POPULATION CONCERNS NOW INTEGRATED INTO OVERALL SOCIAL DEVELOPMENT POLICY CUBA TELLS COMMISSION ON POPULATION AND DEVELOPMENT

25 March 1999

Press Release
POP/716

POPULATION CONCERNS NOW INTEGRATED INTO OVERALL SOCIAL DEVELOPMENT POLICY CUBA TELLS COMMISSION ON POPULATION AND DEVELOPMENT

19990325 Commission Acting as Preparatory Body For General Assembly Special Session to Review Results of 1994 Cairo Conference

The Cairo Conference had changed the isolated manner in which countries once dealt with population policies, and propelled their integration into each country's overall social and development policies, the Commission on Population and Development was told this morning, as it continued preparations for the special session of the General Assembly that will review implementation of the action plan of the International Conference on Population and Development (Cairo, 1994).

Addressing the 47-member Commission, which is acting as the preparatory body for the special session, the representative of Cuba said that although his country did not have a specific population policy, it had included various population goals into an integrated development strategy. That strategy sought to guarantee employment for all, include women in the economic and social life of the country on an equal basis, and provide free access to education and health services. The present review process should produce new ideas and transform aspirations into reality.

The Chief of the Population Programme Service, Food and Agriculture Organization (FAO), said that today's population challenges had less to do with isolated problems than with how societies would organize themselves to cope with the multifaceted transformation processes under way. Countries should anticipate demographic change and incorporate those factors into their development strategies. Single-sectoral approaches to development should be replaced by more integrated, multi-sectoral efforts.

The representative of the Russian Federation said that, like many other transition economies, her country was facing great problems in drafting a population policy. Those difficulties had been exacerbated by the financial crisis that hit Russia last summer. Despite the obstacles, her Government was

Population Preparatory Committee - 1a - Press Release POP/716 3rd Meeting (AM) 25 March 1999

doing everything possible to lift the country out of its demographic crisis. It was tackling problems concerning women, children, and the elderly. Infant mortality rates had stabilized, the number of abortions had been reduced by one-third, and abortion-related maternal mortality had been reduced by 20 per cent.

Also this morning the Commission Chairman, Anwarul Chowdhury (Bangladesh), said he mistakenly announced yesterday that the Commission's Vice-Chairman from Uganda would be Jotham Musinguzi. Instead, the Vice-Chairman from Uganda would be the Permanent Representative, Matia Mulumba Semakula Kiwanuka.

Statements were also made by the representatives of Norway, Mexico, Venezuela, Philippines, Malaysia, Madagascar, France, Azerbaijan, Côte d'Ivoire and Thailand.

The Commission will meet again at 3 p.m. today to continue its preparations for the special session of the General Assembly on implementation of the Cairo Programme of Action.

Commission Work Programme

The Commission on Population and Development met this morning to continue its session as the preparatory committee for the special session of the General Assembly for reviewing implementation of the Programme of Action of the International Conference on Population and Development (Cairo, 1994). (For background information see Press Release POP/709 of 18 March.)

Statements

INGE NORDANG (Norway) said that insufficient financial and human resources continued to be an important obstacle. Donor countries, as well as developing countries, must live up to their commitment from Cairo. Norway had for nearly two decades fulfilled the official development assistance (ODA) target and has also given priority to population and reproductive health. The international community needed to ensure that resources were well targeted, especially given the large gap between the estimated need suggested in Cairo and actual funding levels that had now been reached. Giving priority to the poorest countries and poorest members of societies was of special importance for reproductive health, since reproductive health problems were so inequitably distributed.

He added that the vulnerability of adolescence was shown clearly in the figures on high-risk teenage pregnancies and the prevalence of sexually transmitted diseases among young people. General health services must be made more "youth friendly". Young people, parents and the community must be involved in the design, monitoring and evaluation of health care systems. Figures for maternal mortality showed the widest gap between regions. The low priority given to the provision of the necessary health care for women to survive their pregnancies reflected the low value often accorded to women and the invisibility of their contribution to society. The cost to society of maternal morbidity and mortality must be examined.

RODOLFO TUIRAN (Mexico) confirmed his Government's commitment to implementing the goals of the Cairo Programme of Action. That pledge was reflected in practice by its decision to incorporate those objectives into national population programmes. Following the Cairo Conference, the Mexican Government implemented a national programme against domestic violence. The new perspectives opened up by the Cairo Action Programme had encouraged his country to adopt a new approach to the relationship between population and development. It sought to mobilize resources and integrate diverse perspectives.

