As a young girl in Colombia, I remember long conversations around the dinner table about the urgency of access to family planning for all Colombians. My family is Catholic, but my grandmother felt strongly that providing access to contraceptives was the most significant thing we could do to disrupt the poverty that curtailed our people’s aspirations. Around that table, my grandmother led our conversations with unarguable statistics, convincing me that reproductive health was the key to impacting human development.
When I came to live in the Philippines, conversation like ours about family planning were socially stigmatized. I wanted to pursue that dialogue I had grown up with, make it part of the national dialogue here. In Colombia, my family had supported Profamilia and its founder Dr. Tamayo when he was threatened with ex-communion. I was inspired by his efforts to advocate for the Profamilia model in the Philippines, as an opener to that conversation about family planning. Two decades later, it’s a conversation we’re still having.
In the Philippines, we now have one of the highest growth rates of unwanted pregnancies in adolescents of any country. This is a crisis. Nearly 54% of sexually active or in-union adolescent girls have never used contraception. A five-year delay in developing the Philippines’ comprehensive sexual education (CSE) curriculum has put a whole cohort of young people at risk, held back by concerns based in ideology not evidence. And it's not just the Philippines. Population Council research has demonstrated early and unintended pregnancy puts girls’ and young women’s aspirations off track, into child marriage, out of school, at greater risk of gender-based violence and HIV, and out of the workforce. Globally, we see that stigma and unfounded fears about sexual activity restrict young people’s access to the information and contraceptives they so desperately need.
I still count the Philippines’ 2012 Reproductive Health Law, establishing a national family planning program, as one of our great successes. The bill had many iterations before it was passed and ultimately had less teeth than many advocates may have hoped, but in the years since I have seen a shift in attitudes towards reproductive health. Legislative change shone a spotlight on family planning and I see a renewed willingness to address the challenges we face.
But legislation is a beginning, not the end. What matters most is implementation. Implementation of our hard-won national family planning program has been spotty, and funding remains a challenge. While most countries are reducing teen pregnancy, rates in the Philippines are on the rise. The Government of the Philippines’ commitment last year of $78 million for contraceptives, demand generation, and advocacy is welcome, and we look forward to seeing this reflected not only in the national budget and priorities, but also at the local level where implementation happens.
When the need is so great, it is more important than ever that these limited resources are invested in programs grounded in evidence – not intuition – about what works for adolescents. Research has shown that sexuality education programs that address gender and power are much more likely to be effective than those that do not. The Reproductive Health Law required the Department of Education to develop a CSE curriculum to inform young people of their choices in public schools, but this work was delayed by a Temporary Restraining Order in the Supreme Court and we are only now getting started. While I’m positive about the future, I cannot help but think of the many young people we could have reached in the past five years. Information and education on their reproductive health and rights would have enabled these young people to pursue their dreams, without being derailed by unwanted pregnancy or illegal abortions. We have let them down.
Over 40 percent of the world’s population is under 25 years old, almost half of which lives in South Asia and sub-Saharan Africa. I see a tremendous opportunity to harness the power of the largest ever youth generation and lay the groundwork for our future prosperity. But we will only realize that promise through strategic, evidence-based investments in young people, including in their sexual and reproductive health and rights. Decades of research tell us that adolescence is a pivotal time for young people. Lifelong behaviours are established, attitudes are formed, and reproductive health outcomes shape the rest of our lives.
For countries in Asia, a large youth population presents an opportunity for accelerated economic growth, as our youth reach working-age and enter employment. But this development is by no means a given. These benefits will only be realized with effective investment in human capital. When girls get pregnant early, the economic dividend is easily lost, as they drop out of education and the workforce. There are 23 million adolescents in developing regions with an unmet need for contraception, and age-appropriate, evidence-based family planning is one of the most effective investments we can make to give these young people a chance to thrive and plan their futures.
As an advocate, I’m always conscious that just because we’ve won one battle, it doesn’t mean the job is finished. It took us 14 years to get the Reproductive Health Bill passed in the Philippines, and another six years to begin to see it implemented. Over the coming years, we’ll be advocating to ensure those precious investments in our national family planning program are based on evidence about what young people want and need, enabling them to pursue their dreams for themselves.
As a long-time supporter and former Board member at the Population Council, it matters to me that we invest in policies and programs that have been shown, through high-quality research, to have their intended impact on the people for which they’re designed. But even that is not enough. As leaders – Goalkeepers – it’s up to us to not only demand evidence-based programs, but to invest in evidence generation.
We cannot fail another generation while we sit by and talk about solutions. The problem is urgent, and when world leaders gather in New York City for the General Assembly this month, it’s time for them to act on investment in family planning and sexual education. When we invest in adolescents’ health and well-being, there is a profound ripple effect, benefitting their lives as well as their families, communities, and society at-large.