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 Raymond Burke, prefect of the Apostolic Signatura, speaks to Thomas McKenna of Catholic Action Insight. Catholic Action Insight
Hilary White Hilary White Follow Hilary

Catholics shouldn’t sue one another: Cardinal Burke comments on Fr. Rosica’s lawsuit against blogger

Hilary White Hilary White Follow Hilary
By Hilary White

ROME, March 2, 2015 (LifeSiteNews.com) – Citing Scripture, Cardinal Raymond Burke told an interviewer this week that Catholics should not sue each other: “Our Lord in the Gospel and St. Paul in his First Letter to the Corinthians instruct us not to take our disputes to the civil forum, that we should be able, as Catholics, to resolve these matters among ourselves.”

The cardinal’s comments to the Traditionalist Catholic website Rorate Caeli follow an uproar in the Catholic media world last week when it was revealed that Vatican spokesman Father Thomas Rosica has threatened to sue a Canadian blogger for defamation in the civil courts.

Cardinal Burke, who served under Pope Benedict XVI and Pope Francis as the head of the Vatican’s highest court, is a noted expert on canon law. He told Rorate Caeli, “Unless the blogger has committed a calumny on someone's good name unjustly, I certainly don't think that that's the way we as Catholics should deal with these matters.”

“I think contact should be made. I presume that the Catholic blogger is in good faith, and if there’s someone in the hierarchy who is upset with him, the way to deal with it would be first to approach the person directly and try to resolve the matter in that way,” Burke added.

Fr. Rosica, a Canadian Basilian, is the English language press officer for the Vatican and founder of the Toronto-based Salt and Light Television network.

He sent the legal letter to David Domet, a Toronto music composer and part-time Catholic blogger who has long criticized what he says are Fr. Rosica’s departures from Catholic orthodoxy. The priest’s lawyer told Domet to remove nine separate items from his blog and apologize, but added that this would not necessarily remove the threat of the civil action.

The conflict was covered in a feature by Michael Voris’ Church Militant TV, and the internet’s Catholic blogger world exploded with indignation. So furious was the backlash that it got coverage by the US conservative news site, Breitbart. This followed dozens of blog posts, nearly unanimously calling the threatened legal action of a well-placed priest against a lay pensioner a “PR disaster” for Rosica. 

The uproar has launched Domet’s small blog, Vox Cantoris, into the international limelight, and has earned Fr. Rosica an avalanche of criticism. “Though Rosica publicly defends the right to freedom of speech and press, he is attempting to silence the blogger who has criticized him,” Austin Ruse, president of the Catholic Family and Human Rights Institute, wrote for Breitbart.

Among Domet’s criticisms of Fr. Rosica is his apparent support for the proposal by Cardinal Walter Kasper to allow divorced and civilly remarried Catholics, and others in “irregular” sexual unions, to receive Holy Communion.

Fr. Rosica has also recently come under fire for comments he made a year ago, in a lecture in Windsor, Ontario, in which he argued that Catholic doctrine could change. (See video below. Quotes can be found at 48:12.)

“Will this Pope re-write controversial Church doctrines?” Fr. Rosica said in the lecture, which was posted to Youtube. “No. But that isn't how doctrine changes. Doctrine changes when pastoral contexts shift and new insights emerge such that particularly doctrinal formulations no longer mediate the saving message of God's transforming love.”

Fr. Rosica continued: “Doctrine changes when the Church has leaders and teachers who are not afraid to take note of new contexts and emerging insights. It changes when the Church has pastors who do what Francis has been insisting: leave the securities of your chanceries, of your rectories, of your safe places, of your episcopal residences go set aside the small-minded rules that often keep you locked up and shielded from the world.”

In the Rorate Caeli interview, Cardinal Burke refuted the idea that the Church can change its “pastoral practice” without changing doctrine.

