It is a simple message but a powerful one: Gender equality reduces poverty and saves and improves lives.
In the year 2000, the nations of the world came together to forge a unique compact. The eight Millennium
Development Goals (MDGs) sketched out a bold plan to halve extreme poverty by 2015. This unprecedented
global initiative holds great promise. During the next decade, hundreds of millions of people can
be released from the stronghold of poverty. The lives of 30 million children and 2 million mothers can be
spared. The spread of AIDS can be reversed. Millions of young people can play a larger role in their country’s
development and create a better world for themselves and future generations.
This year’s The State of World Population report stresses
that gender equality and reproductive health are
indispensable to the realization of this promise.
The UN Millennium Project, a
panel of more than 250 experts
from all over the world, identifies
gender inequality as one of the primary
drivers of poverty and social
exclusion. This is because discrimination
human capital by denying one half
of humanity the right to realize
their full potential. More than
1.7 billion women worldwide are in
their reproductive and productive
years, between the ages of 15 and
49. Targeted investments in their
education, reproductive health,
economic opportunity and
political rights can spur growth and sustainable
development for generations to come.
The report, The Promise of Equality: Gender Equity,
Reproductive Health and the Millennium Development Goals,
explores the degree to which the global community
has fulfilled pledges made to the world’s most
impoverished and marginalized peoples. It tracks
progress, exposes shortfalls and examines the links
between poverty, gender equality, human rights,
reproductive health, conflict and
violence against women and girls.
It also examines the relationship
between gender discrimination and
the scourge of HIV/AIDS. It identifies
the vulnerabilities and strengths
of history’s largest cohort of young
people and highlights the critical
role they play in development.
The MDGs constitute a promise by
the world’s leaders to find solutions
to challenges that plague humanity.
The eight goals range from halving
extreme poverty to tackling the problem
of maternal mortality, and
reversing the HIV/AIDS epidemic—all by 2015. As well as pinpointing an actual date for
their achievement, the MDGs include one goal—promote
gender equality and empower women—that is
critical to the success of the other seven. Although the
goal of universal access to reproductive health by
2015, agreed at the 1994 International Conference on Population and Development (ICPD), was not explicitly
included in the MDGs, investments in this area are
now considered essential to their achievement
Education, reproductive health and economic opportunity
for women are three particularly strategic
interventions necessary to the achievement of the
MDGs. Also critical is eliminating violence against
women. Investments in these areas can yield immediate,
longer-term and intergenerational pay-offs.
Moreover, increased political participation and greater
accountability for gender equity will help ensure that
these investments are given the priority attention
Education for all is central to any society.
Yet, too many children living in poverty, especially
girls, are still missing out. Despite evidence that clearly
shows that the education of girls, and—in
particular—secondary education, is critical to poverty
reduction and development, the world has failed to
meet the MDG target to eliminate gender disparities in
primary and secondary education by 2005.
Today, 600 million women are illiterate as compared
to 320 million men. While access to primary education
is increasing, only 69 per cent of girls in Southern Asia
and 49 per cent in sub-Saharan Africa complete primary
school. At the secondary level, the gap is even
wider with only 47 per cent and 30 per cent enrolment
in Southern Asia and sub-Saharan Africa, respectively.
Research shows that for women and girls, secondary
education is associated with improved economic
prospects, better reproductive health, improved HIV
awareness and altered attitudes towards harmful practices
such as female genital mutilation/cutting. Their
children also benefit: Every year of a mother’s education
corresponds to 5 to 10 per cent lower mortality
rates in children under the age of five.
Worldwide, an estimated 250
million years of productive life are lost every year as a
result of reproductive health problems. The poor disproportionately
suffer the consequences, especially women
and young people, and have the most to gain from expanded access to reproductive health services. The
inability to determine when and how many children to
have limits a woman’s life choices. Enabling individuals
to freely choose the number and spacing of their children
also results in smaller families, slower population
growth and reduced pressure on natural resources.
