Reproductive Health and Rights: Key to Achieving the Millennium Development Goals

Statement by Thoraya Ahmed Obaid UNFPA Executive Director

Excellencies,

Friends,

It gives me great pleasure to join you today at the beautiful Chateau St. Gerlach, the country estate of Maastricht, home of the historic Maastricht Treaty.

I would like to extend my heartfelt thanks to Minister Agnes van Ardenne, and to the Government of the Netherlands as President of the European Union, for bringing us together for this important and timely dialogue on achieving the Millennium Development Goals. On behalf of my colleagues in UNFPA, I would like to thank you for your leadership in promoting the agenda of the International Conference on Population and Development (ICPD). We thank you, Madame Minister, and all members of the EU for providing strong support to UNFPA, especially in times of difficulties. I would also like to thank you, Commissioner Poul Nielsen, for your achievements, your proactive dialogue with the United Nations and your support of UNFPA.

Never before has development cooperation been so important to international peace and security and never before have we had such a framework to guide us.

The Millennium Development Goals offer a common framework, and focus, for collective action to make the right to development a reality. This is especially important to the world’s largest youth generation of 1 billion young people between the ages of 15 and 24. This was one main message of Minister Van Ardenne’s statement.

My message today is that the Programme of Action adopted at the 1994 International Conference on Population and Development offers a roadmap to make the MDGs a reality. ICPD is central to all development issues. It confirms that life and death is a political decision.

With ICPD clearly guiding our way, we need to scale up our interventions and responses to poverty eradication, especially within the context of greater policy coherence for development, and greater financial and political commitment.

The available evidence points to one fact, which can neither be avoided nor disputed:

We cannot reduce poverty and maternal and child mortality, promote women’s empowerment and equality, reverse the spread of HIV/AIDS and ensure sustainable development, unless reproductive health and rights are given the highest priority and are treated as a basis for achieving the MDGs.

And this is exactly what each regional meeting and the General Assembly event to commemorate the tenth anniversary of ICPD have reaffirmed.

ICPD: A Human Centered Approach to Sustainable Development

Together we face a great challenge. We must reduce the severe poverty that afflicts 1.2 billion people today, and at the same time create the conditions that will enable the 1 billion people who will be added to world population by 2015 to live decent lives, mostly in the poorest countries.

To effectively address these issues, the Cairo agenda points the way forward.

It addresses diverse population issues—including population dynamics, size, population movements, ageing and migration. It places the emphasis where it should be—on improving the quality of life of every individual. And it puts the focus where it must be: on women and expanding their choices and opportunities, and respecting their human rights. These rights include the right to determine the number, spacing and timing of their children; to live free of discrimination, violence and coercion; and to participate fully in society.

As the international community, governments and civil societies mobilize to achieve the Millennium Development Goals, the Cairo agenda deserves far greater support.

ICPD, Reproductive Health and the MDGs

There is solid evidence that increasing access to education and reproductive health services, including family planning and sexual health, reduces poverty within families and within nations.

Women today in the developing world have half as many children as their mothers did. They are better able to give each child education and healthcare, which helps break the cycle of poverty that runs from one generation to the next.

At the national level, investments in reproductive health and family planning produce what is called a “demographic bonus.” This is spurred by lower rates of fertility and mortality, and a large working population with relatively fewer dependents to support. This bonus results in higher productivity, savings and economic growth.

Both the Millennium Declaration and the ICPD agenda call for universal primary education and closing the gender gap. However, ICPD goes one step further by focusing on the quality of education and calling for curricula that promotes gender equality and includes life skills and sexual and reproductive health so that children and young people have a solid foundation from which to protect their own health and build a healthier and more equitable society.

The links between reproductive health and rights and gender equality and the empowerment of women are strong and well established. The ability of women to control their own fertility is absolutely fundamental to women’s empowerment and equality.

Reproductive rights are essential to women’s human rights.

Reproductive health and family planning play a key role in reducing child mortality. A healthy mother is the first step towards a healthy child. According to UNICEF, a leading cause of infant and child mortality is poor maternal health. So clearly reproductive health is absolutely essential to reducing child mortality.

Reproductive health and rights are also key to improving maternal health. Today the highest proportion of women’s ill health burden is related to their reproductive role. This has high economic and social costs, as the WHO Commission on Macroeconomics and Health described.

Today a woman in sub-Saharan Africa faces a 1 in 16 chance of dying during pregnancy and childbirth compared to 1 in 2800 for a woman in developed nations. To close this gap, women need: 

• Family planning
• Antenatal and post-natal care
• Skilled attendants at birth, and
• Emergency obstetric care.

Because these basic reproductive health services are not more widely available, accessible and affordable, half a million women die each year from complications of pregnancy and childbirth. They are denied the very basic right to life, let alone the right to health. Universal access to reproductive health services would save women’s lives and the lives of their children.