“I think it’s very important to address a false dichotomy that's been drawn by some who say, ‘Oh no, we’re just changing disciplines. We’re not touching the Church's doctrine.’ But if you change the Church’s discipline with regard to access to Holy Communion by those who are living in adultery, then surely you are changing the Church's doctrine on adultery.”

“You’re saying that, in some circumstances, adultery is permissible and even good, if people can live in adultery and still receive the sacraments. That is a very serious matter, and Catholics have to insist that the Church’s discipline not be changed in some way which would, in fact, weaken our teaching on one of the most fundamental truths, the truth about marriage and the family,” Cardinal Burke said.

Fr. Rosica recently criticized Cardinal Burke on his Twitter account by posting an article by Washington, DC’s Cardinal Donald Wuerl on “dissent” in the hierarchy, saying, “Cardinal Wuerl’s response to Burke (and dissenters).”

The priest has also had a confrontational relationship with the pro-life movement for years.

In 1996, Fr. Rosica called the police on pro-life advocates who were leafletting in protest at a lecture by famous dissident Gregory Baum at the University of Toronto’s Newman Centre.

In 2009, Fr. Rosica wrote against objections to the lavish Catholic funeral for US Senator Ted Kennedy’s in Boston. He excoriated the pro-life movement for what he called their lack of “civility.”

“Civility, charity, mercy and politeness seem to have dropped out of the pro-life lexicon,” Fr. Rosica wrote. “To recognize and bring out the sin in others means also recognizing one’s self as a sinner and in need of God’s boundless mercy.

“Let us pray that we will become more and more a people, a church and a community overflowing with mercy.”

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Greg Rohrbough, J.D.

Duck Commander Phil Robertson’s CPAC speech was viral in so many ways

Greg Rohrbough, J.D.
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Last week, the winner of the 2015 Citizens United/CPAC Andrew Breitbart Defender of the First Amendment Award was “Duck Commander” Phil Robertson, paterfamilias of the Duck Dynasty Robertson family. In doing so, they were giving Phil the CPAC stage for a speech, knowing that he would speak his unvarnished thoughts. One doubts they expected his topic.

After bringing out his heavily-duct-taped Bible and telling politicians to keep theirs with them, Phil went on the offensive – against sexually transmitted diseases (STDs). He quoted the federal Centers for Disease Control, which estimates that more than 100 million Americans now have a sexually transmitted infection.

“I don’t want you to become ill. I don’t want you to come down with a debilitating disease. I don’t want you to die early,” Robertson said.

Phil’s solution? One older than Christianity, as old as common sense itself. “If you’re disease-free, if she’s disease-free, you marry. You keep your sex right there. You won’t get sick from a sexually-transmitted disease!”

Logic and mathematics would seem to agree. According to Robertson, his goal was to show love to the listeners. But several left-wing websites didn’t see it that way.

“He certainly used his speech to hate very well. I guess that's the criteria. Who can say the sickest, most vile things about center-left Americans wins!” according to John Amato of Crooks & Liars.

The Huffington Post took offense at his attributing the rise in STDs to the beatniks and hippies.

To their credit, MSNBC acknowledged Phil’s numbers, saying, “For the record, Robertson’s [sic] has his numbers correct. A CDC report from February of 2013 estimated more than 110 [million] cases of sexually transmitted infections in America with about 20 billion [sic, MSNBC’s number] new infections each year at a cost of ‘nearly $16 billion in direct medical costs.’”

The network site then blasted him for comparing ISIS to the Nazis, Communists, and Imperial Japanese.

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Robertson clearly didn’t care what MSNBC thought, though. “You want a Godly, Biblical, medically safe option? One man, one woman, married, for life,” he said.

“What do you call the 110 million people who have sexually transmitted illnesses?” he continued. “It’s the revenge of the hippies! Sex, drugs, and rock ‘n’ roll have come back to haunt us in a bad way!”

But the big question is – is Phil right or wrong? According to the CDC’s website, “Almost every sexually active person will acquire HPV [Human Papillomavirus] at some point in their lives.”

