Wednesday, May 20, 2009

15 and Counting: New Campaign for ICPD +15

15 and Counting is a new campaign developed by the International Planned Parenthood Foundation (IPPF), a federation of non-governmental organizations working in 176 countries worldwide and a global leader in providing and advocating for the right to improved sexual and reproductive health. With a strategic focus to work with and deliver for young people, 15 and Counting aims to break the silence surrounding the issue of sexuality and reproduction, in order to improve the health and well being of the youth, worldwide.

Created in response to the International Conference on Population and Development (ICPD, 1994) 15 and Counting’s aims include:

  • Calling on governments to meet their commitments on sexual and reproductive health,
  • campaigning to achieve better access to sexual and reproductive health services and education,
  • working with young people around the world to highlight their specific needs,
  • advocate for change and
  • share positive experiences.
15 years after ICPD too many governments have failed to make significant strides in the arena of sexual and reproductive health. This failure puts the health and lives of millions of young people at risk. With 5 years remaining for the ICPD vision to become a reality, it is crucial that governments deliver on their promises in order to provide critical services and information to young people.

The 15 and Counting website is set up as a way to learn more about the International Conference on Population and Development (ICPD) as well as a platform for getting involved and making your voice heard.

There are multiple resources that help readers understand the background and motivation for 15 and Counting, as well as templates for letters to stakeholders and press releases.

Additionally, the website provides a petition, which over 1,216 people have signed thus far, that declares support for sexual rights for all. Eventually the petition will be submitted to the Secretary-General of the United Nations, reinforcing the necessity to help governments promote, protect and fulfill their promises to provide better access to sexual and reproductive health services for all.

To get involved, visit the 15 and Counting website at

Tell your co-workers, affiliated organizations (particularly, youth-serving organizations) about the campaign and refer them to the campaign website.

WHO Adds Misoprostol to Model List of Essential Medicines

After years of clinical trials, the World Health Organization agreed to add misoprostol to its Model List of Essential Medicines in April of this year. This is due to the efforts of numerous advocates and stakeholders, including an initiative of Gynuity Health Projects and Family Care International to evaluate misoprostol as an alternative medicine for prevention and treatment of post-partum hemorrhaging.

As a safe and efficient drug for the treatment of incomplete abortion and miscarriage, misoprostol is a necessity to help prevent the 500,000 deaths that occur each year due to childbirth and pregnancy related complications, and ultimately to reach MDG 5, reducing maternal mortality by 75%.

Excessive bleeding, (also referred to as post-partum hemorrhage or PPH) is the leading cause of maternal mortality, killing more than 150,000 women every year. Women who suffer from PPH can die very quickly, often within 2 hours, if immediate and appropriate medical care is not available. Many women in developing countries often deliver at home, and are unable to recognize the signs of excessive bleeding in time to seek care. Those who do realize the serious repercussions may still find that there is not available transport or sufficient time to reach the nearest hospital, and even if they were to make it there in time, many facilities are often under supplied and unequipped to handle such emergencies.

The standard drug used in recent years to stop PPH has been oxytocin, but after conducting extensive clinical trials, misoprostol has increasingly demonstrated potential in preventing and treating post-partum hemorrhaging, based on its ability to stimulate uterine contractions and stop bleeding. In addition, misoprostol offers many advantages over the standard treatment; it can be given via a variety of routes (oral, rectal, sublingual, vaginal), it does not require refrigeration, it has a long shelf life, is stable at high temperatures, is inexpensive ($1 per dose) and has relatively few side effects (Lancet source: Due to these characteristics, misoprostol is particularly well suited for developing countries, as it can be used by a wide range of health care providers in low resources settings as well as by midwives and traditional birth attendants in remote villages.

In order to reach MDG 5, reducing maternal mortality by 75% by 2015, we must continue to support organizations and initiatives to gain approval for drugs such as misoprostol. Venture Strategies, a nonprofit organization created to improve the health of low income people in resource-poor settings, and a partner of PPD, has been working to get misoprostol registered in a number of African countries. Due to the efforts of Venture Strategies and partners, in January 2006, Nigeria was the first country in the world to register misoprostol for postpartum hemorrhage. In the past few years misoprostol has also been registered or approved for obstetric/gynecologic indications in several countries, including Ghana, Sudan, Ethiopia, Kenya, South Africa, Tanzania, Uganda, and Zambia.

