SEXUAL HEALTH, FAMILY-PLANNING POLICIES, HIV/AIDS AMONG SUBJECTS ADDRESSED DURING GENERAL ASSEMBLY SPECIAL SESSION DEBATE
Press Release
GA/9573
SEXUAL HEALTH, FAMILY-PLANNING POLICIES, HIV/AIDS AMONG SUBJECTS ADDRESSED DURING GENERAL ASSEMBLY SPECIAL SESSION DEBATE
19990630 Assembly Continues Review and Appraisal of Implementation Of Cairo Conference on Population and Development Programme of ActionThere could be no talk about safe motherhood and commitments made at Cairo if there was a failure to recognize that abortion was a reality in the lives of tens of million of women, Clare Short, the Secretary of State for International Development of the United Kingdom, said today, as the General Assembly held the second and third meetings of its twenty-first special session.
It was hard to forgive those who denied women access to contraception and drove them into the arms of illegal abortionists, she added, as the Assembly continued its review and appraisal of implementation of the Programme of Action adopted at the International Conference on Population and Development, held in Cairo in 1994. The fact was that women regularly risked their lives for want of a safe abortion. It must be remembered that most women seeking an abortion were in stable unions, that not all sex was consensual, and that contraceptives sometimes failed.
Also on sexual health and family-planning policies, Misa Talefoni, Somoa's Minister of Health, said in his country policies required the Church's cooperation if they were to be universally acceptable. His country had created a workable partnership with religious clergy on family planning and HIV/AIDS strategies. Samoa embraced the Church's basic principle that sexual intercourse should only take place in wedlock. However, it also promoted the practice of safe sex and the use of condoms when that spiritual goal was unachievable. To go against the Church's moral premise would result in a negative impact on safe sex campaigns.
It was imperative to respect national cultures and various religious values in the implementation of the Cairo Programme of Action, said Mohammed Farhadi, Minister of Health and Medical Education of Iran. Such an approach would provide a solid basis for sustainable and genuine international cooperation. He added that Iranian policies confirmed the compatibility
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between religion, population policies and family planning. It carried important theoretical and practical lessons for other developing societies.
A number of statements addressed the topic of HIV/AIDS. Magreth Mensah, Vice-Chairperson of the National Council of Namibia, said the number one killer in her country was HIV/AIDS, and it was third among countries with the highest prevalence of HIV/AIDS. Related to that was an increase in the number of orphans, due to accelerated adult mortality. There was need for increased efforts to provide social services by governments, and the international community must allocate the necessary resources to help governments implement the Cairo commitments.
Statements were also made by: the Vice-President of Zambia, Christon Tembo; the Minister of Health of Hungary, Arpad Gogl; the Minister for Youth, Women, Childhood and Family of Panama, Leonor Calderon; the Minister for Planning of Chile, German Quintana; the Minister for Family Affairs of Nicaragua, Max Padilla; the Minister of Women's Affairs and Associate Minister of Health of New Zealand, Georgina Te Heuheu; the Minister for Social Affairs of Egypt, Mervat Tallawy; the Minister of Health of Brazil, Jose Serra; the Minister for Population, Status of Women and Childhood of Madagascar, Noeline Jaotody; and the Minister of Health of El Salvador, Francisco Lopez Beltran.
Further statements were made by: the First Deputy Minister for Foreign Affairs of Ukraine, Olexander Chalyi; the Under-Secretary for Health of Ecuador, Hermida Bustos; the Minister of Development Cooperation and Human Rights of Norway, Hilde Johnson; the Minister for Health and Children of Ireland, Brian Cowen; the Minister of Survey and Construction Development of the Sudan, Gulwak Deng Garang; the Minister of Finance and Economic Planning of Uganda, Gerald Ssenduala; the Minister for Health and Family Welfare of Bangladesh, Salah Uddin Yusuf; the Minister of Planning of the United Arab Emirates, Humaid Bin Ahmed Al-Mualla; the Vice-Minister of the Ministry of Economic Development and Cooperation of Ethiopia, Mekonnen Manyazewal; the Director General of the Ministry of Labour and Social Affairs of Israel, Yigal Ben-Shalom; the Vice-Minister for Population of Argentina, Aldo Omar Carreras; and the Vice-Minister for Population and Migration Services of Mexico, José-Angel Pescador.
The representatives of Swaziland, Tunisia, Canada, Latvia, Cyprus and Bahrain also spoke.
The Assembly's twenty-first special session will meet again at 10 a.m., tomorrow, 1 July, to continue its review of the implementation of the Programme of Action of the ICPD.
Assembly Work Programme
The General Assembly met this afternoon to continue its twenty-first special session debate on the overall review and appraisal of the implementation of the Programme of Action of the 1994 International Conference on Population and Development.
