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East and Southern Africa has made impressive gains in the reproductive health of its people. Yet, as we count these achievements, we must ensure we maintain the momentum to achieve the new Sustainable Development Goals. With 521 million people, the region’s reproductive health challenges are vast: maternal mortality and morbidity, HIV infection, low contraception use, early marriage, teen pregnancy and gender-based violence, underpinned by gender inequality. Also, gains are quickly reversed during conflict and humanitarian crises. There is no time to lose - together, we need to make change happen.