As the World Health Organization (WHO) has now acknowledged this new drug on its essential medicines list, it is the PPD ARO's hope that significant strides toward reducing maternal mortality will soon be made. Each day more than 350 women die due to severe bleeding, and the creation of a drug that is both effective and actually able to be used in most communities is a huge step in preventing the many unnecessary deaths that occur worldwide.

To learn more about Postpartum Hemorrhage and the use of misoprostol you can access information from Family Care International in English and French at

To review WHO information on misoprostol, including letters of support from various interest groups, please visit

Medical guidelines and research reports are available at:

And read a recent (April 2009) article on global availability (including details on licensing and distribution in each country) from the International Journal of Gynecology and Obstetrics:

Tuesday, May 19, 2009

A Proposal for a Global Health Fund

A recent article published in The Lancet calls for "bold action to streamline the global aid architecture for health" through the creation of a global fund for the Health MDG's. In May and June of this year, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance will hold their annual board meetings. These meetings provide an occasion to propose recommendations for an expansion of the Global Fund and the GAVI Alliance toward becoming a broader global health fund to address the lack of progress toward the MDG's.

Maternal mortality has remained stagnant for far too long, child mortality is declining at too slow a pace, HIV/AIDS remains a huge problem throughout the world, and inequalities are continuing to widen. In order to address these problems and work toward reaching Millennium Development Goals in time, radical action must be taken immediately. Increased funding and efficient spending are the two most imperative reforms that must be addressed.

In the past 10 years funding for global health has been unable to meet the demands of modern societies. Attention to HIV/AIDS has lead to increased funding, yet it is still inadequate in addressing the multitude of new infections occurring every day. Resources for other health needs have remained stagnant, or in some cases, have declined. In the past, developing countries heavily relied on international funding to combat health problems in society, but lately there has been a shift toward national financial autonomy. Such a concept requires that nations receiving assistance should eventually be able to finance their own health services through a reliance on their domestic revenues. Such a model has thus far proven to be ineffective, and serves as a major constraint to "scaling up service provisions in countries where public services rely heavily on international resources."

Increasing prevalence of diseases and other health related problems, such as maternal mortality, combined with the lack of commitment to a national financial autonomy based approach, has shifted reliance back to the international community. More specifically, the GAVI Alliance and the Global Fund, who have themselves admitted that “It is time to take a comprehensive approach with the necessary support from key donors to refocus on all of the health-related MDGs."

Health systems in many countries lack the capacity to implement many of the programmes or assistance plans provided for them, Unable to take full advantage of funding provided is a complete waste and unravels the entire global health funding process. It is thus essential that health systems themselves be strengthened before any further funding in doled out to communities unable to reap the benefits in their entirety. By overcoming structural challenges to service delivery the results will be much more effective, and progress toward the MDG's will in theory speed up.

The Lancet article recommends that the Global Fund should sustain successful programmes while expanding the effective approaches already put in place by the Global Fund and the GAVI Alliance. Eventually, the hope is that such a fund would allow for the prevention and treatment of specific diseases through revamped health services as well as a reduction in costs and a streamlining of the global health architecture.

Radical action must immediately be undertaken in order to achieve the Millennium Development Goals by 2015, and more importantly to save millions of lives that are lost to treatable and often preventable health problems.

You can access the entire article that appeared in The Lancet and learn more about the recommendations for the Global Fund and the GAVI Alliance at:

Thursday, May 14, 2009

International Conference on Family Planning Research and Best Practices

Kampala, Uganda, 15-19 November 2009

The Bill and Melinda Gates Institute for Population and Reproductive Health, Makerere University's School of Public Health, and other international and national partners are organizing a conference on “Family Planning Research and Best Practices.” The conference program will include an opening plenary, multiple concurrent oral sessions, an exhibit area, poster sessions, lunchtime roundtables, a policymaker forum, and special panel presentations. More information is available at:

The dates for the conference are November 15 (evening opening) and November 16-17 (full days) with November 18 as an optional day for third-party sponsored meetings.

