Statement of the Executive Director to the Annual Session of the Executive Board 2023

Check against delivery

Good morning. Buenos dias. We have prepared a brief video that illustrates in just a few frames the life-and-death circumstances in which far too many women and adolescent girls around the world find themselves. Let us view it now. I hope this helps us see why midwives are so essential.

Mr. President,
Distinguished Members of the Executive Board,
Colleagues and friends,

What a pleasure to be here with you for this Annual Session of the Executive Board. We welcome Ambassador Önal of Türkiye to his first formal session as Vice-President.

In this world of conflict and crisis, somewhere, a woman in labour is hiding in a makeshift shelter to avoid rocket fire. Will she and her baby survive? Will the midwife make it to her in time?

Unfortunately, too often the answer is no. UNFPA and our United Nations partners’ latest maternal mortality estimates confirm this. Indeed, decades of progress in preventing maternal deaths – after Covid, because of conflict, with encroaching climate disasters – have ground to a screeching halt. 

In the year 2020, an estimated 287,000 women died during pregnancy, childbirth or the aftermath, according to our new data: that’s one woman dying every two minutes.

Yet, I chose an opening video that tells a story of resilience, of tenacity and of courage amidst challenge. We need such stories of hope.

Countless midwives across the globe demonstrate these traits each and every day. They accompany women as new life is brought into the world. Midwives support mothers and their newborns when they are most vulnerable. They are often the only healthcare workers serving in hard-to-reach places. Midwives are vital partners in UNFPA’s push to reach the last mile and leave no woman or girl behind. Training and support to midwives is at the heart of UNFPA’s Maternal Health Thematic Fund.

That story of hope and persistence is the story of UNFPA, standing with midwives and the women, girls and communities they serve. In just a few days, I will join thousands of proud midwives in Bali, Indonesia, as I participate in the opening of the International Confederation of Midwives Triennial Congress. I gladly journey there to express UNFPA’s solidarity and commitment to expanding the world’s midwifery workforce.

Midwives form the backbone of community-based sexual and reproductive health care. This is one of the most cost-effective ways to end preventable maternal deaths. That’s why we work with partners to address the global shortage of almost a million midwives. If UNFPA succeeds, midwives could help prevent two thirds of maternal and newborn deaths. This is one investment the world cannot afford to miss.

Bear in mind, unintended pregnancy is another critical factor in deaths during pregnancy, if the mother is too young, if she experiences complications or if she resorts to unsafe abortion. UNFPA research shows that nearly half of all pregnancies are unintended and that unsafe abortion is a leading cause of maternal death.

Let us never forget that many of those who die in childbirth are not women at all – they are girls, some as young as 10 to 14 years old. Half a million births each year take place among girls so young they might not even realize they can get pregnant. Girls too young to consent to sex; girls married off or abused, or both.

Ignorance is not innocence – too often, it becomes a death sentence. One that could have been prevented with timely access to quality sexual and reproductive health information and services.

The effort required to tackle maternal deaths is no mystery. Health sector workers and policymakers know what to do: increase access to a range of quality contraceptives of the woman’s choice, improve comprehensive sexuality education for young people to avoid early pregnancy, and protect a woman’s right to decide whether, when, how often and with whom to have children. Rights and choices.

We know this saves and transforms lives. Yet sexual and reproductive health and rights somehow continually face intense political pushback. 

Fortunately, there is also tremendous commitment to keep pushing forward together – on comprehensive sexuality education and on the full range of rights and choices.  We urge Member States and all other partners to seize opportunities for dialogue; to seek consensus, through the ICPD30 process and other intergovernmental arenas, including the High-Level Political Forum, the upcoming SDG Summit, next year’s Commission on Population and Development, and the Summit of the Future. With the stakes so high, women’s rights and choices are something we should all agree on.

A commitment to accelerate progress and keep pushing forward, whatever the challenges, is at the heart of our strategic plan adopted by this Executive Board. It is reflected in our commitment to work within and beyond the United Nations to step up progress, and it is essential if we are to achieve the Sustainable Development Goals and fulfil the ICPD Programme of Action.

I am proud of the results we achieved with your support and guidance in 2022, as outlined in my annual report. 

Last year, UNFPA helped avert more than 13.3 million unintended pregnancies and 3.7 million unsafe abortions.

We assisted 1.4 million safe deliveries in 39 humanitarian-affected countries and trained around 80,000 midwives globally.

More than 111,000 girls were saved from female genital mutilation and over 15,000 women and girls received treatment for obstetric fistula.

