Pregnancy and childbirth are deadly to more than half a million women worldwide every year – a fact that is unacceptable, but not unavoidable. Despite twenty years of campaigning to improve their sexual and reproductive health, the risk of dying in pregnancy or childbirth continues to show the largest gap between the rich and poor of all development statistics. That so little progress has been made in helping the world's poorest women survive pregnancy and childbirth should serve as a wake-up call to all of us.

Each year, over 600,000 children around the world are infected with HIV through mother-to-child-transmission, totaling 2.3 million children living with HIV or AIDS today. The majority of these infections is occurring in sub-Saharan Africa and are acquired from mothers during pregnancy, labor, delivery or breastfeeding. While programs to prevent the transmission of HIV from mother-to-child (PMTCT) are invaluable, they currently are reaching only an estimated five percent of the HIV-positive population.

Family planning dramatically improves the health and chances of survival of both women and their children. At the same time, when parents are more confident their children will survive, they are more likely to have fewer children and plan the size of their families. U.S. international development and humanitarian assistance should support both child health and family planning programs as complementary initiatives.

The Millennium Development Goals (MDGs) offer precise targets for reducing poverty and promoting global development, but they remain incomplete if they do not build from and incorporate the objectives of other major international agreements, particularly those reached at the International Conference on Population and Development (ICPD) and the Fourth World Conference on Women (Beijing). At the 2005 World Summit and in the years leading to the 2015 milestone, the sexual and reproductive health community is taking every opportunity to advance this message: universal access to sexual and reproductive health services is essential to achieving the MDGs.

Nearly 80 million unintended pregnancies occur worldwide every year. More than half of these pregnancies end in abortion, often in countries where abortion is illegal and access to contraception is limited. Access to voluntary family planning services, including contraception, is essential in helping to reduce the number of unintended pregnancies and, consequently, the incidence of abortion.

Sexual and reproductive health services, including family planning, are among the most important elements of the global effort to contain the HIV/AIDS pandemic. Through a well-established infrastructure, they help provide the supplies, education and information that are known to be effective in preventing the spread of infection.

In 2007, more than 6,800 people became infected with HIV every day, and new HIV infections outnumbered persons receiving treatment by nearly 3 to 1. Comprehensive HIV prevention-including both condoms and contraceptives-must become a top priority in the continued fight against HIV and AIDS. Because most HIV epidemics are fueled by sexual transmission of the virus, behavior change-including condom use-is critical to stemming the number of new infections.

The international community has repeatedly agreed to meet young people's developmental needs, including those relating to sexual and reproductive health. Yet young people often have little or no access to the information and services they need to make healthy, informed decisions about their sexual and reproductive lives.

Reproductive illnesses and unintended pregnancies undermine economic development by weakening and killing adults in the prime of their working lives, by disrupting and cutting short the lives of their children, and by placing heavy financial and social burdens on families. In most developing-country settings, much of the loss of life and human productivity that is due to poor reproductive health could be prevented with affordable and cost-effective programs.

There are more than 100 million women and girls alive today who are affected by FGM, the vast majority of them in Africa. Some also live in parts of the Middle East and Asia. With migration, affected women and girls now also live in the United States, Europe and, presumably, other parts of the world.