The PPD ARO will be involved with this conference and is encouraging all PCCs to submit abstracts for oral sessions and poster sessions. The deadline for submission of abstracts is 1 June 2009. Information and guidelines on how to submit an abstract is at:

Limited travel support from the conference organizers may be available to participants whose abstracts are selected for oral presentation. The conference organizers will provide you with travel support application forms with notification letters if you are selected for oral presentation.

As the PPD ARO does not currently have funding to support PCC travel to this conference, we are currently seeking funding from donors to help PCCs attend the conference. Thus, the PPD ARO would be willing to write letters of support to donors in your country (UNFPA country office, etc.) if you request. We will be happy to provide you with more information on the conference as the date nears, and would, of course, be happy to assist you with planning your logistics to the best of our abilities.

The PPD ARO contact for this conference is Mr. Abdelylah Lakssir, Programme Officer. You can reach him by email (E-mail: alakssir at or by phone (+256-772-779-714) or the general office contact:

Conference website:
Contact information:

Tuesday, May 12, 2009

September 2009 NGO Forum on Sexual and Reproductive Health and Development

Global Partners in Action: "NGO Forum on Sexual and Reproductive Health and Development: Invest in Health, Rights and the Future" in Berlin, Germany; 2-4 September 2009

In recognition of the 15 yesr anniversary of the International Conference on Population and Development (ICPD), Global Partners in Action: NGO Forum for Sexual and Reproductive Health and Development aims to strengthen NGOs working in partnership to advance sexual and reproductive health and rights for sustainable development in an uncertain and interdependent world.

The Government of Germany and the United Nations Population Fund (UNFPA) are the co-hosts of this forum. A website with more information on the Forum is at:

Global Partners in Action is led by NGOs and is for NGOs, with considerable emphasis placed on ensuring significant participation from the Global South and of young people. Global Partners in Action will be a highly interactive working meeting, where participants will be able to contribute to approximately 30 breakout sessions, as participants, facilitators, resource persons or rapporteurs. In addition, orientation sessions and regional meetings are being planned for the first day. Participants will furthermore have the opportunity to network and share their work and experiences in a marketplace and at a global café. Plenaries featuring high level speakers will also inspire Global Partners in Action. Finally, all participants will be welcome to assist in the drafting process for the Call to Action throughout the duration of the Forum and outcomes from discussions in various sessions will feed into the Call to Action and an NGO Action Plan.

The Call to Action is envisioned as an advocacy tool for NGOs to share with government and parliamentarians immediately following Global Partners in Action. The NGO Action Plan is foreseen as a medium term road map to ensure that Global Partners in Action charts a way forward for enhanced efforts toward the achievement of the ICPD Programme of Action in synergy with the MDGs by 2015 and beyond.

There will be 400 participants at Global Partners in Action. Out of these, 225 will come from the Global South and will, as far as possible, be fully funded to attend. There are 100 spots for Northern NGOs, these will not generally be funded to attend. However, there will be no registration fee.

The forum steering group aims to ensure diverse representation from as many countries, regions and NGO's working in different fields of health and development as possible. Youth participation is also a priority and a commitment has been made to have at least 25% of participants under the age of 30.

The Global Partners in Action NGO Forum is inviting applications from individuals representing NGO's around the world that:
  • Are committed to the principles of the ICPD Programme of Action;
  • Focus on activities that address key aspects of the ICPD Programme of Action (for example: sexual and reproductive health and rights, women's rights, HIV and AIDS, youth participation, gender equity, etc.);
  • Work at either a local, national, regional or international level;
  • Are interested and able to share best practices, lessons learned and areas for capacity building;
  • Can commit to collaborative follow-up to the Global Partners in Action NGO Forum, guided by the NGO Action Plan and Call to Action that will be produced during the Forum.
For more information, please see a copies of the application form in English, Spanish and French at The Global Partners in Action NGO Forum encourages applications through the website:

The deadline for applications is Monday May 25, 2009. Applications will be reviewed by a Selection Committee, which has established several measures to ensure a transparent and objective process. For example, an external consultant will remove all personal and organizational information from initial applications to make them anonymous. They will also be assigned a code that identifies their region, country and age group. The anonymous applications which fill all of the selection criteria will then be analyzed for content and relevance to the ICPD agenda and the objectives of the forum.

