The Future of Family Planning Convening Keynote Address by UNFPA Executive Director Dr. Natalia Kanem

Excellencies, 
Esteemed partners, 
Dear friends, 
Dear young people,

I greet you in Peace, the noble purpose of the United Nations and the fervent wish of the women and girls UNFPA serves in over 150 countries around the world. 

Thank goodness for the forward-looking initiatives of the William H. Gates Sr. Institute for Population and Reproductive Health. Thanks to the cohosts for bringing us together, the Johns Hopkins Bloomberg School of Public Health, and FP2030.

As you and I look to the future of family planning, we need a time frame. That outlook could span 10 years from now – which is basically tomorrow – or all the way to the end of the century. 

For instance, I’m currently leading the Lancet Commission on 21st Century Threats to Global Health, established with co-chair Christopher Murray of IHME.  

We need a longer-term perspective because the effects of threats like to health like pollution, climate change, antimicrobial resistance, or an inverted population pyramid will take decades to alter future trajectories. 

Modeling at the future through the lens of our Lancet Commission, we’ve made bold to peek through the magnifying glass to discern what just might happen by the year 2100. 

That’s why standing here with you, I have no qualms to make bold and posit what will be the features of family planning in an intermediate era, say maybe 20 to 30 years. 

From the outset, the future of family planning is built upon the bedrock of human rights. That future we envision is one of equality for all. 

The future of family planning will be characterized by self-agency, especially on the part of young people — who expect innovation and demand the modernization of our field. They’re impatient for safe, effective, convenient, reversible and affordable methods. On top of that, the contraceptive offerings should be products that are pleasurable, that incorporate fun.

Let’s pose a fundamental question. Will we continue the expectation that it’s the woman with the womb who should bear eternal responsibility for planning the shape and the contours of the family of the future? 

Which leads to another question: When will men step up and take their responsibilities? When will men be availed of reliable, quality commodities that are emblematic of sharing the burden as well as the triumphs of good family planning? 

Second, in the future the clamor is for ready access. 

I hope that this comes with the understanding that the risk proposition of hormonal or barrier methods will become so improved, that access will be through self-care. Through autonomous decision-making by fully empowered users of contraception who need no arbiter. Who need no permission from the husband, the significant other, the mother-in-law, the father, or any authoritative figure nominated by patriarchy. No doctor. No nurse. No gatekeeper’s intervention. 

And of course, the means and methods to monitor and course correct must be there, if and when side effects would appear. Bodily autonomy demands just that. 

Mind you, right now, nearly half of women lack the power to make their own decisions about their sexual and reproductive health. This must change – and we can change it – if we stand strong and stand together in upholding, protecting and advancing this fundamental human right for everyone – no exceptions, no exclusions. 

As we contemplate the future, let’s take a look at how far we’ve come: from Bucharest in 1974, to the all-important rights-based 1994 Cairo International Conference on Population and Development (the ICPD), which put women and girls squarely at the center of development. 

Jump to the London Summit on Family Planning in 2012, after which our collaborative efforts yielded remarkable results: 

92 million more women in low and middle-income countries using modern contraception. 

Since 2000, adolescent birth rates declined; maternal mortality fell by more than one-third; and globally, deaths of children under-5, halved. 

Mothers are safer, babies are healthier, more women and couples can decide freely whether or when to have children, and more girls can stay in school and out of marriage. 

Unfortunately, recently such progress has stalled, and in some places is actually going backwards.

Therefore, another feature of the future of family planning is that it will support demographic resilience. 

Voluntary, rights-based family planning is fundamental to building societies that can adapt to shifting population dynamics. 

Did you know that two-thirds of people now live in countries where fertility rates are trending, at or below replacement level? And people are living longer, populations are aging and catering for that is of increasing concern. 

In response, some governments are attempting to reverse universal access to contraception and instead, introducing pro-natalist incentives, telling women it’s their patriotic duty to bear more babies, even banning postpartum contraception in health facilities.  

Such directives threaten women’s hard-won rights and choices. Furthermore, there is an abundance of evidence that shows that without child care and elder care and paid leave and social support, these types  of pro-natalist monetary incentives just won’t work. 

Women, in all their sexual diversities, have inherent rights. These aren’t contingent on the demographic context. The solutions lie in expanding human rights, not in their constraint. 

Next, I will also note that the future of contraception will cater for women in the direst of humanitarian circumstances. 

Record levels of displacement are driving hardship and humanitarian need, with conflicts and climate induced disasters escalating seemingly everywhere you turn. 

Family planning programmes must be able to continue to function during humanitarian emergencies, allowing women to make safer choices during uncertain times. 

Consider Cecília, a mother of two daughters who UNFPA assists in Mozambique. She faced impossible choices when a cyclone destroyed her rural home and cut off essential services. Unable to access to family planning, she’s unexpectedly pregnant again, jeopardizing her ability to rebuild and get back on her feet, and she’s worried about her girls’ future. 

