1999 was a momentous year for UNFPA. The "ICPD+5" review, our 30th anniversary, and the birth of the 6 billionth person provided us with unique opportunities to look at where we have been and where we are going in our quest to help people make informed, responsible and free choices regarding their sexual and reproductive health. 

By far the most important outcome of the 21st Special Session of the United Nations General Assembly was the adoption of a set of "key actions" to help realize the Programme of Action adopted at the 1994 International Conference on Population and Development (ICPD) in Cairo. The actions, which include new benchmarks, focus on such areas as the need to provide information, counselling and services to young people; to combat high levels of maternal mortality; to provide universal primary education; to combat the spread of HIV/AIDS; to promote gender equality; to reduce abortion and address the health consequences of unsafe abortion; and to build real partnerships to help achieve the ICPD goals. 

Achieving the goals set out in Cairo and in New York at the fifth-year review will require greater political commitment, further development of national capacity, increased international assistance and larger domestic resources. There is also a strong need to further develop effective, transparent partnerships with NGOs, religious groups, the education and academic communities, and the private sector. 

At the top of the agenda today are two kinds of epidemics: HIV/AIDS and violence against women and girls. Both are fueled by gender discrimination and stereotypical notions about manhood and femininity. The empowerment of women and girls, through better education and health care, remains a cornerstone of our work around the world. Women must be able to protect themselves, and men must be prepared to help them do so. 

Empowering women and men to make their own choices results in smaller and healthier families. Nearly 60 per cent of women in developing countries now use family planning, and fertility has fallen by half since 1950. Experience shows that satisfying individual rights, needs and aspirations meets national goals and global imperatives. Smaller families help to combat poverty, ill health and illiteracy, and to secure lasting economic well-being for people as well as countries. 

In all of the 144 countries where the Fund was active in the past year, our support reflected the goals and activities laid out in the ICPD Programme of Action. We spent a total of $187 million in our main programme areas of information and education, reproductive health services, and advocacy and policy development. 

Emergency reproductive health supplies were provided to earthquake victims in Turkey, Orissa cyclone victims in India, Kosovar refugees, and conflict victims in East Timor. The emergency kits sent to some 350,000 Kosovar refugees in Albania included equipment for safe deliveries and emergency contraceptives for rape victims. In Kosovo, which has the highest maternal mortality rates in Europe, the Fund provided training and equipment to ensure safe delivery of newborns and quality maternal care in hospitals and clinics. In East Timor, the Fund distributed emergency home delivery kits to mothers since there was little or no maternity care available. 

During the year, we paid special attention to meeting the reproductive and sexual health needs of young people. While nearly half of all countries have taken measures to address the reproductive health needs of adolescents, as they were urged to do in Cairo, much work remains to be done. This year's annual report focuses on the challenges of providing youth-friendly information and services to the largest youth population in history. 

The United Nations Population Fund remains committed to providing truly universal reproductive health care. The review undertaken in 1999 confirms our belief that population is not a matter of numbers: it is a matter of people. That is the basis of the global consensus: it is the foundation for the progress we have made so far, and it will be the key to success in the future.

Dr. Nafis Sadik,
Executive Director
United Nations Population Fund.