Assuring Adequate Funding

Some wealthier countries in the region can bear a greater proportion of the costs of family planning and other reproductive health programs. But most African countries are extremely poor, and both governments and individuals are limited in their ability to pay for services. Current funding falls far short of the estimated $2.0 billion in the year 2000 and $3.5 billion by 2015 required to meet projected family planning and reproductive health needs. Mobilizing the resources to bridge this gap is thus an enormous challenge.

Governments, private households and international donors must all increase their financial contributions if countries are to reach the goal of universal access to the basic package of reproductive health services by the year 2015.

African governments spent at most only about $200 million in 1990 for all preventive health services, including family planning and reproductive health services. Many African governments could increase spending on basic health care by shifting priorities from military to social spending, reallocating resources from curative to preventive services, continuing to decentralize health services, and gradually introducing appropriate user fees.

Given the poverty of the region and the magnitude of resources required to implement ICPD objectives, donors must continue to bear a large share of the costs of providing reproductive health services in the region. To meet the commitments made by the international community at the ICPD, donors must at least double their collective contribution for family planning and reproductive health in the region by the year 2000 from the current level of roughly $500 million annually.

Donors and governments must work together to make better use of limited population assistance.

Donors need to overcome differences in style and purpose to work together more effectively for the benefit of national programs. To help build sustainable programs, donors should maximize use of local family planning and reproductive health experts, and support increased collaboration and sharing of experience among African countries.

The comprehensive agenda described above will require enormous effort by Africans and their governments. The task is large, yet attainable if these governments increase their commitment to reproductive health and family planning programs. Africa's relatively recent adoption of population policies and programs has given its policymakers the chance to learn from both the mistakes and achievements of other regions which have grappled with the problems of poor reproductive health and rapid population growth. African countries, with help from the world community, can build on these experiences and achieve their own full potential for development.