Reproductive health can result in economic benefits
through the “demographic dividend”. Lower
fertility rates means a higher proportion of young people
entering their productive years with relatively
fewer dependents to support. Coupled with supportive
social and economic policies, this can result in
increased savings and greater available resources to
invest in each child. Economists attribute the unprecedented
growth in East Asian economies between 1965
and 1990 to this dividend. Indeed, researchers estimate
that the demographic dividend could reduce
poverty in the developing world by 14 per cent
between 2000 and 2015.
approaches and development programmes have largely
ignored the economic contributions of women. In
addition to managing households, many women toil in
sweatshops, farms, factories, marketplaces, mines and
offices and do so largely in the absence of supportive
policies, laws, institutions and services. Much of their
work is unrecognized, invisible and unpaid. Even
though women are entering the paid workforce in
increasing numbers, they risk dismissal should they
become pregnant and generally enjoy less overall
income and job security than men. According to the
World Bank, in developed countries, women earn 77
cents for every dollar men earn, and in developing
countries, 73 cents.
In developing countries, rural women are responsible
for 60 to 80 per cent of food production but many
governments still prohibit a woman from acquiring or
disposing of land without her husband’s permission. In
much of sub-Saharan Africa widows have virtually no
land or inheritance rights, and women receive less than
10 per cent of all loans earmarked for small farmers and
only 1 per cent of total agricultural sector credit.
World Bank research in some sub-Saharan African
countries found that output could increase by up to 20 per cent if more women had equal access and control
over farm income, agricultural services and land.
Addressing inequitable economic opportunities can lift
families and communities out of poverty.
One of the major achievements of the 20th Century was
the development of a rich body of international law
affirming the equal rights of all human beings. A major
challenge remains, however, and that is for women and
other neglected groups, especially those whose lives
are circumscribed by poverty and discrimination, to
be aware of, and exercise, their human rights. The
eradication of extreme poverty as called for by the
MDGs, relies on the fulfillment of individual rights
through expanded opportunities, choices and power.
The 1979 Convention on the Elimination of All
Forms of Discrimination Against Women (CEDAW) and
the 1989 Convention on the Rights of the Child (CRC)
set forth the criteria under which governments are
legally bound to end gender discrimination. To date,
180 countries have ratified CEDAW. The UN conferences
of the 1990s buttressed the framework for
women’s rights. In 1993, the Vienna World Conference
on Human Rights declared women’s rights as human
rights for the very first time.
The platforms that emerged from the 1994 ICPD
and the 1995 Fourth World Conference on Women
provide concrete action plans on the human rights
of women and form the basis for national policy and
Putting these instruments into practice requires
changes in the underlying value systems that perpetuate
and legitimize discrimination. Although many
countries are increasingly establishing laws that protect
the rights of girls and women, many of these go
unenforced owing to a combination of entrenched gender
bias, inadequate resources and commitment. In
many countries, women are largely unaware of their
rights and the laws that ostensibly protect them.
Culturally sensitive approaches can be effective in
promoting human rights and gender equality in
diverse national and local contexts. Experience has
shown that communities that understand the dangers
posed by certain practices—such as child marriage, female genital mutilation/cutting, widow “cleansing”
—and question them from within their own cultural
lens, can mobilize to change or eliminate them.
Reproductive rights are human rights and derive
from the recognition that all individuals have the right
to make decisions free of discrimination, coercion and
violence. Chief among these are the right to freely and
responsibly determine the number, timing and spacing
of one’s children and to have the means to do so and the
right to the highest standard of sexual and reproductive
health. This also implies the right of all individuals to
protect themselves from unintended pregnancy and
sexually transmitted infections—including HIV.
Worldwide, reproductive health conditions are the
leading cause of ill health and death in women aged
15 to 44. Although almost entirely preventable, 99
per cent of all maternal deaths occur in developing
countries. Every minute a woman dies needlessly of
pregnancy-related causes. This adds up to more than
half a million lives lost each year and highlights the
low priority placed on women’s lives. At least eight
million more women suffer life-long illness and health
consequences as a result of pregnancy complications.
The death of a mother also increases the risks of
infant and child mortality. Newborns are three to ten
times more likely to die prematurely than those whose
mothers survived delivery.
At the 1994 ICPD, 179 governments pledged to
make reproductive health universally available “as
soon as possible and no later than 2015”. From that
conference emerged the global consensus that reproductive
rights are central to human rights, sustainable
development, gender equality and the empowerment
Maternal death is practically non-existent in industrialized
countries. In no other area of health are
disparities between rich and poor as evident both within
and between countries. And no other area of health
so clearly demonstrates the tragic impact of poverty
and gender inequality on the lives of women and girls.
In sub-Saharan Africa, a women faces a 1 in 16 lifetime
risk of dying from pregnancy-related complications. In
industrialized nations, the risk is 1 in 2,800.