The UNFPA Supplies Partnership continues to show excellent results and is such a tremendous investment.  In 2022, contraceptives provided through the UNFPA Supplies programme, worth approximately US$123 million, saved countries and families an estimated US$508 million in reduced care for pregnancy, delivery and post-abortion care.

Beyond these global figures are the results at country level.

In Cabo Verde, 75 per cent of health and education professionals and police were trained in gender-based violence prevention and response.

In Bolivia, the teenage pregnancy rate fell by half between 2018 and 2022.

In UNFPA-supported districts in Bangladesh, contraceptive stock-outs were virtually eliminated.

In China, the number of women screened for cervical cancer doubled in one hospital, due to improved service provider capacity and proactive health promotion.

The list goes on.

Yet, I would be remiss in not stressing that in far too many places sustainable development is endangered, rights appear to be in retreat, and peace in peril.

The impacts of COVID, conflict, climate change, economic and geopolitical setbacks, and proliferating humanitarian crises have made our path to 2030 steeper.

At UNFPA, we know our goals. In the over 130 countries where we work, we remain focused on our normative work and targeting those subjected to multiple, intersecting forms of discrimination, including people of African descent, indigenous populations, people with disabilities, refugees and people on the move.

Last week, I was pleased to address the second session of the Permanent Forum on People of African Descent here in New York and to renew UNFPA’s commitment to advancing the Afro-descendant agenda.

I take this opportunity to assert that UNFPA will continue to proudly uphold the human rights of LGBTQI+ and gender-diverse people. We recently welcomed our latest staff-led group, Pride@UNFPA. They join the youthful Tangerines, Women@UNFPA and our efforts in policy and action to strengthen disability inclusion – all reflective of our push to create a workplace culture of openness, trust and mutual respect.

We are scaling up innovations, such as the use of telemedicine and digital platforms for services, and we are investing in women innovators to address challenges in maternal health, family planning, menstruation and gender-based violence.

UNFPA is leading the way in bringing the issue of technology-facilitated gender-based violence into the spotlight, including in Silicon Valley.

In Argentina, we integrated technology-facilitated GBV into the comprehensive sexuality education curriculum to ensure that young people are digitally literate, can protect themselves online and claim their #bodyright.

Through our Equity 2030 Alliance, we work with a broad range of partners to close the gender gap in science, technology and finance so that the needs of women and girls are integrated into the design of health solutions right from the beginning. For too long, men – in particular, adult white men – have been the default reference population in research and studies, ultimately resulting in a worse standard of care for women.

In all of this work, we endeavour to hold ourselves to the highest standards of transparency, accountability and oversight, and we know that the tone at the top is critical. We continue to reinforce measures for protection from sexual exploitation and abuse and sexual harassment, prioritizing the rights and dignity of victims and survivors, and ensuring that offenders are held accountable. It’s why we have made important investments in our oversight offices. This includes supporting the strengthening of the independence of the Office of Audit and Investigation Services (OAIS) by providing adequate resources within the approved budget. 

And I am pleased to report that management and OAIS have agreed on final revisions to the OAIS Charter, which will be implemented shortly.

UNFPA entities, including our independent functions, have created a UNFPA integrity group. It brings together different offices to enhance accountability and transparency. We are instituting new tools, training and guidance to support the effective implementation of our Enterprise Risk Management (ERM) policy. We are enhancing how we ensure compliance with recommendations from independent oversight bodies. All of this is with a view to strengthening our speak-up culture and ensuring we remain effective and efficient custodians of public resources that deliver lifesaving results for women and girls.

I am therefore pleased to report that UNFPA achieved a 91% implementation rate for internal audit recommendations due by year-end 2022. Furthermore, no recommendations older than 18 months are outstanding. I aim to assure that UNFPA will maintain this strong implementation rate this year and beyond.

We know that UNFPA needs to remain adaptive and open, as always, to improvement. In this regard, we welcome the Joint Inspection Unit review of management and administration in UNFPA.  There will be a separate presentation of the report and management response later today.

As you know, Quantum, the new Enterprise Resource Planning (ERP) system, went live in January 2023. I am happy to report that, after a brief period of increased support, the system is now stable and operating as planned. Our focus now will be on the remaining modules and continued improvements to ensure that we will benefit from the system for years to come. In particular, this year the UNFPA module for more streamlined results planning and monitoring will be updated.

The Quantum ERP was the principal component of our ICT transformation project, approved by the Board, which has a total planned cost of US$39 million, of which US$31 million was expended by the end of 2022. Full separate disclosure of the project is included in our statutory Financial Statements currently being audited by the United Nations Board of Auditors.

