This report is the fourth in a series, including studies on China, India and Pakistan, which examines family planning and other reproductive health services in the developing world. The report highlights the progress countries in sub-Saharan Africa have made towards expanding access to these services and the key challenges they face, drawing on research by and interviews with experts on Africa, and information the authors gathered during visits to African countries.

In 1994, at the International Conference on Population and Development (ICPD) held in Cairo, 179 nations endorsed an approach to improving reproductive health based on meeting individual needs and respecting human rights. They pledged to share the costs needed to make basic reproductive health care available to all who need it by 2015. Today, however, most donor and developing countries still fall short of paying their “fair share.”

A generation has passed since the onset of the HIV/AIDS pandemic. During this time, 65 million people have been infected with HIV and more than 25 million people died of AIDS. Despite the devastation, many countries, using a variety of interventions, have been successful in slowing the spread of the virus. The interventions that have been most successful are those that are congruent with the local epidemiology. With the overall HIV/AIDS epidemic being composed of a series of smaller local epidemics interconnected by space or time, a range and mix of responses in the fight against HIV/AIDS is necessary. And the relative impact of each response will always depend upon the level, stage and pattern of the epidemic in each locale. Therefore to be effective, interventions should respond to local needs.

Britain's recent pledge of US$15 billion to fund education in developing countries over the next ten years comes as good news for the estimated 493 million school-age children who are not enrolled in school, the majority of whom are girls. The gender gap-the difference between boys' and girls' school enrollments-is an indicator of gender equity and of a country's level of development. The gap is widest among countries in sub-Saharan Africa and a few Asian countries, including Yemen and Pakistan. Education has a profound impact on the future course of women's lives, influencing employment opportunities, earning potential and political participation. Access to quality education is also one of the best defenses against HIV infection, providing young people with the skills and knowledge to make informed decisions. Education is especially critical to HIV prevention in girls, as it reduces the power imbalances and social and financial dependencies that typically make females more vulnerable to infection. Moreover, a large body of evidence suggests that education of girls is associated with their roles in family decision-making and patterns of childbearing, resulting in improved maternal and child health, improved childhood nutrition, higher educational attainment among children, and a lower likelihood of experiencing unwanted and high-risk pregnancies.

The term-CBPE for short-refers to the linkages between services that combine aspects of natural resources conservation or similar environmental work and the provision of reproductive health services, including family planning.

More than 25 years into the AIDS epidemic, prevention remains a top priority in the continued fight against new HIV infections. Today, new HIV infections outnumber persons receiving treatment by nearly three to one. Comprehensive HIV Prevention: Condoms and Contraceptives Count provides evidence that condoms and contraceptives must be promoted as scientifically proven components of comprehensive HIV prevention

Condoms Count, first published in 2002, tracks funding levels and the quantities of condoms provided to developing countries by donors, as part of its tracking of overall donor support to reproductive health programs and policies, including HIV prevention. This information is updated every two years in the form of supplemental data updates. The following are the highlights of the results of Condoms Count: 2006 Data Update.

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.

With the largest population in Africa, Nigeria's political and economic developments reverberate across the continent. Nigeria chairs the Economic Community of West African States (ECOWAS) and is the eighth largest oil exporting country in the world. More than 40 percent of the region's gross domestic product is accounted for by Nigeria's economy, and the petroleum industry is responsible for about two-thirds of national revenue and a great deal of international interest in the country. Yet the government maintains a delicate hold on democracy, and the country has recently experienced political instability. Throughout 2006, militant rebels angry about the distribution of oil revenue have conducted a series of attacks against the industry, including kidnapping foreign workers, which resulted in the country's petroleum output dropping by 25 percent.

For more than a decade, since the 1986 release of a seminal report by the U.S. National Research Council, discussion of the impact of population growth on economic change in developing countries has languished within both the demographic and economic fields. While the linkage between demographic and economic dynamics is undeniably complex, some recent findings stand out. Despite lack of clear evidence for this relationship in previous decades, new data make clear that during the 1980s, on average, population growth dampened the growth of per capita gross domestic product, the primary measuring unit of economic growth. The negative effects of rapid population growth appear to have weighed most heavily on the poorest group of countries in the developing world during the 1980s and also throughout the two previous decades.