Better access to safe and effective contraceptive
methods is key to achieving the MDGs. Every year, 76
million unintended pregnancies occur in the developing
world alone. Nineteen million of these end in unsafe
abortion—a leading cause of maternal death. Providing
access to family planning could prevent unplanned
pregnancies, reduce the incidence of abortion and cut
maternal deaths by 20 to 35 per cent. In Romania, the
establishment of family planning led to a drop in the
abortion rate from 52 per 1,000 women in 1995 to 11 per
1,000 in 1999.
Poverty, discrimination and violence make women
and girls particularly vulnerable to HIV transmission.
When HIV/AIDS first emerged as a public health concern
in the 1980s, the majority of those infected were
men. Today, approximately half of the estimated 40
million people living with HIV are women, with the
greatest increases occurring in young people between
the ages of 15 and 24. Fifty-seven per cent of all people
living with HIV in sub-Saharan Africa, and 49 per cent
in the Caribbean, are women. Three quarters of new
HIV infections are transmitted between men and
women—many from husband to wife.
Worldwide, a mere 8 per cent of pregnant women
were reached by prevention efforts in 2003. Gendersensitive
approaches are central to halting the
epidemic, while the prevention of HIV among women
of childbearing age is crucial. Furthermore, the need
for condoms has increased in tandem with the spread
of HIV. This has led to serious shortages—particularly
in those countries hardest hit by the pandemic. In
2003, donor support paid for six condoms per year for
each man in sub-Saharan Africa.
Today’s generation of young people is the largest in
history, with almost 3 billion people under the age-of
25. Eighty five per cent live in poor countries, and the
poorest countries have the highest percentages of
young people. Of these, more than 500 million youth
live on less than $2 per day.
Adolescence—defined here as those aged 10 to 19
years—is a critical stage of life, a time of opportunities
but also of vulnerabilities and risks. Adolescent
girls are especially at risk of sexual violence and exploitation, harmful practices, early pregnancy
and HIV infection. Many are forced to abandon their
education and stay at home to help with chores and
care for other siblings. During the next ten years,
100 million girls are likely to be married before the
age of 18. Every year, 14 million adolescents give birth
and are two to five times more likely to die owing to
pregnancy-related complications than women in their
twenties. For every girl who dies in childbirth, many
more will suffer injuries, infections and lingering illnesses,
such as obstetric fistula.
While boys may experience adolescence as a time of
greater freedom, they, too, face the risk of exploitation,
violence and HIV. Almost one quarter of people living
with HIV are under the age of 25, while fully half of
new HIV infections are among young people between
the ages of 15 and 24. In sub-Saharan Africa, young
women living with HIV outnumber HIV-positive men
their own age by 3.6 to 1. In the Caribbean, Middle
East and North Africa, about 70 per cent of all young
people living with HIV are women. Nevertheless,
many young people have only limited access to
Policy makers and the international community
are gradually realizing the urgency of investing more
in young people, their education, skills training reproductive
health and employment. Decisions made today
will reverberate for generations to come.
Development efforts have tended to focus on either
men or women, but rarely on both. Partnering with
men is essential to the achievement of equality.
Restrictive gender norms and stereotypes limit possibilities
for both sexes and gender equality is a winning
proposition for both women and men. The AIDS
epidemic sharply underscores men’s critical role: In
the absence of a vaccine or cure, changes in male
behaviour are central to preventing the spread of HIV.
Because men wield preponderant social and economic
power, they often make decisions about family planning,
their wives’ economic activities and the use of
household resources, including for doctor and school
fees. The care and support of an informed husband
also improves pregnancy and childbirth outcomes and can mean the difference between life and death in
cases of complications, when women need immediate
The same gender norms that oppress and harm
women prevent many men from realizing their full
capacity to care, nurture and be responsible to their
families and communities. Societal norms that promote
an “ideal” of masculinity can also encourage
men and boys to engage in high-risk behaviours that
harm both themselves and others. Furthermore, men’s
sexual and reproductive health needs have largely
Worldwide, a number of initiatives aimed at HIV
prevention, reproductive health and gender-based
violence manage to reach large numbers of men by
engaging them in the workplace, including within
military and police institutions. Most programmes,
however, are small compared to the challenge of transforming
gender relations. Working with adolescent
boys at a formative and potentially risky time in their
lives offers the greatest opportunity to instill equitable
gender values and encourage the next generation
of young adult males to question the very norms that
have denied the human rights of their sisters, mothers,
wives and daughters.
