Stopping the spread of HIV is a primary goal for the Bill and Melinda Gates Foundation. HIV (Human Immuno Deficiency Virus) is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). HIV is carried in semen, vaginal fluid, mucus, blood, and breast milk. It enters the body through cuts or sores in the skin, or through mucus membranes. If HIV destroys enough healthy white blood cells (T-cells) that someone who has the virus is especially vulnerable to infection, that person has AIDS. Though HIV/AIDS can be treated, there is no cure.According to The Bill and Melinda Gates Foundation website, thirty-seven million people worldwide are living with HIV, and seventy percent of those people live in Sub-Saharan Africa. A June 2008 study by the Guttmacher Institute supports the Foundation’s findings. The researchers note that, “Poverty, by influencing sexual behaviour and access to services, can influence the transmission of HIV infection […] HIV prevention programs must devise strategies for increasing condom usage among the poorest.” Practicing safe sex is one of the surest ways to prevent HIV infections.

The Bill and Melinda Gates Foundation wants to increase condom usage by funding the development of condoms that are easy to put on, comfortable to wear, and cheap to produce. In 2013, the company awarded one hundred thousand U.S. dollars to each of the eleven finalists whom The Foundation determined had the most promising, practical condom designs. The Gates’ hope these condoms will one day be available around the world, but they are focusing on promoting qualities that would be valuable to males in Sub-Saharan Africa. According to a 2013 study of six African countries where one-fifth to one-quarter of the country’s population is infected with either HIV or AIDS, the number of condoms needed to prevent the spread of HIV amongst sexually active citizens exceeded the number of condoms available on the market. The Foundation’s effort to fund the development of a condom that could decrease the spread of HIV amongst Sub-Saharan Africans was the first project that showed the Gates’ commitment to promoting technology that would encourage safe sex practices and increase individuals’ agency, regardless of their preferred forms of sexual expression. It won’t be the last.

Now, with the U.S. states of Missouri, Alabama, Georgia, and Ohio all passing bills banning any abortions performed after six weeks, The Bill and Melinda Gates Foundation is working to make sure a woman has as much agency as possible in determining when or whether she conceives. As of 2019, Gates, whose foundation promotes increasing women’s reproductive options, is developing a birth control implant with an on/off switch. The details: A device, designed to be implanted under the skin, has a supply of the pregnancy-preventing hormone, levonorgestrel, stored in the hermetically sealed reservoir of a microchip inside the device. Each day, an electric current passes through the reservoir’s seal. The electric current melts the seal, releasing thirty milligrams of levonorgestrel per day. When one reservoir is empty, the next will move forward. If a woman no longer wants to prevent conception, the electric current can be stopped at any time, by pressing a button on a remote control that is provided to either the woman using the device or her physician. One device should be viable for up to sixteen years.

The idea for this technology was developed by Massachusetts Institue of Technology (MIT) researchers, Robert Langer and Michael Cima, and then Phd student, John Santini. The researchers licensed the technology to the Massachusetts company, MicroCHIPS Biotech. According to MIT Technology Review, Bill Gates visited Robert Langer’s MIT lab in 2013. He asked Langer if it would be possible to develop a birth control device that could be switched on and off. He also wanted the device to be effective for a longer period of time than any device currently on the market. Langer directed Gates to the technology Langer had licensed to MicroCHIPS Biotech. In 2017, The Bill and Melinda Gates Foundation gave MicroCHIPS Biotech 4.6 million U.S. dollars to fund the development of the birth control device.

If it is perfected, this birth control device will give women who can afford it an unprecedented level of control over their reproductive decisions. The Gates’ hope this device will be the most affordable form of long term birth control. By contrast, according to Planned Parenthood, contraceptive implants that are currently on the market can cost up to one thousand U.S. dollars f0r those who have either inadequate insurance or no insurance. Therefore, the widespread availability of affordable, long term birth control could positively affect, not only American and European women to whom birth control is already readily available, but women in the Sub-Saharan African countries to which The Bill and Melinda Gates Foundation is especially committed to providing resources for the prevention of the spread of HIV and the promotion of reproductive rights and reproductive health. At present, no thorough assessment of the potential health risks of the device is not available, because it has not been approved by The U.S. Food and Drug Administration (FDA).

Since MicroCHIPS Biotech’s device is still just an ambitious idea, the primary opposition it is facing is based on a hypothetical scenario: If the electrical current that melts the seal of the reservoir, thus controlling the release of levonorgestrel, is turned on and off by remote control, then who should have custody of the remote control? Will the remote control be so complicated to operate that it should stay in the possession of a professional physician, or will a woman’s autonomy over her reproductive rights be compromised if the remote control isn’t in her own possession? Though the best solutions to these questions could be determined on a case by case basis if this device were on the market, there is one question that will require a more complex answer: How could the device be encrypted to prevent non-consensual¬† use of the remote control? Answering this question might be the first step to forever changing reproductive planning.