Finally, national discussions leading up to the Forum are being planned where possible. The objective is to promote discussion among NGOs on key questions related to the assessment of ongoing progress and needs, successful approaches, remaining barriers, ways forward and additional needs realting to the ICPD agenda. These discussions aspire to have broad participation and to inform the Forum and any subsequent follow-up efforts and to promote intensified discussion of how to implement the ICPD Programme of Action.

Global Partners in Action thanks you for your interest and invites you to visit the web site at:

After Accra: Delivering on the Agenda for Action

Jeffrey Gutman of the World Bank Institute recently put together a special report entitled After Accra: Delivering on the Agenda for Action, which attempts to assess the progress made toward the Paris Declaration (2005) and the recent Accra Agenda for Action (2008). The report looks at overall progress and the effectiveness of programmes in specific countries, as well as outlines the next major steps that need to be taken by donors, developing countries, and the World Bank.

In 2005, the Paris Declaration on Aid Effectiveness was implemented as a "roadmap to improve the quality of aid and its impact on development." An agreement between donor and recipient countries, the Paris Declaration attempted to reform the delivery and management of aid funding to strengthen its impact and effectiveness. Five principles (ownership, alignment, harmonization, managing for development results, and mutual accountability) outline the goals of the Paris Declaration and can be read in their entirety here. 122 donor and recipient countries and 26 international organizations adhered to the agreement and are currently attempting to improve the effectiveness of aid funding by 2010.

Three years later, a High Level Forum (HLF) was held in Accra, Ghana, to assess progress on the implementation of the Paris Declaration on Aid Effectiveness, and to set out an agenda for action. The result of this meeting was the Accra Agenda for Action (AAA) which recommitted the international community to achieving progress toward the Paris Declaration, as well as the Millennium Development Goals. The AAA lists actions that developing countries and donors should take in order to accelerate implementation of the Paris Declaration, and improve aid effectiveness.

The HLF in Accra was especially significant in that it took steps to increase the developing countries role in the process. At the event, "developing countries’ concerns determined the agenda, developing countries’ representatives were part of all decisions relating to the HLF, and developing countries were full partners in the negotiations leading to the final communiqué, the Accra Agenda for Action." By allowing developing countries a voice in such a forum, concerns and issues can be addressed, making the implementation of such an agreement much smoother and feasible. Developing country participants at Accra are not only necessary as a voice at such meetings, but also as a way to "take the message of Accra back to their communities and institutions and put them into practice."

The AAA not only provides a platform to improve aid effectiveness, but also adds a new dimensions to the discourse as a whole. Recognizing the role of Parliaments, local governments, civil society institutions, research institutes, media, and the private sector, as well as middle-income countries and global funds, the agreement has a plethora of partners in its development efforts and is able to achieve significant progress throughout the country toward set goals. South-South cooperation is highlighted, with an emphasis on sharing good practices and experiences among others trying to reach the same goals. Specifically, Gutman's article highlights Madagascar and Sri Lanka, which have taken noteworthy steps to reduce poverty and improve the quality of life for their citizens. Furthermore, the AAA is unique in that is emphasizes a true partnership between donors and developing countries, rather than a dictated agenda.

In order to achieve considerable progress by 2010, the international community must constantly work toward meeting the goals set out by the Paris Agreements and the Accra Agenda for Action. Checks on the effectiveness and implementation of such practices are essential in order to highlight those countries that are leading the way, and encourage others to follow in their footsteps.

To read more about Gutman's take on progress since Accra, and to see his suggestion for what developing countries, donors, and the World Bank now need to do, see his article, After Accra: Delivering on the Agenda for Action at

You can learn more about the Accra Agenda for Action (AAA) by reading the policy briefs produced by the Partners in Population and Development Africa Regional Office (PPD ARO) shortly after the Accra meeting in 2008:

Wednesday, May 6, 2009

Evaluation of World Bank Support for Health, Nutrition, and Population

Between 1997 and mid-2008 the World Bank Group's support for health, nutrition, and population (HNP) provided $17 billion for government-run projects in the fields of nutrition, health, and family planning. An additional $873 million was invested in private health and pharmaceutical investments. Although these numbers may seem high, a report issued last week by the bank's Independent Evaluation Group revealed that one third of the 220 projects undertaken by the World Bank HNP had failed to achieve their goals. Furthermore, the emphasis on HIV/AIDS related projects has resulted in unsatisfactory outcomes, and progress in the nutrition and family planning sectors have greatly been inhibited by such unequivocal funding measures.

