The demand for reproductive health commodities is increasing rapidly, for reasons listed below. Donor support has not kept pace. This gap has dire consequences.

Each million shortfall in funding means:

• 360,000 unwanted pregnancies
• 150,000 additional induced abortions
• 800 women’s deaths
• 11,000 infant deaths
• 14,000 additional deaths of children under five.

Several factors contribute to the gap between supply and demand:

• More people of reproductive age. More than 1 billion people are between 15 and 24 years of age, entering their reproductive lives as the largest-ever generation of young people.
• Increased demand for contraceptives. The number of contraceptive users is projected to increase more than 40 per cent between 2000 and 2015, due to population growth and the success of family planning programmes.
• Insufficient donor funding . Meeting demand requires a sustained commitment of adequate funding and close coordination among donors to avoid gaps or duplication
• Inadequate management capacity . A secure system of supply requires technical, financial and human resources that are sorely lacking in developing countries—including a full range of reproductive health information and services for effective delivery.

Increasing Costs, Decreasing Support

Costs are increasing, yet donor support is decreasing. In the early 1990s, donors provided an average of 41 per cent (1992- 1996) of the amount required each year for contraceptive commodities. That level of support fell to only 24.7 per cent in 1999. Contributions in 2002 totalled $158 millions. UNFPA estimates that between 2000 and 2015, commodity costs for contraceptives and condoms for STI/HIV prevention will increase as follows:

• From $572 million to $1.25 billion for family planning contraceptives;
• From $239 million to $557 million for condoms to prevent sexually transmitted infections including HIV/AIDS;
• In total, from $811 million to over $1.8 billion for family planning and HIV/AIDS commodities combined.

When shortfalls in funding have threatened supplies, donors have often stepped in with last-minute contributions. While these are greatly appreciated, steady funding is vital to long-term planning.

In the absence of large increases in financial support by donors and developing country governments, the world can expect to see a rise in death and illness related to poor reproductive health. Conversely, many studies have shown that investments in reproductive health services and commodities can have far-reaching benefits.

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