Election of Forum Office-bearers and other Matters
Functioning of the Forum
Findings and Proposed Actions
Creating an Enabling Environment
Enhancing Gender Equality, Equity and Empowerment of Women
Promoting Reproductive Health, Including Family Planning and Sexual Health, and Reproductive Rights
Mobilizing and Monitoring Resources
109. To implement the ICPD Programme of Action, Governments need to commit themselves at the highest political level to achieving the goals of the ICPD. The Programme of Action specified the financial resources, both domestic and external funds, necessary to implement the population and reproductive health package over the next twenty years. It estimated that in the developing countries and countries with economies in transition, the implementation of programmes in the area of basic reproductive health, as well as programmes that address the collection and analysis of population data, would cost (in 1993 $US) $17 billion by the year 2000, $18.5 billion in 2005, $20.5 billion in 2010 and $21.7 billion in 2015 (ICPD para. 13.15).
110. Up to two thirds of the projected resources required in developing countries and in countries with economies in transition will continue to be met in the countries themselves and in the order of one third, or $5.7 billion, will be needed from external sources. The Programme of Action called upon the international community to achieve an adequate level of resource mobilization and allocation, at the community, national and international levels, for population programmes and for other related programmes. The Programme of Action noted that additional resources would be needed to support programmes addressing population and development objectives in those areas not specifically costed in the Programme of Action.
111. The Hague Forum took special note of the recommendations of the Parliamentarians', Youth, and NGO Forums, which strongly supported the mobilisation of adequate resources for population and development.
112. Donor funding has increased since the ICPD. International assistance for population activities increased significantly between 1993 and 1995, from a total of $1.3 billion in 1993 to an annual average of $2.0 billion per year during 1995-1997. For 1998, it appears that there has been a slight decrease in donor funding.
113. The percentage of ODA earmarked for population is at its highest level. Preliminary figures for 1997 show that donor countries contributed approximately 3.1 per cent of their total ODA to population. While the volume of ODA is declining, the percentage earmarked has increased. This figure is the highest percentage ever recorded.
114. Developing countries are mobilizing domestic resources for population activities. Very rough estimates of the global domestic resource flows for population activities provided a crude global figure of just under $8 billion for domestic financial resources for population activities in 1997.
115. The private sector, including private foundations and NGOs, is playing an increasing role in the mobilization of resource flows. A number of large private foundations have announced plans to increase funding for population activities.
Issues and constraints
116. Resource flows have levelled off. While funding for population activities has increased since the ICPD, it has not increased at a rate which would ensure mobilizing the required $17 billion by the year 2000. The momentum generated by Cairo appeared to have diminished by 1996, when international assistance remained at the 1995 level of around $2 billion. Preliminary data for 1998 indicate a decrease in level of funding to about $1.9 billion. Overall, external sources have met 33 per cent of their ICPD commitment.
117. Total ODA is decreasing. Although the increase in percentage of ODA that was earmarked for population activities is encouraging, it should be noted that total ODA has declined from $56.5 billion in 1993 to $47.6 billion in 1997.
118. Most domestic resource flows originate in only a few large countries. In aggregate, developing countries have met 68 per cent of the ICPD commitment. Most developing countries, however, are unable to generate the necessary resources from domestic sources to cover the cost of national population programmes.
119. Difficult economic circumstances and political instability in a number of countries are impeding efforts to mobilize the domestic resources required to implement national population policies and programmes.
120. Shortfalls in resource mobilization require heightened attention to improvements in the efficiency and effectiveness of resource utilization. In order to maximize scarce resources, cost-effective organizations and programmes, appropriately sensitive to equity and quality concerns, must be identified and utilised.
121. The HIV/AIDS epidemic has progressed faster than previously projected, requiring additional resources.
122. Youth needs for sexual and reproductive health are still inadequately addressed. Additionally, youth participation in the design, implementation and monitoring of programmes is rarely accommodated.
Mobilization of resources
123. Urge donor countries and developing countries to fulfill their financial commitments. Levels of resource commitments to ODA need to be increased. Countries should make every effort to reach the nominal 0.7 per cent of GDP allocation to ODA. In this context, countries should reach, at a minimum, the nominal commitment of 4 per cent of ODA to population activities and consider increasing the minimum to 5 per cent with due regard for the broader definition of population and reproductive health programmes adopted in the ICPD Programme of Action.
124. Urge donor countries and developing countries to increase levels of funding to UNFPA. As was requested by many developing countries and countries with economies in transition, countries are urged to substantially increase their voluntary contributions to UNFPA so it will be in a better position to help countries, including many countries where it is the only source of population assistance, to meet their population and reproductive health challenges.
125. Give appropriate priority to HIV/AIDS prevention. Since the HIV/AIDS epidemic has made deeper inroads than were originally projected, special attention to promptly meet, at a minimum, the entire $1.3 billion for HIV/AIDS prevention in the year 2000 called for in the Programme of Action (13.15c) is required, with particular attention to young populations.
126. Mobilize additional resources for the broader population and social sector objectives. Additional resources are required to support programmes addressing population and development objectives in those areas not specifically costed in the Programme of Action. The 20/20 Initiative, which includes reproductive health and other basic social service components, should be considered as an instrument of resource mobilization efforts.
127. Redouble advocacy efforts. Advocacy efforts should be increased between countries and within countries to ensure that the necessary additional resources are mobilized. Parliamentarians should undertake measures to increase support for population and reproductive health programmes through legislation, advocacy and expanded awareness-raising and resource mobilization as noted in The Hague Declaration of Parliamentarians on ICPD Review.
