13 April 2005

Investing in Reproductive Health and Rights

Stockholm High-Level Round table

Your Excellencies,

Distinguished Delegates,


Ladies and Gentlemen,

It is with great pleasure that I join you today.

Reducing Poverty and Achieving the Millennium Development Goals (MDGs) are international priorities. We are here to discuss how investing in reproductive health and rights will move us forward.

We are pleased to co-organize this high-level round table with the Government of Sweden. We have invited ministers and officials of ministries of finance, health and planning, and representatives from the United Nations and civil society to discuss the importance of investing in reproductive health programmes as one of the means of fighting poverty and expanding chances for economic prosperity.

I would like to stress from the beginning that when we talk about reproductive health services, we do so within the context of the primary health care system, in order to strengthen the health system and improve public health and individual well-being.

I would like to thank Carin Jämtin, the Swedish Minister for International Development Cooperation, for hosting this round table, along with her staff who have been working hard to make this happen. And I would like to thank all of you for attending.

I am personally encouraged by your participation, given what we deem to be a very important topic for discussion. Your participation is yet another endorsement of your support of the Programme of Action of the 1994 Cairo International Conference on Population and Development (ICPD), and the Millennium Declaration.

We have asked some of you to make presentations or to be speakers during these two days. But I sincerely hope that all of you will feel free to participate in the discussions and share your experiences with all of us. Let us make this meeting informal and open.

Why We Are Here/Expected Outcomes

We are here in Stockholm to see how we can better support women and girls and couples to fulfil their aspirations, to avoid unintended pregnancies, to prevent HIV infection, to combat gender-based violence and to ensure healthy pregnancies and safe deliveries.

These issues are key to the right to development and to rights of women, men and young people in every region to a better quality of life.

We are here to reinforce the message that investments in reproductive health and rights are crucial for the achievement of the MDGs – to reduce poverty, improve maternal and child health, curb the spread of HIV/AIDS, promote gender equality, and ensure sustainable development.

And we are here to discuss what needs to be done to make this message loud and clear in all forums, particularly in the review of the Millennium Declaration to be held at the United Nations in September.

We have prepared a draft Call to Action, which will be discussed during this meeting and hopefully adopted to galvanize increased political commitment and resources for reproductive health and rights.

Link Among Poverty, Reproductive Health and Rights

Today, poor sexual and reproductive health is a leading cause of death and disability in the developing world. It limits life expectancy, hinders educational attainment, diminishes personal capability and productivity, and thus directly affects economic growth and poverty reduction.

Every year, more than half a million women die during childbirth, with more than 95 per cent of them in Africa and Asia. Every minute, 10 people are newly infected with HIV and 3 million people die of AIDS each year.

While devastating, these global statistics do not fully convey the true tragedy to a family when a mother dies during childbirth, or when a child loses a family member to AIDS. This is a double tragedy because we know how to prevent these easily preventable deaths. Effective interventions exist.

Yet today, poor people have the least access to education and health care, including reproductive health information and services. And this keeps them trapped in a vicious cycle of poverty that runs from one generation to the next.

It is this poverty trap that must be broken if we are to achieve the Millennium Development Goals. And investments in sexual and reproductive health play a significant role.

Benefits of Investing in Reproductive Health and Rights

Good reproductive health enables couples and individuals to lead healthier, more productive lives, and in turn to make greater contributions to their household incomes and to national savings.

The health benefits of these investments are well known, well documented and substantial.

They include the prevention of deaths due to HIV/AIDS, cancer, complications of childbirth and unsafe abortion; the prevention or reduction of conditions such as obstetric fistula and other sexual and/or reproductive illnesses and disabilities; better nutritional status and decreased risk of anaemia for women; and increased survival rates and better health for infants.

It is estimated that ensuring access to voluntary family planning could reduce maternal deaths by 20 to 35 per cent, and child deaths by as much as 20 per cent.

The World Bank estimates that ensuring skilled care in delivery and particularly access to emergency obstetric care would reduce maternal deaths by about 74 per cent.

These are significant benefits. But as striking as these numbers are, the personal, social and economic benefits of reproductive health services may be even more important.

These benefits are extremely important for human welfare and economic development. They include improvements in women’s status and greater equality between women and men, as well as benefits at the individual, household and societal levels.

A study in Mexico found that for every peso the Mexican social security system spent on family planning services between 1972 and 1984, it saved nine pesos in expenses for treating complications of unsafe abortion and providing maternal and infant care. In Thailand, every dollar invested in family planning programmes saved the Government more than $16. Even more dramatically, analysis in Egypt found that every dollar invested in family planning saved the Government $31. This projection included government spending on education, food, health, housing, and water and sewage services.

Studies also show that the benefits go beyond government savings.

Where mortality is high, parents are likely to have more children, but to invest less in each child’s health and education, impeding economic prospects. It is also known that chronic disease and poor health and low productivity discourage foreign direct investment in business and infrastructure.

It is also true that reproductive health investments, in particular family planning, can produce what is called a demographic bonus.

This is spurred by lower rates of fertility and mortality, and a large healthier working population with relatively fewer dependents to support. If jobs are generated for the working population, this bonus results in higher productivity, savings and economic growth.

In East Asia, where poverty has dropped dramatically, the demographic bonus is estimated to account for about one third of the region’s unprecedented economic growth during 1965 to 1990.

There is also no doubt that investing in sexual and reproductive health is strategic for curbing the HIV/AIDS epidemic.

With over 75 per cent of HIV cases due to sexual transmission, delivery and breastfeeding, it makes sense to link HIV/AIDS efforts with sexual and reproductive health, which would benefit women and young people mostly, since they are the real faces of HIV.

Stronger linkages will result in more relevant and cost-effective programmes with greater impact. By using the same services, the same health workers and the same infrastructure—with investment in training, and upgrading—we can scale up responses that are so urgently needed to improve maternal health, decrease child mortality, prevent HIV infection and provide HIV counselling, treatment and care.

The countries that have been able to significantly reduce rates of HIV infection have used reproductive health interventions. I am referring to Brazil, Thailand and Uganda, where condoms, community mobilization and changing behaviour played a vital role.

These are just a few examples of the benefits of investing in reproductive health and rights, and I trust those represented in this round table have many more tangible examples to share.

I would also like to stress that the reports of the Millennium Project, the Commission for Africa and of the United Nations Secretary-General in preparation for the September Summit all stress the importance of investing in sexual and reproductive health, as part of overall efforts to strengthen health systems and improve public health.

The Task Force on Maternal and Child Health of the Millennium Project has recommended that universal access to reproductive health be added as a target to the goal of improving maternal health. UNFPA fully supports this effort and I encourage all of you to do so, too. This is important so that reproductive health is clearly articulated in the MDGs and can be mainstreamed and monitored throughout the development process.

We know what needs to be done. We know what works.

What we need is the political will and action to make reproductive health and rights a reality.

We need to move from lines in speeches to lines in budgets.

We need to ensure that health-sector reform and sector-wide approaches benefit individual women and men and youth and increase access to basic health services, including reproductive health.

And we need to further strengthen the partnerships among the United Nations, donors, developing nations and civil society to ensure that information and services are expanded and scaled up to reach all people, especially those with the greatest need.

By increasing investments in reproductive health and rights, we will make progress and we will be proud of the progress made. We have the next two days to focus on this important development issue and to strengthen political commitment. It is my hope that, when we leave Stockholm, we will carry this message forward in our communities, countries, regions and at the global level.

Thank you.