Money matters and policies count. Ten years ago, at the International Conference on Population and Development (ICPD) in Cairo, the international community endorsed an approach to improving reproductive health based on meeting individual needs and respecting human rights. The 179 nations present agreed on a plan for achieving universal access to basic reproductive health care by 2015-and on the financial resources needed to make it a reality. They pledged to share the costs, estimated at US$18.5 billion annually by the year 2005, and donor nations committed to providing one-third of that total.

Since 2001, the U.S. Congress has encouraged the U.S. Agency for International Development – USAID, the agency that dispenses foreign development assistance – to implement family planning and related reproductive health programs in areas where biological diversity is threatened and where species are endangered. Congress has never specified a funding level for these activities, which are supported by funds appropriated for international family planning programs, amounting to more than US$400 million annually in recent years. Over the past few years the agency has allocated between $1 million and $2 million annually to fund such projects and to explore the implications of the population-environment linkage as it applies to the conservation of critical ecosystems and the biodiversity they shelter.

The Programme of Action adopted at the International Conference on Population and Development (ICPD) in 1994 establishes the right of men and women to be informed about their reproductive choices and health, and to have access to the information and services that make good health possible. The Programme of Action mandates access to a range of reproductive health care services, including health education, information and counseling on sexuality and reproductive health issues-including parenting, family planning, prenatal care, delivery, and postpartum care, abortion (where not against the law) and post-abortion care-and the prevention and treatment of reproductive tract infections, sexually transmitted diseases and infertility.

Governments in developing countries have an important role to play in making reproductive health products and services affordable for the poor and other under-served groups. Accordingly, efforts to improve access to family planning and other reproductive health care have focused primarily on the public sector.

Paying their Fair Share - Donor Countries and International Population Assistance outlines the need for more financial support from donor countries to improve reproductive health while slowing population growth.