He said his country's population policy was the product of an autonomous decision, which was profoundly humanistic and governed by the principle of respect for the freedoms and rights of its people. That policy had managed to maintain a high degree of continuity and enjoyed an increasingly broad

Population Preparatory Committee - 3 - Press Release POP/716 3rd Meeting (AM) 25 March 1999

consensus. The policy highlighted the importance of reproductive health and, in that regard, it sought to guarantee universal access to a broad range of quality health services, with the emphasis on free choice. Profound changes had also taken place in the institutional, legal and administrative structures of the health sector, but much remained to be done.

The challenges were complex and far-reaching, and those needed to be faced decisively, he said. Efforts should be redoubled to ensure the high quality and technical competence of medical personnel and to strengthen coordination of reproductive health programmes with broader strategies encompassing social development and the eradication of poverty. The highest priority concerned adolescent care, particularly their reproductive health. Ignorance and lack of protection were a "death sentence", and adolescents, their parents and teachers, therefore, should lead a real crusade to provide information guidance to ensure their necessary health protection. It was essential to meet the demand for contraceptives, in order to guarantee the right to make reproductive health decisions.

JACQUES DU GUERNY, Chief of the Population Programme Service, Food and Agriculture Organization (FAO), said the international community needed to start looking at issues that so far had received insufficient attention, but had serious long-term implications and thus required immediate action. Today's population challenges had less to do with isolated problems than with how societies would organize themselves to cope with the multifaceted process of the transformation they were undergoing. To achieve that objective, countries needed to better comprehend their population situation, develop greater sensitivity to expected demographic changes, understand the needs of society, and implement solutions around those needs.

He said that policies to accelerate development, including programmes to improve reproductive health and to combat AIDS, could greatly benefit from taking the complexity of demographic factors into account. The ambitious ideas of Cairo would be better served if single-sectoral approaches in developmental strategies were replaced by more integrated, multi-sectoral efforts. Only by doing that could effective solutions be developed. The issue of improving the well-being of human population necessitated close collaboration on many different levels.

ANNA ELISA OSORIO (Venezuela) said her country was committed to the goals of the Cairo Conference. It had worked to reduce maternal mortality, to care for the welfare of children, and provide equal access to basic education and health services for all. The economic crisis in her country, which started in the 1980s, had caused a reduction in social investment and a deterioration in the quality of education and health programmes. Child and maternal mortality had increased and children continued to leave schools early. Another problem was the increase in the number of children that were born to adolescents. Public policies had adjusted to address those problems

Population Preparatory Committee - 4 - Press Release POP/716 3rd Meeting (AM) 25 March 1999

and they were focused on sustainable development. However, foreign debt servicing placed a large burden on social programmes and continued to take up a substantial amount of the annual budget.

Despite Venezuela's complicated situation, she said, there had been opportunities to approve laws that protected marginalized groups. There was a law to prohibit violence against women, as well as laws protecting them from discrimination. Reproductive health and sexual education were also priorities in national education policies. Her county had taken an integrated approach to health care and was attempting to increase the quality of health care to ensure a gender perspective, which included giving poor women access to health care. Her country was also providing for the active participation of adolescents in activities to promote sexual and reproductive health.

RAUL TALADRID SUAREZ (Cuba) said his delegation fully supported the statement made by the representative of Guyana, on behalf of the "Group of 77" developing countries and China. The Cairo Conference had left behind isolated population policies, and propelled their integration into the country's social and development policies. Now, five years later, the momentum must not be lost. Thus, an analysis of progress should lead to new ideas, thereby enabling those aspirations to become a reality. The review was not intended to revise agreements, which were the result of intensive and complicated negotiations.

He said his country did not have a specific population policy, but had included various population goals into its integrated development strategy, which sought to guarantee employment for all, to include women in the economic and social life of the country on an equal basis, and provide free access to education and health services. The Government had implemented a number of maternal and child health care programmes, as well as a reproductive health care programme. Among other things, those had produced improved child and maternal mortality rates. Life expectancy was 75 years, and 99.9 percent of child births occurred in hospitals. The number of children per couple was 1.7, and abortion was legal, although it was not promoted as a contraceptive method.

Despite such achievements, however, he said that new population and health problems had arisen. There was a trend towards ageing among the labour force, as a result of an advanced demographic transition, and there were low fertility rates. Those problems justified the need for an integrated approach, particularly under the current difficult economic conditions, and the long term economic and trade blockade of Cuba. Population growth rates needed to be maintained. Health improvements were also challenging the country. Full implementation of the Cairo Programme of Action could not be attained without the involvement of the entire international community. Without the necessary resources, those goals would be relegated to a promise on paper.

