Report on the Destruction of Contraceptives and its Conflict with Sustainable Development Goals

Executive Summary

A decision by the United States government to incinerate contraceptive supplies valued at over $9.7 million is set to severely undermine public health and development progress in five African nations: the Democratic Republic of the Congo, Kenya, Tanzania, Zambia, and Mali. This action directly contravenes multiple Sustainable Development Goals (SDGs), particularly those related to health, gender equality, and sustainable practices. The destruction of these viable medical supplies, many not expiring until 2027-2029, will deny essential reproductive healthcare to over 1.4 million women and girls, leading to an estimated 174,000 unintended pregnancies and 56,000 unsafe abortions.

Direct Contradiction of Sustainable Development Goals (SDGs)

SDG 3: Good Health and Well-being

The decision fundamentally obstructs progress towards SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages.

• Violation of Target 3.7: This target calls for universal access to sexual and reproductive healthcare services, including family planning. The destruction of contraceptives creates an artificial shortage, directly preventing access for millions.
• Reversal of Progress on Target 3.1: This target aims to reduce the global maternal mortality ratio. By increasing the likelihood of unintended pregnancies and subsequent unsafe abortions—a leading cause of maternal death in the region—this action will likely increase maternal mortality rates.

SDG 5: Gender Equality

The action represents a significant setback for SDG 5, which seeks to achieve gender equality and empower all women and girls.

• Undermining Target 5.6: This target focuses on ensuring universal access to sexual and reproductive health and reproductive rights. Denying women and girls the tools to plan their families curtails their educational, economic, and personal autonomy.
• Exacerbating Gender-Based Vulnerabilities: In Kenya, it is noted that nearly one in five girls aged 15-19 is already pregnant or has given birth. Withholding contraceptives worsens this crisis and perpetuates cycles of poverty and inequality.

SDG 12: Responsible Consumption and Production

The choice to incinerate usable goods is in direct opposition to the principles of sustainable resource management outlined in SDG 12.

• Wasteful Destruction of Resources: The incineration of $9.7 million worth of manufactured, packaged, and ready-to-use medical supplies represents a profound failure of responsible management and contributes to unnecessary waste.
• Rejection of Sustainable Alternatives: The International Planned Parenthood Federation (IPPF) offered to redistribute the supplies at no cost, providing a sustainable and life-saving alternative to destruction, which was declined.

SDG 17: Partnerships for the Goals

The refusal to collaborate with non-governmental partners highlights a failure to uphold the spirit of SDG 17.

• The US government’s rejection of the IPPF’s cost-free redistribution offer demonstrates a breakdown in public-private and civil society partnerships, which are essential for achieving the SDGs.

Country-Specific Impact Analysis

The impact of the withheld contraceptives is projected to be severe, representing a significant portion of the annual need in several countries.

1. Tanzania
   • Withheld Supplies: Over 1 million injectable contraceptives and 365,100 implants.
   • Impact: Fulfills 28% of the total annual need for these commodities.
   • Context: The country is already experiencing a shortage of contraceptive commodities due to prior USAID funding cuts.
2. Mali
   • Withheld Supplies: 1.2 million oral contraceptives and 95,800 implants.
   • Impact: Fulfills 24% of the country’s annual need.
3. Kenya
   • Withheld Supplies: 108,000 contraceptive implants.
   • Context: The country is already facing depleted stockpiles of long-term contraceptives and a 46% funding gap in its national family planning program. Unsafe abortions are among the top five causes of maternal death.
4. Zambia
   • Withheld Supplies: 48,400 implants and 295,000 injectable contraceptives.

Policy Rationale and International Response

Stated Justification for Destruction

A US State Department spokesperson confirmed the decision was made because the contraceptives could not be sold to “eligible buyers.” This is linked to US laws and regulations that prohibit providing US aid to organizations that provide or advocate for abortion services overseas.

International Condemnation

The decision has been met with outrage from global health and rights organizations.