Evaluation continues to provide important insight into our activities on the ground – what works, what we need to do better and how.

 UNFPA welcomes the 2022 Annual Report on evaluation. We commend the use of innovative evaluative approaches, including the launch of a feasibility study to leverage Artificial Intelligence. And we look forward to the outcomes and recommendations of the ongoing peer review of the evaluation function.

We also welcome the two recent centralized evaluations before the Board. The formative evaluation of UNFPA support to population dynamics and data is the first on this theme in the organization, and it includes a specific focus on the demographic dividend and population ageing and low fertility.

The formative evaluation of UNFPA support to adolescents and youth acknowledges the holistic approach of our adolescents and youth strategy – “My Body, My Life, My World” – and will help us enhance this work. Of particular note, a Youth Steering Committee worked alongside the senior evaluation team – an intergenerational partnership to increase the voice and agency of youth evaluators, as advisors, decision makers, and key contributors of evidence and insight.

The evaluations recognize UNFPA’s forward-looking thought leadership on important global agendas and will help inform the midterm review of our Strategic Plan.

Mr. President,

In the lead-up to ICPD30 next year, UNFPA is linking wherever we can – with the rest of the UN, governments, the private sector, women-led groups, youth groups, religious groups, parliamentarians and civil society. We encourage Member States to support national, regional and global initiatives related to the ICPD Review – including national consultations, regional population conferences and the three global dialogues – on youth, demographic diversity and the impact of technology on the ICPD agenda.

The ICPD base is expanding with new alliances and vocal partners. The ICPD30 review provides an opportunity to reflect on past achievements, take stock of challenges, reduce polarization and misinformation and chart a course for the future.

UNFPA continues to build a case for rights and choices, and we rely on data and evidence to guide this work and everything we do.

Our recent State of World Population report, titled 8 Billion Lives, Infinite Possibilities – The case for rights and choices, shows that world population is radically shifting. At 8 billion, our human family is now larger than ever before, and the world more demographically diverse.

Two-thirds of people live in a place with below-replacement fertility. Others live in countries experiencing vigorous population growth.

Everyone wants to know what all of this means, and without a clear answer, there is a serious risk that human rights, and particularly reproductive rights, could be undermined. We must not allow women’s bodies to be held captive to population targets.

Mr. President,

Turning now to UNFPA humanitarian action – more important than ever in a world beset by conflict, crisis and rising humanitarian need, I am reminded of these lines by the Somali-British poet Warsan Shire from her poem “What they did yesterday afternoon”.

later that night
i held an atlas in my lap
ran my fingers across the whole world
and whispered
where does it hurt?

it answered
everywhere
everywhere
everywhere.

This time last year, 274 million people needed humanitarian assistance -- a 17% rise from the previous year. For 2023, that number has grown yet again, to 339 million people in need. This is a very alarming trend that affects women and girls disproportionately. They are already the hardest hit by poverty and hunger and are the most vulnerable to sexual and gender-based violence, especially during conflicts.

To reach our three zeros – zero unmet need for family planning, zero preventable maternal deaths and zero gender-based violence and harmful practices, we must continue to deliver, and deliver well, in humanitarian settings.

In April, the humanitarian Inter-Agency Standing Committee (IASC) declared a system-wide scale-up for Haiti, where much of the capital of Port-au-Prince is under control of armed gangs, and over 40% of the population need humanitarian assistance and protection.

UNFPA is one of very few agencies still able to operate in Haiti’s gang territories, because we apply a community-based approach, which builds the acceptance that protects us. With gender-based violence response identified as a top priority, UNFPA is focusing on scale-up of lifesaving sexual and reproductive health and gender-based violence services.

In Sudan, hopes for peace and stability hang by a thread as the country slips towards humanitarian catastrophe. More than a million people have been displaced, exposing women and girls to increased risk of gender-based violence. Sudan already had one of the world’s highest maternal mortality rates before the fighting broke out. Now, over 90,000 women are expected to give birth during the next three months.

A BBC report earlier this week showed just how dire the situation is in the few maternity wards that remain open: health providers working around the clock, often without anaesthesia and other resources. Caesarean sections being performed with only a few mobile phones to illuminate the area of operation.

In Sudan, UNFPA works with a network of over 400 local midwives to provide safe deliveries. We’ve distributed 10 metric tons of lifesaving supplies, and we are providing fuel to maternity hospitals in Khartoum so that services remain available during frequent electricity black-outs. Let me emphasize that health facilities should never be a target. Health workers should never be a target. UNFPA stands in solidarity with our partners and with health workers in insisting that humanitarian law must be respected.

