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.

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.

Assessment of the progress nations have made towards achieving the goals set by the International Conference on Population and Development (ICPD) in 1994. The ICPD examined the social context of population growth and size by focusing on the reproductive health and rights of women and men.

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.

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.

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.

A recent report by an independent task force enlisted by the Council on Foreign Relations (CFR, More Than Humanitarianism: A Strategic U.S. Approach toward Africa, 2005) recommends that the U.S. government step up funding to international family planning programs in sub-Saharan Africa as part of a strategy to increase U.S. engagement and prioritize assistance to that region (see p. 16, pp. 119-120).1

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.