The impact of humanitarian crisis is not gender-neutral. As livelihoods collapse and stress escalates, gender based violence explodes and child marriages surge.  Cecília said she dreads the nightfall, fearing for her girls’ safety in the darkness as they sleep on mats under a tree.  

Climate change brings its own unique consequences to reproductive and maternal health. Extreme heat increases miscarriages and stillbirths, and food insecurity endangers maternal and newborn health outcomes. 

Family planning considerations of the future should be part and parcel of humanitarian resilience and response efforts, right from the start of a crisis — and not an afterthought. 

Dear colleagues, dear friends, 

Ours is a time of unprecedented challenges and uncertainty. Should I repeat that? 

Rampant opposition is undermining progress on gender equality and compromising the rights and choices of women and girls all around the globe.  

Within the halls of the United Nations, longstanding agreed language on gender, diversity, and sexual and reproductive health and rights is increasingly coming under attack. The hostility is organized, very well funded, careless and relentless. 

Uncertainties about donor investment – notably the recent abrupt terminations of funding for major global health and humanitarian work – pose a grave threat to the well-being of millions, particularly people marginalized and already furthest behind. 

Despite it all, lastly, I’m happy to tell you my crystal ball reveals that the future of family planning is well-resourced. 

Despite all the turmoil, we will remain focused, and united. The opposition may be rampaging, yet our commitment to upholding women’s rights is fiercer. Our understanding of community needs is deeper. Our intellectual heft is stronger. Our willingness to defend the rights and choices of people in all their sexual diversities is steadfast. 

And our commitment to science, to data and evidence for good planning, means we’re unconquerable.  

UNFPA and this community have weathered many a storm before, and we will not waver in standing with women and girls, with families and communities, and with all our partners in the SRHR sector. 

The backsliding in global funding is not just about dollars and cents. It’s about a woman walking for hours to a rural clinic, and turned away because the shelves are bare. It’s about a desperate adolescent girl, coerced into early marriage because contraception was out of her reach. Long-term sustainable financing for family planning is crucial.  It’s lifesaving.  

The UNFPA Supplies Partnership has pioneered successful approaches through financing innovations — mechanisms like Country Compacts, Matching Funds, and Bridge Funds— with the important added benefit of accelerating country-led domestic financing.  

I applaud the wisdom of low and middle-income countries’ unprecedented investments to safeguard their family planning supplies, and to strengthen the supply systems.  

I urge you to work where you are and where you have influence — in academia, in government, civil society, foundations, financial and private sector institutions, religious and traditional communities.  Work to close the financing gap, to end stigma and to turn our dream of well-resourced family planning into reality! 

So then, 30 years after Cairo and Beijing and with scarcely five years to go until 2030:  

What is the future of family planning? 

We’ve made significant gains, yet formidable challenges threaten future progress—pandemics, climate change, conflict, declining donor investment, and then — the systematic attacks on women’s rights and bodily autonomy.  

Our response must match the scale of these threats. This calls for intergenerational partnerships, that transcend geographic and sectoral boundaries and that leverage diverse expertise, resources and influence. 

It will take an estimated $60 billion in new funding annually to end the unmet need for family planning in 120 priority countries by the year 2030. There ‘is’ no better return on investment—as much as $120 for  every $1 spent, and countless lives are transformed  for the better. 

Let me assert that the future of family planning will be determined by the choices we make today – together, unapologetically, and with the fierce urgency that this moment demands. 

Change starts with us and leads to a future where every woman and girl can exercise her reproductive rights and choices with dignity, security, and freedom. 

Our UNFPA vision of the future?  

Contraceptive technology and research will significantly advance, reaching the ideal of full effectiveness and free access without limitations or boundaries.  

Countries of the global South will lead, streamlining access to contraceptive services and information, institutionalizing policies that integrate SRHR into essential healthcare. Finally, family planning becomes part of integrated women's health services and education. 

Every individual, every couple, regardless of location, socioeconomic status, or background, will know where to easily turn for a full range of high-quality, affordable contraceptive offerings seamlessly integrated into maternal health, HIV, and routine wellness care and checkups. 

In the future, family planning is recognized and acknowledged as an accelerator of gender equality, family wealth building, and of real development for people in their own home villages and urban landscapes. 

After centuries of all-too familiar barrier methods and over a hundred years of tried and true hormonal methods, the future cries out for innovation; let’s have much more research and development of solutions designed with women and with adolescents.  

Now that’s a bright future. Now that’s a future we can all get behind.

Dear friends, 

It is said that: It’s only in winter that we know which trees are evergreen. 

Thank you for being an astute and evergreen friend to women, to adolescents and to families.  

The threads that bind this community are strong.  They are unbreakable. We’re in this for the long haul, together, and together we shall win.