Statements
CHRISTON S. TEMBO, Vice-President of Zambia: Since the 1994 Cairo Conference, Zambia has made progress towards the implementation of the population and development programme. Measures include: the development of a socio-economic policy framework to foster broad-based economic growth through development of infrastructure and enhancement of social delivery mechanisms; the development of a poverty-reduction framework and national plan of action for implementation by Government, private sector, non-governmental organizations (NGOs) and civil society; the development of health sector reform programmes aimed at increasing access to quality health services at the community level; introduction of an integrated reproductive health policy and national youth policy; and the establishment of a comprehensive data- monitoring framework to provide socio-economic indicators for programme formulation and overall economic management.
Populations with high growth rates, declining economic output and high debt burdens, continue to impede the development efforts of many developing countries. Zambia's population is currently growing at 3.1 per cent while the economic output has remained stagnant. The stock of debt as a ratio of export earnings has continued to rise, resulting in the unsustainability of the country's foreign-debt burden. This has resulted in overall economic decline and inadequate resources for capital and human resource management. High poverty levels, widespread illiteracy, and inhibiting cultural and traditional systems continue to be major obstacles to enhanced population development in Zambia.
In order to successfully mitigate against the negative population dimensions and their manifestations, such as disease and poverty, we need to: introduce universal basic education; promote the status of women and mainstream gender in all aspects of population and development; provide adequate information to couples and individuals on the need to have manageable family sizes; enhance an integrated reproductive health service reform; reduce the high rate of infant and maternal mortality by improving health facilities and services; and establish a national institutional framework to address the HIV/AIDS epidemic. In this regard, Zambia is revising the national population policy in order to accommodate the emerging issues of HIV/AIDS, the environment, gender and the broader concept of reproductive health.
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ARPAD GOGL, Minister of Health of Hungary: Hungary is among the countries where demographic processes have long been the focus of political and public attention. Over the past decade, low fertility and continuing high mortality rates have resulted in a steady decrease of the population with serious economic and social consequences. The Government views the demographic situation of the country as a major national and social issue which calls for governmental responsibility and the joining of all forces of society. Our immediate aim is to moderate and stop the process of population decrease and later to achieve a modest increase, resulting in a more favourable age structure of the population.
Despite changing family-formation patterns, family is and remains a basic unit of society and a basic unit of reproduction. The Government strongly supports and advocates measures to promote family cohesion and the ability of families to raise children. We encourage a moral renewal of the society, where bringing up children wins respect and where the related costs and difficulties are mitigated by a family-friendly economic and social environment. Important measures have already been taken by the Government that are aimed at improving the situation of the families with children, through a reformed tax and social-security system and an elaborate new family policy.
High levels of mortality and morbidity in all age groups, but especially among the male population, require special attention in Hungary. In order to develop a better and more efficiently operating health-care system, there is a need to make it more prevention oriented, to promote healthy lifestyles and to make it more attractive for the population. Human dignity is a right belonging to all generations. This fundamental right can be enjoyed only in a well-developed system of care and support for the elderly people. These challenges require joint efforts by the family, the local community and the government.
LEONOR CALDERON, Minister for Youth, Women, Children and Family of Panama: Since the 1994 Cairo Conference, a commission on population and development has been set up in the national legislative assembly. Among other functions, it recommends actions regarding policies on social development. Panama's population is roughly 2.8 million, with 54 per cent located in urban areas, as the result of a high level of migration in recent years. The dearest wish of the Panamanian people is about to be fulfilled -- as of 31 December, the Panama Canal will be fully implemented by nationals, who have been preparing for that for decades.
Over the last five years, State expenditure in the social sector has increased steadily. Given the need to address the needs of vulnerable sectors, her Ministry was set up in 1997. It promotes participation and social equity. On its impetus, national councils for women, family and youth
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have been established. Panama's fertility rate is low -- about two children per woman -- with considerable differences between rural and urban areas. A national commission on sexual and reproductive health consists of representatives from all sectors, including Government, non-governmental groups, unions, legislative bodies and religious groups. With consensus from those groups, a national sexual reproductive health plan is being developed under the auspices of the United Nations Population Fund (UNFPA) and with technical advice from the Pan American Health Organization (PAHO), promoting integrated and high-quality services. Panama remains committed to the Cairo action plan.
GERMAN QUINTANA, Minister of Planning and Cooperation of Chile: Chile is engaged in an intense economic and social transition due to its dropping population growth rate. That is due to a drop in fertility rates, which have fallen from 5 children per family in the 1960s to 2.4 in the 1990s. The Government has adopted policies based on rights, focusing on the needs of people and setting priorities based on those needs. Efforts have been made to reduce poverty, secure gender equality and ensure the right to reproductive health. To protect women's equality, there is an equal opportunities plan to highlight the contribution women could make in the various spheres of development.
