“Let’s try to create markets for these goods and ways of funding
them….” With that charge near the
end of her remarks last Friday on the 15th anniversary of the Cairo International
Conference on Population and Development (ICPD), Secretary of State Clinton put
her finger on one of the key avenues for long-lasting improvement in the lives
of women and children around the world:
markets.
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.