"Reproductive Health and Reproductive Rights with Special Reference to HIV/AIDS" " -- UN Commission on Population and Development

1 April 2002
Author: UNFPA

It gives me great pleasure to address the 35th session of the Commission on Population and Development. Let me begin by expressing my appreciation to Mr. Joseph Chamie and the Population Division for their hard work in organizing this meeting.

Mr. Chairman, the very timely theme of this year's meeting, "Reproductive rights and reproductive health, with special reference to HIV/AIDS", has important implications for all of humanity. What we are talking about here is ensuring that people have the freedom and the means to make their own informed decisions about sexual relations, marriage, and pregnancy-free of violence, discrimination and coercion. What we are talking about is ensuring that individuals and couples can choose the number, timing and spacing of their children. What we are talking about is enabling people to protect themselves from unwanted pregnancy and HIV infection. In short, what we are talking about is ensuring that people can protect their health, their lives and their futures.

Ladies and gentlemen, reproductive rights are basic human rights.

Eight years ago in Cairo, 179 governments agreed on the goal of universal access by the year 2015 to reproductive health services-to family planning, safe motherhood, prevention of sexually transmitted infections, including HIV/AIDS, and an end to gender violence. It was part of a package of goals adopted by the International Conference on Population and Development (ICPD)-goals designed to empower women, promote gender equality, slow and eventually stabilize population growth, and foster sustainable economic growth in the world's poor countries.

Mr. Chairman, a few weeks ago, demographers from around the world met here at the United Nations and said that the world's population has not grown as fast as had been expected. They said we might have 9 billion people on our planet in 100 years instead of the earlier-projected 10 billion. They said birth rates are dropping faster than predicted in many large developing countries such as Brazil, Egypt, India and Mexico.

And I say to you today that this is not only good news; this is an affirmation of the vision and success of the Cairo agenda. We are on track and we must continue.

The decline in fertility is due to improved levels of schooling, higher survival rates of children, and better access to contraceptives. When women and couples are given a real choice, they choose to have smaller, healthier families. In Cairo, the world's governments agreed that population decisions are individual decisions.

And today, I want to make one thing very clear: The slowdown in population growth does not mean we can slow down efforts for population and reproductive health-quite the contrary. If we want real progress and if we want the projections to come true, we must step up efforts to provide reproductive health services because demand is growing and quite frankly, we are not keeping up.

Today, there are more than 120 million women who want to space the births of their children or stop having children altogether that do not have access to family planning services. And demand for contraception is expected to increase by a further 40 per cent in the next 15 years.

You see, while population growth is slowing, it is still growing by 77 million people every year. Over the next 25 years, the world will add as many people as it did the past 25 years. And while people are ageing, the world has more young people than ever before. Nearly one half of all people on our planet are under the age of 25-the parents of the next generation. The Population Division of the United Nations Department of Economic and Social Affairs estimates that the number of married women in developing countries will grow by 179 million by 2015.

Today, we are faced with a paradox: The need for reproductive health services is great and growing. At the same time, the funding for such services is declining.

So far, governments have contributed about $11 billion of the $17 billion that was agreed at the ICPD in Cairo. While the developing countries have reached 80 per cent of their target of $11.3 billion, the developed countries have not met even 50 per cent of the $ 5.7 billion that is needed.

It is time for developed countries to act on their commitments and raise development assistance in line with the Cairo agreement. Commitments to fight poverty and inequality must be matched by resources. Failure to meet agreed financial targets is derailing the achievement of international development goals, especially in the poorest countries. And the consequences are tragic.

Today, one woman dies every minute during childbirth and most of these deaths could be prevented with prompt care and adequate treatment. Yet today, 52 million women in Asia, Africa and Latin America deliver their babies alone, without a nurse, midwife or doctor present.

Today, despite increased awareness and commitment, HIV/AIDS continues to spread and 14,000 people become newly infected each and every day. In Africa, where HIV/AIDS has hit the hardest, millions of young women, who are highly vulnerable to infection, are dangerously ignorant about HIV/AIDS. Many have never even heard of the deadly disease and many others harbour serious misconceptions about how the virus is transmitted. Today, teenage girls in some African countries have rates of HIV infection that are five times higher than boys their age. They simply do not have the information, the power and the means to protect themselves from unsafe and unwanted sexual relations.

