If I had a billion dollars,
I know exactly how I would spend it: improving women’s access to family
planning in the world’s poorest communities.
Some might think this is an
unusual choice. But throughout my 29-year career as a doctor and public
health professional working in developing countries, I have seen first-hand
how contraception can change women’s lives-allowing them and their
families to survive, thrive, and plan for better futures.
We need to remember – amidst
daily reports about a troubled economy here in the United States – that
many of those living on the other side of the world confront daily emergencies
of their own: poverty, malnutrition, HIV and AIDS, lack of health care,
civil strife, and depleted environmental resources.
There’s no doubt that $1
billion is a lot of money. But for what amounts to just .03% of President
Obama’s proposed federal budget, a $1 billion investment in family
planning can help mitigate all of these challenges at once.
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Family planning as a global
health and development priority does not get the attention it deserves,
particularly the direct connection between population and poverty. The
chances that you can achieve a better life for your family are diminished
when you are struggling just to feed and support your children. But
with smaller families, parents can afford more for each child-providing
better food, shelter, education, and health care-and can save more.
This greatly improves their chances of breaking the cycle of poverty.
With better access to family
planning come opportunities to improve social, political, and environmental
conditions. When women and couples can decide when to have children,
their opportunities outside the home can also expand, and they may contribute
more to their communities socially and economically. There is less competition
for food, jobs, and housing and more equitable and less harmful use
of natural resources. For families in rural areas, this could reduce
the need to seek a better life in urban areas, where the daily influx
of new migrants strains already limited infrastructure.
Yet right now, millions of
women and couples who wish to limit or space their births have no way
to access the contraception that would let them do so. Over the last
several years, U.S. support for family planning programs has dwindled
while the need for it has increased, and few donors have stepped in
to fill this gap. So a good portion of a $1 billion investment is needed
just to rebuild these programs to the levels they were at several years
ago. And across Africa and Asia, high levels of unmet need for contraception
are likely to only grow as the largest youth generation in the world’s
history comes of reproductive age.
These are all compelling reasons
to support family planning, but the bottom line for me is that it is
a right, and not having access to it is a price paid in women’s lives.
Maternal mortality continues to devastate families – with more than
500,000 women dying during pregnancy or childbirth every year. Up to
one-third of these deaths could be prevented if women had access to
contraception. And, family planning reduces deaths from AIDS; it is
the most effective way of preventing mother-to-child transmission of
In the coming weeks, President
Obama will be making allocations for the fiscal year 2010 federal budget.
Please join me in calling on him to raise the United States commitment
to international family planning programs to $1 billion in 2010-less
than a penny per day per American.
It’s sure to be one of our