International Policies & Funding

Committments to Achieve Universal Access

The International Conference on Population and Development (ICPD) in Cairo in 1994 called for the provision of universal access to a range of population-related programs, including family planning and reproductive health services, by 2015.  The ICPD produced estimates of the annual resource requirements to achieve the ICPD goals, which were anticipated to exceed US$30 billion each year by 2011 (when adjusted for inflation).  The donor share of these costs was assumed to be one-third, with developing country governments and patient out-of-pocket expenditures making up the remaining two-thirds.  Donor funding has consistently fallen below the original ICPD estimates.

In response to growing demand for family planning and reproductive health services and escalating costs, the United Nations Population Fund (UNFPA) produced updated estimates of the resource requirements to achieve the ICPD goals and Millennium Development Goal (MDG) 5, Target B: Achieve universal access to reproductive health by 2015.  These revised estimates are roughly double the initial estimates, suggesting that donors need to massively scale-up their funding for family planning and reproductive health to meet current needs. 

The Importance of Family Planning and Reproductive Health

Achieving the ICPD goals is essential to ensuring the health and well-being of women and their families.  Poor reproductive health is the leading cause of death and disability among women in their childbearing years.¹ An estimated 201 million women in developing countries want to delay or stop childbearing, but lack effective contraceptives.  Satisfying their unmet need for family planning would avert 52 million unintended pregnancies each year, saving more than 1.5 million lives and preventing 505,000 children from losing their mothers.²

Access to quality voluntary family planning services has positive spillover effects outside of health.  For example, early childbearing reduces women’s ability to obtain an education; therefore preventing unplanned pregnancies enables educational attainment.³ Family planning and reducing unplanned pregnancies is also fundamental to achieving the MDGs, primarily because population growth increases the number of people whose needs must be met, pushing up the cost of achieving the goals.⁴

PAI's Role

Since before Cairo, PAI has been a leader tracking funding for family planning and reproductive health and holding donors and developing countries accountable to their funding commitments. Most recently in 2007 we updated Progress & Promises - Trends in International Assistance for Reproductive Health and Population with new data, and a new ranking of donor countries based on their policies and funding in support of the ICPD goals.

As donor funding mechanisms have gotten more complicated and donor funds more difficult to track, PAI has worked to better understand the changing funding landscape for family planning and sexual and reproductive health. For example, many donors are moving away from using in-kind reproductive health commodities towards providing budget support—or aid that is deposited into a government account that the government can use to purchase their own supplies. But some government procurement and logistics systems need strengthening. Weak systems hinder governments’ ability to purchase and distribute contraceptives to meet demand, which can lead to supply stock-outs. It is important for countries to bolster their ability to manage aid inflows for family planning and reproductive health, and donors need to be ready to provide emergency in-kind contributions when needed.