Commitments are the lifeblood of the FP2020 movement: formal pledges by countries, donors, civil society, and private sector partners to expand access to voluntary, rights-based, high-quality family planning. The commitments are specific statements of intent, outlining what actions the commitment-makers will undertake, what objectives they will pursue, what policy changes they will seek, and how much money they will invest. As such, they function as a blueprint for collaboration, providing partners with a shared agenda and measurable goals. Taken together, the FP2020 commitments add up to an enormous, unprecedented global undertaking to bring health and empowerment to millions of women and girls.
A YEAR OF NEW COMMITMENTS
The past year has seen the largest wave of new commitments to FP2020 since the 2012 London Summit on Family Planning. This enthusiasm is testament not only to the compelling power of the FP2020 vision, but to the growing value of this platform as a catalyst for change.
The locus of this forward momentum is the countries. When countries commit to FP2020 they are setting the agenda for progress, underpinned by a multisectoral foundation of support. They are investing in a transformational strategy that will lead to healthier and more prosperous women, children, families, and communities. And they are joining a global partnership of donors, experts, and advocates who are equally committed to realizing a future where every woman and girl has the right to grow, thrive, and shape her own life.
Seven additional countries have joined the FP2020 movement in the past 12 months, bringing the total number of commitment-making countries to 36.6 This means that more than half of the 69 FP2020 focus countries are now formally pledged to the partnership:
Burundi committed to increasing its contraceptive prevalence rate (CPR) from 22% to 50% by 2020. The government plans to create a national population board, which will integrate population, health, and environmental objectives; increase budget allocations for family planning by 10% every year beginning in 2015; coordinate financial mechanisms to improve engagement with donors; encourage greater public-private partnerships to expand family planning service delivery points; and improve family planning services by training health providers.
Cameroon pledged to realize its Strategic Plan for Reproductive, Maternal, Neonatal and Child Health for 2014–2020 and to increase its modern contraceptive prevalence rate (mCPR) from 16.1% to 30% by 2020. The government aims to increase its budget allocation for reproductive health to 5% by 2020; offer subsidies on family planning services to more vulnerable groups, such as adolescents and women with disabilities; and ensure commodity security, so that stock-outs of vital contraceptive supplies do not occur.
Togo committed to increasing its mCPR from 13.2% in 2010 to 24.3% by 2017. The government’s objectives are to improve the access of local populations to family planning services; scale up best practice interventions in reproductive health and family planning service delivery; optimize the supply chain; strengthen communication around family planning; and develop partnerships with the private sector to provide family planning services. The government also pledged to launch a national plan for repositioning family planning and to provide a specific financial grant for the purchase of contraceptive products.
Mali pledged to increase its mCPR from 9.9% to 15% by 2015, with a special focus on meeting the unmet needs of teens and young adults. The government pledged to implement the National Family Planning Action Plan 2014–2018 and to strengthen its partnership with stakeholders, including the private sector and professional organizations; to increase by 5% each year the budget allocation for contraceptives; and to diversify the source of financing for family planning activities, especially by mobilizing the private sector.
Somalia committed to increasing its mCPR from 2.6% to 10% by 2016. The government pledged to bolster links between local communities and health facilities to expand contraceptive access; fortify existing family planning programs to emphasize quality of care, reinforce community-based distribution of contraceptives, and strengthen the referral system; conduct outreach and awareness campaigns about family planning, including targeted messages to men and young people; develop a regulatory framework to underpin the supply of health services, training, equipment, and commodities; and implement the Campaign on Accelerated Reduction of Maternal, Newborn and Child Mortality in Africa (CARMMA).
Nepal pledged to reposition family planning as a key strategy for fostering sustainable economic and social development; to execute its newly developed National Family Planning Costed Implementation Plan 2015–2021; and to remove barriers to family planning faced by young people, those living in rural areas, and other vulnerable and marginalized groups. Tragically, within weeks of announcing its new FP2020 commitment, Nepal was struck by its worst earthquake in nearly a century. Development priorities have been upended as the country struggles to recover from the devastation. The government of Nepal remains committed to FP2020, however, and is currently evaluating how best to pursue its family planning objectives with support from FP2020 partners.
Madagascar committed to increasing its contraceptive prevalence rate (CPR) to 50% by 2020 and to reducing unmet need for family planning by half. The government pledged to create a favorable legislative and regulatory environment for family planning; enforce all laws related to family planning and marriage; improve access to family planning services for youth; institutionalize the annual national campaign for family planning; strengthen community mobilization and distribution; ensure contraceptive security and the availability of contraceptive products; improve health training in family planning, particularly for long-acting and permanent methods; and strengthen public-private partnerships and multisectoral engagement. The government also pledged to increase its budget allocation for family planning by at least 5% each year.
Five institutional partners have also made FP2020 commitments in the past year, infusing the global movement with new resources and fresh momentum:*
The Brush Foundation joined the FP2020 partnership with an initial pledge of US$30,000 toward global family planning efforts, including funds for FP2020’s Rapid Response Mechanism. The Brush Foundation subsequently extended its commitment by an additional US$50,000, with contributions to Pathfinder International and the Guttmacher Institute.
