Sunday, July 15, 2012


Contraception and development Opening the Gates Jul 12th 2012, 13:53 by J.P. | LONDON WHEN several heads of state, a dozen health ministers and hundreds of delegates piled into a conference centre in the middle of London on July 11th, there was a sound of broken barriers everywhere. The family-planning summit was the first big international meeting on birth control since a United Nations conference in Cairo in 1994, a sign that international attitudes seem to be chnaging towards a long-neglected subject. It was an indication that the British government, the joint sponsor of the meeting, is ploughing something of a lonely furrow in development at the moment. As Duncan Green, the head of research at Oxfam, has pointed out, this is a period of British exceptionalism. “The UK is pretty much alone among traditional donors,” he writes, “in sticking to its promises to increase aid despite deep public spending cuts, and is simultaneously pushing ahead in the multilateral arena.” In addition to the family-planning meeting, Britain will convene a “hunger summit” during the Olympic Games, and the prime minister, David Cameron, is one of three co-chairs of a UN panel to look at what comes after the millennium development goals. But in some ways the loudest sound of broken barriers comes from the summit’s other sponsor, the Bill and Melinda Gates Foundation. When the foundation began in 1994, Mr Gates’s idea was that it would focus on areas neglected by others-vaccines not being financed by governments; complex crop research that was too long-term for governments or companies to contemplate. Where governments or the private sector were taking a lead, the idea was, the foundation would stay away. But over time, that self-denying ordinance has proved hard to maintain. At first, the foundation concentrated mainly on diseases and health. But nutrition is one of the main determinants of health; agriculture is vital to nutrition-and the Gates foundation has ended up as one of the most important financiers of agricultural research today (especially into the crops of the poor, such as cassava and millet). Something similar seems to be happening with birth control. Family planning was part of the foundation’s health programmes from the start. But its programmes were small and now are being scaled up quickly. Perhaps more important, the summit shows that the modest “after-you-Claude” approach is hard to reconcile with an operation that paid out $2.4 billion in grants in 2010, making the Gates foundation the size of a medium-sized country donor, comparable to Australia or Belgium. The family-planning summit was an example of the Gates foundation not merely filling in gaps left by others but acting to change the behaviour of countries. Donors have avoided or downplayed family planning for years, partly because of its former association with coercion, partly because of religious objections, especially to abortion, and partly because some developing-country governments have viewed it as white people coming to poor nations and telling them to have fewer children. But as evidence collected in the new edition of the Lancet, a medical journal, convincingly shows, family planning also has substantial, long-term health and economic benefits. The attitude of some developing countries has already started to change; Rwanda, Malawi, Tanzania and Nigeria have all launched or expanded family-planning programmes in the past few years. But it has taken the Gates foundation to team up with Britain to push western donors into a big expansion of official support: at the London summit, they promised $2.6 billion worth of aid, aiming to cut by more than half the number of women in developing countries without access to modern contraceptive methods.

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