2012 was a year when sexual and reproductive health hit the headlines in a big way. The London Summit on Family Planning in July finally woke the world up to the fact that over 200 million women want, but do not use contraception.
But it was just one of many stories making waves. Sexual and reproductive health continues to cause passionate debate around the globe year after year. But we have a good feeling about the year just past because the tide seemed to turn from talk to action. Here are our top 10 picks from the last 12 months, and why they are good news for the women and men who want to have children by choice, not chance.
- In July the world's eyes turned to London as Melinda Gates declared that family planning will be her principle focus for at least the next decade. David Cameron, leaders from developing countries, donors, the private sector and civil society organisations joined her in saying that when it comes to women and men being able to access a contraceptive method of their choice, there is simply '#nocontroversy'. The summit wasn't without its issues: some felt that abortion should also be discussed, while others felt that rights weren't enough to the fore. Without question though, this summit generated unprecedented levels of funds and support for an issue often thought 'too difficult'. And the fact that the governments of Nigeria, Ethiopia, Senegal and the Philippines have already followed up with their own national level summits fills us with hope that the family planning revolution might one day be completed.
- In second place by dint of its massive impact on sexual and reproductive health around the world as well as in the US, Barack Obama's re-election in November had those in our sector quietly dancing in the aisles. His second term means that the Mexico City Policy or 'Global Gag Rule' will not be re-signed in January, so US funding for international organisations providing a wide range of sexual and reproductive health services will continue. It also means that for women in the US, contraception may be covered by their health insurance for the first time, albeit in an era where their right to safe, legal abortion is increasingly under threat from political opponents at state and federal level. A flush of new pro-choice candidates in the US Congress was an additional bonus which may pay dividends over the coming years.
- For sheer longevity and perseverance in the face of adversity, the Philippines' long awaited Reproductive Health (RH) Bill gets third place - almost unbelievably, it was first raised more than ten years ago. The struggle with conservative forces in the country - most notably certain representatives of the Catholic Church hierarchy - has been long and fierce but last week the bill finally passed through both Congress and the Senate, and is now awaiting President Aquino's signature, which is expected by the end of the year. While it feels like we should never count our chickens with this bill, if passed it would mean that the poorest women and men in Philippines will finally be able to access contraception free of charge, paid for by the government.
- Abortion causes emotional debate the world over, but nowhere more so than in Ireland and Northern Ireland: landmark developments in both these countries have brought a fourth place slot. In October the world's media descended on our new sexual and reproductive health centre in Belfast. Although it won't halt the flow of women having to travel to England if they have chosen to have an abortion, it does mean that the women most in need will be able to access medical abortion under nine weeks if they meet certain legal criteria. While the debate continues to rage, the thousands of letters of heartfelt support we received from men and women in Belfast and beyond told us everything we needed to know. South of the border just this week, the Irish government clearly stated that they will create new legislation on abortion, to make it crystal clear to women in the Republic that they are legally entitled to an abortion should their pregnancy pose a threat to their life. The sad death of Savita Halappanavar in November drove home the great need for this change, not least because it will give health professionals much needed legal backing should they decide a termination is warranted.
- Fifth place goes to Afghanistan's first ever policy on post abortion care - a rare good news story from a war torn country where articles about women are usually highlighting their lack of rights. More than 20 million women - the vast majority of them in poor countries - resort to unsafe abortion each year. An estimated 47,000 women die in the process, and 5 million need urgent medical attention. Our teams frequently encounter women suffering the effects of incomplete abortions and miscarriages, and the Afghanistan government's explicit support for post abortion care via the use of the misoprostol drug will help us to prevent these women becoming another statistic.
- Still on drugs but this time mifepristone not misoprostol, sixth spot goes to a landmark development in Australia. More commonly known there as RU486 or 'the abortion drug', we were able to register mifepristone for wider use by health professionals in the country for the first time this year, meaning that if women choose to have an abortion, more of them will now have the option of taking pills to end the pregnancy rather than having to undergo surgery.
- In a bid to help give 27 million more women and girls access to contraception, Bayer HealthCare announced they would cut the price of the Jadelle contraceptive implant by more than 50%. Access to high quality, affordable contraceptives remains a serious, if not impossible, hurdle for women in the developing world, and we have been working with manufacturers, governments, donors and partner organisations to make sure this commitment truly opens access to contraceptives.
- As the UK's leading provider of sexual and reproductive health services, we naturally keep abreast of developments here, hence the eighth spot. 2012 was a year like no other for abortion in the UK, when it seemed like the subject was never off the front pages. First off the starting blocks was a feisty debate on sex selective abortions, where we were pleased to make clear our opposition to this practice. Next up was the welcome dismissal of Nadine Dorries' attempt to restrict the provision of pregnancy counselling by independent providers, a move which would have also opened up this crucial service to anti-choice groups. Finally, the debate on the legal limit for abortion time limits resurfaced. Although all were clear that the Government had no plans to legislate on the issue, remarks by David Cameron, Health Minister Jeremy Hunt and Women's Minister Maria Miller added fuel to the groups calling for access to abortion after 20 weeks to be ended, despite scientific opinion continuing to recommend the current 24 week limit. If we could make one wish for 2013, it would be that providing the best quality service to women becomes the focus.
- At number nine are the World Health Organization's new guidelines on tasksharing, which were developed with the help of some of our technical experts. Tasksharing is a word we and organisations like us use a lot, but it's less well known outside these circles. Put simply, tasksharing is when health professionals like nurses and midwives are allowed to perform procedures - like family planning - which previously only doctors could do. In the developing world, where there can be as little as one doctor caring for 30,000 people, it is simply not possible for them to provide contraception to everyone who wants it, as well as meeting their general health needs. Our nurses in the developing world say tasksharing is crucial, and now the World Health Organization has told every country in the world that they should embrace it for key reproductive health procedures too.
- And finally ... not strictly the tenth most important development in 2012 but a festive story to warm the heart. Our team in Papua New Guinea were expecting a typical day providing family planning when they arrived in remote Morobe Province last week. As they were welcomed to the community a woman was brought to them in her third day of labour with severe complications which meant that both her life, and that of her baby, were in danger. The nearest hospital was eight hours away along treacherous roads so our team leader offered to assist and within hours a beautiful baby was safely delivered. The family were so grateful to our team for saving the lives of both the mother and child that they kindly named the baby Marie Stopes ... fortunately it was a girl.