Reproductive health services also combat HIV and AIDS. There is wide recognition that sexual and reproductive health services provide an important opening for HIV prevention and testing, as well as for preventing and treating other sexually transmitted infections, which increase the risk of contracting HIV. Linking or integrating reproductive health and HIV services is the only way to scale up responses, to reach the largest number of women and young people, and to optimize the use of available human, financial and institutional resources.

In contributing to environmental sustainability, ICPD emphasizes the importance of achieving a balance between consumption and management of natural resources.

WHAT DO WE NEED TO DO?

We must work together to ensure the physical, emotional and mental well-being of individuals, as stipulated by ICPD. We must work together to ensure that the world community recognizes that the provision of sexual and reproductive health information and services that are accessible and affordable, including reproductive health commodities, is one component of well-being.

As I see it, there are four main areas for action.

1. Develop National Capacity for Population and Reproductive Health.

We must improve health systems to deliver reproductive health and HIV services as a component of primary health care; this includes building the capacity of health workers, medical staff, medical institutions, along with restructuring the ministries of health to implement integrated rather than vertically isolated reproductive health, family planning and HIV programmes.

We must mobilize legal and protection systems to respect reproductive rights and to address gender discrimination and violence. In this context, it is especially important to ensure the rights of young people.

We must increase capacity to collect and analyse gender-disaggregated population data for development planning and monitoring.

We must ensure that humanitarian and peacekeeping operations include gender analysis and reproductive health interventions, including interventions related to gender-based violence in conflict situations.

Together we must scale up responses with quality sexual and reproductive health services, especially for youth. To achieve this, it is urgent that all countries, both developing and developed, strengthen their human and institutional resources to implement ICPD.

2. Continue to Mobilize the Necessary Support, Including Financial Resources

I would like to thank European countries for the assistance provided to population and reproductive health. You have been saving women’s lives through very difficult years and we thank you for that. I would also like to thank the EU Presidency for the recent EU initiative of mobilizing $75 million for condoms and other reproductive health commodities. And we thank all countries that have already declared their pledges. This is a message to the world community that the EU is fully committed to the implementation of ICPD. This is an issue that requires ongoing efforts; it is not a one shot solution. UNFPA is working to build national capacity in logistic support and to increase sustainability by ensuring that RH commodities are included in national budgets.

As Ministers for Development Cooperation, you are also working to achieve the commitments made in Monterey and in Johannesburg.

The recent Strasbourg Statement of Commitment, adopted by the 2004 International Parliamentarian Conference on the Implementation of the ICPD Programme of Action, 18-19 October, resonates with your own commitment in support of ICPD.

3. Position ICPD and Sexual and Reproductive Health in the Millennium Declaration follow-up process

2005 will be a busy year. UNFPA believes that the follow-up to the Millennium Declaration, the Beijing at 10 process, the five-year follow-up to the General Assembly Special Session on HIV/AIDS, and the ongoing UN reform offer golden opportunities to position sexual and reproductive health in the center of development policymaking where it belongs. Therefore, together we should be: 

• Looking ahead and planning strategically to ensure the link between ICPD and the MDGs at the September 2005 five-year review of the Millennium Declaration.
• Working together at the country level to advocate and provide support to ensure inclusion of reproductive health in MDG national reports, a process that we have already started with the governments.
• Working with all countries to ensure that the ICPD goal of universal access to reproductive health services is reflected in the MDG targets and indicators to ensure full implementation and monitoring at the country level.
• Supporting efforts at the country level to ensure national ownership and to integrate ICPD goals and issues into national poverty reductions strategies and sector-wide approaches.
• Working towards involving Ministers of Finance to sensitize them to the population and reproductive health agenda and to ensure that sexual and reproductive health is included in the national budgets of individual ministries, as well as PRSPs, SWAPs, budget support, health sector reform, etc.

4. Provide the moral, political and financial support to UNFPA, as the lead multilateral agency for population and reproductive health.

• Ensuring that where and when possible, multi-year funding commitments are announced to UNFPA regular resources in order to allow for proper planning and programming.
• Continuing and strengthening advocacy for ICPD and for UNFPA as the lead organization within the United Nations system to promote ICPD within the work of the UN country teams.
• Ensuring that UNFPA has the required and qualified human resources to allow the Fund to take ICPD forward during the next decade and to meet increasing demands.

Conclusion

As we look ahead to the future, we must stay focused on the Programme of Action that was adopted at the International Conference on Population and Development. Reproductive health and rights remain sensitive issues that are often misunderstood and mistakenly portrayed. We need to apply a culturally sensitive approach to the implementation of the ICPD Programme of Action without compromising human rights. Also, it is important that all efforts be scaled up drastically and in a cohesive manner to achieve the Millennium Declaration.

With greater resources effectively focused on sexual and reproductive health, millions of lives can be saved, gender equity can be increased and the poverty that afflicts so many people can be reduced.

It was here in Maastricht that the vision of an integrated and unified Europe became reality. I hope that it is here in Maastricht today that we can bring the vision of human centered development closer to reality and thereby improve regional and global prospects for peace and security.

Thank you.