Melinda Gates made a promise five years ago.
In 2012 she co-chaired a global summit, Family Planning 2020, that pledged to provide access to contraceptives to 120 million more women around the world by 2020.
The effort is falling behind, and it is tougher than expected, she concedes.
“Unfortunately, our progress has not yet lived up to our ambition,” the co-founder of the Bill & Melinda Gates Foundation wrote in a recent op-ed for National Geographic.
“We are now more than halfway to the 2020 deadline, but not yet on track to reach 120 million women by the promised date. As of the halfway point in July 2016, we had reached 24 million additional women with family planning services.
“It was an ambitious but achievable goal — and an important promise to women in the world’s poorest places that they will not be forgotten.”
Providing poor women in developing countries access to contraception has become a mission for Gates. The foundation she leads with her husband has donated more than $1 billion for family planning efforts around the globe, according to The New York Times.
“If you allow a woman — if you counsel her so it’s truly voluntary — to have a contraceptive tool and she can space those births, it unlocks the cycle of poverty for her,” Gates told the Times last year.
“In the early days, I’d be out traveling for the foundation, I’d be there to talk to women about vaccines, I’m going be frank, for their children, and what they would say to me is: ‘O.K., I have questions for you. What about that contraceptive, how come I can’t get it anymore?’ To me, it’s one of the greatest injustices.”
Gates told the Times that she sees resistance to the use of contraceptives all over the world in countries led by men.
“I mean, you even see it sometimes in the United States, right? Men wanting to take control of women’s health,” she told the Times.
“And I think that’s why I’ve been so adamant about this effort that we’re working on. It has to be grass-roots, ground-up. We can’t do the top-down planning that happened in the world in the 1970s, where we told women what to do. It was about population control, it was about coercion.”
In her National Geographic essay she wrote that in the decade and a half since she and her husband started their foundation she has heard from women all over the world about how important contraception is to helping them take charge of their lives.
“When women are able to plan their pregnancies around their goals for themselves and their families, they are also better able to finish their education, earn an income, and fully participate in their communities,” wrote Gates, who began her essay by stating that she has used contraceptives for years.
“I knew I wanted to work both before and after becoming a mom, so I delayed getting pregnant until Bill and I were sure we were ready to start our family,” she wrote. “Twenty years later, we have three children, born almost exactly three years apart. None of that happened by accident.
“The decision about whether and when to get pregnant was a decision that Bill and I made based on what was right for me and what was right for our family — and that’s something I feel lucky about.
“There are still over 225 million women around the world who don’t have access to the modern contraceptives they need to make these decisions for themselves.”
She wrote of Anita and Sushila, two women she met in a village named Kamrawa in India.
Anita, 40, is raising five children with no source of income.
“She spent all of her time and energy looking after her family and trying to keep her household running — preparing food, tending to animals, keeping things clean in a house with no running water — leaving almost no time at all for her to do anything else,” Gates wrote, describing Anita’s life as “deprivation, hard work and endless worrying.”
Sushila, 28, a mother of two, used contraception and told Gates she and her husband will plan their family accordingly so they’re able to give their children the lives they deserve.
“Sushila also told me that as soon as both her kids are in school, she plans to return to her job as a teacher,” Gates shared. “A generation ago, working moms were almost unheard of in villages like Kamrawa. But now that women have the option to plan their pregnancies, they have many other options, too.”
When you think about the difference between Anita’s life and Sushila’s life, Gates wrote, it’s clear that progress is possible.
“The question is whether we will commit the resources and mobilize the will to ensure that this progress extends to more women in more places,” she wrote.
Since her visit, women in Kamrawa have been give access to contraceptives and the difference is notable, Gates wrote.
“As a result, families are smaller, and parents are better able to afford nutritious food and school fees for all of their kids. The whole village is healthier and more prosperous,” she wrote.
“In 2012, we made a promise to women around the world. Our actions over the next three years will decide whether we keep it.”