The unfinished Cairo agenda incorporates many things that were supposed to, by 2015, dramatically improve the health and lives of women, children and societies. Close to forty percent of women in the world still deliver their babies without a doctor, nurse or midwife. Fifteen years after the world pledged to remedy this, every minute, a woman still dies in childbirth or due to pregnancy related cause
The clear linkage between the Cairo agenda and the UN’s Millennium Development Goal 5 was reaffirmed when, at the 2005 World Summit, a new target and more specificity was added. MDG 5 now calls for universal access to reproductive health care – which includes meeting women’s unmet need for family planning - along with reducing maternal mortality by three-quarters between 1990 and 2015. Reducing the number of mothers dying from preventable causes, related to giving birth -- who could be against that? And yet the world has made almost no progress against this goal. Last year, more than half a million women died in childbirth or due to pregnancy related causes. Twenty million unsafe abortions were performed, many leading to death or disability of women. More than 200 million women who wish to space, time or limit their pregnancies, still lack access to safe, modern contraceptive methods.
The good news is markets for these simple life-saving and life-changing family planning products and services exist, everywhere people live. There is a natural demand on the part of women – even those who have been held down and back by lack of access to education and opportunity – for products that will improve their lives, improve the lives of their families, and nurture the children they already have. The missing ingredient is reliable, high-quality supply of these products and services.
Historically, social marketing is designed to plug this gap. Social marketing uses the discipline of marketing, supply-chain management, quality control, advertising, promotion, place, and price, to put oral contraceptives, or an IUD, or an implant, or a condom, into the hands of low-income and vulnerable people who are not being served by the commercial market. Social marketing manipulates the price of a good or service – today social marketing sometimes takes that price to zero, or even negative – to ensure that low-income and vulnerable consumers are getting the access they need to lead healthier lives.
Social marketing is “Mad Men” meets “Heroes.”
How does this look in practice? In the Congo, for example, the public health infrastructure was almost completely destroyed after years of civil conflict. Neither the government nor donors focused on reproductive health or family planning. But private health centers and pharmacies continued to function and, after the conflict subsided, they thrived. Operating without interruption in the Congo for over 20 years, PSI established the Confiance network, a branded network of private clinics and pharmacies that provide quality family planning services, information and products to Congolese consistently over time. In addition, we created family planning messages that aired on television and on radio, along with informational spots on family planning that became so popular stations were asking to air them for free. Over the past five years, PSI has maintained product supply to nearly 300 private partner pharmacies, nearly 100 private partner clinics, and through more than 100 mobile educators – and all that translates into an ongoing supply of health products and services for women, even during times of crisis.
By treating women around the world as customers, by creating incentives for the private sector--which already interacts with these women--to carry life-saving products as well as soap or cooking oil, by using marketing to encourage behavior change the same way we were encouraged to wear a seat belt or are now encouraged to Twitter, we reach more women and we change more lives.
Social marketing can work even in circumstances where donors lose interest or politics get in the way. Because a market for a product or service, once stimulated, tends to perpetuate itself. When resources aren’t available for price subsidies that are needed to reach low-income consumers, social marketing can use cross-subsidization: in other words, selling higher-priced products to consumers willing to pay, and transferring the surplus into subsidies for lower-income consumers.
Since social marketing involves subsidy, sometimes substantial, nonprofits like mine are its champions. And in this day of stubbornly high needs around the world and crushing budget pressures on all donors, isn’t it smart to make donor resources go as far as they can and reach more women? Social marketing uses markets and the private sector to reach many more people than emergency give-aways are able to do. And, it offers the poor something often overlooked: dignity, choice and a voice in improving their own health.
Markets. Secretary Clinton has seen them work for the benefit of women, girls and families around the world. They exist anywhere humans exist. With dedication and skill, we can use those markets to reach the women who need our help most in order to end the mind-numbing carnage that is caused by lack of access to family planning and reproductive health products and services.
The markets already exist, Madame Secretary. Let’s make them work for the poor.