© 2008, johns hopkins university. all rights reserved. making the case for family planning duff...
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© 2008, Johns Hopkins University. All rights reserved.
Making the Case for Family Planning
Duff GillespieProfessor and Senior Scholar
Johns Hopkins Bloomberg School of Public HealthThe Bill and Melinda Gates Institute for Population and Reproductive Health
Unfinished Agenda for Family PlanningThe World Bank, HNP – Brown Bag Lunch Series
Washington, D.C.May 6, 2009, 11:00am– 1:00pm
Country to Global Pathways Project
Importance of the United States
Making the Case for International Family Planning
Presentation – Three Parts
IPPF and Gates Institute Collaboration
In Nigeria, Tanzania, Brazil, Mexico and Indonesia
Follow-on Projects are Planned
Country Global Pathways Project
“ We hear from European Governments. We hear from NGOs from the North. We don’t hear from the South, from the countries most affected by our decisions.”
European Diplomat to the UN
Why Country to Global?
NATIONALGOVERNMENT
RHChampions
International NGOs
LocalNGOs
PRSPsBudget SWAPS LoanRequests
G7
IFIs
UNDonorGovernments
GlobalFund
EU
CURRENT RegionalOrganizations
Country to Global Pathways
NATIONALGOVERNMENT
RHChampions
International NGOs
LocalNGOs
PRSPsBudget SWAPS LoanRequests
G7
IFIs
UNDonorGovernments
GlobalFund
EU
DESIRED RegionalOrganizations
Country to Global Pathways
Decentralization makes advocacy more difficult
A focused advocacy effort can be effective
RH organizations will initially resist participation
MDGs are organizing template, MDG-5b is still missing
Donors’ policies still influence country programs
Donors perceived as not serious about FP, not to mention SRHR
Donorship to ownership not seen as inherently good
Some Lessons from Country Global Pathways
0
50
100
150
200
250
300
350
sub-Saharan Africa Asia/Pacif ic LatinAmerica/Caribbean
REGION
TO
TA
L IN
US
D (
MIL
LIO
NS
)
Internal External
External and Internal Population Funds* by Region, 2002
Source: UNFPA/NIDI, Resource Flows, Index. Data for 2003 is estimated. http://www.resourceflows.org/index.php/articles/c31/
Number of Countries (17) (11) (9)
*includes family planning, reproductive health and HIV/AIDS
No matter what administration,
the United States has remained thedominate donor in reproductive health,
especially family planning, since the 1970s. This dominance has sometimesbeen a positive force, sometimes anegative force.
U.S. is the Dominant Donor
“I believe that American leadership has been wanting, but is still wanted.”
Statement of Sen. Hillary Rodham Clinton
Nominee for Secretary of StateSenate Foreign Relations Committee
Testimony on January 13, 2009
Primary Funds of Donor Countries for Population and AIDS activities, 2004*
*estimated
Source: UNFPA/NIDI, Resource Flows, Real Time Estimates for Donor Assistance for Population and AIDS Activities, 2004
USAID’s HIV/AIDS Program Profile 2001
The Great Divide – 2002 Edition
“All people should be able to have a satisfying and safe sex life. This includes women, lesbians, gay men, bisexuals and transgender persons.”
Mona Sahlin, Minister for Democracy, Sweden
“The United States is unable…to endorse the…statement [because it] includes the concept of ‘sexual rights…”
Kelly Ryan, Deputy Assistant, Secretary of State
The Great Divide – 2009 Edition
“Sanger’s prolific writings dripped with contempt for those she considers to be unfit to live. Sanger was an unapologetic eugenicist and racist…as I think you know, in 2000 alone, Planned Parenthood killed over 305,000 children by abortion in the U.S. alone, and millions more worldwide.”
