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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Metro mayors can help Labour return to government

Labour champions in the new city regions can help their party at the national level too.

2017 will mark the inaugural elections of directly-elected metro mayors across England. In all cases, these mayor and cabinet combined authorities are situated in Labour heartlands, and as such Labour should look confidently at winning the whole slate.

Beyond the good press winning again will generate, these offices provide an avenue for Labour to showcase good governance, and imperatively, provide vocal opposition to the constraints of local government by Tory cuts.

The introduction of the Mayor of London in 2000 has provided a blueprint for how the media can provide a platform for media-friendly leadership. It has also demonstrated the ease that the office allows for attribution of successes to that individual and party – or misappropriated in context of Boris Bikes and to a lesser extent the London Olympics.

While without the same extent of the powers of the sui generis mayor of the capital, the prospect of additional metro-mayors provide an opportunity for replicating these successes while providing experience for Labour big-hitters to develop themselves in government. This opportunity hasn’t gone unnoticed, and after Sadiq Khan’s victory in London has shown that the role can grow beyond the limitations – perceived or otherwise - of the Corbyn shadow cabinet while strengthening team Labour’s credibility by actually being in power.

Shadow Health Secretary and former leadership candidate Andy Burnham’s announcement last week for Greater Manchester was the first big hitter to make his intention known. The rising star of Luciana Berger, another member of Labour’s health team, is known to be considering a run in the Liverpool City Region. Could we also see them joined by the juggernaut of Liam Byrne in the West Midlands, or next-generation Catherine McKinnell in the North East?

If we can get a pantheon of champions elected across these city regions, to what extent can this have an influence on national elections? These new metro areas represent around 11.5 million people, rising to over 20 million if you include Sadiq’s Greater London. While no doubt that is an impressive audience that our Labour pantheon are able to demonstrate leadership to, there are limitations. 80 of the 94 existing Westminster seats who are covered under the jurisdiction of the new metro-mayors are already Labour seats. While imperative to solidify our current base for any potential further electoral decline, in order to maximise the impact that this team can have on Labour’s resurgence there needs to be visibility beyond residents.

The impact of business is one example where such influence can be extended. Andy Burnham for example has outlined his case to make Greater Manchester the creative capital of the UK. According to the ONS about 150,000 people commute into Greater Manchester, which is two constituency’s worth of people that can be directly influenced by the Mayor of Greater Manchester.

Despite these calculations and similar ones that can be made in other city-regions, the real opportunity with selecting the right Labour candidates is the media impact these champion mayors can make on the national debate. This projects the influence from the relatively-safe Labour regions across the country. This is particularly important to press the blame of any tightening of belts in local fiscal policy on the national Tory government’s cuts. We need individuals who have characteristics of cabinet-level experience, inspiring leadership, high profile campaigning experience and tough talking opposition credentials to support the national party leadership put the Tory’s on the narrative back foot.

That is not to say there are not fine local council leaders and technocrats who’s experience and governance experience at vital to Labour producing local successes. But the media don’t really care who number two is, and these individuals are best serving the national agenda for the party if they support A-listers who can shine a bright spotlight on our successes and Tory mismanagement.

If Jeremy Corbyn and the party are able to topple the Conservatives come next election, then all the better that we have a diverse team playing their part both on the front bench and in the pantheon of metro-mayors. If despite our best efforts Jeremy’s leadership falls short, then we will have experienced leaders in waiting who have been able to afford some distance from the front-bench, untainted and able to take the party’s plan B forward.