3rd Asia-Pacific Conference on Reproductive and Sexual Health

Tun Dr. Siti Hasmah Hj. Mohd Ali, Patron of the 3rd Asia-Pacific Conference on Reproductive and Sexual Health,

Honourable Datuk Seri Shahrizat Abdul Jalil, Honourable Minister of Women, Family and Community Development,

Honourable Dato’ Dr. Ng Yen Yen, Chairperson of the International Steering Committee,

Dr. Steven Sinding, Director-General of the International Planned Parenthood Federation (IPPF),

Dr. Raj Karim, Regional Director of IPPF ESEAOR,

Dr. Kamaruzaman Ali, Chairperson of the Local Organizing Committee,

Ladies and Gentlemen,

It gives me great pleasure to address you in this vibrant city of Kuala Lumpur. I would like to thank the International Steering Committee, especially the Federation of Family Planning Associations of Malaysia, for organizing this important Conference in collaboration with UNFPA, IPPF and the Ford Foundation and many other partners. And I would like to thank the Government of Malaysia for its warm welcome and for graciously hosting this meeting. Special thanks for ensuring that the youth find their voices in this conference. I am looking forward to my meetings with Government representatives and non-governmental organizations in Malaysia over the next couple of days.

The theme of this Conference, Expanding a Comprehensive Response in Sexual and Reproductive Health and Rights for All Communities, could not be more important or more timely.

Just two months ago at the 2005 World Summit held at the United Nations, New York, Heads of State and Government from around the world committed themselves to achieving universal access to reproductive health by 2015, as set out at the 1994 Cairo International Conference on Population and Development (ICPD). This is the highest level of approval and commitment.

They agreed to integrate this goal in national strategies in order to achieve the Millennium Development Goals (MDGS) and they agreed that universal access to reproductive health is essential for the achievement of goals aimed at reducing child mortality, improving maternal health, promoting gender equality, combating HIV/AIDS and reducing poverty.

There is no doubt that reproductive health and rights are central to the international development agenda and touch on the lives of women and men of all ages. Sexual and reproductive health is an investment in human capital, in other words, investment in people, who are the building blocks of healthy families, stable communities, productive societies and, thus, prosperous nations. Reproductive health and rights are also key to the larger peace and security agenda—human security and human rights.

At the World Summit, Heads of State and Government made strong commitments to eliminate gender discrimination and violence, and they proclaimed that progress for women is progress for all.

My message today is that we now need to use this opportunity to accelerate action, and monitor the results of our actions. We need to build on the momentum of the World Summit and turn these words of commitment into concrete actions and ensure that we can achieve sustained results.

We need to work together to expand comprehensive sexual and reproductive health information and services. Together, we have to ensure that reproductive health is part of every nation’s development and poverty reduction plan, integrated into the primary health system and national budgets.

To do this, we need to transform lines in speeches and agreements to lines in budgets for reproductive health and commodities and also to become more effective in reaching communities and impact on peoples’ lives.

Let me stress that we need to pay special attention to young people—not only because they represent nearly half of the population of the Asia-Pacific region, but also because young people are absolutely critical to our success.

Last week, I was in Indonesia and met Government officials and visited Aceh. I took every opportunity to discuss the situation of young people and their needs and rights to sexual and reproductive health. My visit to a youth centre in Jakarta, run by the Indonesian Family Planning Association, an affiliate of IPPF, gave me and my colleagues an opportunity to have some dialogue with street children, drug users who are HIV- positive and others, on their aspirations in life and needs for support. Tragically, they seemed prisoners of their poverty, which made their aspirations in life very limited. We need to work with these young people, all over the world, so that they see possibilities of life beyond their immediate situations. We need to give them hope because, as one of the leaders of women living with HIV/AIDS, once told me: “what kills more than death is the loss of hope”.

I am sure policy makers know that a healthy population, with increased opportunities for all, is the greatest asset that the region can have to meet current and future challenges. All over the world, and we have models here in Asia, the countries that have made the most progress during the past few decades have invested heavily in education and health, including sexual and reproductive health.

I am very pleased that sexual and reproductive health and rights for young people is a key issue to be addressed at the first plenary session today. This is very critical for the deliberations of this meeting.

Today, expanded access to sexual and reproductive health, including family planning, is needed to reduce unwanted pregnancies and unsafe abortions in order to improve women’s lives and save them from a deadly end. It is estimated that family planning alone could reduce maternal and child mortality by 20-35 per cent. Services for antenatal care, safe delivery and emergency obstetric care are critical to achieving maternal and infant health.

