The lead Editorial in this week's edition of The Lancet discusses how more than 200 million women worldwide want contraceptives, but currently lack access to them. Addressing this unmet need, and the 76 million unintended pregnancies globally each year, would slow population growth and reduce demographic pressure on the environment.

The Editorial says: "Countries in the developing world least responsible for the growing emissions are likely to experience the heaviest impact of climate change, with women bearing the greatest toll. In tandem with other factors, rapid population growth in these regions increases the scale of vulnerability to the consequences of climate change, for example, food and water scarcity, environmental degradation, and human displacement."

The recent International Conference on Population and Development (ICPD) meeting in Berlin is discussed, with the Editorial saying: "Many of the NGOs still seem to be working in silos, avoiding the multisectoral engagement required to change societal attitudes." It describes as 'disappointing' the tensions that remain between various groups in these communities, but adds: "However, the discussions on how the sexual and reproductive health community are grappling with the emergent environmental crises that now shadow the landscape of women's health drew much attention at the Berlin meeting."

A study (soon to be published by WHO*) of the first 40 National Adaptation Programmes of Action (NAPAs), submitted by the least developed countries to the UN Framework Convention on Climate Change, showed that 37 such countries made the link between population growth and climate change. But only six of them identified family planning as part of their adaptation strategy - likely because family planning falls under the remit of the Ministries of Health rather than Environment, who are responsible for the NAPA documents. Additionally, only 7% of the 448 projects across the 40 NAPAs were in the health sector.

The Editorial says that the health response is missing from the current approaches to combat climate change. It highlights a case study in Ethiopia, that trained people in sustainable land management practices, while increasing availability of family planning. The programme resulted in an immediate improvement to the environment with better agricultural practices-which in the long term will be sustained and not eroded by a rapidly increasing population.

The Editorial concludes: "With less than three months to go, the UN Copenhagen conference on climate change provides an opportunity to draw attention to the centrality of women. The sexual and reproductive health and rights community should challenge the global architecture of climate change, and its technology focus, and shift the discussion to a more human-based, rights-based adaptation approach. Such a strategy would better serve the range of issues pivotal to improving the health of women worldwide."

Link to editorial

The Lancet

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