At a CEDPA (Center for Development and Population Activities) panel today on integrating family planning and HIV/AIDS services, a discussion arose about how to sell the integration of services to donors, such as the US. Services right now are funded seperately for many reasons, some of them being the US's large funding project that is PEPFAR and our political resistance to funding family planning activities (since they are clearly a code for sinning, etc.).

Someone stood up and said that when selling family planning and HIV programs we should focus on subjects that are clear and "less controversial" to donors, like maternal and child mortality. I don't think this person's strategy was wrong, but I do think it is sad and false that there is still some sort of line we draw between trying to lower maternal mortality and providing family planning services and abortions.

In practice, this line does not exist. Maternal mortality is proven to be lowered by contraceptive access. Even more obvious of a blurring is the fact that maternal mortality rates are calculated including death during childbirth and death during abortions. So unsafe abortions aren't only directly linked to maternal mortality, they ARE maternal mortality.

Evidence is found in this article on Nepal. According to the article, Nepal has halved its 2001 maternal mortality rate of 540/100,000 live births to 280/100,000 live births. How did it do this? One major way was to legalize abortion. By legalizing abortion, Nepal provided access to safe abortions, cutting down on the number of women who die after an illegal, unsafe, abortion. Nepal also increased pre-natal care access and quality, training workers, and increased immunization against tetanus.

These dropped rates indicate how important each piece of the puzzle is in dealing with the many problems in the developing and developed worlds. Funding HIV/AIDS projects, or talking only about maternal and chld mortality will not solve the problem without working on so-called "controversial" pieces as well (there is significant evidence these issues are only controversial to congress, not average Americans), including abortion access and contraceptive commodities.

So wake up Congress, wake up international funders, wake up activists! Dealing with these issues seperately costs lives, and we need to get past this if we ever want to come close to solving these problems and reaching the Millenium Development Goals.