Opening remarks by UNFPA Executive Director Dr. Natalia Kanem at the launch of the State of World Population 2024

Opening remarks by UNFPA Executive Director Dr. Natalia Kanem at the launch of the State of World Population 2024 at the Palais des Nations, Geneva.

Excellencies,
Dear colleagues and friends,

I greet you in peace, the noble purpose of the United Nations, and the fervent wish of people everywhere, especially the women and girls UNFPA serves. They want peace in their homes; peace in their communities, and peace in our world.

Woman is the thread. Woman is the needle. She is the weaver of family and society. This ancient proverb reminds us that our world is intertwined, from each woman’s family to the human family. 

Yet when we read the headlines, what do we see? War. Polarization. Division. Fear. 

These relentless messages are eroding faith in our one proven solution to the world’s greatest challenges – cooperation. 

This year, as half the world goes to the polls, the Secretary-General of the United Nations warns that too many people are “peddling the perverse math that says you multiply support by dividing people.” 

We know that the opposite is true: The fabric of humanity is strong because our fates are woven together. 

Today we launch our flagship State of World Population report, titled Interwoven Lives, Threads of Hope: Ending inequalities in sexual and reproductive health and rights. 

In it, we show that, yes, inequalities are widening. Human reproduction is being politicized. The rights of women, girls and gender diverse people are the subject of increasing pushback. 

Yet we can, and we must, push forward – together – because that is what works.

Global solidarity is how we reduced the unintended pregnancy rate by nearly 20 per cent since 1990. It is how we reduced the maternal death rate by 34 per cent since the year 2000. It is how we reduced new HIV infections by one third in the last 15 years.

In the last three decades, the proportion of women serving in parliaments has more than doubled. We have secured laws against domestic violence in more than 160 countries.

Not so long ago, most countries in the world had legislation against LGBTQIA+ sexuality. Today, two thirds do not, and punitive laws are falling more quickly than ever.

These are gains we achieved together – following the world’s agreement, 30 years ago at the International Conference on Population and Development in Cairo, to secure the reproductive health and rights of all people. These are gains from investments in sexual and reproductive health and rights, which increased fivefold after countries agreed, at the turn of the millennium, “build a world with no one left behind”.

And our capacity for global collaboration has only grown. New technologies have advanced the frontiers of medicine, allowed for real-time information sharing, and amplified our ability to collect and process data. Indeed, we know much more about the world and its needs – and the solutions – than ever before in human history. 

And yet today, that progress is slowing. By many measures it has stalled completely. 

Annual reductions in maternal death have flatlined. Since 2016, the world has made zero progress in saving women from preventable deaths in pregnancy and childbirth.

One woman in four cannot make her own health-care decisions. One woman in four cannot say no to sex. And nearly 1 in 10 are unable to make their own choices about whether to use contraception. 

We have, for the first time, data on whether women’s bodily autonomy is strengthening over time – and in 40 per cent of countries with data, it is actually diminishing.

Why?

One important reason, our report shows, is that we have not prioritized reaching those furthest behind.

We see, for example, that barriers to health care fell fastest for women who are more affluent, educated and privileged. When we look at ethnic disparities, we see that the groups that have benefitted the most are those that had the fewest barriers to begin with.

Access to modern contraceptives varies by race, refugee and migration status, education and location. And while gender-based violence sadly is pervasive everywhere, risks increase based on age and sexual orientation.

Many of these findings are the result of having better data than ever before. Thirty years ago, maternal mortality rates were only rough estimates.

Today, data allow us to see clearly the unacceptable rates at which women are dying while giving life; data also show the inequalities that are quite literally killing them. A woman in a country with a fragile health system is 130 times more likely to die from pregnancy and childbirth complications than a woman in a country with easy access to emergency obstetric care. 

And while there are vast inequalities between countries, our report finds that, in many cases, disparities in health access are even greater within countries.

Health systems today are weak, tainted by gender inequality, racial discrimination and misinformation.

For instance, midwives have long been undervalued, underpaid and under-supported in male-dominated health systems, even though increasing midwifery coverage could avert more than 40 per cent of maternal deaths.

We also see that women of African descent experience higher rates of mistreatment and neglect by health providers. Indigenous women are routinely denied culturally appropriate maternal health care. As a result, these groups are much more likely – in some places six times more likely – to die in pregnancy or childbirth.

Women and young people with disabilities, migrants, people living with HIV, and gender diverse people continue to experience discrimination and exclusion when they seek sexual and reproductive health care.

These inequalities are plain facts of life for millions of people – for the one billion people estimated to experience disability in their lifetime, for the 700 million people living in extreme poverty, for the 160 million women with an unmet need for contraception, and so many more.

These inequalities should not be politicized or used as an accusation of bias; they should not be points of division – they are entry points for accelerating progress.

Because everywhere we look, we see gaps, and those gaps are widening. Stalling progress will turn into a reversal of progress.

Anxiety over high fertility rates, low fertility rates and global migration is leading to xenophobia and turning women’s bodies into battlegrounds. Yet these trends – population growth in some places, population ageing in others, accelerating migration – are unlikely to change.

What must change, then, is our outlook – starting with the silences and taboos being used to divide us, such as stigma about sex and sexuality that is driving the unwelcome return of congenital syphilis, for example, by keeping vulnerable populations from the vital health services and information they need.

We need to redouble our efforts to achieve comprehensive, universal and inclusive health care grounded in human rights and modern science. A medical revolution is under way, with telemedicine and self-care poised to remake health systems. This future requires that we equip people – from adolescents to doctors to policymakers – with accurate, modern sexual and reproductive health information.

We need to collect more and better data, disaggregated by factors like ethnicity, disability and more, to understand who is being left behind and how to reach them.

And let’s bring women outside the circle into decision-making roles and positions of leadership. Empower local actors to identify local needs, with health systems and programmes guided from the ground up, not the top down.

These measures are not simply about reaching people at the margins. They are about strengthening all of us – the whole human tapestry. A fabric is only as strong as its weakest thread.

Our report shows how investing in sexual and reproductive health benefits all of us.

Comprehensive sexuality education, ending gender-based violence, promoting gender equality and ending unmet need for contraception, these steps would contribute trillions of dollars to the global economy, and unleash gains in terms of education, productivity, workforce participation, and human happiness.

We have every reason to act – for human rights, for gender equality, for justice and for the world’s bottom line.

We know what can be accomplished when we work together. We have done it before, and now we must do it again. The fabric of humanity is rich and beautiful, composed of 8 billion threads and counting, each one of us unique. Our strength, our resilience comes not from any individual strand but from the collective, interwoven whole. The way forward, how we proceed and succeed, is by working together.