Gates: Women need birth control on global health agenda

In an address with potentially far-reaching health care consequences, Melinda Gates today called upon governments to set as goals universal access to birth control for women who want it. She said the measure could save hundreds of thousands of lives each year.

A Catholic, Gates is a co-chair and trustee of the Melinda and Bill Gates Foundation, which distributes billions of dollars annually in the developing world to raise agricultural productivity, health care and education levels while it works to eradicate global diseases.

Speaking before a TEDxChange audience in Berlin, Gates stressed her Catholic identity and values, saying they have shaped her career at the Gates foundation, adding that it has been her Catholic education that led her to question her church’s official teaching that artificial birth control is sinful.

She said each year some 100,000 women who don’t want to be pregnant die in childbirth and some 600,000 women who don’t want to be pregnant give birth to infants who die in their first month of life.

She said the use of contraceptives is a broadly accepted idea, adding that couples use them because they want the power to plan their own lives and to raise healthier, better-educated, and more prosperous families.

“But for an idea that is broadly accepted in private, birth control generates a lot of opposition in public,” she said.

“Some people think contraceptives are code for abortion, which they’re not. Some people are uncomfortable because contraceptives have to do with sex. Some people worry that the real goal is to control populations. All these side issues have attached themselves to the core idea that men and women should be able to decide when to have a child. As a result, birth control has almost disappeared from the global health agenda.”

She wants to change this, adding the consequences of this disappearance has led to much suffering and death. The greatest victims, she said, have been in sub-Saharan Africa and the poorest parts of South Asia which contraceptives are frequently unavailable.

Gates contrasted modern contraceptive use in countries such as Germany where the proportion of people currently using modern devices is 66 percent (Thailand, 64 percent; El Salvador, 66 percent) with Nigeria, 10 percent (Chad, 2 percent; Uttar Pradesh, the biggest state in India, 29 percent).

Gates insisted that her call for a wider distribution of contraceptives has nothing to do with abortion or population control.

“We are talking about giving women the power to save their own lives and their children’s lives — and to give their families the best possible future.”

The Gates Foundation, the largest private foundation in the world with $36.3 billion in assets, has focused for decades on improving the quality of lives in the developing world, pouring billions of dollars into agricultural, development, education, and disease fighting programs. Gates referred to some of these in her address.

“There are lots of things we have to do as a community to make a better future. Fight diseases like diarrhea and pneumonia that are killing millions of children. Help farmers on small plots of land grow enough food. Make sure all children are educated.”

Then she added: “But one of the simplest and most transformational things we can do is give everybody access to the birth control methods that almost all Germans — and all Americans — use at some point in their lives.”

She called efforts to make contraceptives more available “a global movement in waiting.”

Gates said she was raised a Catholic and attended Catholic schools through high school. She said her mother's great uncle was a Jesuit priest and her great aunt was a religious sister. In high school, she said, the Catholic sisters made service and social justice a priority. “In my work at our foundation, I believe I am applying the lessons I learned in school.”

Referring to her church’s teaching that holds the use of artificial contraceptives to be morally unacceptable she said, “In the tradition of the great Catholic scholars, the nuns also taught us to question received teachings. One of the teachings most of my classmates and I questioned was the one saying that birth control is a sin.”

She then refuted those who claim the use of contraceptives encourages promiscuity. She said her personal decision regarding birth control, like that of other women she knows, had nothing to do with promiscuity.

“I had a plan for my future. I wanted to go to college, and I studied hard. I am proud that I was one of the very few female computer science graduates in my class. I also wanted to have a career. I went to business school, and I became one of the youngest female executives at Microsoft. I didn’t want to have children right away, but I did want very badly to have children … when I was ready. Now Bill and I have three.”

She said that in her travels throughout the world she finds women generally express similar family sentiments.

“The thing that strikes me most when I travel around on behalf of our foundation is that all women want the same thing. Last year, I met with a mother’s group in a slum outside Nairobi. The women were taking turns explaining why they use birth control. Finally, a woman named Mary Ann summed up the whole conversation in a phrase I’ll never forget. She said, quote, ‘I want to bring every good thing to one child before I have another.’ ”

“That’s universal,” Gates said. “We all want to bring every good thing to our children. What is not universal is our ability to provide every good thing to our children.”

“We can help poor families build a better future,” Gates concluded. “We can insist that all families have the opportunity to learn about contraceptives, and have access to the full variety of methods so they can decide which one is right for them. That is the clear goal: universal access to the birth control that women want. To achieve that goal, rich and poor governments alike must make birth control a priority.”

[Fox is NCR publisher. His email address is tfox@ncronling.org.]