Michael Cook

An unmet need for sound thinking

Michael Cook
By Michael Cook
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July 16, 2012 (Mercatornet.com) - If you are not too greedy and need only a modest amount of other people’s money, get a sawed-off shotgun and a balaclava. However, if you are more ambitious, get an acronym. This is clearly the lesson to be drawn from the latest banking scandal, in which Britain’s leading banks scammed US$300 billion, perhaps much more, by fibbing about the Libor—the London Interbank Offered Rate—an acronym which politicians had never heard of and regulators hardly questioned.

But the same mistake was made all over again at this week’s London Family Planning Summit. The rich and famous of the world have donated $2.6 billion to meet the “unmet need” of 120 million women in the developing world for family planning. The UK has pledged $800 million, the Bill and Melinda Gates Foundation $560 million, the UNFPA $378 million, Norway $200 million, the Netherlands $160 million, and Germany $122 million. Those are just the donors in the hundreds of millions.

Do any of these governments and organisations really know what $2.6 billion of “unmet need” means? In a year when voters in some countries are rioting over “austericide” in the wake of the global financial crisis, are they tipping money into a gigantic black hole?

A professor at Harvard University’s Kennedy School of Government, Lant Pritchett, told MercatorNet that “unmet need” is a meaningless concept employed by no one except a coterie of family planning experts. Pritchett, who was described last year as one of the world’s 100 top global thinkers by the magazine Foreign Policy, was scathing in an email to MercatorNet. “Wow, I thought all of this was dead and gone… I wonder what is driving this revival?”

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“It has never caught fire except in a tiny group that push and push and naif outsiders assume they know what they are talking about and take it at face value. No one who has looked at it closely… really thinks it has any analytic use other than advocacy value. I am just amazed this nonsense has come back from its well-deserved dustbin of history.”

The argument which has diddled some of the world’s richest governments and philanthropists was set out this week in a special family planning issue of Britain’s most prestigious medical journal, The Lancet. Melinda Gates and Australia’s foreign minister, Bob Carr, contend that “Across the developing world, some 222 million women who want to avoid pregnancy are not using a modern method of contraception”. Providing them with contraceptives will—they claim—lead to 600,000 fewer newborn deaths and 79,000 fewer maternal deaths each year. With fewer children, women will have more money to spend educating their daughters. And with fewer people there will be a “demographic dividend” allowing more economic growth.

The $2.6 billion pledged at the Summit will reach 120 million of the 222 million women with an “unmet need” for contraception.

“Unmet demand” was dreamed up in the first family-planning surveys in the 1960s. Its high-water mark was the Cairo population conference in 1994 which resolved that: “Governmental goals for family planning should be defined in terms of unmet needs for information and services”. As the organiser of the London summit, Melinda Gates has breathed new life into the idea. But as Pritchett points out, there have always been knotty problems with “unmet need”.

First of all, “unmet”. According to a World Bank briefing note, women with “unmet need for contraception” are those “who do not want to become pregnant but are not using contraception”. Astonishingly, this includes women who are currently pregnant, women who are breast-feeding, and women who find it difficult to become pregnant. The World Bank blandly acknowledges that “women with unmet need may still not have any intention to use contraception were it readily accessible and of good quality”.

In other words, Melinda Gates’s 220 million women include women who know all about contraceptives, can access them, and can pay for them. But they are worried about side effects, or they have religious objections or they have husbands who are working overseas. This makes no difference. Even if they don’t want contraception, Mrs Gates and her supporters know that they need contraception. “Note that the measurement of unmet need,” says the World Bank, “does not include an assessment of whether women want or intend to use contraception.” Even Africa’s 65,000 Catholic nuns fit into that definition.

“The strange thing is,” says Pritchett, “that one of the stalwarts of the family planning movement, Charles Westoff, wrote a paper decades ago showing many of the same criticisms of ‘unmet need’ – eg, that is does not correspond to what women want, that it includes women not currently fecund, etc.—but then they just went on using it anyway.”

Second, “need”. What does “need” for contraceptives mean to a woman? Does it mean “desperation”—Mrs Gates seems to think so—or does it mean “like”? A woman staggering through the Sahara is desperate for a drink; a woman staggering through a bar would like (another) one. In Mrs Gates’s books, both of them have an “unmet need”. But among the 220 million women, should those who are just vaguely interested in contraception be counted?

