Resources for service provision: policies and politics

Looking back 25 years, this journal reported on the formation of a new Faculty that drew upon the synergy of different professional entities, supporting the British government’s priority for sexual health in its new health strategy. International comparisons, with Eastern Europe and America, were valuable for objective reviews of service delivery. Twenty-five years on, in 2017, a rapidly changing political situation in the United States is again threatening global reproductive health. Twenty-five years ago, this journal reported on Dr Elphis Christopher’s astonishingly prophetic perspective on family planning (FP) in her Jennifer Hallam Memorial Lecture, delivered at the 19th Current Fertility and Reproductive Health Symposium of the National Association of Family Planning Doctors (NAFPD) and the Family Planning Association.1 Recalling the court case of 1876 against Annie Besant and Charles Bradlaugh for republishing a pamphlet with its advocacy for contraception, she regretted that despite the favourable environment from subsequent socioeconomic, legal and attitudinal changes, there was still poor utilisation of contraceptive services due to apathy, fatalism and religious convictions. Dr Christopher stated that the failure of FP services also included unsuccessful management of involuntary infertility, which affected 12% of couples, the success rate of in vitro fertilisation at that time being only around 15%. Finally, she referred to an increasing trend for couples to elect to be childless: as "abortion of a potential life that cannot be cared for is part of planning a family", services for induced abortion were needed for unwanted pregnancies.1 Turning to the USA, Dr Christopher said that the most important donor for international population assistance was a "paradoxical society" and a "complex, wealthy nation with such contradictory public attitudes to …