Contraception is not a panacea

The UK Government/Gates Foundation summit on family planning is a good thing, but we can't be fooled into thinking it can solve all our problems.

Every day around the world 1,000 women die from complications related to pregnancy or childbirth. Think about it: that’s 365,000 women every year – almost as many as the total population of Bristol.

In many of the world’s poorest countries early marriage, overstretched healthcare services and low adoption of modern contraception methods together create a situation where pregnancy can be a cause for real concern as well as celebration.

So it is great news that the prime minister will tomorrow host a joint UK Government/Gates Foundation summit on family planning intended to provide 120 million women with access to contraception over the next eight years at a cost of £2.6bn.

David Cameron and International Development Secretary Andrew Mitchell certainly deserve real credit for putting the issue of family planning firmly on the development agenda. Giving millions more women the means to choose when and whether to start families will not only save lives, it will also help families who are struggling to feed their existing children avoid unwanted pregnancies. And it could play a role in helping younger brides delay pregnancy until they are ready to have children.

But the government needs to avoid the misconception that contraception is a panacea. Girls forced into early marriage, for example, often have less control over the choice about when to start a family. Handing out contraceptives is necessary but not enough. These efforts need to be backed up by education and support services that empower women to assert their rights. And women who choose to get pregnant will still die unnecessarily unless there are good quality health services to take care of them.

Alongside the provision of contraception we need more programmes like the one Oxfam runs in Hadrahmout Governate in Yemen where only a quarter of the population has access to primary healthcare.  There we are building health facilities, distributing home delivery kits and supporting health education and awareness raising programmes. We are also training midwives, a process which not only improves healthcare but can also raise the status of women in society.
These issues may not get much airtime at the summit, to be held on July 11, World Population Day, which is planned as the government’s latest effort to communicate to the British public the benefits our aid brings. In these tough economic times, ministers deserve a loud cheer for its unwavering commitment to keeping Britain’s promises to the poorest in the face of some significant opposition on their own backbenches and beyond.

There are potentially two reasons why ministers find family planning an attractive topic for such an event. Firstly, giving women a chance to gain control of their own reproductive health is something that can save lives, and that we can all understand.

Critics opposed to aid or who believe that our concern for the poorest should begin and end at home have two simple questions to answer: do you believe that it is right that women in Sierra Leone, for example, are more than 70 times more likely to die as a result of pregnancy or childbirth than those in the UK? If not, what would you do about it?

The second attraction of family planning is potentially more problematic. Population growth is the public’s number one concern about development– yes, higher than corruption. This goes beyond simple prejudice about growing numbers of Africans or Asians (although that doubtless does exist) - it is also fuelled by concerns that population growth is responsible for climate change and other environmental problems.

This is based on a fallacy. It is consumption in the rich rather than the poor world that is primarily responsible for the pressure on our planet. In the 25 years to 2005, for example, Sub-Saharan Africa accounted for almost a fifth of the growth in the world’s population but only 2.4 per cent of the increase in CO2 emissions. By contrast, North America was responsible for four per cent of population growth but a staggering 13.9 per cent of the rise in emissions.

These facts did not stop the Optimum Population Trust deciding a couple of years ago, ahead of the Copenhagen climate summit, to launch a carbon off-setting scheme where instead of planting forests your money was used to fund family planning in poor countries.

It is the government’s job to challenge public prejudice which is not based on fact. It needs to find ways to ensure that tomorrow’s summit avoids reinforcing such lazy and (for us high consumers) convenient thinking.

Barbara Stocking is Chief Executive of Oxfam

Indian programme officer G. Shilpa poses with a female condom at an awareness camp in Hyderabad. Photograph: Getty Images
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Theresa May's "clean Brexit" is hard Brexit with better PR

The Prime Minister's objectives point to the hardest of exits from the European Union. 

Theresa May will outline her approach to Britain’s Brexit deal in a much-hyped speech later today, with a 12-point plan for Brexit.

The headlines: her vow that Britain will not be “half in, half out” and border control will come before our membership of the single market.

And the PM will unveil a new flavour of Brexit: not hard, not soft, but “clean” aka hard but with better PR.

“Britain's clean break from EU” is the i’s splash, “My 12-point plan for Brexit” is the Telegraph’s, “We Will Get Clean Break From EU” cheers the Express, “Theresa’s New Free Britain” roars the Mail, “May: We’ll Go It Alone With CLEAN Brexit” is the Metro’s take. The Guardian goes for the somewhat more subdued “May rules out UK staying in single market” as their splash while the Sun opts for “Great Brexpectations”.

You might, at this point, be grappling with a sense of déjà vu. May’s new approach to the Brexit talks is pretty much what you’d expect from what she’s said since getting the keys to Downing Street, as I wrote back in October. Neither of her stated red lines, on border control or freeing British law from the European Court of Justice, can be met without taking Britain out of the single market aka a hard Brexit in old money.

What is new is the language on the customs union, the only area where May has actually been sparing on detail. The speech will make it clear that after Brexit, Britain will want to strike its own trade deals, which means that either an unlikely exemption will be carved out, or, more likely, that the United Kingdom will be out of the European Union, the single market and the customs union.

(As an aside, another good steer about the customs union can be found in today’s row between Boris Johnson and the other foreign ministers of the EU27. He is under fire for vetoing an EU statement in support of a two-state solution, reputedly to curry favour with Donald Trump. It would be strange if Downing Street was shredding decades of British policy on the Middle East to appease the President-Elect if we weren’t going to leave the customs union in order at the end of it.)

But what really matters isn’t what May says today but what happens around Europe over the next few months. Donald Trump’s attacks on the EU and Nato yesterday will increase the incentive on the part of the EU27 to put securing the political project front-and-centre in the Brexit talks, making a good deal for Britain significantly less likely.

Add that to the unforced errors on the part of the British government, like Amber Rudd’s wheeze to compile lists of foreign workers, and the diplomatic situation is not what you would wish to secure the best Brexit deal, to put it mildly.

Clean Brexit? Nah. It’s going to get messy. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.