This week marks the 10 year anniversary of the landmark "Cairo Conference" on population and development. In 1994, officials, experts and activists from 179 countries drew up a 20 year plan to deliver reproductive health care for all. But the plan is being threatened, says Dr Shereen El Feki, acclaimed health-care correspondent at The Economist magazine, by ideological battles, a severe shortfall in international funding for reproductive health, and the HIV pandemic, which shows no sign of slowing.

In a provocative essay published today, as a "sneak peak" of the October launch issue of PLoS Medicine (http://www.plosmedicine.org), the new open access global health journal from the Public Library of Science, Dr El Feki argues that since the Cairo Conference, "a fierce battle has emerged between religious conservatives who eschew abortion and condoms in favour of abstinence and fidelity, and more liberal voices who argue for a full armamentarium."

The fight between conservatives and liberals is clearest, she argues, in the case of the US. Although it spends more than any other country on reproductive health--$429 million this year--the money comes with strings attached. For example, under the Mexico City Policy (the "Global Gag Rule"), which George W. Bush reinstated in 2001, US family planning assistance cannot be given to any non-American non-governmental group unless it certifies that it neither performs nor endorses abortion. "International Planned Parenthood Federation (IPPF), Marie Stopes International and their local affiliates have been hard hit by the Rule," says Dr El Feki, "scaling back services in Kenya, Ghana and elsewhere offering essential health-care to thousands of women and children."

These ideological battles are compounded by rich countries neglecting the commitments they made at the Cairo conference. "Rich country contributions reached an estimated $2.3 bi
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Contact: Gavin Yamey
gyamey@plos.org
415-624-1221
Public Library of Science
8-Sep-2004

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