128. Ensure that population and reproductive health concerns receive the necessary allocations in integrated and sector-wide programmes.
129. Increase the role of private sector institutions in the mobilization of resource flows. There is a need for the private sector, including private foundations and NGOs, to make available additional funding for population activities. Multinational Corporations (MNCs) should be encouraged to consider making contributions to finance population and reproductive health programmes as part of their social obligations. Mobilization of private sector resources within countries should also be further developed, including dialogues with local pharmaceutical companies and international firms. The private sector should be required to abide by ethical standards in the research and development of sexual and reproductive health technologies and drugs, and encourage affordable prices.
130. Support core funding for NGO activities to implement the ICPD Programme of Action. Donors should provide support to NGO activities to supplement their local resource mobilization efforts. Particular attention should be given to providing core support (e.g., funding sufficient to cover true overhead expenses), including long term support as necessary. Such support should be provided in ways which do not compromise the autonomy of the NGOs, but within a context of good management and accountability. Local NGOs should be supported. Support should be given for capacity-building for NGOs including appropriate training institutions addressing their managerial and technical skills and operational needs.
131. Support countries least able to mobilize domestic resources. Countries least able to generate domestic resources for population and reproductive health programmes - including the least developed countries, countries in emergency situations, countries suffering from economic crises, and countries with economies in transition (especially in order to initiate integrated reproductive health programmes) - need special attention from external donor sources.
132. Increase resource flows directed to meeting adolescent reproductive health needs. At least 20 per cent of donor allocations to reproductive health programmes should be earmarked to meet the information and service needs of adolescents. These programmes should involve youth in their design, execution and monitoring.
133. Donor allocation decisions should use indicators that take full account of the ICPD Programme of Action recommendations. Donor countries should recognize a range of selected performance indicators, both qualitative and quantitative, that take into account the perspectives of current and potential beneficiaries of programmes.
Efficiency and effectiveness in the use of resources
134. Improve the efficient and effective use of available funds. In view of the limited resources, there is a need for both donors and developing countries to ensure that resources are used as effectively and efficiently as possible. Duplication in national programmes may lead to waste of financial and human resources and should be minimized. Strategic planning approaches are encouraged. The use of management systems linking programme resource decisions to outcomes should be explored.
135. Meet the needs of poor populations. Government and donor resources should be directed to promoting access to information and services for people who are unable to pay.
136. Increase accountability. There is a need for technical and managerial capacity-building and more transparent information systems on resource allocations and expenditures to increase accountability at all levels and for all partners.
137. Coordinate financing policies. Donors should coordinate financing policies and planning procedures to enhance the impact and effectiveness of contributions to population programmes. Greater flexibility in donor policies and management approaches and efforts to harmonize donor processes and initiatives will be needed.
138. Strengthen mechanisms to coordinate national reproductive health programmes. There is a need for developing countries to enhance the coordination of national reproductive health programmes.
New mechanisms to generate additional resources to meet ICPD goals
139. Explore additional mechanisms to increase resource mobilization. Additional means to increase funding for population activities could include the selective use of user fees, social marketing and other forms of cost recovery. Innovative financing approaches such as new forms of taxation on financial transactions should be considered.
140. Support expanded South-South cooperation and information exchange. Efforts to increase cooperation and technical assistance among developing countries and countries with economies in transition, such as the Partners in Population and Development, should be encouraged and appropriately supported by the international community. There is also a need for greater exchange of information on cost-effective strategies in national programmes and the exchange of "best practices" among all partners in public and civil society institutions.
141. Strengthen partnerships to mobilize resources. Enhanced partnerships in international assistance, including special initiatives directed to particular issues and/or regions could be used to provide additional resources for population activities. These efforts should involve commitments to specific time-frames for programmes of activity, to the extent possible.
142. Utilize more efficient mechanisms to reduce the burden of external debt in order to encourage allocations to population and reproductive health programmes. Debt cancellation and debt relief should be further explored and mechanisms created to expedite consideration and implementation. Agreements involving debt swaps for basic social service investments, particularly in the area of population, health and education, should also be given serious consideration.
143. Advocate for increased funding for population and reproductive health from international financial institutions. Donor countries and loan recipients should ensure that lending agreements include adequate allocations for population and reproductive health programmes. There is a need to be proactive with Ministries of Finance and in joint donor and lending institution consultations with finance and planning officials to ensure adequate support to population and reproductive health concerns. Regional development banks should also be involved in policy discussions to increase their lending to support population and reproductive health efforts.
Monitoring resource flows
144. Improve monitoring of resource flows for the costed integrated population and reproductive health package. Necessary methodological research for improved monitoring of international and domestic resource flows should be supported, including operational research. Resource flows need to be monitored by levels of poverty and by gender.
145. Monitoring of supportive social sector expenditures. Financial flows to the non-costed portions of the Programme of Action need adequate monitoring, especially those addressing gender concerns and population and environment interactions. Appropriate costing exercises should be considered by institutions with relevant expertise and institutional mandates.
146. Technical review of the costed package. Technical discussions to evaluate the cost projections in the Programme of Action should be given appropriate higher priority while efforts to increase resource mobilization should continue. In this connection, the area of safe motherhood requires special attention. Further analyses should be undertaken which examine costs of services at different system levels, the benefits of safe motherhood programmes, and the costs that would be avoided (to families, communities and society) by their successful implementation.