(Not for release before 3 December 2002)
Achieving many of the Millennium Development Goals
depends in part on the universal availability of family plan-ning
and other reproductive and sexual health services.
The essential require-ments
are to target assistance directly to the poor, to reduce
their costs, and to give them a voice in the policies and pro-grammes
that affect them.
Governments, communities, the private
sector and the international community must cooperate
more closely. Donors should encourage partnerships among
governments and non-governmental organizations (NGOs).
Particular attention should be paid to incorporating
the views of the poor in the design, implementation
and monitoring of programmes.
Reproductive health—family planning, prevention of
sexually transmitted infections and HIV/AIDS, care during
pregnancy and birth and safe delivery—is most effective
as part of an integrated package.
Effective health sector reform depends
on guaranteed funding, by providing more resources and
better use of available funds, and central support for
services that cannot be supplied locally. Specific action
is needed to protect preventive services like reproductive
The poor cannot afford to pay user fees,
which have deprived millions of poor people, particularly
women and children, of the care they need.
In 1994, at the International Conference on Population
and Development (ICPD), nations committed themselves
to the goal of universal access to reproductive health by the
The goal remains a priority for
the international community. Meeting the goal requires
safety net systems— free services, subsidized care,
insurance schemes and sliding-scale fees—to ensure that
poor clients receive reproductive health care.
The ICPD agenda helps frame the issue of health financing
in terms of client needs and empowerment. The question
that needs to be asked by any policy initiative is, will it hurt
the poor and will it discriminate against women?
Closer attention to poverty alleviation demands that
programme benefits reach poor people directly. Underserved
groups include the rural and urban poor, migrants, refugees
and displaced persons, as well as adolescents.
Integrated approaches, covering
different needs, empower people to set their own course
out of poverty. Micro-credit schemes are among the most
effective and often include other services such as literacy
and family planning. Countries need to improve data
systems for monitoring progress towards the Millennium
Development Goals, and the poorest need external assistance.
UNFPA is working with partner institutions of the United
Nations, the international financial institutions, bilateral
donors and foundations to strengthen national monitoring
Since 1969, UNFPA has been the largest multilateral
source of population assistance, providing nearly $6 billion
for population and reproductive health programmes.
At ICPD, countries agreed that one third of the $17 billion
annual requirement for basic reproductive health and
population programmes in 2000, or $5.7 billion, was to come
from the international community; two thirds, or $11.4
billion, was to be provided by developing and other countries
In the year 2000, total expenditure was $10.9 billion,
$6.1 billion short. Donor countries contributed $2.6 billion,
less than a quarter (24 per cent) of total expenditure, and
less than half (46 per cent) of their commitment. Developing
countries contributed $8.3 billion, 76 per cent of the total
spent and about 73 per cent of their commitment.
The international goals for poverty reduction and
improvement of life quality offer a noble vision. Achieving
and protecting them will require both a focus on the goals
themselves and sensitivity to the context. Universal
access to reproductive health care, universal education and
women’s empowerment are goals in their own right, but
they are also conditions for ending poverty.