In a thought-provoking paper which Professor Pritchett wrote in 1996, not long after the Cairo Conference, he pointed out that in comparison to the need for food, water, medical care and fuel, the need for contraception was very small in poor countries.

“Contraception is a very effective technology for having unregulated coital activity and not having children but no one needs contraception in order not to have children. There is no question you need a parachute to jump out of airplanes and not suffer serious injury, but does that mean you need a parachute? Well, the need for parachutes is obviously only as great as the need to fling oneself out of planes, which is pressing if you’re in the 82nd Airborne, but not really otherwise.”

Third, the idea of “unmet need” is patronising, even demeaning, for women. How can they “need” something that they do not want? This kind of reasoning comes from a patriarchal mindset. Women in developing countries are already pushed around too much. They should be allowed to make their own choices in peace. Pritchett told MercatorNet:

“This is exactly like calculating the ‘unmet need’ of Jewish people for pork. That is, one could do the calculations of the ‘need’ for protein, look at which Jewish people are getting enough protein, conclude that the experts think the most cost-effective way of getting protein is pork and then attribute an ‘unmet need’ for pork to people who are Jewish. Of course it is completely disrespectful of women to not listen to their reasons for not using contraception and insist they have a ‘need’ for something they do not ‘want’. It is precisely this kind of disrespect for women and their autonomy and choices that led to the disasters in India and China.”

Fourth, “unmet need” may possibly make sense in marketing, but as an analytical tool, Pritchett says, “it makes no economic sense at all”. Even in underdeveloped regions, women are well aware of the existence of contraception. If demand for it were high, the price should rise. In fact, family planning organisations often have to work hard to give contraceptives away.

As Pritchett points out in his 1996 paper, it is not a question of price. Even poor households in countries like Indonesia and Nepal spend between 2 and 3 percent of household income on tobacco. “If the household can afford tobacco the household can afford contraception,” he wrote.

More recent research shows that the use of contraceptives in developing countries does not decline if their price rises. This suggests that the problem is lack of demand, not lack of supply. American academics examined sales of contraceptives during the severe financial crisis which hit Indonesia in the late 1990s. They found that “very large changes in prices of contraceptives have little impact on the decision to use contraceptives or on method choice, even among the poorest couples.”

In an interview with The Guardian about the Summit Melinda Gates described improving access to contraception across the globe as her life’s work. Unfortunately, a gremlin in the typesetting had her claiming that 200 billion women wanted access, rather than 200 million. But perhaps when you are dealing with esoteric matters like Libor or “unmet need”, billions and millions, whatever, all sound the same. As long as the donors feel good about themselves and family planning bureaucrats continue to draw their paycheques.

Michael Cook is editor of MercatorNet. This article reprinted under a Creative Commons License. 

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Cardinal Dolan: Debate on denying Communion to pro-abortion pols ‘in the past’

Lisa Bourne
By Lisa Bourne

As America heads into its 2014 midterm elections, a leading U.S. prelate says the nation’s bishops believe debate over whether to deny Communion to pro-abortion Catholic politicians is “in the past.”

The Church’s Code of Canon Law states in Canon 915 that those “obstinately persevering in manifest grave sin are not to be admitted to Holy Communion.” Leading Vatican officials, including Pope Benedict XVI himself, have said this canon ought to be applied in the case of pro-abortion Catholic politicians. However, prelates in the West have widely ignored it, and some have openly disagreed.

John Allen, Jr. of the new website Crux, launched as a Catholic initiative under the auspices of the Boston Globe, asked New York Cardinal Timothy Dolan about the issue earlier this month.

“In a way, I like to think it’s an issue that served us well in forcing us to do a serious examination of conscience about how we can best teach our people about their political responsibilities,” the cardinal responded, “but by now that inflammatory issue is in the past.”

“I don’t hear too many bishops saying it’s something that we need to debate nationally, or that we have to decide collegially,” he continued. “I think most bishops have said, ‘We trust individual bishops in individual cases.’ Most don’t think it’s something for which we have to go to the mat.”

Cardinal Dolan expressed personal disinterest in upholding Canon 915 publicly in 2010 when he told an Albany TV station he was not in favor of denying Communion to pro-abortion politicians. He said at the time that he preferred “to follow the lead of Popes John Paul II and Benedict XVI, who said it was better to try to persuade them than to impose sanctions.”

