Statement at the 2004 UNDP/UNFPA Executive Board Special Event Panel Discussion

by Thoraya Ahmed Obaid, Executive Director, UNFPA

I am very pleased to be here with all of you. I would like to thank you for coming today to discuss different aspects of the historic and visionary Cairo agenda on population and development. I look forward to a real dialogue on the progress that has been achieved during the past 10 years, the lessons learned and, most importantly, on how we are going to make greater progress together in the decade to come. I would like to thank the President of the Executive Board, His Excellency Mr. Abdullah M. Alsaidi of Yemen, for reading the message of the Secretary-General. It is gratifying to know that the Cairo agenda enjoys strong support at the top of the United Nations. I would also like to thank Mr. Serge Chappatte, Assistant Director-General, Swiss Agency for Development and Cooperation, for his insightful remarks.

Before I speak about the findings of UNFPA’s Global Survey on national progress in implementing the ICPD Programme of Action, I would like to explain how today’s discussion is organized. To make it more dynamic, the Special Event is organized in two segments. In the first segment four panelists will speak. After that the floor will be open for discussion for a period of approximately one hour. Following that, in the second segment, the remaining three panelists will speak, after which the floor will once again be open for discussion and dialogue for approximately 45 minutes. We ask that all panelists keep their presentations within 7 minutes so that the maximum time is allowed for dialogue.

As we have heard, Implementing the ICPD Agenda and Achieving the MDGs requires putting people first, because the United Nations is about WE THE PEOPLE. It requires listening to people, investing in people, and ensuring that governments make these critical investments.

A total of 169 countries responded to the Global Survey we conducted last year, and their responses show a depth of commitment over a broad range of population and development issues—despite resource shortfalls and a range of competing priorities and crises. This is quite a record response to questionnaires on the subject, and let me use this opportunity to thank again those countries that have so generously participated in our survey.

I am very proud to launch the Global Survey report on this occasion and pleased to see that you have copies of the report and the summary with you. I am also pleased to inform you that Arabic, French and Spanish versions of the report and the brochure will soon be available. The Survey was conducted to appraise national experiences ten years after Cairo and to better understand the challenges that remain in implementing the ICPD Programme of Action. UNFPA will use the valuable findings to guide our efforts in the years to come.

Comparison of the findings of the 2003 Global Survey with similar exercises we have conducted in 1994 and in 1998 has shown significant progress over the last decade. Most countries have taken measures to address a wide range of population and reproductive health issues. Countries have truly made ICPD their own and have internalized its agenda to various extents in their national policies, strategies and programmes. The Survey was not meant as an evaluation of the measures taken – our aim was to review progress and identify constraints. We concluded our analysis of the findings with a recognition that much has been done over the last decade, but much still remains to be done if we want to achieve the ICPD goals. One key conclusion is the need to build on and scale up the measures taken, so they truly bring their benefits to all.

Population and Development

The Survey reveals that there has been notable progress in integrating population issues—such as age structures, population distribution and movement, and fertility and mortality into development planning and policymaking, including sectoral planning, in poverty reduction strategies and in decentralized planning and programming. For example, 57 per cent of countries reported taking action to integrate population factors into poverty reduction strategies, a steep increase from 1994 when only 13 per cent of countries reported action in this critical area.

Countries are also increasing their action to address migration, including issues such as asylum seekers, migrant workers and human trafficking. However, there is a need to strengthen capacity at the national level for analyses of the causes and consequences of migration to help countries develop comprehensive policies.

Another area where concrete progress has been achieved is in collecting and analyzing population data. Nearly all countries reported action to strengthen national capacity in this area - including for national data systems. However, there is a need to strengthen data collection and analysis for the formulation and monitoring of development policies; and for designing programmes targeted at poverty reduction, especially for vulnerable groups.

Gender Equality, Equity and Empowerment of Women

Since Cairo, gender has played an increasingly prominent role in population and development, and a large percentage of countries reported having addressed gender as a priority concern. The Survey findings shows that most countries have taken legislative, policy, administrative or programmatic measures to protect the rights of women and girls, to remove gender discrimination, to address gender-based violence, to reduce the gender gap in education, and to increase women’s participation in the socio-economic spheres, etc. However, gender is such a pervasive issue, and countries trying to implement the gender component of the ICPD PoA have encountered a number of constraints. Even with efforts to produce gender-disaggregated data, there are still important gaps to understand and monitor gender issues in countries; the concept of gender mainstreaming is still not fully understood, and integrating gender into policies and programme has been fraught with difficulties; the enforcement of laws and the implementation of policies to protect women’s rights remain inadequate.

