Travels Changed Gates's View on Global Birth Control [View all]

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SEATTLE—A little more than a year ago, Melinda Gates made a bold and controversial pledge to help women in the developing world get better access to contraception. It was an unexpected declaration from the practicing Catholic and co-chair with husband Bill of a private philanthropy better known for promoting vaccines and working to improve education. She was sharply criticized by Catholic groups that argue that global health and development funds should go to other causes.

In her travels across sub-Saharan and South Asia over more than a decade, Ms. Gates says she had seen the same scene play out over and over. Women she met with to talk about vaccines would ask her how they could get birth control. "They would say to me, 'But what about that shot I used to get?' " she said in an interview at the headquarters of the Bill & Melinda Gates Foundation. The women were referring to Depo-Provera, she explained, an injectable contraceptive that they told her they like and walk miles to get—only to find often out of stock.

Now, one year later, Ms. Gates appears well on her way toward her goal. At a summit last summer hosted by the Gates Foundation and the U.K. Department for International Development, donors pledged $2.6 billion—$300 million more than the hosts had hoped to raise—to bring voluntary family planning services to 120 million more women in the world's poorest countries by 2020.

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Countries such as Senegal and Tanzania are investing money to improve contraceptive education and availability, Ms. Gates said. Senegal's public-health clinics and hospitals were plagued with stock shortages of contraceptives, but now a new system being introduced across the country has improved supply and variety of products.

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While she differs with the Catholic Church on contraceptive methods, she said she shares its social-justice mission. "I believe they're in the halls of Congress as much as I am fighting for foreign aid on behalf of poor people," she said.

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