However, in 2004 Cardinal Joseph Ratzinger, who became Pope Benedict XVI the following year, wrote the U.S. Bishops a letter stating that a Catholic politician who would vote for "permissive abortion and euthanasia laws" after being duly instructed and warned, "must" be denied Communion. 

Cardinal Ratzinger sent the document to the U.S. Bishops in 2004 to help inform their debate on the issue. However, Cardinal Theodore McCarrick, then-chair of the USCCB Task Force on Catholic Bishops and Catholic Politicians, who received the letter, withheld the full text from the bishops, and used it instead to suggest ambiguity on the issue from the Vatican.

A couple of weeks after Cardinal McCarrick’s June 2004 address to the USCCB, the letter from Cardinal Ratzinger was leaked to well-known Vatican reporter Sandro Magister, who published the full document. Cardinal Ratzinger’s office later confirmed the leaked document as authentic.

Since the debate in 2004, numerous U.S. prelates have openly opposed denying Communion to pro-abortion Catholic politicians.

In 2008, Boston Cardinal Sean O’Malley suggested the Church had yet to formally pronounce on the issue, and that until it does, “I don’t think we’re going to be denying Communion to the people.”

In 2009, Cardinal Donald Wuerl of Washington D.C. in 2009 said that upholding of Canon 915 would turn the Eucharist into a political “weapon,” refusing to employ the law in the case of abortion supporter Rep. Nancy Pelosi.

Cardinal Roger Mahoney, archbishop emeritus of Los Angeles, said in a 2009 newspaper interview that pro-abortion politicians should be granted communion because Jesus Christ gave Holy Communion to Judas Iscariot.

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However, one of the Church’s leading proponents of the practice, U.S. Cardinal Raymond Burke, who is prefect of the Vatican’s Apostolic Signatura, insists that denying Communion is not a punishment.

“The Church’s discipline from the time of Saint Paul has admonished those who obstinately persevere in manifest grave sin not to present themselves for Holy Communion,” he said at LifeSiteNews’ first annual Rome Life Forum in Vatican City in early May. "The discipline is not a punishment but the recognition of the objective condition of the soul of the person involved in such sin."  

Only days earlier, Cardinal Francis Arinze, former prefect of the Congregation for Divine Worship and the Discipline of the Sacraments, told LifeSiteNews that he has no patience for politicians who say that they are “personally” opposed to abortion, but are unwilling to “impose” their views on others.

On the question of Communion, he said, “Do you really need a cardinal from the Vatican to answer that?”

Cardinal Christian Tumi, archbishop emeritus of Douala, told LifeSiteNews around the same time that ministers of Holy Communion are “bound not to” give the Eucharist to Catholic politicians who support abortion.

Pro-life organizations across the world have said they share the pastoral concern for pro-abortion politicians. Fifty-two pro-life leaders from 16 nations at the recent Rome Life Forum called on the bishops of the Catholic Church to honor Canon 915 and withhold Communion from pro-abortion politicians as an act of love and mercy.

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‘His bones are basically like paper’: Parents refuse to abort baby with rare condition

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By Kirsten Anderson

At just 11 weeks old, little Layton Diven is not like other babies. Every time his parents pick him up or cuddle him, there is a chance they will break his bones. In fact, Layton has already suffered more than 20 fractures in his short life – beginning at the moment of his birth.

Layton has Osteogenesis Imperfecta (OI), a rare disease that makes his bones brittle and prone to breakage. There are several types of OI, and Layton’s type, OI Type III, is the most severe type found among infants. Most babies born with the disease, like Layton, are born with multiple fractures, especially along the rib cage. Many struggle to breathe or swallow. The incurable disease is progressive, so it will get worse as he gets older.

Layton was diagnosed with OI in the womb, but abortion wasn’t an option for his parents, Chad and Angela Diven, who considered their baby a gift from God, no matter his condition.

“We weren't going to have an abortion, so he was born with the disease,” Angela Diven told KSLA. “God chose me for him, to be his mom, so I have to take that huge responsibility and do what's best for him.”

That responsibility comes with a heavy price. Layton requires 24-hour care, but both Angela and Chad have full-time jobs. He can’t go to regular daycare, because it’s not safe for him.

“You can't just pick him up like a normal baby,” Diven said. “You can't dress him like a normal child; his bones are basically like paper. He can't go to daycare because of his condition. He's medically fragile, and a daycare can't handle him."

