Few outsiders are likely aware of the stagnation of Pakistan's family planning program, which provides key services and affects the country's larger demographic trajectory....Pakistan was among the vanguard countries in Asia in starting a family planning program more than five decades ago, with intermittent support from international donors including the United States. Yet fertility has declined more slowly in Pakistan than in most other Asian countries.

A Measure of Survival: Calculating Women's Sexual and Reproductive Risk classifies 130 developing and developed countries (comprising 96 percent of the world population) into five categories from highest to lowest sexual and reproductive risk for women based on indicators of access to reproductive health service and outcomes.

Pregnancy and childbirth are deadly to more than half a million women worldwide every year – a fact that is unacceptable, but not unavoidable. Despite twenty years of campaigning to improve their sexual and reproductive health, the risk of dying in pregnancy or childbirth continues to show the largest gap between the rich and poor of all development statistics. That so little progress has been made in helping the world's poorest women survive pregnancy and childbirth should serve as a wake-up call to all of us.

Shortages of critical reproductive health supplies (RH supplies) around the world are undermining progress towards achieving the Programme of Action established at the International Conference on Population and Development in Cairo and the poverty reduction targets included in the Millennium Development Goals. Without supplies, no health or poverty reduction program can be successful.

Each year, over 600,000 children around the world are infected with HIV through mother-to-child-transmission, totaling 2.3 million children living with HIV or AIDS today. The majority of these infections is occurring in sub-Saharan Africa and are acquired from mothers during pregnancy, labor, delivery or breastfeeding. While programs to prevent the transmission of HIV from mother-to-child (PMTCT) are invaluable, they currently are reaching only an estimated five percent of the HIV-positive population.

Weak infrastructure and limited distribution systems in low-income countries complicate access to health services, especially in rural areas. Government health outlets may be relatively few and widely dispersed, and private-sector sources often favor wealthier urban areas, resulting in uneven service availability within a country. In the absence of a solid heath infrastructure, strengthening primary health care and innovative community-based health service delivery systems help provide more equitable access to health services.

HIV prevention has long been approached at the level of individual behaviors, operating to some extent under the assumption that behavior is determined by a person's conscious decisions. However, a paradigm shift toward considering the physical and social environments in which individual HIV risk behavior takes place is gradually gaining momentum. These structural factors-whether political, economic or cultural-may directly or indirectly affect an individual's ability to avoid exposure to HIV.1 The Dominican Republic offers an example of this progression from successful individual HIV behavioral interventions among sex workers, toward broader community approaches and policy initiatives.

Whatever one's view about population as an issue, few people fervently wish the world were home to a lot more human beings than it is. Some may wonder if another Mahatma Gandhi or an Albert Einstein or a Mother Theresa missed out on being born due to the declining global birthrates of the past few decades. But most know that such a question is fundamentally unanswerable and don't stay awake at night thinking about it.

On January 22, 2001 - his second day in office - President George W. Bush announced the reinstatement of the restrictions on overseas health care organizations in effect during the mid-1980s and early 1990s, commonly known as the "Mexico City Policy." The policy reversal has had serious ramifications for U.S. support for international family planning and reproductive health programs around the world.

A generation has passed since the onset of the HIV/AIDS pandemic. During this time, 65 million people have been infected with HIV and more than 25 million people died of AIDS. Despite the devastation, many countries, using a variety of interventions, have been successful in slowing the spread of the virus. The interventions that have been most successful are those that are congruent with the local epidemiology. With the overall HIV/AIDS epidemic being composed of a series of smaller local epidemics interconnected by space or time, a range and mix of responses in the fight against HIV/AIDS is necessary. And the relative impact of each response will always depend upon the level, stage and pattern of the epidemic in each locale. Therefore to be effective, interventions should respond to local needs.