UNFPAState of World Population 2004
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HOME: STATE OF WORLD POPULATION 2004: Introduction
State of World Population
Sections
Introduction
Population and Poverty
Population and the Environment
Migration and Urbanization
Gender Equality and Women's Empowerment
Reproductive Health and Family Planning
Maternal Health
Preventing HIV/AIDS
Adolescents and Young People
Reproductive Health for Communities in Crisis
Action Priorities
Notes
Sources for Boxes
Indicators
Graphs and Tables

Introduction

Putting People at the Centre
From Words to Action
Countries Report on Progress
National Ownership and Culture
Birth of a New Global Consensus
Wide-ranging Impact
Long Way to Go
The Way Forward

Birth of a New Global Consensus

AN EVOLVING UNDERSTANDING.(2) The Cairo consensus centred on reproductive health and rights grew out of more than 25 years of experience with population programmes, and evolving international understandings about development and human rights. In 1969, when UNFPA became active, there was no working agreement on population among the members of the United Nations; by 1994 UNFPA had programmes in 140 countries.

At the time of the first World Population Conference in Bucharest in 1974, a large group of countries, including most of Latin America, franco-phone Africa and parts of Asia, were ambivalent about population activities beyond data gathering and maternal and child health. Two decades later, almost all countries supported the spectrum of reproductive health activities, including voluntary family planning, safe motherhood, HIV/AIDS prevention, and protection against and treatment of sexually transmitted infections.

FAMILY PLANNING AS A HUMAN RIGHT. The International Conference on Human Rights in Tehran in 1968 was the first international forum to agree that “parents have a basic human right to determine freely and responsibly the number and spacing of their children”.

The Bucharest conference affirmed that family planning was a right of all “individuals and couples”. But its discussion about reducing high rates of fertility in developing countries was not explicitly grounded in women’s rights. The 1974 World Population Plan of Action, an uneasy compromise, mentioned women only once.

A year later, however, the First World Conference on Women, in Mexico City, agreed that the right to family planning is essential to gender equality.

The 1984 International Conference on Population, also in Mexico City, added that men should share responsibility for family planning and child-rearing “in order to provide women with the freedom to participate fully in the life of society”, an objective “integral to achieving development goals, including those related to population policy”.

The 1984 conference also called attention to the large “unmet needs for family planning” among couples who wanted to limit or space child-bearing but lacked access to contraception, and noted that those needs would rise sharply as the number of reproductive-age couples grew in the decade ahead.

The 1992 United Nations Conference on Environment and Development identified rapid population growth as a serious obstacle to sustainable development. But there was no consensus on actions to address it, in part because of lingering distrust of family planning programmes.

This impasse was broken at Cairo by linking development goals to human rights and the advancement of women.

REPRODUCTIVE RIGHTS. During the two decades prior to 1994, a number of international forums had broken new ground in elaborating human rights, including the rights to development and health, women’s rights and reproductive decision-making. The ICPD put these together, elaborating a new concept of reproductive rights.

Reproductive rights broadly encompass the right to reproductive and sexual health, throughout the life cycle; reproductive self-determination, including the rights to voluntary choice in marriage, and to have the information and means to determine the number, timing and spacing of one’s children; equality and equity for women and men in all spheres of life; and sexual and reproductive security, including freedom from sexual violence and coercion.(3) These were spelled out in a variety of human rights treaties and conventions and international consensus agreements.

In the run-up to the ICPD, reproductive rights proponents in governments and civil society, particularly women’s groups, mobilized to ensure that these understandings would underpin the new plan of action to address population and development concerns.

The 2003 UNFPA global survey found that since the ICPD, 131 countries had changed national policies or laws, or made institutional changes to recognize reproductive rights. For example, South Africa and Venezuela include reproductive rights in their constitutions as fundamental human rights. India’s human rights commission has adopted a declaration on reproductive rights and directed state governments to promote and protect them.(4)

In Ecuador, Ethiopia, Ghana, Kenya and Liberia, among other countries, NGOs such as women’s lawyers’ organizations promote and monitor government actions supporting reproductive rights.

ICPD ON REPRODUCTIVE RIGHTS

[R]eproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents. These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes their right to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents. In the exercise of this right, they should take into account the needs of their living and future children and their responsibilities towards the community. The promotion of the responsible exercise of these rights for all people should be the fundamental basis for government- and community-supported policies and programmes in the area of reproductive health, including family planning.

—from ICPD Programme of Action, para. 7.3

ABORTION COMPROMISE. Broad agreement was reached on most elements of the Programme of Action in lengthy preparatory meetings. But at the Cairo conference itself, the widely reported disagreement over how to address the abortion issue threatened to block the consensus.

After prolonged debate, a compromise was reached. The 1984 International Conference on Population had agreed that abortion should never be promoted as a means of family planning, that women should be helped to avoid abortion through improved access to family planning, and that those who have had recourse to abortion need humane treatment and counselling. The 1994 Programme of Action reaffirmed these points. Acknowledging that unsafe abortion(5) is a major public health concern, it added that women should have access to quality services for managing complications of abortion. Abortion policy, governments agreed, is a matter for national decisionmaking; where abortion is not against the law, it should be safe.

The 1995 Fourth World Conference on Women in Beijing upheld the Cairo action plan and reproductive rights as central to the agenda for advancing gender equality. Beijing elaborated on the concept of sexual security, specifying that “The human rights of women include their right to have control over, and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence.”

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