By contrast, today two-thirds of Mexican women use contraceptives, average fertility rates are 2.2 children per woman, infant mortality rates are 20.5 per 1,000 live births, and average life expectancy is 75 years of age. In other words, as contraceptive use has skyrocketed and women have been able to achieve their desired (smaller) family size, birth rates and infant mortality rates have fallen by as much as two-thirds.  Not surprisingly, maternal mortality rates have dropped dramatically, too.

Fortunately, Mexico is hardly alone in these successes. Thanks in part to pioneering U.S. family planning funding and technical assistance, first begun in the late 1960’s, countries such as Egypt, Indonesia, South Korea, Thailand and Tunisia have achieved major improvements in the health and economic development of women, families and their nation as a whole.

Unfortunately, the "job" of expanding access to voluntary FP/RH services is far from done. In fact, more than 200 million women in poor, developing nations who would like to delay or end childbearing are not using modern contraceptives (PDF).  And demand for birth control is steadily increasing around the globe.  So the challenge today is to replicate the successes that have been achieved in places like Mexico in those parts of the developing world that are still beset by high infant and maternal death rates, lack of knowledge and access to family planning, and the resulting high birth and population growth rates: namely, sub-Saharan Africa and parts of the Middle East and south Asia.

But replicating these successes is running into trouble because the United States and other donor nations are investing far less in FP/RH programs than they used to -- and, most importantly, far less than is needed.  Current U.S. funding for international FP/RH programs is a whopping 40 percent less than what we provided back in 1995 (when adjusted for inflation).  

Apparently, one of the reasons for this decline is that not enough policymakers see the interconnections between voluntary family planning and larger, more pressing humanitarian and foreign policy goals, even though these linkages exist in everything from poverty and hunger to security and climate change.

I think “what if” questions on these issues are fascinating and don’t get the attention they deserve.  For example, if Mexico's birth rates had remained where they were in the early 1970’s, its population today would be about 50 million greater.  That staggering 50 percent increase (its population today is about 107 million) would certainly have major negative ramifications in a country where widespread poverty still compels millions of its citizens to risk their lives in a search of a better life in the United States.  And it obviously would have a significant impact on the United States as well.

It's these types of interconnections that policymakers need to think about when deciding how much to invest in international FP/RH programs.  Unfortunately, it seems that most of them don't think about these links, and because of that we all pay a price -- from the micro level of the women themselves and their quality of life to the macro level of the future sustainability of our world.

So, one last “what if?” question before I wrap up.  What happens in terms of global population if access to voluntary family planning doesn’t improve and birth rates remain where they are today?   If that happens, we will likely grow from 6.7 billion people to just under 12 billion by 2050.  In other words, we’ll add the equivalent of the entire world population in 1990.  

Do our policymakers really think this would be a good thing?