Today Melinda Gates is convening a Family Planning Summit in London where she hopes to secure governmental and non-governmental commitments of $6 billion to meet what she sees as a massive “unmet need” for contraceptives in poor countries. Gates says wherever she travels in the developing world, the number one thing she hears from women is that they need contraceptives. More than vaccines, basic medical care, economic development, and education, it is contraceptives they want.
Melinda Gates is hardly the first fabulously wealthy person to determine there are too many poor people in the world. John D. Rockefeller got the modern population-control movement going when he became alarmed at the growing population of young Asians whose political radicalization he feared.
Population control faded as an organizing principle through a combination of success and remarkably bad press. Fertility rates fell off a cliff almost universally and the world faces a new reality of demographic winter. Moreover, coercive population control and family-planning programs seriously blackened the eye of such top-down programs.
The terms of the debate changed at the International Conference on Population and Development in Cairo in 1994. Population control went out the window and “rights” were introduced into the debate. “Reproductive rights” sounds less coercive and still gets them rapidly declining fertility rates.
Even so, advocates are dissatisfied with the progress toward lower fertility rates. Though most of the world is in below replacement fertility, with Africa soon to follow, Melinda Gates sees this great “unmet need” for contraception.
But, here is the question: Did these programs really work? Did these programs really reduce fertility rates? And was there really a great “unmet need”? Is there one now?
At the time of the Cairo Conference, Harvard professor Lant Pritchett published a groundbreaking paper published by the Population Council that said that “unmet need” was a phony concept so vast as to include any woman who for whatever reason did not want to use contraceptives.
He also found that the key determinate of family size was not economics, education, or the prevalence of contraceptives. It was the desire of the women for a certain number of children. He found that family-planning programs had a “negligible” effect on family size.
Gates contends there is a dearth of contraceptives in the developing world. In fact, current family-planning funding in the developing world is $4 billion. The 2012 USAID budget for family planning and reproductive health services is $524 million. The Gates family alone spent $437 million in 2009 on family planning. Toss in hundreds of millions more from the EU and the Nordic donor nations and you are talking real money.
Maybe all this cash is not enough. But compare it to other things poor women really seem to need. The US spent $75 million in 2010 on its entire global-nutrition program. The $514 million for family planning is more than the entire US budget for tuberculosis, public health threats, pandemic influenza, vulnerable children, and nutrition.
#more#Besides the fact that family-planning programs have a negligible effect, and that they drain valuable resources away from much needed health and nutrition programs, there is the reality of coercion. Give a local bureaucrat a salary and set of family-planning goals,along with a pocketful of pills, IUDs, or what they call “injectibles”, and pretty soon he is telling women lies and otherwise coercing them into contraception and even sterilization. This has happened all over the world.
Gates insists her program will not be coercive and that it will not be connected to the abortion debate. But, in fact, her key partners are hip-deep in abortion and coercion. The UN Population Fund helped set up the Chinese one-child policy. International Planned Parenthood Federation is the world’s largest abortion provider and its U.S. affiliate has been shown to accept sex-selective abortions. And the UK Department of International Development was just accused by the left-leaning Guardian of funding coercive family planning in India.
There is little doubt that Melinda Gates will collect her $6 billion. What is also certain is that every dollar spent on coercive UN-style family planning will be a dollar lost to the real needs of poor women: basic medical care, skilled birth attendants, education, clean water, and nutrition. This is an old, sad story that is being played out once more.
— Austin Ruse is president of C-FAM, a New York and Washington, D.C.-based research institute focusing exclusively on international social and legal issues.