Reproductive Rights and Reproductive Health

The Survey shows that countries have embraced the idea and the practice of reproductive health, moving to make reproductive rights a reality, to empower women in their reproductive health choices and to encourage male involvement in reproductive health. A large proportion of countries implementing health sector reform have reported including some aspects of reproductive health as part of the package. Significant progress has been made since 1994 with 90 per cent of countries reporting having taken measures to adjust laws, policies or institutions to promote reproductive rights. This is a major step forward. Let me give some examples:

• Over 90 per cent of countries have taken measures to integrate reproductive health into primary health care services
• Almost all countries reported measures to increase access to high quality RH services.
• 87 per cent of countries reported one or more steps to improve RH commodity security.
• Safe motherhood has moved up the policy agenda, with most countries having taken measures to reduce maternal morbidity and mortality.

However, countries stressed the need to correct shortages of trained staff, particularly midwives and for essential obstetric care. While contraceptive use in developing countries has increased 10 per cent in the past 10 years, there is still a serious unmet need with over 120 million women without access to safe and affordable family planning services. And there is a need to make RH services more accessible to the poor and those living in remote areas.

Adolescent Reproductive Health

Since 1994, there has been significant progress in understanding the importance of, and the strategies needed to addressing the rights and reproductive heath of adolescents, and progress has been made in the provision of youth-friendly information and services, with an incremental approach rooted in the socio-cultural context. Progress has been uneven among countries, and in many cases, is reaching only a fraction of the youth. Scaling up efforts and institutionalizing them remain a challenge for the coming years.

HIV/AIDS

One of the biggest challenges to achieving both the ICPD and Millennium Development goals is HIV/AIDS. Action around the world to address HIV/AIDS varies, with some countries following a multi-sectoral approach and other continuing to use a predominantly health-centered approach – however, some countries continue to take little action to halt HIV/AIDS. It is encouraging to see that 74 per cent of countries reported the adoption of a national AIDS strategy, and that many countries have successfully reached-out to groups at highest risks of infection, while striving to meet the needs of adolescents.

But the Survey reveals the need to further strengthen the integration of reproductive health and HIV/AIDS services, to promote a more coordinated multi-sectoral approach and to more fully address the specific needs of women and girls. Overall, there is a need to break the cycle linking poverty and AIDS with interventions to assist the most vulnerable.

The Survey reveals also the need to ensure that the social and cultural environment is taken into account for successful behavioral change communication strategies so that they are more effective, and for ensuring ownership by the community.

Culture and Religion as factors Impacting Programming

Generally, a higher percentage of respondents considered cultural factors as constraints to action in the areas of gender, reproductive health and rights, adolescent reproductive health and HIV/AIDS. Fewer cultural factors were considered contributing to work in these areas. Gender and reproductive health and rights were the two areas generally considered to be more affected by cultural factors than adolescent reproductive health and HIV/AIDS, despite the fact that the latter two areas were considered more controversial.

Religion was also mentioned as a constraining factor as it did not allow the discussion of reproductive rights and health issues among the people, especially to and among adolescents. However, the responses clearly indicated that in countries where religious organizations and leaders were positively involved in reproductive health programmes, including in sensitizing the public, religion was considered a contributing factor. The reasons for this were, among others, that religion encourages abstinence before and monogamous relations during marriage, that religion teaches its constituents to show care for their families and communities and thus can help all people affected by HIV/AIDS.

Partnership and Resources

The Global Survey also shows strengthened partnerships with NGOs and the private sector to implement the ICPD Programme of Action. With regard to resources, over 80 per cent of countries reported that available resources did not meet their countries’ reproductive health needs. To end on a positive note, 82 per cent of developing countries reported taking action to increase domestic spending for population and reproductive health.

The point I would like to stress today is that we do have a real possibility and hope of achieving the MDGs if we build on the progress that has been achieved in implementing the ICPD Programme of Action. The vast majority of countries have put in place laws, policies and strategies, we have built collectively a good knowledge-base, the tools to operationalize the ICPD vision; we have best practices and lessons learned from the 10 year experience since Cairo. The groundwork has been laid. Collectively, we know how to implement Cairo, and we know it works. We now have a historic opportunity to build on this solid foundation to ensure full implementation of the Cairo agenda and the Millennium Development Goals. Putting people first, investing in people – this is the ICPD message and promise. Thank you.