“Sexually active” would seem to indicate activity with new or multiple partners, rather than this Duck Doctor Phil’s Prescription.

But still – “Almost every…person.” That’s quite a few – the website also says, “about 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year.” While it is the most prevalent venereal disease, HPV is only one of many.

Generally, HPV’s symptoms are more a painful nuisance than life-threatening – genital warts, often only appearing years after the initial infection. But there are also life-threatening illnesses such as cervical cancer, which HPV causes.

Much more frightening, however, is the specter of HIV/AIDS. According to the CDC, there are about 1.2 million people currently living with HIV, and as many as 50,000 new cases a year, with 63 to 66 percent of those being “MSM,” or “Men who have Sex with Men.” Sadly, the lion’s share of new HIV infections is found in the 13-24 age group; despite being 16 percent of the nation’s population, they account for 26 percent of all new infections, with 72 percent of those being young MSM. While HIV is treatable, there is still no cure.

Although HIV, as well as the current increase in syphilis and hepatitis, are primarily targeting homosexual males, heterosexuals with multiple partners are by no means off the hook. As well as HPV, herpes, drug-resistant gonorrhea and chlamydia are on the rise, as well. The year 2013 saw 1.4 million cases of chlamydia and 820,000 new cases of gonorrhea, and the CDC estimates that one person in every six in the U.S. between the ages of 14 and 49 has herpes.

Criticize Phil all you like, folks – he doesn’t mind. He’s only saying this because he cares.

Listen to him again: “I don’t want you to become ill. I don’t want you to come down with a debilitating disease. I don’t want you to die early.”

“And if you hate me because I told you that,” he said, “I told you, my love for you is not contingent on how you feel about me. I love you anyway. I don’t want you to see you die early or get sick. I’m trying to help you, for cryin’ out loud! America, if I didn’t care about you, why would I bring this up?”

From this CPAC attendee’s perspective, Phil’s speech was not only important from a physical health perspective, it also, along with that duct-taped Bible of his, reminds us of the words of Charles Spurgeon: “A Bible that’s falling apart usually belongs to someone who isn’t.”

Greg Rohrbough, J.D., has been director of government relations for the Meredith Advocacy Group since 2006.

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Steve Weatherbe

Former abortionist who failed to kill unborn baby hit with $1 million lawsuit: baby was born with hole in heart

Steve Weatherbe
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OTTAWA, March 2, 2015 (LifeSiteNews.com) – An Ontario mother of a baby born by mistake is suing the former doctor who botched her abortion for $1 million for his “gross negligence” and “medical malpractice.”

Tania Brown already had four children when she went to Dr. Michel Prevost in Almonte, Ontario in early 2011 for a medical (or pharmaceutical) abortion to prevent a fifth, which her doctor had advised might have birth defects. Several months later she suspected Prevost’s one-two punch of methotrexate (a poison to kill the baby) and misoprostol (to expel the corpse a week later) had not worked. An ultrasound confirmed a beating heart.

Too late for an abortion now, she gave birth, in May, to a baby with “a smaller brain; he had a hole in his heart; he had something wrong with his palate.” She gave him up for adoption.

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Dr. Prevost relinquished his medical licence earlier this month with the certainty that if he didn’t, the Ontario College of Physicians and Surgeons would expel him after an investigation found him “incompetent in his practice of obstetrics and gynecology.”  They looked into 28 abortion cases, two so badly “botched” that the babies survived.

Small wonder the whole business sent Brown into a “debilitating depression,” but her lawyer Ralph Lee told the CBC the case “brings up larger issues…the issue of a woman’s access to abortion.”

Basically, Prevost couldn’t get the dosages right. Methotrexate, MedicineNet.com warns, “has infrequently caused serious (sometimes fatal) side effects.” These include severe azotemia (too much blood urea nitrogen), severe blood infection, stomach and intestinal bleeding, and perforation.

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