EngenderHealth pledged to spend US$40 million on programs in West and Central Africa that will expand women’s access to family planning. EngenderHealth also committed to developing an advocacy campaign to inspire support in the United States for women in developing countries who want access to contraception (the WTFP?! Where’s the Family Planning?! campaign, rolled out in 2015), and to finalizing its new Checkpoints for Choice guide, designed to help governments and partners ensure that family planning services are grounded in human rights.
INTERNATIONAL CONTRACEPTIVE ACCESS FOUNDATION
The International Contraceptive Access (ICA) Foundation joined the FP2020 partnership with a commitment to donate 20,000 levonorgestrel-releasing intrauterine system (LNG IUS) contraceptive devices to FP2020 countries each year from 2016 to 2020. The LNG IUS is a soft plastic IUD that steadily releases a small amount of contraceptive hormone and is effective for up to five years. The Population Council and Bayer HealthCare Pharmaceuticals established the ICA Foundation as a public-private partnership to distribute the LNG IUS on a not-for-profit basis in resource-poor settings, primarily in developing countries. (This commitment was announced after the print edition of FP2020 Commitment to Action 2014–2015 went to press.)
Bayer HealthCare (BHC) committed to expanding its successful youth-centric health programs under the umbrella of the World Contraceptive Day (WCD) initiative and its related It’s Your Life—It’s Your Future campaign, pledging financial and in-kind support worth more than US$8.4 million over the next five years. BHC’s work with WCD focuses on increasing the awareness and knowledge of sexual and reproductive health among adolescents and youth worldwide, with medically accurate and unbiased sexuality education provided through national, regional, and global programs.
Pfizer joined the FP2020 partnership with a commitment to sell Sayana® Press for US$1/dose to qualified purchasers. Sayana® Press combines Depo-Provera with Uniject™, a completely self-contained one-dose injection system that eliminates the need for health workers to store medicines and syringes or measure out doses. The price agreement allows Sayana® Press to be offered to women in FP2020 countries at reduced or zero cost. Financial support is provided by the Bill & Melinda Gates Foundation (BMGF) and Children’s Investment Fund Foundation (CIFF), while in-country distribution is made possible by PATH, DFID, UNFPA, and USAID.
MANAGEMENT SCIENCES FOR HEALTH
Management Sciences for Health (MSH) pledged to work with national, subnational, and local leaders to help them plan for and achieve their FP2020 goals. MSH will build upon its performance management approaches and frameworks, such as the Leadership Development Program, to strengthen decision making at all levels of the health system, and will expand its YOUTHLEAD program to cultivate young champions of family planning. MSH will also foster dialogue between the family planning community and ministers of finance to establish accountability platforms, work with FP2020 to develop and monitor costed implementation plans, and provide tools and technical assistance to strengthen supply chains.
A CALL FOR RENEWAL
In April 2015 the FP2020 Reference Group convened for a milestone meeting in New Delhi, India. After reviewing the progress of the initiative to date and assessing the need to fast-track efforts, the Reference Group urged partners to do more—to reinvigorate their FP2020 commitments with more ambitious objectives and innovative, practical strategies to meet them. And partners are stepping up with new and increased pledges:
BILL & MELINDA GATES FOUNDATION
The Bill & Melinda Gates Foundation is announcing a major expansion of its FP2020 commitment with this report, pledging to increase its financial investment by 25% over the next three years. The new funding will be concentrated in three areas: enabling social marketing organizations to reach greater scale, family planning in urban contexts, and helping to grow the global community of support for family planning. The Gates Foundation also plans to invest in a new learning agenda for adolescents and youth.
MARIE STOPES INTERNATIONAL
Marie Stopes International (MSI) responded to the call by doubling its FP2020 commitment. MSI’s original pledge, delivered at the 2012 London Summit, was to reach 6 million new users of contraception by 2020; now it will aim to reach 12 million, representing 10% of FP2020’s overall goal. MSI plans to halve the cost of reaching each new user by employing economies of scale, improving operational efficiencies, and harnessing emerging forms of contraception. MSI will draw from its own funds and also seek to double its annual income from donor and domestic financing.
Jhpiego also announced a sizable increase in its FP2020 commitment. Jhpiego’s original pledge was to invest US$200,000 to expand the availability of postpartum family planning (PPFP) and postpartum intrauterine devices (PPIUDs) in Burkina Faso. That initial US$200,000 turned into US$7 million with the April 2015 launch of a three-year scale-up program, funded by an anonymous donor. The new project will increase access to PPFP and PPIUDs in Burkina Faso and support the integration of these services with the training of midwives and physicians.
Pathfinder International renewed its FP2020 commitment with a pledge to expand sexual and reproductive health services to 25 million youth in developing countries by 2020. Pathfinder’s original FP2020 commitment was to raise US$3 million to augment and expand its existing family planning programs. By the end of 2014 Pathfinder had already exceeded this pledge, increasing its financial support for family planning to US$172 million, expanding to two additional countries (Bangladesh and Haiti), and launching a new program focused on the family planning needs of young married couples in francophone West Africa.