International Planned Parenthood Federation and Marie Stopes International (MSI) announced at their annual Donors meetings this week, a new Organisational Agreement between the two organisations to respond to the challenging environment in delivering sexual and reproductive health services and rights. IPPF and MSI will commit each of their organisational strengths to maximize the benefit to women and girls from each and every dollar received. The agreement, signed by IPPF Director General, Tewodros Melesse and Simon Cooke, MSI’s Chief Executive Officer, acknowledges the value of both competition and cooperation. It is will drive quality, efficiency across services, advocacy efforts and data capture at global, regional and national levels. The agreement also will look at a joint effort to develop national plans in 12 countries. Tewodros Melesse, IPPF Director General, said on signing the agreement “It is evident that the global environment for sexual and reproductive health and rights services has changed. This means that we have to find new ways to improve how we drive services at country level. This agreement is an opportunity to make sustainable change and also ensure that each and every client will get the best experience and care wherever and whoever they are.” Simon Cooke, CEO of Marie Stopes International, said: “We look forward to working in greater collaboration with IPPF on specific projects, to ensure that many more women and girls in developing countries are able to receive the contraception and safe abortion services that will help them take control of their futures. The priority for both our organisations is to get the best outcome for the millions of women worldwide who depend on our services.” The agreement covers three areas of cooperation: Operations: Greater coordination to reduce duplication at national level Mobilise joint strengths to address service gaps in national health systems Extend geographic coverage for SRHR services Increase mix of service delivery channels Strengthen systems for cross referral where needed Strength supply chains Facilitate learning and sharing Work within client’s individuals rights frameworks Delivers providers’ needs Advocacy: Aligned missions for joint advocacy efforts Advocacy that expands access for most underserved Mapping and division of labour of policy and advocacy in different spheres Key deliverables at national and global level that cover advocacy issues, joint plans and accountability of FP2020 progress and implementation Data: Sharing and supporting use of data tools and processes for effectiveness Data sharing for advocacy Joint initiatives to improve indicators and reporting Improving health outcomes through supporting use of client based data Develop a shared research agenda Subscribe to IPPF's updates

IPPF’s Director General, Tewodros Melesse, has paid tribute to the Government and people of Japan, following the announcement that Japan will support the provision of sexual and reproductive health and rights (SRHR) for 2017.  The Japanese Government has announced that it will contribute approximately 3.1 billion yen (roughly $28 million) to IPPF and the United Nations Population Fund (UNFPA) in annual support.  Mr Melesse said: “IPPF is grateful for Japan’s continuing support to SRHR through funding IPPF and UNFPA. Particularly in the current negative climate around SRHR, Japan’s expression of its strong will to continue its support for SRHR is warmly welcome.”  “Japan’s long-lasting support for IPPF and for sexual and reproductive health care and rights has always been appreciated. These funds will help IPPF member associations around the world mitigate the cuts in funding we are seeing from some other sources. This will help protect health and save the lives of many people, especially women and girls.”  Mr Melesse added: “We agree completely with the Government of Japan when it says that the provision of services relating to sexual and reproductive health and rights is essential for realizing universal health coverage (UHC), that ensures affordable access to basic health services for all whenever they need them throughout their lives.  This is stated clearly in the Basic Design for Peace and Health, Japan’s global health policy and one of the outcome documents of the G7 Ise-Shima Summit, as well as in an outcome document from the The World Assembly for Women in Tokyo 2016 (WAW), the Third United Nations World Conference on Disaster Risk Reduction and the Sixth Tokyo International Conference on African Development (TICAD VI).  IPPF would like to congratulate Japan’s leadership and commits to working closely with the Government of Japan to make a real difference to the lives of women, men and young people in around world and to achieve the Strategic Development Goals.”  IPPF received approximately $1.13m  from Japan in early 2017 for its activities targeted to Syrian refugees and internally displaced people, and will receive funding of $7.76m which was recently approved by the Japanese Parliaments.  

