Statement at the 30th Session of the UN Economic Commission for Latin America and the Caribbean - Sessional Ad-Hoc Committee on Population and Development
29 July 2004
29 July 2004
by Thoraya Ahmed Obaid, Executive Director, UNFPA
Mr. President, Honorable Ministers, Distinguished Delegates, Parliamentarians, Representatives from the civil society, and of sister agencies;
Mr. Jose Luis Machinea, Executive Secretary of the Economic Commission for Latin America and the Caribbean;
I would like to start by extending my warm thanks to the people and the Government of Puerto Rico for hosting this very important meeting. I would like to thank the Ad Hoc Committee on Population and Development for its work on the ten-year review of the implementation of the ICPD Programme of Action, which culminated in the Santiago meeting last March.
I would also like to extend my full gratitude and appreciation to the UN Economic Commission for Latin America and the Caribbean. Your unflagging support to the countries of the region in implementing the ICPD Programme of Action, the technical support you have provided, and the lead role you have played in the review process all deserve recognition and high praise. Having come to UNFPA after 23 years of service at the Economic and Social Commission for Western Asia (ESCWA), I am fully aware of the important role that the regional commissions play in providing a multilateral framework for regional integration and cohesion. You have been consistent in your commitment to the Cairo consensus, and in particular in analyzing and incorporating lessons learned during the process to better assist countries in the region as they apply ICPD principles and recommendations to their national development plans and policies. This is the true spirit of partnership that is essential to economic and social development. On behalf of UNFPA, I thank you very much for this true partnership.
Last but certainly not least, I would like to congratulate the countries of Latin America and the Caribbean for your actions and commitment during the past ten years to ensure that the promise of Cairo is more than a paper promise. This commitment is well reflected in the great advances made by many countries in the region in the area of population, in general, and in reproductive health and reproductive rights, in particular.
I would also like to acknowledge the strong partnership with civil society which was so very essential in building the consensus in Cairo and, throughout the last decade, in ensuring that the Cairo agenda is implemented at the grass-roots level. I would also like to underline the key role of Parliamentarians, both as legislators and as a bridge between the people and the government, as well as the unique and crucial function of the Ombudsman offices in the region, which demonstrate the strength of democracy and the importance given to protecting people’s rights.
The Cairo consensus is a remarkable agreement. At its heart are the concepts of gender equality, sexual and reproductive health, and reproductive rights. It is a landmark agreement that has moved population policies away from a demographic approach focusing on human numbers to a people-centered approach focusing on human rights. For the first time, and this is what makes the Cairo agreement truly visionary, there is an acknowledgement – indeed a conviction - that women’s health, rights, and empowerment must be at the centre of population and development policies, if those policies are to succeed. And Cairo was a landmark meeting at which 179 governments agreed on a comprehensive set of actions to ensure universal access to reproductive health information and services, uphold fundamental human rights, reduce poverty, secure gender equality, protect the environment, and strengthen the institutions of democracy.
There has been strong support for the ICPD Programme of Action from all quarters, reaching across the political spectrum, and across countries and communities and diverse cultures and religions. This support proves that the long and painstaking negotiations that led to the Cairo agreement are bearing fruit.
The true strength of the Cairo agreement, and the one that has been echoed loudly and clearly from Bangkok to Dakar, and from Geneva to Port-of-Spain and Santiago, is its balance and its breadth. The Cairo agenda is an agenda for all of us. It is an agenda that strengthens families, communities and nations. And it is an agenda that enables people to take charge of their own lives, and to participate fully in, and achieve, sustainable human development. But the one point I would like to emphasize here is that the Programme of Action is the blueprint for action in just about all countries. It is their Programme of Action, and they will implement it as they think best to meet their national development goals.
Another important step came five years later, when the overwhelming majority of countries in the world, including those of Latin America and the Caribbean, reaffirmed their commitment to the goals and principles of Cairo, and agreed on a set of Key Actions to further the implementation of the ICPD Programme of Action. At the five-year review in 1999, in response to emerging challenges, there was an increased emphasis placed on HIV/AIDS and also on adolescent reproductive health.
ICPD at Ten: Global Survey on the implementation of the ICPD Programme of Action
Today, we find ourselves at the halfway mark in the implementation of the 20-year ICPD Programme of Action. To assist in the ten-year review process and to help guide our efforts in the next 10 years, UNFPA conducted a Global Survey. The findings of the Global Survey are contained in a report, entitled Investing in People, which I launched in Geneva last week at the meeting of our Executive Board – and which will soon be available in Spanish. A total of 169 countries responded to the Global Survey, which, by any measure demonstrates real commitment to, and national ownership of, the Programme of Action by all of you. It is my pleasure to congratulate you on the impressive response rate from this region - 100 percent.
The survey shows great progress and a depth of commitment over a broad range of population and development issues - despite resource shortfalls and a range of competing priorities and crises. 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. They are broadening their programmes to reach more people in need of services and integrating family planning with other services. And the vast majority of countries are adjusting their laws, policies or institutions to promote reproductive rights.