Key to these efforts is reproductive health commodity security—making sure that condoms and contraceptives and other essential supplies are available, at the right time, at the right place and at the right price. I just received information two days ago that 15 health ministers of ECOWAS (the Economic Community of West African States) have committed themselves to introducing a line for reproductive commodities in their health budgets and to ensure that it is funded. They are a true example of committed leaders and we need to congratulate them. I hope that we can hear more good news soon from the remaining countries in this region, which do not yet have such budget lines, or who have budget lines but without any money in them.

Only with such determination of governments like those of ECOWAS can we ensure people’s right to sexual and reproductive health. And we want to achieve this with our partners, especially the IPPF. Commodity security is as important to the success of reproductive health as vaccines are to the success of child survival.

These commodities should be included in every nation’s essential drugs package. And every nation should have a coordinating body—an alliance of key stakeholders—to define, own and drive a national strategy to achieve commodity security.

Another area where greater progress must be made is in the integration of efforts for sexual and reproductive health and HIV/AIDS. It is time to integrate sexual and reproductive health in all national AIDS plans. And it is time to include HIV prevention, counselling and voluntary testing in reproductive health programmes, including family planning and antenatal services. This will save money and, most importantly, it will save lives.

Today in this region, the gap between the rates of HIV infection among men and women is narrowing. Although the main mode of transmission in the region has been through injecting drug use and sex work, there is evidence that HIV transmission between spouses is on the rise and has become a more prominent cause of new infections.

The best way to reach out to women is through established reproductive health services. By more fully linking sexual and reproductive health and HIV/AIDS, and combating gender discrimination and violence, Asia and the Pacific can halt the epidemic from spreading further into the general population.

The countries that have been the most successful in combating AIDS have pierced through silence, denial and discrimination and tackled the problem head-on. They have focused on vulnerable and high-risk populations and involved them in the design and implementation of programme activities. They have engaged in dialogue and strong leadership, and they have taken concrete steps to provide basic reproductive health services and basic supplies, such as condoms. A comprehensive, multisectoral approach is an urgent demand.

Following the World Summit, we are in a period of opportunity and the challenge is to make sure that every nation takes action to prevent further spread of HIV, with a focus on young people.

Promoting positive behavioural change, making motherhood safer and improving reproductive health services are serious challenges in many countries due to gender discrimination, widespread poverty, weak infrastructure, isolation of many rural areas and weak and poorly managed health systems. As a result, many people are caught between an inadequate public health system and a private one they cannot afford.

It is clear that in most countries, health sector funding has to increase substantially, with reproductive health getting its fair share. There is also a need to improve education, especially for women, and to increase their decision-making and autonomy. We all can play a critical role to end gender discrimination and violence. Eliminating the causes of discrimination will require changes in attitudes and values that sustain the power gap between men and women.

And to do this, we have to achieve the funding goals set at the Cairo Conference and the funding requirements to combat HIV/AIDS and achieve the Millennium Development Goals. While funding for population and reproductive health is increasing, it is not enough.

Excellencies, Ladies and Gentlemen,

While some progress has been achieved, the importance of investing in reproductive health has not been sufficiently appreciated my many policy makers in Asia. In South Asia, for instance, government spending on health has remained at one per cent of gross domestic product (GDP). And the meagre sums that are allocated to this sector are not equitably distributed across various groups. The health of women, youth and children suffers the most.

Governments have the major responsibility for implementing the ICPD Programme of Action and the strategies to reduce poverty and ensure development. But non- governmental organizations (NGOs) and communities also have a key role to play. Governments, donors and intergovernmental organizations should ensure that the voices and contributions of NGOs are integrated into formulating, implementing, monitoring and evaluating programmes. Without this inclusion, programmes will lack a very critical component.

We can, together, help policy makers understand that a healthy population is the greatest asset that a country can have to meet current and future challenges. We can encourage the adoption of supportive laws and policies to build up women’s empowerment, gender equality and reproductive health and to ensure the right to sexual and reproductive health. Together, through culturally sensitive approaches, we can be a bridge between cultural practices and religious interpretations and issues of reproductive health and human rights.

The formulation of health policies that respond to the needs of the people will happen only when there is greater participation of the community in policy-making and debate. Effective monitoring and control are essential. And we have to reach out to people.

In closing, I would like to stress that millions of lives can be saved and improved in Asia through relatively inexpensive interventions and access to knowledge. Reproductive health and rights and women’s empowerment and gender equality are part of an investment package and the larger quest for human rights. By expanding the coverage of sexual and reproductive health care to women, youth, rural populations and the poor, the health and productivity of individuals, families and communities will improve dramatically. Combating discrimination and violence against women and girls contributes to economic and social progress.

Thank you.