Mexico City Policy will have a devastating impact for International Planned Parenthood Federation (IPPF) with its extension far beyond family planning.  Restrictions into support for HIV, maternal health and infectious diseases programmes will mean that millions will be denied lifesaving healthcare they need. The policy will hit hardest, the women living at the margins of society – the poorest, the most remote and those under 25.    The Global Gag Rule, also known as the Mexico City Policy, denies US funding to organizations who provide any abortion related services, including counselling, even when such services are legal in a national context.   IPPF has a special focus on working with the world’s most poor and vulnerable and tailoring services to meet their needs. At country levels, the US funding loss will reduce or halt IPPF’s services and arrest opportunities to scale up, build capacity and reach more people.   Tewodros Melesse, IPPF Director General, said in reaction, “For over 30 years, the Mexico City Policy has played politics with women’s lives. It is a cynical attempt to silence the choice and voice of the world’s poorest women.  As a champion for them and people everywhere, we will not be held back.   "This extended policy covers every aspect of IPPF’s work with the world's poorest people. It also fails in its stated intent to reduce the global incidence of abortion. With the expansion of its restrictions to work on broader health efforts it is short-sighted and dangerous, and threatens years of IPPF gains to advance the health and well-being of communities and undercuts health care access for millions worldwide.”   The extended policy will now affect IPPF’s long record of working on HIV prevention in more than 20 countries covering Africa and Latin America often providing clients integrated sexual and reproductive health care services. The Global Gag rule could also endanger emergency funding for Zika prevention, education and health services in Latin America and the Caribbean, where the epidemic continues to rage.   Examples of Country Impact: Barbados: IPPF partner Barbados Family Planning Association receives funding from the U.S. government to provide HIV prevention and education services to at-risk, hard-to-reach populations including men who have sex with men. The Caribbean has the second-highest HIV prevalence rate among adults after Sub-Saharan Africa.   Nepal: IPPF aims to increase voluntary use of family planning services by increasing accessibility and availability of quality comprehensive family planning services to the hard to reach, disadvantaged, poor and adolescent populations in 11 districts and increase access to voluntary family planning information, education, and services. Nepal has failing and patchy family planning coverage which is often only available at certain times of the year. IPPF are working closely with the government to expand and strengthen static clinics in selected district hospitals, health posts and health facilities with birthing centers to reach all year round, reaching eligible couples with high unmet need. Malawi: The Family Planning Association of Malawi are providing much needed integrated family planning and HIV prevention to young adolescent and women in Malawi via clinics and outreach teams travelling to communities to raise awareness and offer services for vulnerable young women to prevent and treat sexual  gender based violence, HIV infection and access to family planning. Without funding they will no longer be able to provide or expand this vital information, support community learning and offer both family planning services and treatment for sexual and gender based violence in one place.   The rule blocks critical funding for health services like contraception, maternal health, and HIV prevention and treatment for any organization that refuses to sign up to it.    For IPPF, it means foregoing US$100,000,000 that would be directed to proven programmes that provide comprehensive sexual and reproductive health services for millions of women and girls who would otherwise go without vital services that save lives.   IPPF is the world’s largest women’s health network with members in 170 countries with over 45,000 service delivery points delivering over 300 services a minute. Individuals can donate to IPPF’s online appeal www.ippf.org/donate     WANT TO GET INVOLVED? SUBSCRIBE NOW TO GET UPDATES FROM IPPF SUPPORT OUR WORK WITH A DONATION JOIN OUR THUNDERCLAP     View my Flipboard Magazine.

