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Center for Biological Diversity:
7 Billion and Counting
The Guardian, January 10, 2012

The US is out of sync on contraception
Across Africa, leaders are starting to recognise that birth control saves lives. But the US still treates it as a political football.

By Jessica Mack

On the poor outskirts of Dakar, Senegal, we sat before six imams in an airy mosque. They are holy men, respected community leaders, and, lately, birth control champions. "Family spacing," they called it, as they cheerfully explained why Islam supports it. "What's good for a woman is good for her family, and for her society. We want healthy societies."

Meanwhile, 4,000 miles away and two weeks earlier, Barack Obama met quietly with Roman Catholic leaders to discuss the feasibility of including religious and moral exemptions to birth control coverage in a new healthcare bill. Never mind that 98% of sexually active Catholic women in the US currently use modern contraception.

I was in Dakar for the International Conference on Family Planning, where thousands had convened to talk about birth control. At registration, we received conference bags as per usual, which included a pack of emergency contraception – the thin white box tossed in amid flyers, pens, and condoms as the basic supply, that it is. Across the Atlantic a week later, US secretary of health and human services Kathleen Sebelius announced that she was overruling – for the first time in history – the Food and Drug Administration's recommendation that emergency contraception be available to individuals under the age of 17 without a prescription. The contrasts are striking.

The US is increasingly out of sync with developed and developing countries worldwide on these issues. Others get it: access to birth control is a linchpin in efforts to save lives. But the US continues to treat the issue as a political football. When people can choose whether or when to become pregnant, everyone benefits. Women are healthier, and their babies and children more likely to be fed, educated and healthy. The workforce is more robust; the government spends less on healthcare – study after study says so. The breadth of birth control's benefits are matched only by the chronic magnitude of unmet need for it. Still today a staggering 215 million women around the world want, but lack, access.

Meanwhile, in October, the US house of representatives advanced a bill to cut $40m in funding from the United Nations Population Fund (UNFPA), the largest public sector provider of birth control in the world. The bill was just one part of larger efforts to undermine reproductive health, which included gutting family planning programs in the US and reinstating the "global gag rule" to punish developing countries for addressing unsafe abortion.

Although the final 2012 spending bill allocates more to global birth control than it initially threatened to, it's still $5m shy of last year's sum – and even that took heroic efforts to achieve. This year, the US must throw its weight behind ensuring birth control access, both at home and abroad. Other developed countries are wholeheartedly doing so. "You get it right for girls and women – you get it right for development," said under-secretary of state Stephen O'Brien of the UK's department for international development (DFID) recently. Last month, DFID pledged £35m in new funds to UNFPA and a day later tacked on an additional £5m for female condoms.

Women in sub-Saharan Africa and south-east Asia, where the vast majority of maternal deaths and unmet need for birth control lies, are struggling. Twin burdens of preventing or spacing pregnancies and dodging HIV risks are compounded by a chronic lack of health services and topped by taboos around sexuality. The US should be striving to do right by women worldwide by supporting their access to birth control. The Global Health Initiative, Obama's novel effort launched in 2009, gave a modest bump to US global family planning programme, but more is needed. The US secretary of state Hillary Clinton rightly espouses the centrality of women to US foreign policy, yet on the issue of global birth control access the US remains a laggard.

By not prioritising birth control access within US borders or worldwide, the US is sending a message that contraceptive access is not important. Nothing could be farther from the truth. Developing countries – including Muslim nations – know this. In Dakar, dozens of health and finance ministers from across the African continent gathered to extol the virtues of family planning and strategise better ways of delivering it to those in need. Ambition and innovation are palpable, from Nigeria to Ethiopia. More and more developing country leaders are committed to improving women's lives, and access to birth control is the first stop. Progress is imminent, especially in Africa.

Yet it would be much more so if the US were to fall into line. Other countries, wealthy, poor, and in-between, seem to have got the message: access to birth control is essential for health, rights and economic development. Millions around the world and in the US need access to a range of birth control options and the freedom to choose their reproductive futures. Addressing this should be on the top of the US's new year's resolutions.

This article originally appeared here.

Photo © Paul S. Hamilton