What Has Gates Done Lately on Global Family Planning? Big Things, With a Big Partner

Improving access to birth control, safe abortions, and family planning in general is critical for improving global health and development. In a TED Talk she gave a few years ago, Melinda Gates said giving everybody access to birth control is "one of the simplest and most transformative" things that the global health and development community can do. Later in the talk, she noted that in order for that to happen, "both rich and poor governments alike must make contraception a total priority."

Access to contraception has certainly been a priority for the Gates Foundation, which has committed over $1 billion in grants backing family planning efforts around the world. To advance its global family planning mission, in 2012, Melinda Gates and the Gates Foundation launched Family Planning 2020 (FP2020).

FP2020 is a global campaign fighting for the rights of women and girls around the world to decide for themselves when and if they want to have children and how many children they would like to have. The critical mission, here, is to provide 120 million women and girls with access to modern contraceptives by 2020, no matter their circumstances and no matter where they live. Since 2013, the Gates Foundation has awarded around $24 million in grants to FP2020.

That's a lot of money over three years. But the Gates Foundation bumped things up in a major way with its $37.5 million in support for DKT International last month. A third of that money took the form of a loan from the foundation. 

We've written about DKT before. It's a powerhouse NGO in the family planning space—serving 30 million couples last year alone—and has a forward-thinking revenue model, as its CEO Chris Purdy explained to Inside Philanthropy not long ago. Much of its revenue now comes from sales, which is not what you'd expect from a contraception provider working in some of the poorest countries in the world. But Purdy insists that it's a key to the group's financial stability, as well as its independence. Sales accounted for most of its $180 million operating budget in a recent year. This model also means that DKT is well positioned to cash in on the growing enthusiasm for impact investing among more foundations and wealthy donors, as the new loan from the Gates Foundation shows. You might not think of reproductive health as an area that would attract this kind of money, but it's intriguing to think of how larger-scale private investment capital could boost work that's traditionally leaned so heavily on government and philanthropic dollars. 

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The Gates Foundation has been funding DKT's sexual and reproductive health work since the late 1990s, starting with a $4.3 million grant to reduce infant mortality and HIV transmission among adolescents in Ethiopia. In 2001, Gates began supporting DKT's work specifically related to birth control and family planning. Since then, Gates has awarded the group over $18 million in grants, the largest until now being a $4.5 million commitment to increase access to high-quality, low-cost contraceptives to low-income populations in Indonesia. Gates' latest grant of $25 million has far surpassed the foundation's cumulative grantmaking to support FP2020 over the past three years. One might suspect that this reflects a growing urgency at the foundation about family planning and, related to that, Melinda Gates's growing forcefulness as an advocate for such work—and gender issues broadly—both inside and outside the foundation. "I have really gone all in on family planning," Gates told a conference earlier this year. 

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The foundation's $25 million give to DKT funds its geographic expansion to "provide contraceptives to at least 11 new countries designated as critical to the FP2020 initiative." The funding will provide access to birth control for 10 million more couples by the end of 2020. The grant is also being put to good use in DKTs other endeavors.

In a press release, Purdy noted that the funds would also allow the organizations to scale its existing programs "and expand the sale of contraceptives to at least 20 new countries." Additionally, it will use the money to increase the sale and distribution of modern contraceptives and launch mass media campaigns to increase demand, mainly in West Africa and Latin America.

DKT is also planning to increase its engagement with young people by providing information about contraception and reproductive health and increase the number of community health workers offering sexual and reproductive health services in underserved communities.

The remaining $12.5 million loan commitment, which DKT will pay back at a below-market interest rate, is designed to increase sustainable access to sexual and reproductive health products in least-developed countries. 

While it's not unusual for Gates to make program-related investments in for-profit companies doing work to advance its goals, this $37.5 million loan-grant combo is the first of its kind for the foundation. 

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Gates's funding to DKT is results-based, but not in the sense that the foundation requires regular progress reports to measure impact and progress. Generally speaking, those reports are required regardless. Rather, in this case, if DKT doesn't meet its stated goals and outcomes, it won't receive full funding from 2018 to 2020.

One last thing: Not everyone is thrilled with Bill and Melinda Gates's stepped-up interest in family planning. When President Obama awarded the couple the Presidential Medal of Freedom last month, anti-abortion media outlets described the Gateses as "pro-abortion" activists. In fact, Gates money has prevented innumerable abortions worldwide, not to mention saving thousands of women from maternal death. Contraception is the best way to fight abortion, and DKT International's record of success underscores that. It says that in 2015, it prevented over 5 million unwanted pregnancies and 2.6 million abortions. Show me a pro-life group anywhere that can claim such impact. If anti-abortion advocates were less puritanical and more practical, we would see a lot more concrete progress of this kind around the world.