While Supplies Last: Time for Countries to Invest More in Contraceptives
We are marking the midpoint of the FP2020 initiative by reflecting on the current status of funding for contraceptives in sub-Saharan Africa, and what is needed to ensure contraceptive commodity security into the future.
Availability of family planning supplies relies largely on funding from donor countries. However, growth in donor funding could be very volatile into the near future, and is not sustainable into the long term. The United States is preparing for an election year, and therefore is unlikely to increase its funding. The European Union (EU) is in the midst of an immigration crisis, again pointing to flat or declining funding for family planning. As one of the largest donors to family planning, Britain’s exit from the EU has eroded the value of its currency and undermined its legitimacy as a champion for sexual and reproductive health and rights in the EU. UNFPA is currently facing a nearly 40% funding gap of its supplies program. All of these factors come together to signal a looming crisis in donor funding for contraceptives.
With an unpredictable future in donor funding, the possibility of governments in the Global South taking ownership of funding their own contraceptives is a promising answer. While countries in the Global South are beginning to make moves toward more sustainable contraceptive funding through important steps like establishing budget lines for reproductive health supplies, most do not yet have enough resources to fund a significant portion of their contraceptives.
In an effort to better assess governments’ ability to cover contraceptives, we looked at data from USAID DELIVER’s CS Indicators in Africa, where most of FP2020 focus countries are located.
To encourage increased government funding for family planning, FP2020 has focused on the development of government budget lines for ‘reproductive health supplies,’ which typically means contraceptives. While more than half of the 26 African countries with budget information available have contraceptive budget lines, many of them are symbolic and do not cover a significant part of contraceptive needs. Sixty-five percent of these countries (or 17 countries) contribute less than 10 percent of the estimated contraceptive funding needed in their country.
While the inclusion of contraceptive budget lines in health budgets is a positive step, countries are far from self-sufficient. In fact, 24 of the 26 countries depend on external donors to fund more than half of their contraceptive needs for the public health system. And almost half of the countries rely entirely on donors to fund the contraceptive needs of women. This significant reliance on donor funding means that many countries would struggle to find enough money to fill the gap. Women and girls who rely on these services would ultimately pay the price.
While donors and governments have taken steps to invest in a more sustainable contraceptive future, most countries are still largely reliant on additional funding for contraceptives. In the immediate term, donors need to step in and fill funding gaps. In the longer-term, there is clearly still work to be done to support countries so they can take more ownership of meeting their own contraceptive needs.