Rep. Chris Smith (R, NJ)
“We, obviously, have a profound disagreement. When I think about the suffering that I have seen of women around the world, I’ve been in hospitals in Brazil where half the women were enthusiastically and joyfully greeting new babies and the other half were fighting for their lives against botched abortions…we have a very fundamental disagreement and it is my strongly held view that you are entitled to advocate and everyone agrees with you should be free to do so anywhere in the world, and so are we…the Administration happens to think that family planning is an important part of women’s health and reproductive health includes access to abortion, that I believe should be safe, legal and rare.”
Secretary of State, Hillary Clinton
Source: Transcript of Senate Hearing at HFAC, April 2009
Senate 50-50
House
Bush ClintonReagan GW Bush Obama
Making the Case is
An evidence-based advocacy initiative
Focused on increasing the funding level of USAID’s family planning program
Complements larger advocacy efforts
Funded by the David and Lucile Packard Foundation and the Bill and Melinda Gates Institute at Johns Hopkins University
Making the Case Strategy and Tactics
Are the product of consultations with advocacy community, congressional staffers, lobbyists, public relation experts, and international survey of reproductive health communities
Have a narrow focus reflecting comparative advantage of former directors
Will appeal to broadest spectrum of policy makers who control funding
Exclude non-funding related messages, e.g., elimination of Global Gag Rule, women empowerment, etc.
The “Billion Dollar Ask” Letter
Excerpt of a July 15th, 2008 letter signed by 13 U.S. Senators and addressed to Chairman Patrick Leahy and Ranking Member Judd Gregg of the Subcommittee on State, Foreign Operations, and Related Programs, Committee on Appropriations
“This continuing population growth is a major contributor to resource scarcity and hinders efforts to combat climate change. Unsustainable population growth plays a role in the destruction of forests and the spread of deserts, the pollution and overfishing of oceans and waterways, and increases in emissions that contribute to global climate change.”
Message Flow
Making the Case
AUDIENCECongress
White House
DonorsInternational Community
Executive Branch
Advocacy Community
Media
Opinion Leaders
How can MTC best be used to increase support for family planning?
•MTC Report
•Activities of the Former Directors
•Complement and supplement other advocacy groups
•Overseas activities
Slide Source: Making the Case for International Family Planning, January 2009. http://www.jhsph.edu/gatesinstitute
Slide Source: Making the Case for International Family Planning, January 2009. http://www.jhsph.edu/gatesinstitute
Slide Source: Making the Case for International Family Planning, January 2009. http://www.jhsph.edu/gatesinstitute
Slide Source: Making the Case for International Family Planning, January 2009. http://www.jhsph.edu/gatesinstitute
Slide Source: Making the Case for International Family Planning, January 2009. http://www.jhsph.edu/gatesinstitute
Economic Crisis – Getting Air Time
Second Tier Political Appointees Not in Place
Access Outside SRHR Community
Former Directors’ Limited Availability
Maternal Health “Push Back”
USAID Effective & Rapid Use of Funds
Issues Confronted in MTC Process
Approval of Barack Obama’s Actions as President
Naming special envoys for Middle East, Afghanistan, Pakistan
Tightening ethics rules for administration officials
Limiting interrogationtechniques on prisoners
Instituting higher fuelefficiency standards
Making it easier for workersto sue for pay discrimination
Ordering Guantanamo Bayprison be closed
Allow funding for overseas family planning groups that provide
abortions
76%
76%
74%
66%
44%
35%
74%
Source: Jan 30 – Feb 1 USA today/Gallup poll
-Expand Existing Programs
-Expand Contraceptive Security
-Accelerate Contraceptive Development
-Diffuse Successful Country Programs
-Use NGO Network
-Refund IPPF & MSI
-Start Donorship to Ownership Process
USAID Effective & Rapid Use of Funds
U.S. leadership is more than the U.S. government, but the economic crisis makes USAID programs even more important.
“Contrary to the Malthusian view that population will grow to the limit of how ever
many kids can be fed, in fact parents choose to have enough kids to give them a high chance that several will survive to support them as they grow old. As the number of kids who survive to adulthood goes up, parents can achieve this goal without having as many
children.”
Bill Gates, Annual Letter, 2009, page 6
Thank You