As discussions get under way in the United States as to whether or not commodities should be exempt from the Global Gag Rule, here in Europe experts are not only interested in the funding for reproductive health commodities but also the manner in which they are provided and supported.
According to the Brussels-based Reproductive Health Supplies Coalition, the issue is not just about funds but also process and greater awareness amongst recipient countries. "Many ministries of health are run by medical professionals, who need to learn more about supply chains for reproductive health products," says the Coalition's Director John Skibiak. "They also need to learn about how to promote the need for those supplies in discussions with their colleagues [within Government]".
Lester Chinery, who runs the reproductive health social marketing group ICON, does argue that funding is an issue, "not least of all in the climate of USAID'S increasing lack of support for contraceptive provision". He concedes that the nature and strength of debate amongst European donors has greatly improved in the last two years, but suggests there is still room for improvement. "I don't think we can bash Bush too hard until European donors have fully committed to comprehensive reproductive health commodities provision," he says.
Interestingly, other experts argue that the emergency reproductive health supplies that are sometimes provided by agencies are not in tune with some European donors' interests in building capacity and stronger health systems in recipient countries. The argument is that recipient governments know that they can receive emergency reproductive health supplies, so they don't worry about supply until it becomes an emergency. This is dangerous for two reasons: it keeps reproductive health supplies security off political agendas at local levels, and it also contributes to stock outs whereby the end user is the worst and first affected.
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According to UNFPA "without essential commodities—from contraceptives to testing kits to equipment for emergency obstetric care—the right to reproductive health cannot be fully exercised". This seems a strong starting point. What worries me is that donors (in Europe and the United States) and recipient countries continue to think of this right only as an afterthought, rather than a comprehensive achievable aim.