The United Nations Population Fund (UNFPA) provides international leadership on population issues and is a key source of financial assistance for family planning and reproductive health programs in poor countries. Restoring U.S. funding for UNFPA programs is crucial to improving the health and lives of women and their families and to addressing demographic trends and promoting sustainable development.

Over the last two years, the architecture of U.S. foreign assistance has undergone an unprecedented restructuring. At the same time, a congressionally-mandated commission on poverty-focused development has issued its report; a Senate staff delegation has conducted an extensive overseas fact-finding mission; and numerous nongovernmental organizations, think tanks, and presidential campaigns have issued policy prescriptions on the future of U.S. foreign aid. In all of these efforts, insufficient attention has been paid to the implications of actual and proposed changes in the U.S. foreign assistance program to the future priority and funding of family planning and reproductive health (FP/RH) care overseas-highly successful and cost-effective programs that have received U.S. government funding since the 1960s.

A Measure of Survival: Calculating Women's Sexual and Reproductive Risk classifies 130 developing and developed countries (comprising 96 percent of the world population) into five categories from highest to lowest sexual and reproductive risk for women based on indicators of access to reproductive health service and outcomes.

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.

Country stakeholders – governments, parliamentarians and civil society – have always been challenged by a limited ability to influence decisions made at the international level. With international donors now seeking to move decision-making and ownership to the country level, we have a remarkable opportunity to establish a transparent, participatory and inclusive process. This is particularly critical to the SRHR community which, due to the often controversial nature of the work, requires institutionalized processes as well as strong, well-informed champions, to ensure that its concerns are adequately funded in development strategies.

Shortages of critical reproductive health supplies (RH supplies) around the world are undermining progress towards achieving the Programme of Action established at the International Conference on Population and Development in Cairo and the poverty reduction targets included in the Millennium Development Goals. Without supplies, no health or poverty reduction program can be successful.

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.

Weak infrastructure and limited distribution systems in low-income countries complicate access to health services, especially in rural areas. Government health outlets may be relatively few and widely dispersed, and private-sector sources often favor wealthier urban areas, resulting in uneven service availability within a country. In the absence of a solid heath infrastructure, strengthening primary health care and innovative community-based health service delivery systems help provide more equitable access to health services.

The Shape of Things to Come provides valuable new insights into the programs and investments that can make countries "healthier"-more stable and peaceful, more democratic, and better able to provide for the needs of their citizens. It places all countries into one of four major age structures with attendant characteristics, benefits and risks associated with governance, security and economic development.