Ladies and gentlemen, in country after country, most poor women and adolescents still do not have the education and health services they need. These needs are especially urgent in the poorest countries and in already stressed urban areas because this is where population is growing most rapidly. In the poorest, least developed countries, where social services are painfully inadequate and the average woman has more than 5 children, population is expected to triple over the next 50 years (from 658 million to 1.8 billion.)

At this time, following the global conferences of the 1990s and the Millennium Summit, the United Nations system is focussed on helping countries achieve the Millennium Development Goals. These goals include reducing extreme poverty, improving access to education, promoting gender equality, reducing child and maternal mortality and halting the spread of HIV/AIDS. UNFPA is very much part of this global effort. We are working in 140 countries to help governments monitor trends and translate these data into effective population and development strategies that address real human needs. We are also working to ensure that the follow-up to the ICPD is part of this effort, most particularly, that universal access to reproductive health is a necessary condition for the achievement of the Millennium Development Goals of reducing infant and maternal mortality, as well as of HIV/AIDS prevention and gender equality

If we are to stay on track and make further progress, reproductive health and reproductive rights must be placed high on the agenda of the upcoming global meetings this year-the World Assembly on Ageing, the Children's Summit and the World Summit on Sustainable Development. The Cairo Programme of Action is working, and it will continue to work-women will continue to have smaller, healthier families-if they have the health, education and family planning services they need.

However, today, many countries face a shortage of contraceptives and condoms. This is most alarming in the fight against HIV/AIDS. The widespread availability of male and female condoms, combined with effective efforts to change people's behaviour, is central to any prevention strategy. But in all of the affected countries, the supply of condoms is far short of what is needed. Last year, in sub-Saharan Africa, there were just three condoms available for every man. Clearly we can do better and we must. The United Nations Population Fund has spearheaded a global campaign for reproductive health essentials and we encourage stronger partnership and support. We predict that the funding required for contraceptives for family planning and condoms to prevent HIV/AIDS will double in the next 15 years to $1.8 billion. Despite this growing need, donor support for contraceptives is at its lowest level in five years and far below what is currently required.

Mr. Chairman, UNFPA has prepared two reports for the Commission this year: 1) the Report of the Secretary-General on the Monitoring of Population Programmes Focusing on Reproductive Rights and Reproductive Health, with Special Reference to Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) as Contained in the Programme of Action of the International Conference on Population and Development and 2) the Report of the Secretary-General on the Flow of Financial Resources for Assisting in the Implementation of the Programme of Action of the International Conference on Population and Development.

While population growth and fertility rates are declining, the need for accessible, quality reproductive health services continues to be great and continues to grow. This is especially true in the poorest countries and in areas where AIDS is spreading. As long as there is a single person who does not have access to information and services and as long as the reproductive health of any woman or man is compromised in any way, there is a need for quality reproductive health care services. This is not merely a matter of population growth and demographics. It is a matter of human rights and the right to development and human well-being.

However, in far, far, too many places, the chief constraint to achieving accessible, quality reproductive health services is lack of adequate funding. The ICPD financial targets, agreed by consensus in Cairo, are sadly far from being met. More resources are urgently needed if we are to achieve our goals. I hope that the recent Monterrey Conference on Financing for Development will result in greater funding for reproductive health, which is so crucial to women, families and sustainable development.

Mr. Chairman, at this current session, the Commission will also be discussing possible options for the 10-year review of the ICPD. UNFPA believes that the focus of ICPD+10 should be on the acceleration of ICPD implementation and a review of progress achieved at the country, regional and global levels. UNFPA is ready to collaborate and ensure the success of the event in whatever form decided by the distinguished delegates.

Mr. Chairman, if we pool our human and financial resources and work together to achieve our common goals, we will move closer to the world that we all wish for ourselves, our children, and our grandchildren.

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