International Conference on Reproductive Health: Key to Development and Poverty Reduction -- Panel on Youth: Agents of Change

21 November 2003
Author: UNFPA

Good morning.

I bring you warm greetings from Thoraya Ahmed Obaid, Executive Director of UNFPA, the United Nations Population Fund. She regrets she cannot be here, but wishes us great success. I am pleased to deliver this statement on her behalf.

This conference would not have been possible without the work of Wouter Meijer of the World Population Foundation. Thank you. While we are sad to see you leave the Foundation, we know our friendship will continue and wish you all the best. I would also like to thank the other co-organizers: the Dutch National Commission for International Cooperation and Sustainable Development and Share-Net.

UNFPA is honoured to take part in this important conference. We are particularly pleased to be joined by our partners: the International Planned Parenthood Federation, the World Bank, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. We are also thrilled that young people are participating in this conference.

Here we are, on the eve of the 10th anniversary of the Cairo International Conference on Population and Development (ICPD). It is most fitting that Dr. Nafis Sadik, the Secretary-General of that historic Conference is with us today. As the Secretary-General’s Special Envoy on HIV/AIDS for Asia, and UNFPA’s Special Ambassador on Obstetric Fistula, you continue to be a fearless champion of the Cairo vision and its guiding principles. In you, the women of the world have a true ally.

The Cairo Conference was an outstanding success. Consensus was sought, on very sensitive issues, and attained. Differences among cultures were debated. And in a true spirit of leadership, governments learned to respect those differences and find the values we hold in common. The Universal Declaration of Human Rights expresses these values; and the success of Cairo was that all countries agreed, finally, that reproductive health is a human right.

The 20-year ICPD Programme of Action remains just as valid today as it was in 1994. None of the Millennium Development Goals will be achieved unless the Cairo agenda, and the key actions agreed at the fifth-year review, are implemented.

Ladies and gentlemen,

The words of a 19-year-old young woman from Honduras ring in my mind. She said: "Some grown-ups think we are too young to know. They should know that we are too young to die."

Isn’t it unbelievable that in this global information age, youth continue to be denied the most basic information about their own bodies and their sexual and reproductive health?

The result is widespread ignorance and unnecessary confusion. Not to mention millions of unwanted pregnancies and abortions, and millions of cases of sexually transmitted infections, and HIV/AIDS. Today, half of all new HIV infections occur among youth aged 15 to 24.

What future is in store for the 6,000 young women and men who become newly infected each day?

Is it morally correct to send young people ignorant into the world, when a little knowledge might save their lives?

Unfortunately, and mistakenly, some people continue to believe that sexuality education increases promiscuous behaviour, when, in fact, just the opposite is true. Studies show that young people use the information to make informed and responsible decisions.

It is important that we address gender norms and power dynamics, because they have a strong effect on sexual and reproductive health.

In some countries, adolescent girls are being infected with HIV at a rate five or more times higher than boys. All over the world, young married women are being infected by their husbands. In Kenya, married teenage girls have higher HIV infection rates than unmarried girls their same age who are sexually active.

Early marriage is harmful to adolescent girls. Early marriage jeopardizes their health, limits their opportunities, usually disrupts their education and often violates their human rights. One of the saddest ironies is that teenage mothers often find it difficult to obtain reproductive health services, including family planning, and yet they face the highest maternal health risks.

For teenage girls, complications of pregnancy and childbirth are a leading cause of death, with unsafe abortion being a major factor. Other tragic outcomes of early pregnancy include obstetric fistula, and a higher chance of having children with low birth weight, inadequate nutrition and anaemia.

And what can we say about the 2 million girls between 5 and 15 who are introduced into the commercial sex market each year, or the 2 million at risk of female genital cutting?

The sad fact is that for many adolescent girls, their first sexual experience is forced, often by people they know, including family members. This can lead to long-term physical and psychological damage.

While there is greater recognition and attention to the sexual coercion and violence in the lives of many adolescent girls, the response is far from what is required.

More attention also needs to be paid to the sexual and reproductive health needs of adolescent boys. Many boys feel heavy peer pressure to become sexually active, and they do not have space to discuss their feelings and experiences. In the Russian Federation, for instance, young boys become sexually active in their early teens, at a much younger age than girls. Furthermore, the girls are talking to their mothers about these issues and, for the most part, the boys do not. So, their minds are filled with myths and misperceptions.

