Unmet need for family planning – the ratio between the demand for contraception and the use of modern methods – has barely moved in the past two decades, despite dramatic increases worldwide in the number of contraceptive users. Projecting this trend into the future, we can safely estimate that between 2008 and 2015, demand for family planning in the developing world will likely increase from the current 818 million to 933 million women, while the number of family planning users will increase from 603 million to 709 million (see Figure 1). This includes 64 million new users in 66 low-income countries and 42 million in 89 middle-income countries.

Clearly, such a projected increase of 106 million users is substantial – equivalent to almost half the level of current unmet need. Yet the anticipated increase in demand between now and 2015 would still leave roughly 224 million women with an unmet need for modern contraception. And as a percentage of total demand, 709 million users would still represent only 76 percent of women who wish to delay or prevent a pregnancy – barely more than today’s 74 percent.

The HANDtoHAND Campaign proposes to break this deadlock by adding 100 million new users of modern contraception to the 66 low-income countries by 2015. That would mean 36 million more new users than the 64 million likely to occur in those countries anyway. And in the 89 middle-income countries, we would expect increased global commitments to indirectly give rise to 12 million more new users than the expected addition of 42 million. Together, these “incremental amounts” of 36 and 12 million users would raise the total number of users of modern family planning from the 709 million estimated to occur anyway, to 757 million globally. And as a percentage of the anticipated total demand of 933 million, a successful HANDtoHAND Campaign would meet the family planning needs of 81 percent of all women in low- and middle-income countries (see Figure 2).

These figures are achievable, but they are also ambitious. Among the low-income countries, adding 36 million users will require doubling (56 percent) the historic annual increase in contraceptive prevalence for modern contraceptive methods. And even among the middle- income countries, where contraceptive prevalence is higher, 12 million new users would require an increase of 28 percent over historical trends.

One hundred million new users in low-income countries would also require $1.6 billion more than the $1.1 billion currently being spent each year on contraceptive commodities, logistics, training, communications, service delivery and other services. Among both low- and middle- income countries, costs would rise to $5.7 billion per annum.