Melinda Gates has made providing poor women in developing countries access to contraception a mission. The Bill & Melinda Gates Foundation, which she leads with her husband, has donated more than $1 billion for family planning efforts and will spend about $180 million more this year. Since 2012, she has helped lead an international campaign to get birth control to 120 million more women by 2020. Four years later, a reportexplains why achieving that goal is proving tougher than expected. This is a condensed and edited version of our conversation about family planning.

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