In Afghanistan, the erosion of women’s rights, including the recent ban on women working with the United Nations, is deeply disturbing, complicating the delivery of lifesaving assistance. Yet, UNFPA continues to deliver.

Last month in Geneva, UNFPA joined IASC Principals in assessing the operational challenges and the collective action required to strengthen operations in Sudan, Syria, Haiti, Burkina Faso, Afghanistan, and Myanmar. We committed to strengthening collective advocacy, localization, preparedness, and protection, and to address the big funding gaps.

In Ukraine and elsewhere, UNFPA and our humanitarian partners are on the frontlines, delivering a response that is relevant to the needs identified by the affected communities themselves.  Yet, what they need above all is peace.

We know that in many cases, were it not for UNFPA, no one would be there to raise the alarm about the dire plight of women and girls, nor to look after their sexual and reproductive health and rights.

With needs far outstripping the resources available, we also know that we need to think and work differently – to focus on prevention and build resilience, so that humanitarian interventions lay the groundwork for development. We also know we need to partner like never before.

We are very grateful for the increase in humanitarian funding, even as we remain concerned about the funding outlook for 2023 and beyond.  I appeal to Member States for your continued support, especially for core resources but also more flexible other resources.

We have closed the books for 2022, and we note with appreciation that UNFPA mobilized a total of US$1.55 billion in overall resources, well above the Strategic Plan revenue target, including US$442.5 million in core funding. Cofinancing reached US$1.1 billion, with an increased share of 42% received for our humanitarian work.

We urge Member States to prioritize long-term, predictable funding and financing for sexual and reproductive health and rights, including both targeted official development assistance and increased domestic resources.

Data and evidence consistently show that these are investments with huge returns – for the individual, for economies and for societies.

UNFPA is working to use our own funding and expertise to leverage significant, broader financing across a range of actors and financing instruments – domestic, and international, public, and private.

I just returned from Kazakhstan, where UNFPA, in partnership with the Government and with funding from the World Bank, supported the development of a regulatory framework to ensure the sustainability of a network of youth-friendly health centres.

A key result of the project was the Government’s decision to lower the age of consent to receive outpatient services to 16 years of age. In Almaty, I met with a group of young people at one centre who spoke enthusiastically about the difference the services, information and support provided make in their lives.

The Government has now expanded the programme across the entire country with a sustainable budget of around 12 million USD per year.

Another quick example of funding-to-financing innovation is a new agreement of nearly US$10 million with the Government of Angola for UNFPA to support a World Bank project to improve access to health services and information for adolescents and youth, through partnerships with civil society organizations.

I share these examples to assure the Executive Board that UNFPA is working hard to address financing gaps. However, as important as these initiatives are, they cannot replace core resources. Core resources are irreplaceable.

Mr. President,

At the end of June, we say goodbye to two esteemed, long-standing UNFPA leaders: Ms. Argentina Matavel Piccin, Regional Director for West and Central Africa, and Mr. Mabingue Ngom, Senior Advisor to the Executive Director and Director of UNFPA Representation Office to the African Union, and previously, Regional Director for West and Central Africa and Director of the UNFPA Programme Division. I want thank Argentina and Mabingue. Your dedication to advancing the ICPD mandate throughout your distinguished careers has made a difference to millions of women and girls around the world. I also welcome Mr. Sennen Hounton as the new Regional Director for West and Central Africa, bringing extensive programmatic and technical experience to the role. We look forward to Sennen’s contributions.

Finally, in keeping with our commitment to bring voices from the field to you in New York, with your permission, I am now pleased to turn the floor over to Ms. Lydia Zigomo, Regional Director for East and Southern Africa, to update you on UNFPA activities there.

Thank you, Lydia, for your leadership and for the important work the ESARO team is doing. I’d also like to acknowledge the hard work of my leadership team – our deputies and directors and representatives around the world – and indeed of our staff. These are dedicated individuals who every single day live up to the expectations of our mandate. I am very grateful to them all.

Mr. President, Distinguished Members of the Executive Board,

In the nearly thirty years since the Cairo International Conference on Population and Development, with its groundbreaking Programme of Action, together we have made significant progress in advancing reproductive health and rights. Yet, we are still far from the finish line. The 10-year-old girls of the world are still waiting…. They are waiting for us to put aside our differences, find common ground, exercise joint leadership and help them. They want to finish their education, stay healthy, avoid the calamity of unintended pregnancy, and they want us to help them reach their infinite potential.

That 10-year-old girl is real. She and millions just like her keep UNFPA committed and focused. We focus on her rights, her choices, her bright future of unlimited horizons.

Thank you.