Worldwide, nearly 80 million unintended pregnancies occur each year, with over half of them ending in abortion—even in countries where the procedure is illegal. These unintended pregnancies—and resulting abortions—could be prevented if women had access to the reproductive services and supplies, including condoms and emergency contraception, they want and need to determine if and when to conceive a child. The global community must fund reproductive health programs worldwide—these supplies, services and education are crucial to improving and saving lives that might otherwise be lost to maternal mortality and unsafe abortion.

In Uganda an estimated 775,000 unintended pregnancies a year result in at least 297,000 abortions. This is despite the fact that abortion is illegal, except to save a woman’s life. Shockingly, a recent study reports that one-third of Ugandan women of reproductive age want to stop or delay pregnancy but don’t use modern contraceptives. It is tragic that the lives of these women are put at risk because they lack access to the reproductive health supplies and services that are taken for granted in other parts of the world.

Uganda is just one of many countries where women lack the knowledge or supplies necessary to make their own decisions about if and when to have a child. Over 200 million women worldwide want to avoid pregnancy, but are not using any form of modern contraception. Family planning programs providing access to modern contraceptives, disease screening and prenatal care have led to declines in maternal mortality resulting from unsafe abortion and complications from high-risk pregnancies.

But many of these programs are at risk—funding shortages, burdensome policies and the heavy and still growing number of those suffering from HIV/AIDS and other diseases have made it increasingly difficult for family planning and reproductive health programs to adequately serve the women and men they are trying to reach.

Making abortion illegal doesn’t prevent abortion from happening—but we can all agree that averting unintended pregnancy does. The good news is that increased use of contraception has been accompanied by significant declines in abortion rates in a number of countries, including Bangladesh, Bulgaria, Russia and Chile. Expanding access to voluntary family planning programs is a key—and proven—way to reduce the number of unintended pregnancies and, consequently, to reduce the incidence of abortion.

Washington, DC, January 22, 2007 – Today marks the 34th anniversary of the landmark Roe v. Wade decision legalizing women’s right to safe abortion in the United States. While the debate about the right to abortion continues to rage on here in the U.S., a number of countries are recognizing that access to safe abortion can save women’s lives. PAI hails these efforts and urges more countries to consider taking such life-saving actions.

Last May, a decision by the highest court in Colombia – where all abortions had previously been banned – legalized abortion in cases of rape or when the health of the woman or the fetus is in danger. In July, the Ethiopian Ministry of Health began allowing abortion in cases where the health of the woman or fetus is in danger, in cases of rape or incest, and in cases where a woman is physically unable to raise a child due to age or mental or physical disability. And Great Britain created the Global Safe Abortion Fund (now called the Safe Abortion Action Fund) offering NGOs grants for safe abortion advocacy, service provision or research - to help stem the damage done by the U.S.’s Global Gag Rule, which prohibits U.S. funding of any group that provides abortion services, counseling or referral.

And on February 11, Portugal will be holding a referendum on whether to decriminalize abortion; current law states that women can be jailed for up to three years for seeking an illegal abortion. With between 20,000 and 40,000 Portuguese women obtaining clandestine abortions every year, the passing of this referendum could drastically decrease the number of hospitalizations and deaths that result from septic or incomplete abortion.

Tragically, last year also witnessed the passage of Nicaragua’s total ban on abortion and the beginning of debates in the Polish Parliament to pass a constitutional amendment banning abortion. Draconian laws like these only serve to put women at an even higher risk of maternal mortality.

Complications from unsafe abortion account for approximately 70,000 deaths a year. PAI urges governments to expand access to safe and legal abortions to women who need them and comprehensive sex education, contraceptives and counseling to all women and men in a real effort to make abortions more rare.

Saving women's lives depends on it.

Religious leaders are often among the most influential members of their communities. When they promote sound reproductive health practices and unite with health care providers, they can help make monumental strides toward ensuring reproductive health for all.

A new family planning program in Pakistan has clerics distributing contraceptives and literature on safe sex—a great example of the important role religious leaders can play in the fight against HIV/AIDS and in expanding access to reproductive health care. Armed with evidence-based information and adequate supplies, religious leaders and institutions can be a powerful ally in stemming maternal morbidity and mortality, as well as in helping prevent the spread of sexually transmitted infections, including HIV/AIDS.

Religious leaders advocating family planning are making an impact. Iran has implemented an extremely successful family planning program, issuing religious rulings that reassure patients that they are acting within the guidelines of Islam. Thailand carefully considered Buddhist values when formulating its successful promotional campaign advocating family planning and contraceptive use. And the Christian Health Association of Ghana collaborated with Pathfinder International to develop a comprehensive program that included abstinence and safe sex education, as well as condom distribution. These unique programs—from very different parts of the world—showcase the positive impact collaboration can have on expanding access to reproductive health.

The success or failure of reproductive health programs hinge on how well they are received by the community. Support from religious leaders can generate greater acceptance of programs and lead to greater success than could be achieved by family planning advocates alone.

As new discoveries in HIV prevention are made, including the use of circumcision and microbicides, the U.S. must have maximum flexibility to spend limited resources in the areas of HIV prevention that are most relevant to country demands. New discoveries are made in vain—and at considerable cost—if they cannot be funded and utilized in the countries where they can make the greatest impact.

While the end of 2006 delivered promising new research in the area of male circumcision for HIV prevention, it is in the New Year and beyond where the potential to do great things with this new research will be realized. As reported late last year, male circumcision has been shown to reduce HIV infection rates in males by roughly 50%. While this is a promising development, support for male circumcision programs could be hampered by the abstinence-until-marriage earmark in the President’s Emergency Plan for AIDS Relief (PEPFAR).

If it is determined that male circumcision should be included in HIV prevention programs—to be used in addition to other evidence-based prevention efforts—it has the potential to make a huge impact in places like sub-Saharan Africa where there is both high HIV prevalence and low male circumcision rates. However, PEPFAR support for this new prevention method would compete with limited prevention funding due to required spending for abstinence-until-marriage programs.

As 2007 gets underway, PAI urges the U.S. to overturn the abstinence-until-marriage earmark in PEPFAR and allow countries to develop HIV prevention programs that take full advantage of scientific discoveries that offer the most potential to save lives.