According to the evaluation, 7 out of 10 AIDS projects financed by the bank had failed to achieve satisfactory outcomes. In Africa, the epicenter of the AIDS pandemic, 8 out of 10 AIDS projects had unsatisfactory outcomes, one of the bank's worst records worldwide. The report insinuated that the failure is not a result of incompetent or ineffective programmes, but rather the inability of inexperienced or weak bureaucracies to carry out such complex projects (ironically, which were encouraged by the donor). Julian Schweitzer, the World Bank’s director of health, nutrition and population, admitted that inexperience and weakness was not just at the country level, but also "sometimes our own".

To improve the effectiveness of such programmes, the report suggested a simplification of projects, a reduction in the number of government ministries involved, and a focus on more modest objectives. Also addressed, was the need to improve programmes in developing nations, with a specific focus on Africa. Middle income countries ranked adequately in their ability to carry out such initiatives, but in Africa, more than three-quarters of the projects were deemed ineffective. The World Bank Group's support for health, nutrition and population needs to make an immediate effort to concentrate resources where they are most crucially needed, and more importantly to ensure that programmes are being carried out appropriately within these regions.

Aside from the issue of programme efficiency, the report detailed another important trend in global health, namely, the disproportionate attention and funding allotted to AIDS programmes in the last decade. Since 1997, foreign assistance for global health has increased, with a specific focus on HIV and AIDS. Although it is incredibly important to deal with such a deadly disease, the focus on family planning has greatly declined as a result of this relatively new emphasis on AIDS funding. In reaction to the report, Professor William Easterly of New York University stated that the evaluation of the World Bank confirmed "a fear that many of us have had for some time: that hugely disproportionate attention to AIDS has had a negative effect on aid efforts for all other health problems."

Since 1997, nearly 60% of World Bank HNP projects have focused on AIDS, while efforts aimed at tuberculosis, malaria and leprosy were granted significantly fewer resources (malaria made up only 3% of the projects, and tuberculosis only 2%). Family planning has also been negatively affected by the disproportionality of funds, and leaders of the evaluation group have realized the implications of this. Martha Ainsworth, lead author of the report, reaffirmed the groups commitment to increase funding for family planning by stating, "helping women control the number of children they bear is essential to reducing the high rates at which they die in childbirth in the poorest nations, the fact that no one’s been paying attention to reducing high fertility is critical for Africa."

Mr. Schweitzer, of the World Bank, strongly agreed with the evaluators call for greater efforts in family planning and nutrition, and reaffirmed the necessity of donors and recipient countries working together to coordinate projects and achieve targeted results. In recent years, PPD has advocated against global decrease in population and family planning funding, and it is our hope that such an internal evaluation will be a call to action for the World Bank Group's support for health, nutrition, and population to change their efforts. And as PPD has long recognized, an emphasis on the African region and family planning efforts are crucial to achieving progress worldwide.

To view an executive summary of the report, visit:

Or you can access the entire evaluation at:

Interested in reading more about specific countries project performance assessment reports? Then check out:

Sunday, May 3, 2009

Governments Declare Maternal Mortality a Human Rights Violation

In March this year, 83 Governments issued a joint statement to the United Nations Human Rights Council. Expressing concern over the unacceptably high number of women who die each year due to pregnancy related complications, the delegation urged the Human Rights Council to declare maternal mortality a human rights violation.

Each year more than 500,000 women die from pregnancy or childbirth. Most of these deaths could be prevented, and by not doing so, such inaction clearly constitutes a human rights violation. A women's right to health, life, education, dignity, access to information and appropriate healthcare are violated each and every time a preventable death occurs, and this is completely unacceptable. Reaffirming the importance of The Convention on the Elimination of All Forms of Discrimination Against Women, The International Covenant on Economic, Social and Cultural Rights, Millennium Development Goal 5, The Beijing Declaration and The International Conference on Population and Development, the delegation demanded a recommitment to such global obligations.

