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Voices of Experience: A Conversation with Former Directors of USAID’s Office of Population and Reproductive Health

Organized by Center for Global Development

January 17
5:00 PM – 6:30 PM
Center for Global Development
Washington, DC


(This event will also be a Live Webcast)

Join Center for Global Development (CGD) for a conversation with four former directors of United States Agency for International Development (USAID)’s Office of Population and Reproductive Health. Since the Office’s inception in 1969, the US government has played a substantial role in supporting expanded access to voluntary family planning around the world through technical assistance, diplomatic and policy engagement, and financial support. But differences in policy across administrations have meant that US leadership in international family planning has often faced periods of uncertainty. CGD is convening a panel to revisit historic experiences and to shed light on lessons learned that may be used to inform stakeholders in the current landscape.

Featured Speakers:

1) Duff Gillespie, Professor, Johns Hopkins Bloomberg School of Public Health
2) Liz Maguire, Senior Advisor for Reproductive Health and Rights
3) Margaret Neuse, Independent Consultant
4) Scott Radloff, Senior Scientist, Johns Hopkins Bloomberg School of Public Health

Introduction: Amanda Glassman, Chief Operating Officer and Senior Fellow, Center for Global Development

Moderator: Felice Apter, Visiting Fellow, Center for Global Development

Microbicides: Innovative Solutions to Help Women Stay HIV-Free

This guest post was written by GHC Member International Partnership for Microbicides (IPM). IPM is a nonprofit organization dedicated to developing new HIV prevention technologies for women and making them available in developing countries where the epidemic has hit hardest. IPM collaborates with a global network of public, private, philanthropic, academic and civil society partners to develop products designed to empower women with the tools they need to protect themselves against HIV and improve their sexual and reproductive health, so they can live healthy and productive lives.

Why do women continue to be at high risk for HIV? Social expectations, cultural norms and economic inequities all limit women’s ability to negotiate safe sex practices, or even select their partners or the timing of sex. Condoms, while highly effective, are simply not a feasible option for many women. Women are also biologically more susceptible to HIV infection than men.

As a result, HIV/AIDS remains a serious epidemic among women. It is the leading cause of death globally in women ages 15-49. In sub-Saharan Africa, infection rates among women are alarmingly high—young women there are at least twice as likely to become infected with HIV as young men, putting their sexual and reproductive health at risk.

How can we stem the tide of HIV infection among women?
Women urgently need new prevention options, particularly discreet methods they can use without partner involvement. Among the most promising women-centered products are vaginal microbicides, biomedical products being developed to protect women from HIV during vaginal sex. They could come in different forms—such as a monthly vaginal ring developed by the International Partnership for Microbicides (IPM) recently shown to reduce women’s HIV risk—and other products in early development like films and tablets.

The flexible silicone ring, which women insert and replace themselves each month, slowly releases the antiretroviral drug dapivirine over the course of a month.

IPM’s dapivirine ring is the first long-acting HIV prevention method shown to safely reduce HIV risk and is under regulatory review.

What are the next steps for microbicides?
Several vaginal microbicides are being studied in preclinical studies or early-stage clinical trials. The most clinically advanced microbicide is IPM’s dapivirine vaginal ring, which is currently in open-label studies following late-stage efficacy trials. At the same time, IPM is seeking regulatory approval to license the product for public use. The monthly ring is under review by the European Medicines Agency and will be submitted to the South African Medicines Control Council and US Food and Drug Administration in 2018, followed by applications to additional regulatory agencies in Africa. The first regulatory decisions on the ring could come as early as 2019 in some African countries. If approved, the dapivirine ring would become the first microbicide licensed for HIV prevention.

Multipurpose products are also being developed that would offer women increased convenience by combining STI prevention and contraception in a single product. IPM has designed a three-month HIV prevention-contraceptive ring that entered its first safety clinical trial earlier this year.


How do microbicides fit in the HIV prevention landscape?
No one product will end the HIV epidemic. Women need multiple prevention options that they can choose from that makes sense for their lives, from monthly vaginal rings to daily oral ARV pills to products still in development like vaccines. Modeling studies show that a safe and effective microbicide like the dapivirine ring would have a significant impact on the epidemic while empowering women with tools they need to protect their sexual and reproductive health. And when women are healthier, so are their families and communities as a result.

