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The Exchange

Game Changer

The Gates Foundation’s Chris Elias and family planning expert Jose “Oying” Rimon check in on FP2020’s mission of increasing contraceptive access for 120 million women

Illustration by Yann Legendre

More Information: Family Planning 2020

For the field of family planning, the 2012 London Summit was a game changer. Governments, donors, multilateral agencies and NGOs committed to delivering contraceptives to an additional 120 million women by 2020. Two years on, how is FP2020 doing? What are the field’s future priorities? For answers, Johns Hopkins Public Health brought together Chris Elias, MD, MPH, president of Global Development at the Bill & Melinda Gates Foundation, and Jose “Oying” Rimon, MA, PGDip, director of the Bloomberg School’s Bill and Melinda Gates Institute for Population and Reproductive Health. The pair share career-long commitments to family planning, reducing maternal and child mortality, and other critical issues.

JR: Why is the FP2020 goal of reaching and providing contraceptives to 120 million more women by 2020 so important to global health? 

CE: The importance of family planning has been appreciated for 40-plus years but has been kind of crowded out by other issues in recent years. The London Summit helped to put it back front and center as a critical intervention for meeting women’s needs, and thereby supporting the broader empowerment of women and girls, but also preventing preventable maternal and child mortality. 

JR: In 2013, an additional 8.4 million women were using a modern method of contraception. That’s a great advance. What prevented FP2020 from reaching its anticipated level of 9.4 million?

CE: Well, there’s a complicated answer to that, and you know, a lot of your alumni are data geeks, so they might like that complicated answer. [Laughter] New data [from censuses and the Demographic and Health Survey (DHS), etc.] came in after we set our goals. Once we did the adjustments with more recent data … to understand the baseline, we could then estimate the increase in access that is attributable to the post-London Summit efforts. I’m not surprised that there’s a little bit of lag in the initial startup. I do think it should motivate us to do even better in the next year. 

JR: If you could pick one surprising bit of good news in the last two years, what would that be?

CE: I think that there’s a growing sense that reaching youth is actually quite important. That’s a bit surprising because sometimes traditional family planning programs and governments have been very focused, as you know, on married women of reproductive age, and have shied away a bit from younger women who are sexually active, whether they’re married or not, in many places. 

"More than 220 million women in developing countries want to plan their families but are not using a method of modern contraception."

JR: Melinda [Gates] has really emphasized the importance of accurate, timely data measurement. As she puts it, if we were running a business, we could not wait five years to track progress because by then we could be bankrupt. 

CE: What Melinda has said about family planning is also true of many other things in global health and development. We need to measure our progress in order to know what’s working, what isn’t, where we need to course correct, where we need to put more efforts, etc. We’ve made two signature investments to collect and analyze family planning data more frequently at the country level. One is the PMA2020 work at Johns Hopkins … focused in 12 geographies, and some of the largest contributors to the FP2020 goal. It provides DHS-comparable family planning data with estimates generated every six months, on an expanded set of indicators, including supply, demand, quality and equity. This data helps managers to actually manage programs. PMA2020, and its sort of sister investments through the Futures Institute in Track20, are helping to aggregate, analyze and use this data to build stronger policies and programs across all 69 FP2020 focus countries.  

JR: In some places, efforts to increase contraceptive access is seen as a Western plot to control populations of certain countries. 

CE: The fact is, more than 220 million women in developing countries want to plan their families but are not using a method of modern contraception. At the end of the day, this is about saving and improving the lives of millions of women and children, and I think this is something we can all
agree on.

JR: The world’s largest family planning conference will take place in Indonesia in November 2015. What would you like to see come out of that conference? 

CE: We are excited that the conference will take place in Indonesia this year—a priority country and region for advancing family planning efforts. From 1976 to 2002, Indonesia’s contraceptive prevalence rate doubled to nearly 60 percent and its fertility rate was nearly halved. However, progress has stagnated over the last decade. This year, Indonesia made a significant commitment to revitalize its family planning program, and I look forward to seeing the progress they’ve made.

Additionally, I hope we’ll see new political and financial commitments, and that existing dedicated family planning commitments are preserved. I hope the issue of youth-friendly services will receive much-needed attention. Finally, I hope we will focus on the power of data. We need to determine how to disseminate and use data … to develop more effective, evidence-based family planning policies and programs. 

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