All these represent a major step forward, but there is still a serious unmet need for reproductive health services, and a need to make these services more accessible to the poor.
Much has also been done in the area of reproductive health of young people, which has emerged as a priority issue in the last 10 years. Most countries have taken action to provide adolescents and youth with age-appropriate youth-friendly reproductive health information and services. However, 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.
One of the biggest challenges to achieving both the ICPD and Millennium Development goals is HIV/AIDS. While most countries reported the adoption of a national AIDS strategy, the survey reveals the need to develop and strengthen integration of reproductive health and HIV/AIDS services. Indeed, the stronger the linkages between HIV/AIDS and sexual and reproductive health, the more relevant and cost-effective programmes will be. They will also have greater impact.
The survey also shows that countries are making notable progress in integrating population issues -- such as age structures, population distribution and movement, fertility and mortality -- into development planning and policymaking. This is so very important because to make people count, you must count people - and find out more about their situations in order to fashion effective and responsive development strategies.
The Global Survey further reveals that partnerships with NGOs, parliamentarians and the private sector have deepened and broadened since Cairo. With regard to resources, about four fifths of countries have increased their domestic budgets and mobilized increased international financial assistance for population and reproductive health. However, the overwhelming majority of countries still reported the lack of resources as a major constraint in implementing the ICPD Programme of Action.
ICPD in Latin America and the Caribbean
In words and in deeds, the Latin America and Caribbean region has made unprecedented progress in key areas of the ICPD Programme of Action. The countries of the region have effectively integrated Cairo and Cairo+5 into national development strategies and poverty reduction policies; they have recognized reproductive rights and have tried to promote them in their own programmes; they have provided reproductive health services, including those for adolescents and young people; and they have developed strategies to respond to the HIV/AIDS epidemic and to combat violence against women.
But two issues in particular have inhibited the extent of this progress and pose serious challenges for the future in the region. I refer here to widespread poverty and inequality – both of which require greater political commitment and financial support than ever before. Unless these issues - and the challenges presented by a large youth population and a growing number of older persons - are tackled with leadership and vision, there is a danger that the gains achieved so far may never reach the poor, or may well be reversed. Indeed, Latin America and the Caribbean is particularly vulnerable in this regard, as it has one of the most inequitable income distributions of all the regions of the world. As a result, a sizable part of the population of this region - considered a region of middle development - does not have access to basic necessities such as water and sanitation, and does not have access to basic services such as education and health, including reproductive health.
This poverty and inequality is a major concern for all of us in this room. It is also a threat to democracy, which is both fragile and vulnerable, and there cannot be true democracy if there is not true equality. And if there is no true equality, there cannot be true human rights. This means that efforts to reduce poverty must go hand in hand with efforts to increase respect for human rights, and to engage the community of people and the socially excluded in the solution of their problems and in their search for a better life. It also means that we must guarantee their rights as citizens, their right to development, their right to education and health, and their reproductive rights. To do less would seriously impede economic and social development and undermine the very nature of democracy itself.
Millennium Development Goals
As we know, world leaders at the Millennium Summit identified poverty and issues related to inequality as the most critical issues in the development agenda as we try to establish a more secure and sustainable world in the 21st century.
The first millennium development goal is to reduce extreme poverty by half by the year 2015. Other goals focus on ensuring that the thousands and thousands of girls and boys who are excluded from school can attend class, that gender disparities related to education are reduced and ultimately eliminated, that we halve the maternal mortality rate and that we stem the HIV/AIDS epidemic and its expansion.
The goals of Cairo and the Millennium Development Goals reflect and reinforce one another. Indeed, it is now widely recognized that the Millennium Development Goals cannot be achieved without achieving the ICPD goal of universal access to reproductive health services. Moreover, progress in areas of population and reproductive health is absolutely indispensable in achieving at least four of the MDGs: promoting gender equality and empowering women; reducing child mortality; improving maternal health; and combating HIV/AIDS.
The ICPD Programme of Action - with its focus on education and health and empowerment - represents an effective and practical strategy to achieve the MDGs. And the good news is that the policy and legal framework to do so has been partially put in place during the past ten years of ICPD implementation, as the Global Survey shows. The challenge now is to build on this solid foundation to ensure greater progress in the decade ahead as we set our sights on the year 2015.
I am absolutely convinced that providing universal access to sexual and reproductive health, as well as access to education and employment, can effectively break the cycle of poverty in which millions and millions of women, men and adolescents are trapped in this region. Enabling people to make their own decisions about if, and when, to have children and how often, ensuring that women enjoy the same rights as men, and ensuring that people can live their lives free of violence and sexual coercion are not only fundamental human rights, they are also critical elements in policies to reduce poverty.
