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Lack of Access to Contraception Results in Disproportionate Number of HIV Cases Among Women in Developing Countries, UNFPA Report Says

September 15, 2004

About 350 million people in developing countries lack access to contraception, which has resulted in a "disproportionat[e]" number of women being affected by HIV/AIDS in the world's most resource-poor countries, according to a report scheduled to be released on Sept. 15 by the United Nations Population Fund, the Toronto Star reports. The report, titled "The State of World Population 2004," says that although progress has been in increasing access to contraception in developing countries and creating laws to ban discrimination and violence against women since the 1994 International Conference on Population and Development, "key obstacles remain" (Ward, Toronto Star, 9/15). During the 1994 conference -- which was held in Cairo, Egypt -- 179 countries approved a plan to enhance the reproductive health and rights of women throughout the world. Targets set at the Cairo conference aim to provide family planning options and education to prevent unwanted pregnancies as a way to reduce world poverty and hunger and improve women's rights in developing countries (Kaiser Daily HIV/AIDS Report, 9/3). Lack of funding for contraception and other family planning programs resulted in 52 million unwanted pregnancies worldwide in 2003, nearly half of which ended in abortion, according to the report, the St. Paul Pioneer Press reports (St. Paul Pioneer Press, 9/15). In addition, continued "discrimination and violence" have made women especially vulnerable to HIV infection, the report said, adding that "infection rates among young African women aged 15-24 are two to three times higher than among young men. Married women are often unable to negotiate condom use even when they know their husbands have multiple partners" (Toronto Star, 9/15).

Additional Findings
Although approximately 60% of couples in developing countries have access to contraception -- an increase from only 10% to 15% in the 1960s -- international donors provided twice as much funding for contraceptives in developing nations in the early 1990s than they currently provide, Agence France-Presse reports. "The response of the international community has been inadequate," the report said, adding, "Past commitments to development assistance must move from declarations of good intentions to active partnerships and investments" (Agence France-Presse, 9/15). Approximately 137 million women worldwide who want to delay another birth or avoid pregnancy do not have access to contraception, while about 64 million women use contraception that is not the most effective available, the report said. Providing contraception to these women could prevent 23 million unplanned births, 22 million abortions and 1.4 million infant deaths, according to the report. The report also notes that 33% of pregnant women worldwide receive no prenatal care and 60% of births take place outside of hospital settings, according to the Pioneer Press. Such "gaps" in care have resulted in the deaths of 500,000 women due to pregnancy-, childbirth- and abortion-related complications, the Pioneer Press reports (St. Paul Pioneer Press, 9/15). The report also said that the world population is expected to grow from 6.4 billion in 2004 to 8.9 billion by 2050, with the 50 most resource-poor countries tripling in population (Toronto Star, 9/15).

Conclusions, Reaction
The report said, "Differences between poor and rich populations' access to family planning are staggering," adding, "Women in the richest fifth of the population are five times more likely to have access to and use contraception than women in the poorest fifth" (Agence France-Presse, 9/15). The report concludes that an additional $3.9 billion in annual funding for contraception and family planning could prevent about 142,000 pregnancy-related deaths each year (St. Paul Pioneer Press, 9/15). "In 2004, it is a crime that women still die because they are having babies," UNFPA Executive Director Thoraya Ahmed Obaid said, adding, "We know what to do -- increase access to skilled (professionals) at birth and to emergency obstetric care." Werner Fornos, president of the Population Institute, said, "We may have made advances since Cairo, but they're nowhere near what should be happening. There are still 350 million people in the world who say they want no more children, or want to space their children, and that gap hasn't been reduced" (Toronto Star, 9/15). Obaid added, "Unless international assistance rises to the level agreed to at the Cairo conference, the numbers of people who need family planning, maternal health and HIV/AIDS prevention, testing and treatment will continue to grow. Lack of reproductive health care will continue to be the leading cause of death and disability for women in the developing world and the AIDS pandemic will continue to expand and wreak havoc" (UNFPA release, 9/15).

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