Population Preparatory Committee - 5 - Press Release POP/716 3rd Meeting (AM) 25 March 1999

OFELIA TEMPLO (Philippines) said it was important that future initiatives in regard to implementing the Cairo Programme of Action were focused on strengthening the linkages between population and development, as well as on addressing the needs of individuals and families. Population programmes were considered necessary investments in people. Her country's programmes in that regard were aimed at helping parents achieve fertility goals, providing information on reproductive health, reducing mortality and helping economic progress. While the ageing of population was of concern, the population of young people was still larger in number. Hence, programmes should address the needs of youth, such as education and skills training. That was especially important for developing regions, where children made up half the population.

On the topic of migration, she said efforts should be taken to improve the status and health of migrant workers. It was also important to address the causes and problems regarding internal migration. Future actions should highlight coordination to help governments address the problems of migration. The Asian economic crisis had particular impact on the social sector. In that regard, her delegation would like to urge the continuing support and assistance of the donor community.

IRINA ZBARSKAYA (Russian Federation) said her country had always remained steadfast in adhering to the Cairo goals. Although participants were not trying to redraft the conclusions, they could not avoid a sober and unprejudiced analysis of those aspects not adequately covered in Cairo or which had emerged as problems later. The report of the Secretary-General on the special session was a useful basis for negotiation, as it contained several valuable proposals. The concluding document, however, must find space to reflect the whole range of problems arising from implementation efforts, while focusing on priority issues.

Like many other transition economies, she said her country was facing great problems in drafting a population policy. Over the last two years, those problems were rendered even more acute by the financial crisis that had hit Russia in August 1998. Despite those obstacles, the Russian Government in the post-Cairo period was actively tackling problems concerning women and children and the elderly, aimed at lifting the country out of the demographic crisis in which it was languishing. Much had been done to improve health. A certain stability had been achieved in the infant mortality rates, and the number of abortions had been reduced by one-third. Abortion-related maternal mortality had been reduced by 20 per cent.

Of particular concern was the problem of excessive mortality, especially in men of working age, she said. The scale of that problem was adversely affecting prospects for sustainable development. Another problem was a change in the age structure, due to accelerated ageing of the population. The problem of international migration required a strengthened regional dimension

Population Preparatory Committee - 6 - Press Release POP/716 3rd Meeting (AM) 25 March 1999

that entailed active follow-up to the decisions of relevant regional conferences. Also essential was tackling the problems linked to the growing scale of enforced migration, including economic migration, which took place illegally, and for which the role of the United Nations should be enhanced.

The problem of HIV/AIDS had taken even firmer hold since Cairo, in terms of the scale and speed with which it was spreading, she said. That issue should remain a focus of attention, and national and international efforts should complement each other. The availability of medications in countries where the cost was too high was a big problem. Finally, her country was convinced that the mobilization of resources was the responsibility of all countries, particularly since some were unable to generate the resources needed to properly implement the Cairo goals. Russia, as a transition economy, would continue to depend on the world community for help in that area.

RAJ ABDUL KARIM (Malaysia) said her country had developed a national plan of action on population based on the principles of equality and diversity. Its national action plan would be updated in line with the review of the Cairo Programme of Action. Malaysia had created an enabling environment for the process of development, stressing balanced development and giving priority to vulnerable and disadvantaged groups. Her country was currently looking at alternative models for delivery of reproductive health services to address the emerging issues of adolescent and youth sexuality, domestic violence, abuse, AIDS and others.

Malaysia realized that governments alone could not realize the effective implementation of the Cairo goals without collaboration, cooperation and consultations of all sectors, she added. The economic crisis had affected her country. It was, however, fortunate to have safeguards, such as health, education and basic social services, which had minimized the effects of the crisis, especially on the poor and self-employed. Strategic, smart alliances and smart partnerships with the private sector and non-governmental organizations had optimized the use of available resources for social development efforts.

VICTORIEN RANDRIANASOLO (Madagascar) said that greater attention should be paid to reducing the amount of carbon dioxide in the atmosphere, as well as to fight smog in Europe. Those issues could be the subject of periodic reports before the Commission. His country had adopted a national implementation programme with regard to population and development. The National Population Council for the country helped to ensure the integration of population issues into development programmes and steps had been taken to ensure equality among sexes and for the empowerment of women.

He added that training programmes, cooperation with non-governmental organizations and other efforts had been taken to help women overcome

Population Preparatory Committee - 7 - Press Release POP/716 3rd Meeting (AM) 25 March 1999

precarious economic and social conditions. In regard to the health of women and children, community pharmacies and clinics had been opened and educational programmes developed. There was also a national symposium on reproductive health. The Commission Bureau should consider visiting the signatory countries of the Cairo Conference to see first hand the progress made in implementing its Programme of Action.

