International Policies & Funding

Commitments to Achieve Universal Access

The Programme of Action of the International Conference on Population and Development held (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 international community reaffirmed the goals set in Cairo with the addition of Millennium Development Goal (MDG) 5, Target B: Achieve universal access to reproductive health by 2015 as part of improving maternal health. 

The ICPD Programme of Action estimated that the annual resources required to achieve the ICPD goals would exceed US$30 billion each year by 2010 (when adjusted for inflation).  The donor share of these costs was assumed to be one-third on average, with domestic resources making up the remaining two-thirds.  Global funding for the ICPD has consistently fallen below these original targets.  In response to growing demand for family planning and reproductive health services and escalating costs, the United Nations Population Fund (UNFPA) revised the cost estimates for the implementation of the ICPD Programme of Action.  These updated estimates are roughly double the original estimates, suggesting that donors and governments need to massively scale-up their funding for family planning and reproductive health to fulfill 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.  UNFPA estimates that poor reproductive health is the leading cause of death and disability among women in their childbearing years.  An estimated 215 million women in developing countries want to delay or stop childbearing, but are not using effective contraceptives.  UNFPA and the Guttmacher Institute find that satisfying their unmet need for modern family planning would avert 53 million unintended pregnancies and 790 thousand newborn and maternal deaths each year, and prevent 600 thousand children from losing their mothers. 

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.  Family planning and reducing unplanned pregnancies is also fundamental to achieving all the MDGs, primarily because population growth increases the number of people whose needs must be met, pushing up the cost of achieving the goals.

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 2010 we produced Funding Common Ground: Cost Estimates For International Reproductive Health to help advocates and policy makers better understand the funding needed to achieve the ICPD and MDG goal of universal access to reproductive health, to more effectively carry out policy advocacy and plan to fulfill unmet needs.

As donor funding mechanisms have gotten more complicated and donor funding and government expenditures more difficult to track, PAI has worked to better understand aid effectiveness and the changing funding landscape for sexual and reproductive health.  For example, many donors are moving away from funding specific reproductive health projects towards providing health sector support—or aid that is deposited into a government health account to be allocated according to nationally defined priorities.  But if governments fail to effectively prioritize reproductive health, funding dries up and women and their families are left without access to vital services and supplies.  Also, some governments lack strong supply procurement and logistics systems, which hinders their ability to purchase and distribute contraceptives to meet demand and can lead to supply stock-outs.  It is important for countries to prioritize reproductive health in their own budget and policy-making processes, and bolster their ability to manage aid inflows for family planning and reproductive health.  Donors need to be ready to provide emergency in-kind contributions when needed.