FT Health: Family planning pledges more important than ever

Governments and donors meeting in London this week stepped up pledges to help more than 200m women around the world who seek but have no access to contraceptives. The global family planning summit saw participants pledge $2.5bn, but much of that was reaffirmation of existing commitments and the general mood was damped by proposed US cuts to global family planning programmes. Now it is more important than ever that donors ensure that their promises are met.

Enhanced family planning — by spacing out births and discouraging early marriage — has multiple and obvious benefits: it reduces threats to the life and health of both mothers and their children; keeps adolescent girls in education longer; boosts economic growth and eases pressures on the environment from population growth.

Yet progress has been slow towards a target set in 2012 to provide support to an additional 120m women and girls by 2020 in the world’s 69 lowest income countries. An additional 30m have been reached since, compared with the interim objective of 50m, according to Family Planning 2020. The latter’s data below show the proportion of women whose demand for contraception has been met, and the proportion who cannot gain access to it.

Funding is part of the problem. Proposed US cuts not only affect family planning programmes, but also have reintroduced the so-called Mexico gag rule blocking government support to organisations linked to abortion services. 

There are other difficulties. Better data collection and accountability have been lacking; political leadership from low income countries and regions has proved insufficient; supply chains and investment in new types of contraceptives have been neglected; and the voice of adolescents themselves is often left unheard.

As Robin Gorna, co-lead of She Decides, a movement created in response to President Donald Trump’s decision to reduce funds, says: “Whilst the commitments are strong, we can’t achieve the targets without putting the rights of women and girls at the absolute centre of the discussion.”

3 remarks

Based on edited extracts from a speech by Melinda Gates at the 2017 Family Planning Summit in London.

The focus on contraceptives

Growing up, I never would’ve imagined that I would travel around the world to speak on such a personal topic.  But everything changed when Bill and I started our foundation, and I began spending time with women in the world’s poorest places. The topic I hadn’t planned to talk about became the only thing I could think about. For most of my life, I’ve used contraceptives. It’s no accident that our three children were born almost exactly three years apart. Or that I waited to have kids until I’d finished graduate school and spent a decade working in technology. My family, my career, and my life are the direct result of having access to contraceptives.

Their impact

Access to contraceptives changes everything. Families tend to be smaller. Women are freer to work outside the home, earn an income, and contribute to the economy. Mothers and fathers can devote more resources to their kids’ health and education — setting them up for a more productive future.  Multiply that by millions of families, and you see why contraceptives are one of the greatest anti-poverty innovations the world has ever known — and one of the smartest investments countries can make.

Donald Trump’s restrictions

Let me be clear: a milestone is not a finish line. And we still have a lot of work ahead. Our advocacy is needed now more than ever. This is a difficult political climate for family planning. I’m deeply troubled by the Trump administration’s proposed budget cuts. If empowering women is more than just rhetoric for the president, he will prove it by funding family planning. Regardless of what happens in Washington DC, this community made a promise to 120m women.  And we will keep it.

Chartwatch

Big pharma wakes up to big data Vast quantities of patient information could speed up selection for clinical trials. And, in some cases, "real world" evidence could mean those trials are unnecessary. But pharmaceutical companies are still laggards in the world of big data.

News round up

Addicted to finding new smokers Tobacco companies have been taking on regulators in several African countries and Philip Morris has been campaigning against the global anti-smoking treaty (The Guardian, Reuters)

Cuba beats the US In a new Economist index on access to healthcare, the Netherlands comes top followed by other richer countries — but some middle income countries with strong political leadership and a focus on equity do well. (EIU)

Battle over drugs funding Pharmaceutical companies are taking the UK National Health Service to court over its plans to limit what it will pay for medicines. The proposals could prevent patients from securing the latest treatments for the most serious diseases. (Reuters)

Trump’s healthcare plan on life support Republicans have launched a new version of the US healthcare bill that they hope will undo Obamacare, but it has attracted broad criticism because of the proposal for continued taxes on the wealthy and the reduction in healthcare provision for the poor. (FT)

FDA acts on opioids The US Food and Drug Administration is instituting new safety standards for how immediate-release opioids are prescribed, in an effort to curb the nation's opioid addiction. Scott Gottlieb, the new FDA commissioner, has called it his top priority. (WSJ, FDA)

Vaccine doubts A European Court of Justice ruling over the level of evidence to claim compensation for illness allegedly linked to vaccines has worried scientists. (The Vaccine Confidence Project)

Recruitment problems loom The ability to attract the best talent is becoming a pressing worry in the US healthcare industry. (EIU)

UK braced for £85m in health cuts A think tank has concluded that budgets for a range of services, including sexual health and smoking cessation programmes, will see new cuts of £85m. (The Independent) 

Best of the journals

Drug pricing dynamics Far from making the most effective drugs cheaper for those who need them most, so-called indication-based pricing will result in higher costs for those patients and increased use among those who will benefit the least. (NEJM)

Drink more coffee? Researchers have found coffee consumption might help people live longer. (Annals of Internal Medicine)

Original sins A study of more than 1m people in Denmark has found a high correlation between serious injury or abuse in childhood and later conviction for violent crime or admission to hospital for self harm. (The Lancet)

An iron supplement a day Researchers have found a link between low iron levels in the body and the risk of heart attack. (ATVB)

New name, please Non-communicable diseases should be renamed socially transmitted conditions to underline the fact that their prevalance is driven by urbanisation, industrialisation and poverty. (The Lancet Global Health)

Measles on the rise The disease has claimed 35 lives in Europe over the past 12 months, prompting WHO officials to consult on strategies to improve vaccination coverage. (WHO Bulletin)

Meningitis vaccine has unexpected benefits A mass meningitis vaccination campaign in New Zealand had an unexpected benefit — it helped protect people against gonorrhea too. (The Lancet)

Podcast of the week

The new threat of sexually transmitted diseases Professor Kit Fairley, director of Melbourne Sexual Health Centre, outlines problems associated with sexually transmitted diseases, especially the re-emergence of syphilis and very large rises in gonorrhea. (Lancet Infectious Diseases)

Coming up

The International Aids Society conference begins on July 23 in Paris, with discussions on research towards HIV vaccines, curative treatment and improved prevention.

In case you missed it

FT Health last issue: Germany takes leadership on global health

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Final thought

Call for regulation of snortable chocolate A US senator has asked the FDA to look into the risks of inhalable food products such as Coco Loko (Rolling Stone)