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HOME: STATE OF WORLD POPULATION 2002: Population, Poverty and Global Development Goals: the Way Ahead
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Population, Poverty and Global Development Goals: the Way Ahead

Framework
Recommendations for Action
Resources for Population and Reproductive Health
Investing for Health, Fighting Poverty

Framework

THE DEVELOPMENT AGENDA: DEFEAT POVERTY Follow-up to the Millennium Summit in 2000 has concentrated the efforts of the international community and the United Nations system on ending poverty. The Millennium Development Goals include most of the goals agreed in 1994 at the International Conference on Population and Development and subsequent conferences- including better health, increased life expectancy, prevention of HIV/AIDS, universal basic education, and reductions in maternal, infant and child mortality.

The Millennium Declaration process recognized the importance of the development goals and indicators adopted at previous global conferences and is striving for harmonized national strategies for implementation.


GOALS OF THE ICPD AND QUANTITATIVE BENCHMARKS The ICPD endorsed a set of interdependent population and development objectives, including sustained economic growth in the context of sustainable development, and gender equity and equality. Countries were urged to include population factors in all development strategies, and to act to eliminate gender-based violence and harmful traditional practices including female genital cutting.

Quantitative goals in three areas were adopted:

UNIVERSAL EDUCATION Elimination of the gender gap in primary and secondary education by 2005, and complete access to primary school or the equivalent by both girls and boys as quickly as possible and in any case before 2015;

The Millennium Summit accepted these targets and added elimination of gender disparities to all levels of education by 2015 (1).

MORTALITY REDUCTION Reduction in infant and under-5 mortality rates by at least one third, to no more than 50 and 70 per 1,000 live births, respectively, by 2000, and to below 35 and 45, respectively, by 2015; reduction in maternal mortality to half the 1990 levels by 2000 and by a further one half by 2015 (specifically, in countries with the highest levels of mortality, to below 60 per 100,000 live births);

23 STATEMENTS BY THE COMMISSION ON MACRO-ECONOMICS AND HEALTH

"Investments in reproductive health, including family planning and access to contraceptives, are crucial accompaniments of investments in disease control. The combination of disease control and reproductive health is likely to translate into reduced fertility, greater investments in health and education of each child, and reduced population growth."

"If these conditions [communicable diseases] were controlled in conjunction with enhanced programmes of family planning, impoverished families could not only enjoy lives that are longer, healthier and more productive, but they would also choose to have fewer children, secure in the knowledge that their children would survive, and could thereby invest more in the education and health of each child. Given the special burdens of some of these conditions on women, the well-being of women would especially be improved."

"The evidence also suggests that approaches required to scale up the health system to provide interventions for communicable diseases and reproductive health will also improve care for the NCDs [non-communicable diseases]."

"Experience shows, moreover, that family planning services are most effective when they are a part of comprehensive programmes for reproductive health, that include family planning, safe pregnancy and delivery, and the prevention and treatment of reproductive tract infections and sexually transmitted diseases."

"Rapid population growth has multiple and complex effects on economic development. At the household level, investments per child in education and health are reduced when households have many children, that is, when fertility rates are high. At the societal level, rapid rural population growth in particular puts enormous stress on the physical environment (e.g., deforestation, as forests are cut for firewood and new farm land) and on food productivity as land-labour ratios in agriculture decline. Desperately poor peasants are then likely to crowd cities, leading to very high rates of urbanization, with additional adverse consequences in congestion and in declining urban capital per person (e.g., policing services, water and sanitation, etc)."

The Millennium Summit simplified the under-5 mortality reduction (to one third of 1990 levels by 2015) and accepted the parallel three quarters reduction of maternal mortality.

REPRODUCTIVE HEALTH Provision of universal access to a full range of safe and reliable family planning methods and to related reproductive and sexual health services by 2015.

ICPD+5 The five-year review of ICPD in 1999 agreed on new benchmarks, which have been adopted in many nations:

  • The 1990 illiteracy rate for women and girls should be halved by 2005. By 2010 the net primary school enrolment ratio for children of both sexes should be at least 90 per cent;
  • By 2005, 60 per cent of primary health care and family planning facilities should offer the widest achievable range of safe and effective family planning methods, essential obstetric care, prevention and management of reproductive tract infections including STIs, and barrier methods to prevent infection; 80 per cent of facilities should offer such services by 2010, and all should do so by 2015;

  • At least 40 per cent of all births should be assisted by skilled attendants where the maternal mortality rate is very high, and 80 per cent globally, by 2005; these figures should be 50 and 85 per cent, respectively, by 2010; and 60 and 90 per cent by 2015;

  • Any gap between the proportion of individuals using contraceptives and the proportion expressing a desire to space or limit their families should be reduced by half by 2005, 75 per cent by 2010, and 100 per cent by 2015. Recruitment targets or quotas should not be used in attempting to reach this goal.

24 COOPERATING TO FIGHT POVERTY

The Millennium Summit was the start of an unprecedented effort of UN Member States to put political will behind core development goals and heightened cooperation.

The International Conference on Financing for Development in March 2002 endorsed recommendations on liberalizing trade, expanding private-sector involvement and directing debt relief. The European nion and the United States pledged to reverse the decline in official development assistance.

The Secretary-General will report annually to the General Assembly on progress towards the Millennium Development Goals. The 2002 report addressed armed conflict and the treatment and prevention of diseases including HIV/AIDS and malaria. A Global Millennium Project will address key thematic areas, using expertise within the UN community, academia, development assistance and finance institutions, and the private sector in developed and developing countries. The Global Millennium Campaign will mobilize public support for anti-poverty efforts and attainment of the MDGs.

The United Nations system has improved the coordination of its activities at the international, regional and national levels. The United Nations Development Group is coordinating policies of N agencies and organizations. The Senior Management Group meets weekly and reviews policy issues. In May 2002, for example, it dedicated a session to population age structures and development priorities.

UNFPA serves on an interagency group formulating strategies for improved monitoring of progress. The Fund is coordinating efforts to improve data for national-level monitoring. Every developing country is expected to prepare at least one country report by the end of 2004. The technical task forces of the Global Millennium Project will incorporate population and reproductive health expertise supported by the Fund.



HIV/AIDS Recognizing that the HIV/AIDS situation is worse than anticipated by the ICPD, the ICPD+5 review agreed that to reduce vulnerability to HIV/AIDS infection, at least 90 per cent of young men and women aged 15 to 24 should have access by 2005 to preventive methods-such as female and male condoms, voluntary testing, counselling, and follow-up-and at least 95 per cent by 2010. HIV infection rates in persons 15 to 24 years of age should be reduced by 25 per cent in the most-affected countries by 2005, and by 25 per cent globally by 2010.


REPRODUCTIVE HEALTH AND THE MDGS Many of the Millennium Development Goals, including health goals, depend on the universal availability of family planning and other reproductive health choices, and on other issues related to population.

In the area of health, the Secretary-General's 2002 report on progress towards the MDGs was strongly influenced by the work of the Commission on Macro-economics and Health, set up by WHO and the World Bank. Five different working groups spent two years on studies and consultations about priority interventions concerning the relation of health, and particularly the disease-related aspects of health, their costs and expected economic impact.

The Commission recognized that population and reproductive health are central to the attainment of the health goals of the Millennium Summit and to the entire development agenda.

The ICPD in 1994 emphasized the interconnectedness of population dynamics, the ability of individuals and couples to make reproductive choices, better health, development, and poverty reduction. The Commission shared this understanding, as excerpts from its report show (see box 23). National and international action plans for attainment of the Millennium Development Goals should reflect these understandings.

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