Today we know that HIV/AIDS is driven by poverty and inequality. Central America is one of the regions of the world with the highest and fastest growing infection rates. The Caribbean has the second highest prevalence of HIV infection in the world, second only to sub-Saharan Africa. Sadly, the most affected group is young people, in particular young women. Young women in the Caribbean are two-and-a-half times more likely to be infected than young men are. Therefore it is critical and urgent that countries, working hand in hand with people living with AIDS, ensure universal access to prevention, voluntary counseling and testing, and treatment in the context of sexual and reproductive health. It is also essential that these initiatives address gender discrimination and violence.
The young people of this region are a positive and vital force for a prosperous future, and that is why investing in their health and well-being is so vitally important. As leaders, it is our duty and moral responsibility to talk openly and honestly about the issues that affect them, including preventing HIV/AIDS - about delaying sexual activity and about using condoms. I know these are sensitive and difficult issues to discuss. But if a woman like me from Saudi Arabia can talk about them, certainly you can to. And you simply must, if we are to stand a chance in reversing the epidemic and saving literally millions of lives. And let us remember this is not a fight against people living with AIDS; it is a fight against HIV/AIDS itself. Those living with HIV/AIDS have wisdom and experience to share and they should be viewed as part of the solution, not part of the problem. Stigma and discrimination only help the virus to spread.
Adolescents and young people need access to the necessary information and services that will allow them to act responsibly and to protect themselves. The success achieved in Uganda, Thailand and Brazil, among other countries, in reducing the spread of HIV/AIDS is due to a comprehensive, scientific-based response that addresses the needs and realities of people.
There are different points of view about the most effective way to ensure that adolescents and youth have access to information and services to lead healthy lives. The main point is that young people need education, information, counseling and reproductive health services to protect themselves from unwanted pregnancy, HIV/AIDS and other sexually transmitted infections. Evidence proves that when young people are given the necessary and appropriate information and counseling, they make mature and responsible decisions about their reproductive health and rights. UNFPA believes that one of the most effective strategies is through a comprehensive approach that promotes gender equality, self-esteem, empowerment and youth participation.
As the biggest generation of adolescents and young people enters their productive and reproductive lives, we must acknowledge that they need our support. Adolescents and young people need, and want, the support of adults in all aspects of their development, in their access to education and employment, in their relationships, and in practically all questions related to their lives. The challenge of young people is to make this world a better, more just and healthier place. And our challenge is to work with them and support them in doing so. Whenever I meet with youth, they tell me that they want us adults to see them as part of the solution and not as THE problem. And I agree with them -- they are, indeed, part of the solution.
At the same time, greater attention must be paid to the growing elderly population and to their social security. Indigenous populations and afro-descendants should also be the focus of our efforts for the achievement of the MDGs. Another vital issue is migration, both within national borders and beyond. Together, we must ensure that through such instruments as the International Convention for the Protection of Human Rights of Migrant Workers and their Families, policies and laws recognize the rights of migrants and their families, and the benefits of labor migration, as well as protect people against exploitation and human trafficking.
As Ministers and senior officials, you are uniquely placed to offer leadership in all the matters I have mentioned. You can set priorities and budgets, build partnerships and strengthen efforts to empower people to help themselves. Your governments participated in the consensus reached in Cairo and the ICPD+5. And only you know how best to implement the ICPD effectively within the context of your own national laws, communities and culture. We at UNFPA stand by you every step of the way.
Today, and in future, let us build on the solid foundation that has been laid during the past 10 years and in particular over the past months in the lead-up to this regional meeting. Let us build on the groundwork that has been put in place in Port-of-Spain and Santiago. The Santiago consensus truly reflects the commitment of the people and governments of this region to decrease poverty and rampant inequalities, and to strengthen democracy. It recognizes that poverty will only be reduced and democracy will only be consolidated if people can exercise their rights, and if women are empowered so they can contribute to their societies as equal citizens, hand in hand with men.
In Santiago, countries have committed to ensure the right of people to freely make one of the most fundamental decisions in life: the decision of whether, when and how many children to have, a cornerstone of the Cairo Programme of Action.
The Santiago Declaration calls for strengthening efforts to accelerate the reduction of maternal mortality and its contributing factors. A critical part of this is giving women the best chance possible to give birth to a healthy infant in a healthy manner.
And Santiago strongly reflects the commitment of all countries in the region to protect the rights of youth to sexual and reproductive health information and services. It is for all these reasons that it is essential that the Santiago Declaration be fully endorsed at this meeting as an important guide in implementing the ICPD Programme of Action during the next ten years in the Latin American and Caribbean region.
As we complete our 10 year review process of the implementation of the ICPD Programme of Action, we must remain as committed and energized as we start commemorating the 10th anniversary of Beijing. The outcome of the recent Regional Conference on Women, the Mexico Consensus, will guide our actions in the coming years and will contribute to the achievement of both the Beijing and Cairo goals, as well as of the MDGs.
Let us all go forward and never forget for whom we work. Let us try to support and assist all of the people in our respective countries as if they were members of our family, because they truly are. Human rights have been in the hearts and minds of many people throughout history. But we can feel proud to belong to the first generation that dared to imagine a world where all people enjoy their human rights, and to take action to help make it happen.