Contraceptive Shortfall

OPERATOR: Thank you. Ladies and gentlemen, if you have a question at this time, please press the one key on your touch-tone telephone. If your question has been answered or you wish to remove yourself from the queue, please press the pound key. Our first question comes from Linda Holste of Women's E News.

LINDA HOLSTE, WOMEN'S E NEWS: I am wondering if you can give me a sense of who all the stakeholders are besides the groups that you represent -- who's in Istanbul?

WIRTH: Dr. Obaid, do you want to take that question?

DR. OBAID: Yes. The stakeholders are, beginning with the governments themselves, in developing countries. Also the civil society in the same developing countries. We're talking about international organizations, donors, as well as the private sector. All these are stakeholders in the whole issue of securing reproductive health commodities.

WIRTH: Does that answer your question?

HOLSTE: Yes. I'm trying to also to get a scope of how many you are you talking about -- hundreds of decision makers or like thousands of people?

WIRTH: Well ultimately there are, you know, billions of decision makers as it is couples -- men and women – who are going to have to be making decisions for themselves, you know, about not only the size of their families and raising their children, but their own long-term personal healthcare. So the stakeholders are literally millions and millions of people. People are organized, you know, in political jurisdictions and we are hoping that healthcare ministries become engaged in this issue -- they're organized and have the need for the delivery of services. So a great deal of that is done by non-governmental organizations.

And they are organized globally through the United Nations and their efforts. It is an effort that goes from the bottom of the pyramid with millions of people, from the grass roots in need of these services, to the Secretary General who, at the top, has said it's his personal priority to help to lead this effort.

COEN: Well I'd like to just add to this. That is absolutely correct. The stakeholders meeting here in Istanbul, this is a unique meeting because it has a mix that you usually don't see at a global meeting…..It's donors, it's developing countries, it's NGOs, it's providers. It's a real mix so that we get the entire 360 view of the problem and people already working on the issue. So what we're most excited about at this meeting, is that we're going to come out with a plan of action because we have all the stakeholders who can see the problem from all the different angles and that's what makes this so unique.

WIRTH: Next question… Our next question comes from Charnicia Higgins of Reuters Health.

HIGGINS: Hello, I have a question for Amy Coen. When you were speaking you were saying that we know -- you know what to do about the problem but the resources are lacking and I was wondering if you could expand on that a little bit.

COEN: Sure, I'd be more than happy to and my colleagues can add to it.

HIGGINS: OK.

COEN: When I said we know what to do, the family planning programs and AIDS prevention programs are great success stories. I also feel that they're often the best kept secrets. We have really showed curbed population growth, much by providing family planning education, sexuality education, reproductive healthcare services, AIDS education, AIDS prevention education, and condoms to the people who want it and need it and it has allowed people to drastically change their families.

OK, let me give you a better example, a little bit more articulate here. It's true anywhere in the world that your life is dramatically different depending on how many children you have, for my life or for any woman anywhere in the world, and what happens when she's able to get effective, affordable birth control -- family planning – instead of having 10 children and being pregnant, she can have two children or four children -- what she chooses.

She can then educate them, feed them, house them, clothe them. Her entire family benefits by the number of children. Well that's what family planning does. It allows for her to go on and get education -- educate her children. That's what I meant by we know how to offer those services and do the outreach. Michael can talk about HIV prevention and the success of prevention programs on HIV AIDS. Another question?

HIGGINS: Yes. You said we know how to offer the services and do the outreach. So is the problem a lack of funding in the developing countries?

COEN: Primarily one of the big focuses is lack of funding. The other is capacity building -- teaching people in new areas how to expand programs and to move into new communities. Of course, the other thing that we're very worried about is to be able to scale up in the communities where the population growth is the fastest to be able to meet demand. So we’ve got great success to build on and what we need to increase is: one, the funding and stabilize it; and the second is to teach program providers and government countries how to kind of ramp up with the new services, new facilities, to meet the growing demand.

You know the issue with family planning and HIV prevention is it's not like a vaccination. You can't just give someone a shot. You have to educate them -- it was true for us. You have to learn how to use your method of contraceptive. You have to understand how it works. You have to fit into your lifestyle, your faith and your expectations. So you can't just give people shots. That includes comprehensive services and a lot of education. We know how to do that and we just need to do more of it.

The other thing I'll just say we have to do is what my organization focuses on a lot: that it is amazing how many people in the world don't understand about family planning programs -- how they're affordable and how they work. So those of us who do know need to be more aggressive about educating government officials, elected officials, and the people who shape government. The governments of donor nations and developing countries know how important this is.