Gender-based violence knows no boundaries—be they
economic, social or geographic. It is pervasive, pernicious
and is overwhelmingly perpetrated by men
against women and girls. It both reflects and reinforces
gender inequity and compromises the dignity,
autonomy and health of women to a degree that is
truly staggering. Worldwide, one in three women has
been beaten, coerced into unwanted sexual relations
or abused—often by a family member or an acquaintance.
Gender-based violence kills and harms as many
women and girls between the ages of 15 and 44 as cancer.
The toll on women’s health surpasses that of
traffic accidents and malaria combined. The costs to
countries—in increased healthcare expenditures, legal
fees, policing and losses in educational achievement
and productivity—are commensurately high. In the
United States, that figure adds up to an estimated
$12.6 billion each year.
Gender-based violence takes many forms—both
psychological and physical—and includes domestic
violence, rape, female genital mutilation/cutting and
“honour” and dowry-related killings. Violence can
begin even in the womb through prenatal sex selection
and, later, from female infanticide, neglect and abuse.
In Asia alone, at least 60 million girls are “missing” as
Every year, an estimated 800,000 people are trafficked
across borders for exploitation, the majority in
the commercial sex trade. Approximately 80 per cent
are women and girls. Many more are forcibly recruited,
tricked or abducted to face the same fate within
their own country.
National campaigns against gender-based violence
are one of the “quick-win” solutions recommended by
the UN Millennium Project. In some countries, efforts
are already under way. Because gender-based violence
is so widely tolerated, successful action ultimately
requires social transformation: Effective law enforcement
and a strengthened judiciary aimed at ending
impunity, gender-sensitive education, and the mobilization
of communities and opinion leaders are
needed to prevent violence. Needless to say, men must
be engaged to take a strong stand on the issue.
Since the 2000 UN Millennium Summit, conflict has
erupted in more than 40 countries. Almost two billion
people were affected by natural disasters in the last
decade of the 20th Century, 86 per cent by floods and
droughts. Late in 2004, a single disaster—the tsunami
in Southeast Asia—swept away entire villages and
claimed the lives of an estimated 280,000 people and
displaced a million more.
In the wake of wars and natural disasters healthcare
and educational infrastructures collapse, the risk
of HIV infection increases and the levels of genderbased
violence skyrocket. Of the 34 countries farthest
from reaching the MDGs, 22 are in, or are emerging
The nature and scope of war has changed, with
more conflicts occurring within, as opposed to
between, countries. During the 1990s, of the 118 armed
conflicts, the majority were civil. These tend to last longer than conflicts between countries and take a
huge toll on civilians. Abuses include rape, mutilation,
massacre and the forcible recruitment of children to
serve as combatants, sex slaves and “camp wives”.
Many civilians are forced to flee their homes and
sexual violence is widespread. Eighty per cent of
the world’s 35 million refugees and internally
displaced persons are women and children.
Following conflict, reconstruction provides an
opportunity to forge societies anew and address
pre-existing inequities. Indeed, a number of postconflict
countries are actively promoting the rights
of women and young people in order to forestall the
very conditions that can lead to further marginalization
and impoverishment following conflict’s
end. With 49 per cent of seats, Rwanda now has the
highest proportion of female parliamentarians in
Today, in the first decade of the 21st Century, the
world has an opportunity to “make poverty history”.
Doing so, however, will require targeted investments in the empowerment of women and young people;
the provision of universal reproductive health alongside
HIV prevention, and the strengthening and
transforming of health care systems. In Africa, the
ratio of doctors to patients can be as great as one for
every 10,000. This compares to one for 500 in the
United States. Sub-Saharan Africa will need an additional
one million more health workers in order to
achieve the MDGs. Making healthcare systems more
responsive to the needs of women, young people and
indigenous or otherwise marginalized groups, is
critical to meeting poverty reduction goals.
In 2003, donor governments spent $69 billion on
development aid. That same year, global military
spending totaled approximately one trillion dollars.
Given this disparity, it is clear that the cost of meeting
the MDGs is more a matter of political will and commitment
than scarce resources. Considering what it
will accomplish, the cost—$135 billion in 2006 and rising
to $195 billion by 2015—is modest and feasible.
The time to act is now.