Mankayane, Swaziland - On 1 December, IPPF Director General, Tewodros Melesse, made an address on the occasion of World AIDS Day in the Kingdom of Swaziland along with His Excellency the Right Honourable Deputy Prime Minister, Mr Paul Dlamini, Honourable Minister of Health Ms Sibongile Ndlela Simelane, United Nations Resident Coordinator, Mr Israel Dessalegne, and the United States of America Ambassador to Swaziland, Ms Lisa Peterson. "It is an honour and a privilege to be commemorating World AIDS Day with you, the Swazi people. Every year, World AIDS Day provides us with the opportunity to take stock of how far we have come since the early days of the epidemic. I’d like to begin by taking us 30 years back in time, which was 1986. That year, IBM unveiled the first laptop. Mobile phones were the size and weight of large bricks. In apartheid-era of South Africa, Nelson Mandela was behind bars; and here in Swaziland, the country recorded its first case of HIV/AIDS. Many of you here today will agree with me when I say that, while Swaziland has not been immune to the many ways in which the world has changed over the past thirty years, it is the HIV epidemic more than anything else that has shaped this country during that time. For those of you who have lived through the epidemic, you will remember all too well the fear and the stigma that ran through this country and many African countries. You will remember how little we knew about HIV, and about how to prevent it. People living with HIV at this time deserve to be honoured. You showed us the strength and determination to fight for change. You were brave and angry, and gave hope to others. As I stand in front of you, I am keenly aware that there is not a single person here whose life, one way or another, has not been affected by HIV, and that all young people here today have never seen a world without HIV. The young people are the future but we have to remind ourselves that there is no future if we don’t invest in prevention. Many of you have loved ones who were taken from this world before their time. You grieved and continue to grieve the loss of brothers, sisters, mothers, fathers, children, grandchildren, friends, colleagues, and many others. These vibrant souls, remain with us always, in our hearts and in our minds, and give us energy to continue in the future. We can now take some comfort from the fact that the picture has changed dramatically in these past thirty years. Most significantly, people living with HIV are now living longer, healthier, and productive lives well into their old age, thanks to the availability of antiretroviral treatment that has transformed HIV infection into a chronic, manageable condition. I would like to take this moment to commend the Government of the Kingdom of Swaziland for its commitment to providing antiretrovirals free to all who need treatment. The impact of this cannot be underestimated. AIDS-related mortality has reduced by drastically and accordingly, life expectancy has now rebounded. The transmission of HIV from mother to child is close to being eliminated along with syphilis. And overall, Swaziland has also begun to see a downward trend of new HIV infections, especially among young people. ‘Now is not the time to be complacent’ These are remarkable successes, and Swaziland has established a strong foundation. Critically, this is a foundation upon which to build - not to rest. We cannot risk becoming complacent, as HIV remains the greatest public health and socio-economic challenge facing this country. Importantly, our response must be integrated with other key challenges. We know that there is a high unmet need for family planning, leading to high levels of unwanted pregnancy; we know that maternal and infant mortality is unacceptably high; and we know that the overall knowledge of sexual and reproductive health is exceptionally low among young people. ‘There is a serious prevention gap’ This situation is not unique to Swaziland. UNAIDS is raising the alarm about the global picture and what it calls the ‘prevention gap’. Efforts to meet the global target of ending AIDS by 2030 are off track and progress is at risk of stalling. The global community warns that if there is a resurgence of HIV, the epidemic will be impossible to control. This cannot be allowed to happen. Primary prevention has been and will continue to be an essential component of the HIV response. To attain an AIDS-free generation, we need new solutions, new innovations and, importantly, we need to reinvigorate our prevention efforts. Prevention saves lives, saves budget, and increases productivity. ‘Hands Up for HIV Prevention’ Today, people across the global are raising their hands to HIV prevention this World AIDS Day. There is no ‘one size that fits all’ and we must pay special attention to those that continue to be left behind. Young women and girls are at a particularly high risk of HIV infection. They need information and the freedom to make free and informed decisions about their sexual and reproductive health; they need access to effective HIV and sexual and reproductive health services; they need services that are youth-friendly; and they need gender-based violence to be eliminated and gender inequalities to be eradicated. We are also leaving key populations behind – including sex workers, people who inject drugs, transgender people, and men who have sex with men. Many countries in the world push these populations to the margins of society. It is essential that our prevention efforts bring these populations forward. To end HIV, no one can be left behind. I must commend the efforts to ensure the meaningful engagement of these populations; and by taking steps to remove barriers to access services. At the root of all of our prevention efforts is a recognition that the HIV epidemic is being fuelled by inequalities and prejudices entrenched within the legal, social and economic structures of society. Poverty, sexism, homophobia, and other forms of discrimination – are well known barriers to ending HIV. To ensure that everyone can live a life of hope, with dignity, respect and meaning – people must be free to make choices about their sexuality and well-being, in a world without discrimination. ‘We need to work together to give hope’ I truly believe that we will not see an end to HIV unless we work together, be it at the local level, the regional level or at the global level. The remarkable successes that we have witnessed have been the result, not of a single actor, but of a chorus of voices that have called out in unison for better access; and that demanded respect, care and compassion. Civil society in particular has an incredible track record of mobilizing the required response. It has been instrumental in changing public attitudes and perceptions, and has also be mobilised to address barriers that prevent people from realising their right to health. In conclusion, the power to end HIV and AIDS does not lie with a single individual, with a single organisation, or government structure. When we leverage the unique skills that we all bring to the table, we will reach our goal of ending AIDS both in Swaziland and the world. This power is ours and the time to act is now. If we work together as Obama says, ‘Yes, we can!’, then we can do it. I leave you with a story. Like FLAS, I visited the IPPF association in Iran who are working with underserved communities, such as sex workers, and integrating in society. I asked one young woman, ‘if you were God for fifteen minutes, what would you do?’ She said, ‘I would give hope, if you have hope, you can overcome your challenges’. We need to keep that hope and give that hope to the people. We can give that hope by doing it together."