The Real Gamechanger for Women’s Empowerment Initiatives – Family Planning

This guest post was writte by Carolyn Rodehau, Population Council

The makeup of the workforce has changed worldwide. Increasingly, women have become a driving force in our global economy particularly in developing economies. Many institutions, including multinational companies – from Nike to Walmart to KPMG – have recognized the need to proactively expand economic opportunities for women by fostering entrepreneurship, strengthening financial literacy, and promoting women into management positions.  Yet, for all the emphasis on empowering women in business, there is a danger of undermining these vital efforts by ignoring a key enabling factor for women to take advantage of these opportunities ­­– access to safe, voluntary family planning and reproductive health education and services. Such services remain largely ignored when business designs women’s empowerment programs and initiatives.

The demographics of today’s global workforce make the case: participation in the formal workplace by women sharply increases between ages 20-24 and peaks between ages 25-35, the years in which family planning and reproductive health services are most essential[i].  A woman’s ability to enter the job market, hold a job and get promoted depends on her ability to control when she wants to have children and how many[ii].  Entrepreneurship, fair pay, board and management representation are important issues, but such programs can be little more than distant dreams for hundreds of millions of women in the bottom portion of the economic pyramid who still struggle to control their family size while seeking and maintaining basic employment.

The goals of corporate women’s empowerment programs, which include improving gender equality, independent decision-making, confidence, and economic potential are closely aligned to the goals of expanding access and utilization of family planning and reproductive health services. Access to contraception and family planning education empowers women to make informed decisions about whether and when to have children, reducing unintended pregnancies as well as maternal and newborn deaths[iii]. There are a number of studies that have established a connection between a woman’s ability to choose whether and when to conceive with participation in educational and economic opportunities, including the formal workforce[iv]. Ultimately, increased access to safe and effective contraception can save lives and ensure a better economic future for families – countries where women can control the size of their families also enjoy better economic futures.

But make no mistake this is good for the bottom line too. Women workers who have unintended and unwanted pregnancies have business costs – turnover, absenteeism, lower productivity. Corporations through their value chain have enormous opportunities to reach these women in simple, inexpensive ways. To be clear ensuring access to services and information does not mean workplaces need to become primary care facilities. Companies can support and promote family planning and reproductive health is many ways – establishing a strong referral system, providing health information through peer educators, ensuring women workers have access to services (ex. mobile clinics), and addressing menstrual hygiene (ex. provision of sanitary napkins).

The business community should move beyond an economic focus of empowerment initiatives to tackling health and wellbeing. Improving access to high quality family planning and reproductive health services will further improve women’s ability to climb the ladder in the formal economy.


Wilson Center briefing on USAID’s 50 years of family planning

Changing the World:
How USAID’s 50 Years of Family Planning has Transformed People, Economies, and the Planet

Friday, June 26, 2015
10:00am – 12:00pm
6th Floor Flom Auditorium

2015 marks the 50th anniversary of the U.S. government’s first investments in overseas international family planning programs. In his January 4, 1965 State of the Union address, President Lyndon B. Johnson announced, “I will seek new ways to use our knowledge to help deal with the explosion in world population and the growing scarcity in world resources.” Under this mandate, the U.S. Agency for International Development (USAID) began its population and family planning program. In 50 years of assistance, USAID has focused on enabling women and couples to make informed, voluntary decisions about whether to have children and, for those who would like children, when and how many to have.

As the largest bilateral donor for family planning assistance, USAID has played a crucial role in increasing access to modern contraception for women and families, creating positive ripple effects with profound health, environmental, economic, and social benefits for families and communities. Use of modern contraception by married women of reproductive age in the developing world (excluding China) has risen from less than 10 percent in 1965 to 46 percent today.

Join us, the current director of the Office of Population and Reproductive Health, and five former directors to discuss USAID’s history in family planning and future directions, including how the program fits into the Obama administration’s goal to end preventable child and maternal deaths and contributes to the global Family Planning 2020 movement.


Duff Gillespie
Professor, The Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health

Liz Maguire
President and CEO, Ipas

Margaret Neuse
Assistant Secretary, Board of Directors, EngenderHealth

Scott Radloff
Senior Scientist and Director, PMA2020, Bill & Melinda Gates Institute for Population and Reproductive Health

Steven Sinding
Professor, Mailman School of Public Health, Columbia University; Board Member, Abt Associates

Ellen Starbird
Director, Office of Population and Reproductive Health, USAID


Roger-Mark De Souza
Director, Population, Environmental Security, and Resilience, Wilson Center