1. The 20/20 Initiative: Achieving Universal Access to Basic Social Services for Sustainable Human Development. December 1994. Note prepared jointly by UNDP, UNESCO, UNFPA, UNICEF and WHO. New York: United Nations. This included $10-12 billion above the amount available for family planning in around 1990.

2. The evidence is extensively documented in a growing literature over the last decade. It is also clear from the importance given now in the international financial institutions to social protection and to efforts for debt relief. "Development with a human face" is changing from a slogan to a set of practical and pragmatic negotiations and instrumentalities.

3. Estimates of expenditure per capita were calculated by subregion and then expanded to encompass the regions’ entire populations. Data are available from 89 developing countries, 18 donor countries, 5 international lending institutions, 11 foundations, 12 United Nations agencies or organizations, 77 national NGOs and 21 university/research institutions. The compiled and analyzed data will be reported in: UNFPA. (Forthcoming.) Global Population Assistance Report 1998. New York: UNFPA.

4. To advance this process, a meeting was held in Hanoi in October 1998 attended by 29 developing countries, 19 donor countries, 11 international NGOs and 13 multilateral development organizations. The participants adopted the "Hanoi Consensus on the 20/20 Initiative: Universal Access to Basic Social Services" and agreed that the current economic and financial crisis underscores the relevance of the 20/20 Initiative to protect access to basic social services for the most vulnerable people.

5. UNFPA. 1999. Global Population Assistance Report 1997. New York: UNFPA.

6. Estimates on public resources allocated to reproductive health are based on questionnaires sent to government ministries. A few case studies (cited in: Janowitz, Barbara, Diana Measham, and Caroline West. 1999. Issues in the Financing of Family Planning Services in Sub-Saharan Africa. Research Triangle, North Carolina: Family Health International.) indicate that this can understate totals derived from field observations and interviews.

7. A comprehensive review of the difficulties encountered in their work is provided in: Dekker, Ari. 1999. "Background Note on Measuring Resource Flows for Population Activities: Issues and Trends." Internal project document. The Hague: Netherlands Interdisciplinary Demographic Institute.

8. Information on fees charged for family planning and immunization, for example, are assessed in the Demographic and Health Surveys sponsored by USAID. However, there are practical limits on the number of additional questions which can be asked in an already complex inquiry and information on the source of services is subject to some misreporting.

9. Joint United Nations Programme on HIV/AIDS (UNAIDS) and Harvard School of Public Health. 1999. Level and Flow of National and International Resources for the Response to HIV/AIDS: 1996-1997 (UNAIDS/99.25E). Geneva: Joint United Nations Programme on HIV/AIDS.

10. Many analysts, including McGreevey, et al. (McGreevey, William, et al. 1999. Value for Money in Reproductive Health: Issues and Options for Governments and Donors. Washington, D.C.: Planning and Finance Group, The Futures Group International.) have emphasized the unrealistic level of the costs resulting from a strategy focused on anti-retroviral medications, particularly in poor countries. Additional resources will be required for AIDS prevention efforts not included in the costed package of the ICPD, including specialized information and education programmes directed to high-risk populations, particularly where the pandemic is not yet generalized in the population.

11. A recent thoughtful and challenging presentation of the issues can be found in: Behrman, Jere R., and James C. Knowles. 1998. "Population and Reproductive Health: An Economic Framework for Policy Evaluation." Population and Development Review 24(4): 697-738. New York: The Population Council.

12. Herrin Alejandro N., et al. 1996. "National Family Planning Expenditures of the Philippines: Estimates for 1994." Unpublished manuscript.

13. Allison, Christopher. 1998. Personal communication.

14. Calculations based on data in: Conly, Shanti. 1998. Paying Their Fair Share. Washington, D.C: Population Action International. Cited in Janowitz, Measham, and West 1999.

15. Private sector involvement has also been examined in: Bulatao, Rodolfo. 1998. The Value of Family Planning Programs in Developing Countries. Santa Monica, California: Rand Corporation. The UNFPA Global Initiative on Reproductive Health Commodity Management (described in this report) has conducted meetings on the topic and will produce future papers. A theoretical framework for examination of financing decision in reproductive health is given in: Behrman and Knowles 1998.

16. This presentation relies heavily on: Janowitz, Measham and West 1999. See also: Behrman and Knowles 1998; McGreevey, et al. 1999; and Merrick, T. (Forthcoming.) "Delivering Reproductive Health Services in Health Reform Settings: Challenges and Opportunities." Washington, D.C.: The World Bank. Web site: <www.worldbank.org>.

17. Data are most recently available from 1990-1997. 18. For a more extended discussion, see: UNFPA. 1997. State of World Population 1997: The Right to Choose: Reproductive Rights and Reproductive Health. New York: UNFPA.

19. This point is made in a challenging review of primary health care strategies (Filmer, Deon, Jeffrey Hammer, and Lant Pritchett. 1998. "Health Policy in Poor Countries: Weak Links in the Chain." Policy Research Working Paper No. 1874. Washington, D.C.: The World Bank Development Research Group.).

20. See the work of Julia Walsh, Malcolm Potts and their colleagues in the Bay Area International Health Group (e.g., Sylvie, Marceau, Julia Walsh, Elizabeth Townes and Tim Wade. "Can Consumers in Developing Countries Afford Contraceptives?" Draft paper).

21. Details of the economic analysis are presented in: Behrman and Knowles 1998.

22. For details see: Pathak, Laxmi Raj, et al. 1998. Maternal Mortality and Morbidity Study. Kathmandu, Nepal: Family Health Division, Department of Health Services, Ministry of Health, His Majesty’s Government of Nepal.

23. See: Janowitz, Measham, and West 1999; Berman and Knowles 1998; and McGreevey, et al. 1999.