Childcare costs are just the beginning, though – the treatments Layton will need throughout his life are expensive and may not be covered by insurance.

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Layton is currently receiving pamidronate IV therapy, which will help to strengthen his bones. But in order to be able to stand or walk, he will need metal rods implanted in his legs – an operation that will cost the Divens $80,000. The OI specialist coordinating Layton’s care is in Omaha, Nebraska, while the Divens live in Louisiana. As he grows, Layton will also require special equipment, such as a wheelchair, along with extensive physical therapy.

Despite the hardships they knew would come, the Divens stepped out in faith to bring Layton into the world. Now, they are reaching out to the internet for help to shoulder the financial burdens that came with their baby blessing. The family has set up both a GoFundMe and a Facebook page called “Lifting Up Layton Diven,” where people can receive updates on Layton’s condition and contribute to the cost of his care.

To donate to baby Layton’s medical trust fund, click here.

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Sources confirm Cardinal Burke will be removed. But will he attend the Synod?

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By John-Henry Westen

Sources in Rome have confirmed to LifeSiteNews that Cardinal Raymond Burke, the head of the Vatican’s highest court, known as the Apostolic Signatura, is to be removed from his post as head of the Vatican dicastery and given a non-curial assignment as patron of the Order of Malta.

The timing of the move is key since Cardinal Burke is currently on the list to attend October’s Extraordinary Synod on the Family. He is attending in his capacity as head of one of the dicasteries of the Roman Curia, so if he is removed prior to the Synod it could mean he would not be able to attend.

Burke has been one of the key defenders in the lead-up to the Synod of the Church's traditional practice of withholding Communion from Catholics who are divorced and civilly remarried.

Most of the Catholic world first learned of the shocking development through Vatican reporter Sandro Magister, whose post ‘Exile to Malta for Cardinal Burke’ went out late last night.

If Burke’s removal from the Signatura is confirmed, said Magister, the cardinal “would not be promoted - as some are fantasizing in the blogosphere - to the difficult but prestigious see of Chicago, but rather demoted to the pompous - but ecclesiastically very modest - title of ‘cardinal patron’ of the Sovereign Military Order of Malta, replacing the current head, Paolo Sardi, who recently turned 80.”

At 66, Cardinal Burke is still in his Episcopal prime.

The prominent traditional Catholic blog Rorate Caeli goes as far as to say, “It would be the greatest humiliation of a Curial Cardinal in living memory, truly unprecedented in modern times: considering the reasonably young age of the Cardinal, such a move would be, in terms of the modern Church, nothing short than a complete degradation and a clear punishment.”

On Tuesday, American traditionalist priest-blogger Fr. John Zuhlsdorf also hinted he had heard the move was underway. “I’ve been biting the inside of my mouth for a while now,” he wrote. “The optimist in me was saying that the official announcement would not be made until after the Synod of Bishops, or at least the beginning of the Synod. Or at all.”

“It’s not good news,” he added.

Both Magister and Zuhlsdorf predicted that the controversial move would unleash a wave of simultaneous jubilation from dissident Catholics and criticism from faithful Catholics. The decision to remove Cardinal Burke from his position on the Congregation for Bishops last December caused a public outpouring of concern and dismay from Catholic and pro-life leaders across the globe.

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Both men speculated on the reasons for the ouster. 

Magister pointed out that Burke is the latest in a line of ‘Ratzingerian’ prelates to undergo the axe.

“In his first months as bishop of Rome, pope Bergoglio immediately provided for the transfer to lower-ranking positions of three prominent curial figures: Cardinal Mauro Piacenza, Archbishop Guido Pozzo, and Bishop Giuseppe Sciacca, considered for their theological and liturgical sensibilities among the most ‘Ratzingerian’ of the Roman curia,” said Magister.

He added: “Another whose fate appears to be sealed is the Spanish archbishop of Opus Dei Celso Morga Iruzubieta.”

Fr. Zuhlsdorf observed that Pope Francis may also be shrinking the Curial offices and thus reducing the number of Cardinals needed to fill those posts. He adds however, “It would be naïve in the extreme to think that there are lacking near Francis’s elbows those who have been sharpening their knives for Card. Burke and for anyone else associated closely with Pope Benedict.” 

“This is millennial, clerical blood sport.”

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