The Lancet

  • Blog post

    I was startled to see in a recent Lancet paper by Babatunde Osotimehin that fully meeting the family planning needs of people in developing countries—of current users and women with unmet need—would cost about US$8.1 billion annually. Currently, writes Osotimehin,“donors, developing countries, and households are investing some US$4 billion, which leaves a shortfall of about US$4.1 billion” each year.

    PAI: Family Planning: The Smartest Investment We Can Make


    Image redrawn from Population Action International, Family Planning: The Smartest Investment We Can Make

    Osotimehin, who is the United Nations Under-Secretary-General and Executive Director of UNFPA, urges governments of developing countries to commit significantly more of their own regular budgets and other resources to provide contraceptive information and services. In addition, “Donor countries need to step up their contributions to family planning to fulfill their commitments made at the 1994 Cairo International Conference on Population and Development (ICPD).”

    One piece of good news for the funding picture came out of the recent London Summit on Family Planning when international donors and foundations pledged an additional US$2.625 billion dollars to reach 120 million more women with an unmet need for family planning by 2020. Developing country partners, including those in India, Indonesia, Malawi, and Nigeria, pledged an additional US$2 billion. These pledges, according to the London Summit Press Release, mean that by 2020, some 200,000 fewer women will have died in pregnancy and childbirth, there will be 110 million fewer unintended pregnancies, over 50 million fewer abortions, and nearly three million more babies will survive their first year of life.

  • Blog post

    Last Thursday in Chicago, my friend Danielle gave birth to a healthy baby boy named Sam via an emergency C-section six weeks before her due date, safely concluding a high-risk pregnancy that had involved several hospital stays. Roughly 800 other expectant mothers around the world died in childbirth that day, many without the presence of a skilled birth attendant. The majority of these maternal deaths occurred in developing countries, and most could have been prevented with access to basic health services including prenatal care, skilled childbirth attendance, and family planning.  

    Two days before Sam was born, many of the roughly 70,000 women giving birth in India that sweltering Tuesday were plunged into darkness as countless homes, health centers, and hospitals in India lost power completely or were forced to operate on backup generators when the country suffered the worst blackout in its history. More than half of India’s population—600 million people—were affected. The Washington Post noted that this blackout was the largest in global history, leaving nearly 1 in 10 people in the world without power. In India and other countries around the world, as population growth outpaces the development of infrastructure, situations like this will become increasingly commonplace.

    Woman and child search for drinking water in India

    A young woman and child search for drinking water across Machal Lake in India.

    © 2009 Kailash Mittal, Courtesy of Photoshare

    Meanwhile in the U.S., where population growth is leveling off, officials have declared more than half of all U.S. counties disaster areas this summer due to the extreme drought, which has ravaged the country’s agriculture and will likely send food prices soaring. The hardships inflicted by this drought seem minor compared to last year’s drought in East Africa, which caused a severe food crisis in Somalia, Djibouti, Ethiopia, and Kenya; threatened the livelihoods of almost 10 million people; heightened the already crushing refugee crisis in Kenya; and led to the deaths of tens of thousands of people, many of them infants and children suffering from extreme malnutrition. Rajiv Shah, administrator of USAID, attributed the severity of the crisis to global warming. A newly published statistical analysis by NASA scientist James Hansen also attributes the 2012 U.S. drought and several other recent droughts around the world to global warming, a result of ever-increasing greenhouse gas emissions.

  • Blog post

    On the eve of the London Summit for Family Planning, The Lancet published a series of articles and commentaries that explores the links between contraception, population growth, and the health and wellbeing of the planet and its current and future inhabitants. The series reviews an array of evidence on the toll that lack of access to family planning takes not only on maternal and child health but also on the social, economic, and environmental health of communities, nations, and the world.

    Abuja Nigeria Woman and Child Learn About Contraceptive Options

    A mother in Abuja, Nigeria reads a family planning and child spacing brochure to learn about contraceptive options available in the area.

    © 2012 Kim Blessing/CCP, Courtesy of Photoshare

    Those who work in family planning are well aware that national political will and international support for contraceptive programs has waned in recent decades. This neglect has perpetuated a continued lack of access, particularly in low-resource settings where the consequences are most dire. The Lancet’s series examines the potential of family planning to advance global health from so many angles that even readers whose careers are devoted to the cause will gain fresh perspective and new insights.

    The rebirth of family planning: Herbert Peterson of the UNC Gillings School of Global Public Health, who led the planning, commissioning, and preparation of the series, and Richard Horton of The Lancet identify two central challenges to addressing unmet need: stronger advocacy to policymakers to devote more attention to family planning and translating the scientific evidence presented in this series into innovative programs that are implemented well to achieve universal access to reproductive health.

    Making family planning a national development priority: Pierre Damien Habumuremyi, Prime Minster of Rwanda, and Meles Zenawi, Prime Minister of Ethiopia, credit five factors with increased contraceptive use in the successful case studies of Rwanda and Ethiopia over the past decade: