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UNFPA - United Nations Population Fund

State of World Population 2005

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CHAPTER 9

© Maria Soderberg/Panos Pictures
A woman pulls off her Burqa in Kandahar, Afghanistan.

Road Map to the Millennium
Development Goals and Beyond

-Women's Empowerment: Lifting Families and
Nations Out of Poverty


-Empowering Young People: The MDGs and Beyond

-Universal Reproductive Health: Fulfilling Cairo to
Reach the MDGs


-Rights and Equality: Guiding Poverty Reduction
Policies


-Resources: A Modest Price Tag for Human Dignity and
Equity

Resources: A Modest Price Tag for Human Dignity and Equity


Global military spending is about one trillion dollars a year.(46) Development aid in 2003 was $69 billion.(47) Given this disparity, the MDGs' price tag is clearly a matter of global political will and commitment. The cost of meeting the MDGs-estimated at $135 billion in 2006 and reaching $195 billion by 2015(48)-seems a modest and feasible sum, considering what it could accomplish. Thousands of lives could be saved each day. Millions of the world's people could escape the grip of poverty. Every girl and boy could be educated. The spread of AIDS could be curtailed. These are also fundamentals of a more secure world. All could be accomplished with a fraction of what the world spends for military purposes.

Various proposals, including by the European Commission and European heads of state, have been put forth since the 2000 UN Millennium Summit to make additional resources available for MDG implementation. Proposed revenue streams include the creation of an International Finance Facility(49) and taxes on airline fuel, financial transactions and carbon emissions.(50) The 2005 Commission for Africa Report lays out a plan on how best to end poverty in the region. It calls for a doubling of development aid to the continent within the next three to five years, debt cancellation, elimination of agricultural protection and trade subsidies by industrialized countries (which amount to $350 billion a year, or 16 times current aid flows to Africa), and the return of billions of dollars from corruption in bank accounts abroad.(51) It also calls for African countries to strengthen governance, ensure the inclusion of women and youth, and keep to the pledge made in 2001 to allocate 15 per cent of annual budgets to health care and expand access to reproductive health services.(52) The United States established the Millennium Challenge Account in 2002, which places selected countries with good governance records on a preferential list of aid recipients.(53)

Fulfilling the longstanding international commitment on development aid is the single most important step. Thirty-five years ago at the UN General Assembly, donor countries agreed to assign 0.7 per cent of their gross national income to official development assistance. Despite numerous and repeated calls, including at the 2002 high-level International Conference on Financing for Development held in Monterrey, Mexico,(54) only five donor countries have fulfilled their commitment: Denmark, Luxembourg, the Netherlands, Norway and Sweden.(55) Six others have set timetables to reach the goal.(56) Promising developments were unfolding just as this report was going to press: The European Union, as a bloc of its 25 members, made a unanimous, landmark decision in May 2005 to almost double aid in the next five years-with half of it for Africa-and set benchmarks towards the achievement of the 0.7 per cent target.(57) In the same month, Japan announced a doubling of aid for Africa in three years.(58)

The international community can reflect on the costs of failure to meet resource commitments by considering the case of the ICPD and its aftermath. The 1994 Programme of Action was one of the few international agreements that provided cost estimates for meeting the goal it set forth on universal access to reproductive health services by 2015. The international community, both donors and developing countries, did not meet the 2000 target of $17 billion. They were still lagging behind in 2003 and it is still uncertain whether the target of $18.5 billion for 2005 will be reached. Preliminary data for 2003 show that donors have mobilized $4.7 billion, or 77 per cent of their onethird share of the target agreed for 2005. Developing countries mobilized approximately $11 billion, or 88 per cent of their corresponding share.(59) Narrower funding gaps could have saved and improved millions of lives in the past ten years.

One of the priorities singled out as an immediate "quick win" by the UN Millennium Project is ensuring adequate funding for sexual and reproductive health supplies and logistics, including contraceptives. Donor support for family planning has decreased since 1995, when family planning received 55 per cent of all global population assistance. This share dropped to only 11 per cent in 2003.(60) Meanwhile, demand is growing, especially as the largest generation of adolescents in history enters their reproductive years.

Parliamentarians committed to the ICPD continue to play a key role in maintaining policy attention and influencing budgetary appropriations. In Paraguay, UNFPA's support to the Senate's Commission on Equity, Gender and Social Development resulted in a 300 per cent increase in 2005 funding for family planning supplies. Parliamentarians can also use their power to raise additional funds: In Guatemala, the Parliament approved a 2004 law that allocates 15 per cent of taxes on alcoholic beverages and tobacco products to reproductive health programmes.

The ICPD agenda remains highly relevant for both developed and developing countries. UNFPA, the largest multilateral provider of population and reproductive health assistance, received a record high in voluntary contributions for its core resources from 166 countries in 2004. Some European donors, the United States and Japan have been leaders in the provision of international population assistance.(61)


"Development policies and actions that fail to take gender inequality into account or that fail to enable women to be actors in those policies and actions will have limited effectiveness and serious costs to societies."

