I seeded an article today about Melinda Gates' new "No Controversy" campaign. Given that the goal of this campaign is to increase access to contraception among poor women in the developing world, it rather predictably was the object of some controversy. Specifically, this video seen on an article elsewhere:
Seeing as both the original hosting on Youtube and the article re-hosting on Newsvine are both closed to comments, I thought I'd put up my own version to start a conversation, as well as examine some of the claims and almost-claims of the video.
The main objection to the No Controversy campaign seems to center on two big fronts: first, that contraception is a side show to more important issues; second, that contraception represents more of a health risk than a benefit.
Specifically, to make the first claim, the video says that what poor women REALLY need is jsutice, better schools, better hospitals, better roads. Of course, it's foolish to deny that these things are in dire need among poor women in developing economies, but I can't help but remark that insufficient access to contraceptive is, in fact, a matter of social justice. Women have expressed a desire for access to contraception; it is denied them by inadequacies of infrastructure and hobbling of contraception aid by religious and patriarchal institutions. This is unjust, and blatantly so. It's idiotic to say that contraception is the only, or even the biggest social justice issue facing women in the developing world, but to insinuate that it isn't a significant one is possibly even more fatuous.
Second, they make claims and pseudo-claims concerning health effects of oral contraceptives. First, it's worth noting that (at least in the article I read) the discussion did not seem limited to hormonal contraceptives, though they were definitely a lion's share of the conversation; presumably, the Bill and Melinda Gates foundation is not so myopic as to not realize that there are many many ways of avoiding unwanted pregnancy, access to all of which need improvement. Second, the health claims themselves are often misleading. Older forms of hormonal contraceptives are, as they state, present on the WHO's list of known carcinogens, but data on more modern forms is consistent with no relation or beneficial relation, depending on the cancer (source). Specifically, breast cancer risk in older forms of hormonal contraceptive was increased from 1 in 7 lifetime chance to 1 in 6; this relationship has not been demonstrated in modern dosages. Further, modern oral contraceptives seem to provide protective effects against ovarian and endometrial cancers. Data on cervical cancer seems to indicate a mild risk (source).
However, cancer is not the only health effect of contraceptives worth taking into consideration when viewing their costs versus benefits. Consider the lives of women saved by being able to space out childbirth more effectively; this is known to decrease both infant mortality and death in childbirth. Consider the improvement in quality of life in the children born in a family that plans childbirth as opposed to a family where childbirth happens one following another, especially in a society where food is precarious and many families live subsistence lives. To say that these are not significant benefits of contraception is to speak absolute idiocy.
Those are probably the strongest claims made in the video; the rest mostly fell, as I was taking some quick notes, under the category of "general bullshit." A link to a eugenics conference from 100 years ago was drawn in the opening seconds of the video; how this is relevant beyond some exasperating conspiracy theory baffles me. Bemoaned was the fact that Planned Parenthood Foundation International supports this venture, due to them being the biggest abortion provider in the world - neglected, of course, was the fact that Planned Parenthood is also the biggest provider of contraception and (go freakin' figure) family planning in the world (a much bigger part of their expenditure than abortions, as is well known), and for them NOT to be involved would be simply idiotic. A false dichotomy was drawn; 'what point,' the video asks 'is there in providing contraception without releasing women from men who don't appreciate them?' The obvious answer is that, to some degree at least, to provide contraception IS to challenge the men who don't appreciate women, because only such men would DENY them access to contraception. The wording was used that the goal of the campaign was to "put 120 million women in the developing world on the pill," where the more accurate version would be to say that the goal was to "give them access" to the pill - nobody's FORCING anyone, for crying out loud.
In short, the Facts for Melinda Gates spiel essentially serves as a big whine. Someone doesn't like contraception, and they've put up a fatuous and misleading counter-campaign to bemoan a philanthropic effort aimed at improving the lot of poor women in developing countries. Is the No Controversy campaign perfect? No. Does it solve all the problems facing poor women in the developing world? Of course not. It does, however, address a problem that is a big one, and one which has ramifications on poverty, patriarchal social structure, and incidence of disease and famine.