The Contraception Crusade

Bit long, but worth the read

http://www.thedailybeast.com/newsweek/2012/05/06/melinda-gates-new-crusa...

In the 12 years since Melinda Gates and her husband, Bill, created the Gates Foundation, the world’s largest philanthropic organization, she has done a lot of traveling. A reserved woman who has long been wary of the public glare attached to the Gates name, she comes alive, her associates say, when she’s visiting the foundation’s projects in remote corners of the world. “You get her out in the field with a group of women, sitting on a mat or under a tree or in a hut, she is totally in her element, totally comfortable,” says Gary Darmstadt, director of family health at the foundation’s global health program.

Visiting vaccine programs in sub-Saharan Africa, Gates would often ask women at remote clinics what else they needed. Very often, she says, they would speak urgently about birth control. “Women sitting on a bench, 20 of them, immediately they’ll start speaking out and saying, ‘I wish I had that injection I used to get,’” says Gates. “‘I came to this clinic three months ago, and I got my injection. I came last week, and I couldn’t get it, and I’m here again.’”

They were talking about Depo-Provera, which is popular in many poor countries because women need to take it only four times a year, and because they can hide it, if necessary, from unsupportive husbands. As Gates discovered, injectable contraceptives, like many other forms of birth control, are frequently out of stock in clinics in the developing world, a result of both funding shortages and supply-chain problems.

Women would tell her that they’d left their farms and walked for hours, sometimes with children in tow, often without the knowledge of their husbands, in their fruitless search for the shot. “I was just stunned by how vociferous women were about what they wanted,” she says.

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Now the foundation, which is worth almost $34 billion, is putting her agenda into practice. In July it’s teaming up with the British government to cosponsor a summit of world leaders in London, to start raising the $4 billion the foundation says it will cost to get 120 million more women access to contraceptives by 2020. And in a move that could be hugely significant for American women, it is pouring money into the long-neglected field of contraceptive research, seeking entirely new methods of birth control. Ultimately Gates hopes to galvanize a global movement. “When I started to realize that that needed to get done in family planning, I finally said, OK, I’m the person that’s going to do that,” she says.

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Gates believes that by focusing on the lives of women and children, and by making it clear that the agenda is neither coercive population control nor abortion, the controversy over international family-planning programs can be defused. Right now, she points out, 100,000 women annually die in childbirth after unintended pregnancies. Six hundred thousand babies born to women who didn’t want to be pregnant die in the first month of life.