MDG 5 aims to reduce the maternal mortality ratio by three quarters, however, between 1990 and 2005 the global rate decreased by less than 1%. Governments and international organizations must recommit themselves to decreasing maternal mortality by 5.5% annually in order to meet set targets. Maternal mortality is an issue that affects women worldwide, and must not be looked at as a concentrated regional problem, but rather a sector of health in which continuous improvement is required.

The delegation laid out 4 keys actions that the Human Rights Council should undertake to contribute to existing efforts. Identifying the human rights dimensions of preventable maternal mortality and morbidity, reviewing and considering information on discrimination in the provision of and access to healthcare for women and discrimination against women in respect of their right to decide freely and responsibly on the number and spacing of their children, talking about the human rights implications of maternal mortality and morbidity in the universal periodic review and in treaty body dialogues, including the exchange of programmes and policies that have successfully reversed the trend of maternal deaths and injuries, and finally, requesting states to include women in decision-making about maternal health, including decisions on the design of local health care mechanisms, and to recognize women’s right to skilled professional care before, during and after pregnancy and childbirth. Goal 3 highlights the importance of South-South cooperation and sharing of good practices as an excellent tool of progression.

The Council will meet next in June of this year and it is PPD's hope that the suggestions provided by one of the largest joint-intergovernmental statements delivered to the Council will have taken effect, and that maternal mortality will be declared a human rights violation. Urgent action is needed in order to meet Millennium Development Goal 5 and to prevent thousands of unnecessary deaths, and the Human Rights Council has the ability to spur such action.

You can view the entire joint statement issued to the Human Rights Council at

Experts Call on Obama to Recommit U.S. Funds to Family Planning and Reproductive Health Programmes

From 1978 through 2006, Joseph Speidel, Steven Sinding, Duff Gillespie, Elizabeth Macquire and Margaret Neuse successively directed the U.S. Agency for International Development's (USAID) Population and Reproductive Health program. These five development experts recently issued a report entitled Making the Case for U.S. International Family Planning Assistance, urging President Obama to double U.S. Investments in USAID programmes.

USAID was established in 1961 by President John F. Kennedy, and since then has implemented reproductive health programmes in 50 countries. The programme’s funding peaked in 1995, and has continuously declined thereafter. The five said that this may have resulted from the (mistaken) belief that rapid global population growth has halted; from diversion of resources to other needs. . . and from lack of understanding that family planning is not only essential for women's health, but also a critical part of any successful development strategy." In actuality, donor funds for family planning programmes are more crucial now than ever before as countries around the world work to achieve major progress in the arena of sexual and reproductive health in order to meet approaching international deadlines.

The five development experts suggested that President Obama should move quickly to meet the growing demand for planning services worldwide if the goals of the ICPD and Millennium Development Goals are to be reached. U.S. investment in contraceptive supply and reproductive health programmes run by USAID should be doubled, and the United States should recommit itself as a world leader in family planning. With a new administration and Congress in session, the experts urged a reversal in former funding policies that did not meet the demand for women's reproductive health services, and suggested an increase to $1.2 billion for USAID's population budget by 2010. A future increase to $1.5 billion in 2014 was also predicted, taking into account their imminent plans to expand their work into 17 additional countries with unmet family planning needs. The continuous decline in family planning and reproductive health funding has forced many successful programs to remain stagnant or close. The global fertility decline has slowed and the number of women dying from pregnancy-related complications is unacceptable. The U.S. should take the lead in re-establishing appropriate funding to programmes such as USAID, setting the example for countries worldwide to realize the importance of family planning, and commit themselves to effective programmes.

The report discusses the global unmet need for family planning, family planning as a global success story, family planning as a declining priority, USAID as an effective and capable agency, and the request for more funds. Examples of countries excelling in the fields of family planning and reproductive health are also examined throughout the report, and should be looked to as a resource for South-South cooperation.

The entire report can be found online at

An audio clip of the press conference for USAID can be heard at

To read more about what President Obama has accomplished in his first 100 days, regarding women's health, check out