Last November at a summit in Nairobi, the UN Population Fund announced that it would take $264 billion to reduce global maternal deaths and protect women and girls from violence. The agency just released a publication outlining the details of how the billions would be spent—and the fine print includes abortion.
One of the enduring legacies of ICPD in 1994 is the compromise that was struck among nations: that the legal status of abortion was for national governments to determine, and that where legal, it should be “safe.” In the past quarter century, the same feminist organizations that sought to establish an international human right to abortion at the conference have continued to lobby for the same goal, calling it the “unfinished agenda of ICPD.”
Nevertheless, no right to abortion exists in international human rights or humanitarian law, and UNFPA, which receives its directives from agreements reached by governments at the UN, has no mandate to promote abortion. Its three central goals, set out in 2018, are to eliminate preventable maternal deaths, eliminate the “unmet need” for family planning, and to end gender-based violence, including child marriage and female genital mutilation.
The price tag for achieving these three goals, set at $264 billion, was publicized at the Nairobi Summit, but the specific details were set out this month in a new publication. In collaboration with researchers from several universities and other organizations, UNFPA broke down the specific interventions in each category, with cost estimates for each of the three targets.
The elimination of preventable maternal deaths in 120 priority countries, estimated as costing $115.5 billion over the next ten years, requires ensuring that “29 interventions are universally available,” one of which is “safe abortion services.”
Unlike many UNFPA publications, which include a disclaimer specifying that references to abortion apply under circumstances in which it is legal, this estimate includes no such language.
The maternal health estimates also rely on another assumption: “This study assumes that ending unmet need for family planning will also be achieved by 2030,” and if not, “the costs of ending preventable maternal deaths by 2030 could be substantially higher.”
The UNFPA report raised the question: what does eliminating “unmet need” mean in practice? According to the report, “there are 232 million women in developing countries who want to prevent their pregnancies but are not using modern contraceptives.” But researchers estimate that only about 5% of “unmet need” can be attributed to lack of access to family planning. The projected cost of $68.5 billion over the next ten years includes not just delivering commodities but also a variety of other efforts to address “concerns about side effects and demand creation.”
Given that the leading reasons women opt out of using contraceptives include health concerns and religious objections, despite being described as having a “need” for them, it remains to be seen whether UNFPA’s insistence on increased voluntary contraceptive use includes the ability to take no for an answer.
UNFPA’s estimates rely heavily on increasing contraceptive use, both to eliminate “unmet need” and to keep maternal health costs down by reducing the number of pregnancies that could result in maternal deaths due to insufficient health care, nutrition, and infrastructure, including transportation, electricity, and clean water. UNFPA’s costing analysis does not anticipate the need to generate demand for these things.
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