The implementation of family planning programmes.

sum ofmoney equivalent to the cost ofsevenmodern tanks, in 1966 the equivalent to seven helicopters and in 1967 to one B52 bomber (Stycos, 1971). Now it is at a rate that will buy one modern aircraft carrier in 10 years. Currently the IPPF is spending each year slightly more than the inhabitants of the United Kingdom invest in backing horses on Derby Day. Rich and poor countries together spend more on colour films for cameras than they do on contraceptives. Unhappily, family planning programmes have not been structured to work within the real constraints set upon them. Some services in the United States spend as much on recruiting and looking after one family planning acceptor for 1 year as the per capita income of a poor country. In the developing world, programmes are sometimes exclusively tied to health services, which are themselves inadequate for the heavy burden of preventive and curative medicine which they must carry and may be culturally inappropriate. Doctors often prove poor planners and advisers and this defect, combined with the vagaries of legisla¬ tion and the biases ofpoliticians, has led to odd paradoxes. The conventional ideal family planning programme is spelt out by Michanek (1971) in a humane but bold plan for world development. Criticizing UN plans for the 1970s for under-emphasizing the problem of population increase he goes on, 'The UN strategy should have specified that its implementation in fact will depend on : the ability ofhundreds of family-planning programmes to find qualified leaders; the equipping of thousands of clinics; the recruiting, training and placing of hundreds of thousands of employees ; the provision of information and service to hundreds of millions of couples ; the prevention of many millions of births during the next four decades ; the spending of billions of dollars for this work'. Excellent as these ideas are, will they be followed ?