• The IPPF’s Africa Regional Director described the decision as “appalling and extremely wasteful,” highlighting that the supplies were destined for humanitarian contexts where access to care is already limited.
• Feminist, rights, and family planning groups have expressed outrage, prompting the French government to state it is “following the situation closely” amid reports the incineration was planned to occur in France.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The following SDGs are connected to the issues discussed in the article:

• SDG 3: Good Health and Well-being: The article’s central theme is the denial of access to contraceptives, which directly impacts sexual and reproductive health, leading to unintended pregnancies, unsafe abortions, and increased maternal mortality.
• SDG 5: Gender Equality: The lack of access to contraceptives disproportionately affects women and girls, undermining their reproductive rights, health, and ability to make choices about their own bodies and futures. The article explicitly states the destruction will deny “1.4 million women and girls” access to care.
• SDG 12: Responsible Consumption and Production: The decision to incinerate millions of dollars worth of usable medical supplies, which do not expire for several years, is described as “appalling and extremely wasteful,” directly contradicting the principles of reducing waste.
• SDG 17: Partnerships for the Goals: The issue stems from a decision by a developed country (the US) regarding its official development assistance (USAID), affecting partnerships with developing nations and NGOs (like IPPF) and hindering the effective delivery of aid.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.1: Reduce the global maternal mortality ratio. The article directly links the lack of contraceptives to a rise in unintended pregnancies and unsafe abortions, which are “among the five leading causes of maternal deaths in Kenya.” It predicts the decision will lead to “a rise in maternal mortality.”
   • Target 3.7: Ensure universal access to sexual and reproductive health-care services, including for family planning. The entire article is about the denial of access to family planning commodities. It highlights a “shortage of contraceptive commodities,” a “46% funding gap in Kenya’s national family planning programme,” and the fact that millions of contraceptives will not be distributed, directly undermining this target.

2. SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights. The article repeatedly mentions the impact on “women’s health and their sexual and reproductive rights.” The denial of contraceptives prevents women from exercising their reproductive rights and making autonomous decisions about family planning.

3. SDG 12: Responsible Consumption and Production

   • Target 12.5: Substantially reduce waste generation through prevention, reduction, recycling and reuse. The decision to “incinerate more than $9.7m (£7.3m) of contraceptives” that are “ready-to-use” and not expiring until “2027-29” is a direct example of creating waste instead of preventing it. The IPPF’s offer to take them for “redistribution at no cost” was a clear opportunity for reuse that was declined.

4. SDG 17: Partnerships for the Goals

   • Target 17.2: Developed countries to implement fully their official development assistance commitments. The article discusses the “impact of the USAID funding cuts” and the destruction of aid commodities due to US laws. This represents a failure in the effective implementation and delivery of development assistance to partner countries and organizations.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG 3 (Good Health and Well-being):

   • Indicator 3.1.1 (Maternal mortality ratio): The article implies this indicator will worsen, stating there will be “a rise in maternal mortality” and that “unsafe abortions remain among the five leading causes of maternal deaths in Kenya.”
   • Indicator 3.7.1 (Proportion of women of reproductive age who have their need for family planning satisfied with modern methods): The article provides direct data on the unmet need. It states the destruction will deny “more than 1.4 million women and girls” access to care and details the specific quantities of contraceptives being withheld from countries, such as “28% of the total annual need in Tanzania” and “almost a quarter (24%) of the country’s annual need” in Mali.
   • Indicator 3.7.2 (Adolescent birth rate): The article provides a direct statistic for this indicator in Kenya, noting that “Nearly one in five girls aged 15 to 19 are already pregnant or has given birth.”

2. For SDG 5 (Gender Equality):

   • Indicator 5.6.1 (Proportion of women aged 15-49 years who make their own informed decisions regarding… contraceptive use): The article implies a negative impact on this indicator. It states that the shortage “has directly impacted clients’ choices regarding family planning uptake,” thereby reducing their ability to make informed decisions.
   • Indicator 5.6.2 (Number of countries with laws and regulations that guarantee… access to sexual and reproductive health care): The article references the legal frameworks that affect access, mentioning the “Kenyan constitution” versus the “Kenyan penal code” on abortion, and the “US laws and rules that prohibit sending US aid to organisations that provide abortion services.”

3. For SDG 12 (Responsible Consumption and Production):

   • Indicator 12.5.1 (National recycling rate, tons of material recycled): While not a direct measure, the article provides quantifiable data on the waste being generated. The “incineration” of “$9.7m” worth of goods, including “more than 1m injectable contraceptives and 365,100 implants” for Tanzania alone, is a measure of valuable material being destroyed instead of reused or recycled.

4. Table of SDGs, Targets, and Indicators

Source: theguardian.com