JEAN GAEFEMYNCK (France) associated himself with the statement made by the German representative, on behalf of the European Union. In the overall context of the Commission's work, substantial and increasing amounts of ODA should be appropriated for population issues. The financial constraints, however, should not "stop us" from doing the necessary work. Indeed, everyone must focus on identifying special programmes based on clear guidelines with anticipated outcomes. Only then would it be possible to evaluate results on the basis of indicators chosen ahead of time.

Enshrining human rights and liberties into any population policy was the only firm basis on which any such programme could be undertaken, he said. Mustering demographic change was a key variable for sustainable development. Thus, it was crucial to reduce maternal deaths, devise clear fertility plans and make progress in the area of reproductive health. Women must be given their autonomy to ensure that they created their own future. To do so meant tackling the status of women and ensuring respect for them as individuals. Their freedom of choice in marriage must also be ensured. That approach would have far reaching consequences for societies as a whole. In the educational sphere, more girls must be encouraged to enrol in school.

In the area of health, he said it was essential to promote access to certain drugs, and ensure that generic brands were available in all markets. Reproductive health was a particularly urgent priority. Relevant initiatives were aimed at tackling those members of the population most vulnerable to the AIDS epidemic, particularly in the area of prevention. The disease attacked young women of child-bearing age, and was dramatically passed, through nursing, from mother to child. Treatment must be provided to infected pregnant mothers, and their children should be monitored from birth.

ELDAR KOULIEV (Azerbiajan) said the main task of the upcoming special session of the General Assembly was to show the successes and obstacles to implementing the Cairo Programme of Action. His country had faced a number of difficult problems since gaining independence. Among them, it simply did not have enough material resources to meet demands. Azerbiajan had also been badly affected when its neighbour, Armenia, attacked and occupied part of the country. Thanks to actions by the Government, as well as foreign investment, his country had been able to undertake social reforms. It had implemented new laws regarding education and health and a new constitution recognized the rights of women.

Population Preparatory Committee - 8 - Press Release POP/716 3rd Meeting (AM) 25 March 1999

He said that mortality rates had risen, as well as maternal deaths and abortions. Migration had also taken a toll. A state commission was set up to address population and development issues. The Government was working closely with various United Nations organizations, including the United Nations Population Fund (UNFPA). However, the problems facing Azerbaijan were also faced by other countries in the region. The problems relating to refugees and displaced persons, as well as morbidity, must be confronted through regional cooperation and assistance.

JEAN-MARIE AKPOUE (Côte d'Ivoire) said his country had developed a plan of action to implement the Cairo goals, which included the development of a national population policy declaration and the establishment of an institutional framework for its implementation. Since the early 1990s, the country had entered a period of positive growth. That renewed growth, however, had not made it possible to eliminate all of the negative impacts of the crisis on the standard of living.

He said that the primary objectives of the population declaration were to control national population growth and migratory movements, ensure consistency between supply and demand, enhance the value of the family and improve the status of women and young people, and safeguard the environment. In implementing that policy, the Government had created an institutional framework that included a National Population Council. At the regional level, 16 different population councils were set up. That decentralization made it possible for policy makers to take into account the characteristics of those diverse regions.

A decrease in health care services had adversely affected the health care situation, he said. To cope with that emerging problem, the Government had mounted a reproductive health programme, which focused on the health of women and children. Specific objectives would focus on the most vulnerable population growth, including rural women and refugees. It also sought to promote the use of contraceptives, reduce maternal mortality and the risk of morbidity and mortality of mothers, and improve adolescent health. Education and communication in that regard must also be strengthened.

DAMRONG BOONYOEN, Director General, Department of Health in the Ministry of Health of Thailand, said that past experiences of success and failure, as well as national efforts in the pursuance of population and development, indicated that progress required not only good governance, but also a strong civil society. To endure difficulties while minimizing the negative impact on people who were most in need, Thailand would have to mobilize both technical and financial resources from outside. Such resources were needed to maintain current initiatives and undertake new ones. His country pledged to continue its technical cooperation and partnerships, to share its expertise with other developing countries.

Population Preparatory Committee - 9 - Press Release POP/716 3rd Meeting (AM) 25 March 1999

To ensure desirable progress in the implementation of the Cairo Programme of Action, he said there was an inevitable need to undertake an integrated, decentralized approach. That was unlikely, however, if it did not occur in parallel with total health care reform. Nations needed to learn from other's experiences, so they could elaborate the most effective and practical steps required for implementing that complex and highly complicated endeavour.

* *** *