- UN Millennium Project Task Force on Education and Gender Equality


International development cooperation is not a matter of charity, but a collective responsibility of the global community. This principle is enshrined in the UN Charter, the Universal Declaration of Human Rights, and international treaties such as the Convention on the Rights of the Child.(62) The fulfilment of human rights underpins the 2000 UN Millennium Declaration-a global development compact to end poverty.(63) It calls on donor governments and international financial institutions, the private sector and multinational corporations(64) to set rights-based standards for poverty reduction through fair trade, credit and debt facilities, and not least, migration flows and workers' rights. Shocking levels of corruption, estimated at one trillion dollars each year(65)-a cost borne largely by the poor who are left without basic services- underscore the importance of improved governance and the rule of law. Inconsistencies between debt repayment and the macroeconomic policies of international financial institutions with the MDGs need to be reconsidered. Such policies have often resulted in cutbacks to the social sectors. Adjusting them could restore funding to education and health sectors.(66) Some African countries, for instance, have used resources released by debt relief to assign health workers to where they are needed most. Mauritania used these to provide incentives to midwives in order to increase coverage in remote rural areas.(67)

The urgency of the AIDS epidemic has led to a rapid mobilization of commitments and resources, though these still fall short of need. Two major recent funding initiatives include the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the United States President's Emergency Plan for AIDS Relief. The World Bank has also increased support for expanded access to AIDS treatment.(68) As the long overdue support for treatment is increasing, however, resources for HIV prevention-the front-line strategy to avert the epidemic's consequences and costs-still need to be stepped up.(69)

'KNOW HOW' AND PARTNERSHIPS. Specialized knowledge of what works best to attain the goals is a valuable resource. As highlighted by the UN Millennium Project, accelerated transfer of knowledge through cooperation among developed and developing countries is needed to ensure that investments in the MDGs are sound. This includes exchanges among government and non-governmental partners, civil society networks, women's and youth groups, research and training institutes. It calls for the transfer of medical advances and drugs, of knowledge sharing on simple means and proven strategies that can save lives.

Civil society, with its vast global networks and service infrastructure, its considerable flexibility, knowledge and experience, and connections to the on-the-ground realities of specific groups, will be essential to meeting the MDG challenge.(70) Strengthened collaboration and partnership between governments and civil society in national poverty reduction and development strategies, as well as in the direct delivery of services, will be required to implement the larger-scale programmes the MDGs require. Community ownership is one of the "requirements for success" rightly pointed out by the UN Millennium Project,(71) key to the design, accountability and sustainability of interventions. Communities are the best informants on what is working or faltering as MDG-related programmes are developed for their benefit.

Strengthened public-private sector partnership can bring in additional resources. The private sector can contribute both financial and in-kind support. Businesses can provide health information and services to their employees, and transfer skills and training to the communities in which they operate. The International Labour Organization's Code of Practice on HIV/AIDS and the World of Work has led to an increased number of firms adopting helpful policies to address the disease. Nonetheless, a survey of business leaders in 104 countries found that 71 per cent of the companies have no HIV/AIDS policies in place. Some companies in sub-Saharan Africa have set the example for others to follow, by providing services to their employees.(72) Multinational companies and large public employers who recognize the link between the productivity and reproductive health of their employees offer natural entry points to extend education and services.

Ever-expanding coalitions and networks are also forging ahead with focused campaigns on issues that are critical to meeting the MDGs. The "3 by 5" campaign of WHO and UNAIDS to provide 3 million HIV-positive people with access to treatment by 2005 is a prime example. Several others in the health arena have mobilized to address infant mortality, safe motherhood, youth, gender equality and HIV/AIDS.

Additional tools include the expanded use of the media and incentives, such as tax reductions. These can increase public commitment to MDG causes and philanthropic donations by private individuals and foundations, who are major contributors in the United States and some developed countries. Bill Gates and Ted Turner are leading examples of individuals who have made enormous contributions by establishing global foundations that provide MDGrelated grants. Donations and in-kind contributions small and large can make a difference in saving and improving lives. The 34 Million Friends of UNFPA, for instance, has raised more than $2.6 million in support of the Fund, mostly in small contributions from more than 100,000 individuals, primarily from the United States. The media and parliamentarians can take advantage of their power to keep the MDGs high on public and policymakers' agendas and to press for accountability in the countdown to 2015.

TIME TO ACT. The world has an unprecedented opportunity to "make poverty history".(73) With nearly 3 billion people(74) struggling to live on less than $2 a day; one woman dying needlessly every minute in childbirth; 6,000 young people acquiring HIV daily; and millions of women and girls living in fear of violence, the ethically-acceptable response is selfevident: to fulfil the promises for global action on poverty, equality and equity espoused at the UN conferences of the 1990s and the 2000 UN Millennium Summit. Under international law, these agreements are more than rhetoric: They are collective obligations. They embody the principles that led to the formation of the community of countries known as the United Nations. They assert that the right to live in dignity, free of fear and shame, free of oppression and violence and free from want are the minimal rights and entitlements of every human being.

The world has an unprecedented opportunity to enable disenfranchised people to prevail over the circumstances that hold them back and claim their full rights. The strategies are clear. A plan is in place. The needed resources are attainable. The time to act is now.

Notes >>
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