraception available over the counter and without an age restriction.  The decision overturns a policy that restricts access to emergency contraception by requiring that women under 17 obtain a prescription from a physician, and requiring women 17 and older obtain it from pharmacies or health clinics with government-issued identification.

In striking down the restrictions, the judge ruled that when Department of Health and Human Services Secretary Kathleen Sebelius stepped in to implement these restrictions it was “politically motivated, scientifically unjustified, and contrary to agency precedent.”

Emergency contraception reduces the risk of pregnancy after contraceptive failure or unprotected sex up to 120 hours after, but is most effective in the first 24 hours.  It is important, therefore, that women obtain access to emergency contraception in a timely manner.  The current restrictions often led to confusion and human error, effectively denying many women access to emergency contraception, particularly young women and those without any government- issued identification.  By making emergency contraception available over the counter to all women regardless of age it will ensure that women have better access to emergency contraception.  Costs for some women may still pose a barrier, but the court’s decision is still a resounding victory for women and women’s health.

Posted by Jennie Wetter, Director of Public Policy

MDGs: One Thousand Days Left to Go

April 5th, 2013

Nearly 13 years ago the nations of the world came together in a bold new campaign to reduce extreme poverty and improve human well-being in the developing world.  The Millennium Development Goals (MDGs), which were launched at that time, set forth an ambitious development agenda.  Eight broad goals were set with 2015 as the target year for their completion.  The goals set forth a series of targets relating to poverty, hunger, maternal health, child health, drinking water, sanitation, housing and other development objectives.

No one should underestimate the scale of what has been achieved in the past 12 years under the banner of the MDGs.  The accomplishments, by any fair measure, are impressive, but much remains to be done.   The UN Secretary-General’s MDG Advocacy Group this week has called upon the nations of the world to redouble their efforts in the 1000 days between now and the 2015 deadline.  In a statement released by the Secretary-General’s office, the MDG advocacy group, said:

 “The Millennium Development Goals provide an urgent ‘to-do’ list to address many of humanity’s biggest and most important challenges. Since their creation, the global community has mobilized around these common goals to drive incredible progress that is improving lives around the world. More children are reaching their 5thbirthday, fewer people are living in crushing poverty, and as many girls attend primary school as boys.

While we’ve made great strides forward, our work is not done. Now is the time to build on the momentum we’ve started to reach families and communities that have been left behind. Today’s milestone is an opportunity for everyone who cares about creating a more just world to take action in support of the United Nations and the MDGs. What we do over the next 1,000 days matters to millions of people. As MDG Advocates, we are dedicated to doing everything we can to help drive further progress. Let’s seize the next 1,000 days to change lives and chart a course for a brighter future for our world.”

The Population Institute is proud to join with the UN’s MDGs Advocacy Group in calling for a renewed commitment to the MDGs.   In particular, much work still needs to be done on MDG 5, which seeks to reduce the maternal mortality rate by three-quarters for the period between 1990 and 2015.  While notable progress has been made in expanding antenatal care in developing countries, many women still lack access to family planning services and information.  Better access to contraceptive services could go a long ways toward lowering maternal mortality rates, particularly in countries where the prevalence of child marriage and adolescent pregnancy rates are still high.   That’s one of the reasons why the UN—in MDG 5(b)—ultimately set forth 2015 as a target year for achieving universal access to family planning and reproductive health services.

No one expects that MDG5(b) will be achieved by 2015, but that certainly does not diminish the urgency of trying to achieve universal access.   In addition to improving maternal health, expanded access to family planning is crucial to fighting severe poverty, improving food security, boosting educational attainment, and other MDG goals.

While renewing our efforts on behalf of the MDGs we also need to begin thinking about what comes next.   The UN is presently developing a set of Sustainable Development Goals (SDGs) that will either complement or replace the MDGs as the focus of international development efforts in 2015 and beyond.  Whatever happens in the next 1000 days, we can say with absolute certainty that more work will need to be done on achieving universal access to family planning and reproductive health services.

At the same time, world leaders—as part of the SDG process—will need to confront head-on the challenges posed by climate change and resource scarcity.  Now, more than ever, we need to take inventory of the Earth’s resources and their capacity for supporting continued progress on human development. We urgently require some form of resource sufficiency evaluation to determine whether we are living sustainably.  By some estimates, humanity is already using 150 percent of the planet’s supply of renewal resources.  Many scientists warn that by 2030 we will need two planets to sustain us in the long haul.  Unfortunately, we only have one planet, and it is beginning to show considerable wear and tear.

So let us wholeheartedly renew our support for the MDGs, but let us also get to work on the  development of meaningful SDGs.  Human development must not only be achieved, it must be sustained.

Posted by Robert J. Walker, president

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