The Blog

Don't Mention the 'A' Word

I'm happy to admit I never expected to see Melinda Gates, David Cameron and Andrew Mitchell standing on a stage in London talking about the value of family planning - and even happier to admit I was wrong.

On Wednesday I will see something that frankly, I never expected to see.

Personally, I've been committed to providing contraception to women who want, but can't access, contraception since I mistakenly congratulated a pregnant friend in rural Togo. She told me it wasn't congratulations I should offer but commiserations: she was worried beyond belief at unexpectedly having another mouth to feed (her eighth), another child to bring up.

Professionally I've been deeply immersed in the sexual and reproductive health sector for more years than I care to remember, working with a huge number of talented and passionate people who are constantly pushing to get family planning onto the international agenda.

Despite this pushing, I'm happy to admit I never expected to see Melinda Gates, David Cameron and Andrew Mitchell standing on a stage in London talking about the value of family planning - and even happier to admit I was wrong.

Make no mistake: this is a golden moment in the long history of family planning, one that stretches back to the acacia gum used in Ancient Egypt right up to the present, where researchers are investigating sophisticated family planning methods we can only dream of today. Family planning a woman could use for life, turning it off and on in line with when she chooses to become pregnant, unhampered by cost, the need to travel great distances to health clinics, or the need to negotiate condom use with a male partner.

There's an understanding that family planning has been underfunded for decades. Development funding goes in cycles, and given the urgency of the fight against HIV, and advances with vaccines to protect against malaria, polio and HPV, funds have been diverted to these global health priorities in recent years. Family planning is also thought 'difficult', with its past, abhorrent associations with forced sterilisation and the pervasive influence of groups who oppose family planning on religious and cultural grounds.

Happily, it now seems to be the 'turn' of family planning, yet not everyone in our camp is happy. There are those who worry that a woman's right to access a safe, legal abortion isn't central to the planned summit discussions.

At Marie Stopes International, we're acutely aware of the need for women to have access to safe, legal abortion services - not least because in countries where this choice isn't available, we see unsafe abortion having a truly devastating impact. In 2010 over 300,000 women died during and following pregnancy and childbirth, an astonishing 13% due to unsafe abortion. I say astonishing because unsafe abortion is almost entirely preventable.

We're proud that last year we supported 1.9 million women in either their choice to have a safe abortion or their need for high quality post-abortion care. Like it or not, high quality abortion services will always be needed by women. We will always be there to serve women who choose to access it, where permitted, and fiercely defend their right to make this choice.

We also recognise the fact that safe abortion is a complex issue, and worthy of a week of summits in itself. But we have an opportunity here, today, to join together at the summit to address the fact that 222 million across the world want but cannot access contraception. And we can address that now. Doing that will not diminish the importance of a woman's right to choose, or our commitment to it.

Likewise women's rights organisations - a group I count ourselves among - are critical of the summit, and feel it's all about the numbers. The extra 120 million women with unmet need we want to give access to, the number of implants we can deliver, the number of unplanned pregnancies averted. Human rights groups are concerned - as we are - about supporting married and unmarried women in exercising their right to a life free from sexual violence, having their decisions made for them by husbands or their mother in law, from being forced into early marriage, and from being coerced in their sexual and reproductive health choices.

They are concerned that because these things are intangible, and because now more than ever there's a need for governments to demonstrate to citizens the value of the aid their taxes are paying for, that these crucial issues will be sidelined at the summit in the rush to deliver hard results.

Having worked closely with the Bill & Melinda Gates Foundation and DFID throughout the build up to this summit, I can say hand on heart that the event has women's rights at its very core.

At Marie Stopes International we invest heavily in data and measuring our impact, yet strongly believe that this focus on results is not incompatible with the need to further women's rights. We can have both results and rights, and we will do so - because a woman needs services to be available so she can exercise her fundamental rights.

Civil society has a crucial role to play here: for holding governments, donors and service providers such as Marie Stopes International accountable, for making sure we deliver on our vision for a world where women's rights flourish.

I lead a team of 8,500 driven, motivated individuals so I know that NGOs are passionate, and I recognise that we all want what matters most to us to be front and centre at all times. But are we really suggesting that this summit is not a good thing, because it doesn't cover every aspect of sexual and reproductive health? Would we condemn a summit focusing on a newly discovered HIV vaccine, because it doesn't give equal time to treatment for people living with HIV?

We shouldn't be scared to devote attention to one particular area of great need in global health, because difficult problems require focused attention. We can deliver on the promise of family planning, promote and protect women's rights and build health systems, as well as integrating with HIV and other maternal health services.

The vast unmet need for contraception is one problem that deserves focused attention: for the sake of those 222 million women, family planning needs this moment in the sun.