Across the globe, women who want to end an unwanted pregnancy are faced with numerous challenges, not least of which is navigating the legal restrictions that prevent women from accessing safe abortion. In Papua New Guinea it is no different. Located in the South Western Pacific, the country has a high unmet need for family planning and the majority of women wishing to delay or prevent pregnancy are without the means to do so. It is no surprise then, that unwanted pregnancy is a common experience for women in PNG.    This is the situation that Leoba Davana and her husband James Channel found themselves in. Already with two young children to care for, and having previously experienced a life threatening pregnancy, Leoba and James made the decision to have an abortion. Unfortunately, Leoba experienced complications and upon seeking post abortion care she and James were arrested. They now face up to 5 years in jail. In PNG, abortion is legally restricted and only permitted if there is a significant threat to the woman’s health. In addition, any abortion must be carried out by a registered practitioner. In a country with a critical shortage of doctors and with the majority of the population living in rural areas, the ability to obtain a safe and legal abortion is near impossible for the majority of women.  Leoba and James’ case has serious implications for women’s health in PNG. Unless overturned, this conviction will jeopardise efforts to provide access to post abortion care and contraception in the country, and further limit women’s rights and opportunities. We know that criminalising abortion is only effective at making abortion less safe. And where women have limited access to contraception the need for access to safe and legal abortion is even more urgent. In countries like PNG, too many women are too often faced with a stark choice between risking their health and well-being by continuing with an unwanted pregnancy, or risking their health and freedom by obtaining an unsafe and illegal abortion   Leoba and James’ case will be reviewed by the PNG Supreme Court in the coming weeks.   Funds are urgently requested to help cover legal costs. To date K16,593.94 has been raised of the required K50,000. Please support them by donating at: Account Name: Safe Motherhood Alliance PNG Bank: ANZ, Harbour City, NCD, Papua New Guinea BSP: 018-912 Account Number: 14402886 Swift Code: ANZBPGPX Ref: SvD E-mail: [email protected]

IPPF welcomes the release by the Guttmacher Institute of new worldwide estimates of abortion incidence. These estimates provide valuable information for organizations like IPPF working to improve access to sexual and reproductive health and rights. A key finding from the study is that roughly one in four pregnancies globally ends in abortion, showing that abortion is a common occurrence in many women’s life.   The study also shows that the larger decline in abortion rates between 1990 and 2014 occurred in developed countries (where abortion is generally legal and available), but rates have not changed significantly in the developing world, where abortion laws are often restrictive. This demonstrates that restricting access to safe legal abortion does not reduce the number of abortions but rather pushes abortions underground, leading to risks to women’s health and lives. While estimates seem to indicate a reduction in abortion related deaths, complications from unsafe abortion - while less serious due to increased access to post-abortion care and increased availability of misoprostol - continue to affect millions of women each year. In fact, data for 2012  show that 6.9 million women in developing regions were treated for complications from unsafe abortions. Developing regions also continue to be disproportionally affected by unsafe abortion, with nearly all deaths due to unsafe abortion occurring in developing countries, with the highest number occurring in Africa.   Very importantly, the study outlines how high levels of unmet need for contraception contribute to higher abortion rates in developing regions. This again shows the relevance of organizations like IPPF working to prevent unwanted pregnancy through modern contraceptive services, promote comprehensive sexuality education and eliminate sexual violence and coercion.  At the same time, IPPF recognizes the importance of increasing access to safe abortion services and IPPF will continue to provide access to safe abortion and to promote a woman’s right to choose.