Ladies and gentlemen, it is precisely in this context that the ICPD Programme of Action offers solutions. We know what needs to be done. Since Cairo, much progress has been achieved.

Today, we have an unprecedented opportunity. Half the world’s population is under the age of 25. There are 1.2 billion adolescents between the ages of 10 and 19. This largest youth generation in history can be a powerful force for positive change—for increased equality between men and women, for the reversal of the AIDS pandemic, for greater prosperity and opportunity, if we invest in them and make their health and well-being a priority.

Reproductive health and rights go beyond the health sector, and have wide and far-ranging effects. Smaller families are able to save more and invest more in each child. Reductions in fertility also bring about a demographic opportunity. A large working-age population with relatively fewer dependents can register increased savings and faster economic growth. The social and economic benefits of reproductive health interventions are dramatic.

UNFPA has made a strong case for greater investments in adolescents and young people in its 2003 State of World Population report. And we will continue to do so, as we build up to the 10th anniversary of Cairo and beyond. We encourage all of you to do the same.

It is time to place young people at the centre of efforts aimed at ensuring a more stable, peaceful and prosperous world. It is time to ensure that youth issues, including reproductive health and rights, are placed squarely in key policy discussions, within countries and internationally.

In taking action, we must recognize the diversity of adolescents and youth. What is right for a married girl in rural India, is worlds apart from what is needed and wanted by a teenage boy in Brazil. In reproductive health, one size doesn't fit all. Programmes must be carefully constructed and adapted according to the needs of the people who will use them.

Successful programming responds to these varied life circumstances, and priorities. This often includes a multisectoral approach that reaches young people wherever they may be — the army, the workplace, the streets, sports events or other gathering places.

School programmes have the potential to reach large numbers of youth, at least in countries where most young people attend school. But many of the most marginalized young people are not in school. To address the needs of these hard-to-reach groups, strategies must correspond to their life situations, and help them deal with the issues they find most pressing. This is especially critical in conflict zones and refugee camps.

UNFPA supports linking reproductive health with programmes that address life skills, livelihoods, and income-generation activities—and that promote human rights and gender equality.

Gender roles and attitudes are formed early in life, in childhood. Adolescence is an excellent time to instil and foster the ideas of partnership, mutual respect and support, and responsible parenthood. It is a good time to discuss gender-based violence openly, and make a strong case against it.

It is also necessary to work on the policy and legal front, particularly on laws that promote adolescent reproductive health and rights, and that penalize all forms of discrimination, abuse, sexual violence and exploitation.

There is clear evidence from all regions of the world that well-designed information, education and behaviour change programmes do lead to safer, healthier lifestyles. We also know that the involvement of communities, parents and young people themselves are essential to these efforts.

However, despite an increase in services for youth, and the wealth of experience we have gathered as to what works, we are still not implementing these programmes at a level to achieve significant and sustained impact. Part of the problem is a lack of national capacity—and another part is lack of political leadership.

To move forward, we need a strong renewal of political commitment to the ICPD Programme of Action. We need to put this agenda front and centre in today's policy discussions, whether at the World Bank, in the United Nations Development Assistance Frameworks, or wherever decisions are made, with regard to poverty reduction, sector-wide approaches, and health sector reform. We must ensure that reproductive health for adolescents and youth is a priority and that young people are involved in the process.

We must keep our sights on the high-level event that will take place at the United Nations in 2005 to review the implementation of the major United Nations conferences, including the Millennium Summit. Together, we must ensure that the issues of population and reproductive health are high on the agenda at that high-level meeting.

We also need to reach groups that are not already convinced, and expand our circle of partners. In this regard, I am thinking of finance and planning ministers, business leaders, the media, parliamentarians, and other opinion leaders and decision makers. As we expand our partners, we must also be aware of negative campaigning around these issues and respond quickly with factual information.

In closing, I would like to stress that we cannot accomplish the ICPD goals without the financial means to do so. Donor funding is below 50 per cent of what was agreed in Cairo. This is a serious shortfall, and a serious challenge.

In many countries, there are severe shortages of condoms, contraceptives and other reproductive health supplies. Together, we must close this gap. And we must close the gap between rhetoric and action.

All over the world, young women today want fewer children than their mothers did. Will they be free to act on their preference? They want to live free of discrimination, violence and coercion. Will their dreams be fulfilled? Young men and women want to remain HIV free. Will they be able to do so? Many young men today want to be full partners in the family. Will they be free to make that choice?

Together, we must ensure that these choices are available, and fully supported.

Thank you.

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