A series of activities has been developed to highlight women's decision making in the public and private arenas. Also, legal changes have been made addressing such areas as: property in marriage, domestic violence, labour, domestic employment, parental leave, sexual harassment in the workplace, and others. There is a programme to help women in the workplace through occupational training. To help prevent family and domestic violence, agencies have been set up to establish networks to deal with the problem. There are also information centres on the rights of women located in all the capital cities of the various regions. There have also been efforts to revise text books to eliminate all discriminatory references. Chile has also made continuing efforts to pursue maternal health.
CLARE SHORT, Member of Parliament and Secretary of State for International Development of the United Kingdom: We must be clear that although much has been gained since Cairo, we still have a long way to go to achieve the outcomes that were agreed in 1994. It is also not good enough to agree on desirable ends at the United Nations conferences but fail to will the means to deliver them. HIV has robbed 20 years of life from people in parts of Africa, taking with it 20 years of development gains and threatening the survival of large numbers of children. The prospect of the epidemic rampaging through Asia and Latin America is terrible and real. We do know how to prevent HIV. Examples have been set by countries like Uganda and Thailand. They have shown the spread of AIDS can be reversed. Education, information and improved services are agreed actions that work in this area. If young
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people do have sex, they need confidential non-judgemental services and they need condoms which prevent unwanted pregnancy and sexual infection. There is need to make them much easier to get hold of if we respect, care and wish to protect the one billion young people in the world -- the largest generation there ever has been.
Those who want to deny women's rights cannot hide behind culture, religion or tradition. None of the values of the great world religions or proper interpretation of any tradition calls for the oppression of women. The right to health is a fundamental human right. Reproductive health is an essential element of health. It is absolutely correct to have agreed that women refugees have a right to those services. Health systems must respond to people's needs. For women in particular, maternal health is a priority. Nowhere is the inequality and inequity between rich and poor more starkly illustrated than by the number of women who die every year as a result of pregnancy and childbirth. It is not good enough to focus on isolated safe motherhood projects. There is need to strengthen health systems that reach all areas of the poorest countries in order to reduce the dangers of pregnancy.
It is also not good enough to rely on traditional birth attendants. The research is clear -- this does not save lives. There is need to train enough skilled midwives to deliver babies and to make sure that pregnant women can get to health facilities quickly when they need to. There can be no talk about safe motherhood and commitments made at Cairo if there is a failure to recognize that abortion is a reality in the lives of tens of million of women. It is hard to forgive those who deny women access to contraception and drive them into the arms of illegal abortionists and then claim to dislike abortion. The fact is that women regularly risk their lives for want of a safe abortion. The truth is that most women seeking an abortion are in stable unions. The horrible truth is that not all sex is consensual and that rape is a reality. It is also true that contraceptives sometimes fail.
MAX PADILLA, Minister of Family Affairs, Nicaragua: Nicaragua's priority, in which it is intensely involved, is the improvement of the people's living conditions by social and economic development. Our problems are great and their solutions are complex -- it is important to remember the aftermath of a revolution, a decade of civil war and recently the extensive damage caused by Hurricane Mitch. These are misfortunes which Nicaragua shares with other countries of Central America. All of these events make it difficult for us to fulfil our present and future commitments in education, health, nutrition and production.
Most of Nicaragua's population is living in poverty. However, it still recognizes that its most valuable resource for development is the human person. Each person can become an agent for development if he or she is given
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proper access to education, health and other social services. That is why Nicaragua applauds the Cairo Programme of Action in the fields of education, basic health and other social services. After the Cairo conference, Nicaragua put forth a National Population Policy as part of its strategy to reach social and economic development.
Nicaragua's population policy is contained in the Government's overall plan to reduce poverty through policies that make services such as education and basic health more accessible to the poor. Our holistic sex-education programmes are geared towards preparing young people so that, when the time comes, they will know how to live as responsible mothers and fathers. Sex education is promoted within the framework of our culture, our moral values and the exercise of self-control, self-care, self-esteem, fidelity and responsibility. Abortion is considered a criminal act and law prohibits it. The population policy also believes that young people and adults must be informed completely and truthfully in order to make free decisions about existing methods of birth control to avoid unplanned pregnancies and reduce the risk of contracting HIV/AIDS.
GEORGINA TE HEUHEU, Minister of Women's Affairs, Minister for Courts, Associate Minister of Health and Associate Minister for Treaty of Waitangi Negotiations of New Zealand: Women comprise just over half of New Zealand's 3.5 million people. Maori women are currently 15 per cent of all women and 7 per cent of the total population. By the year 2046, Maori women will comprise 21 per cent of all women and 11 per cent of the total population. Their role in the nation's future, therefore is important to all New Zealand's citizens. Their leadership will also be important.
At home and on the international stage, New Zealand has sought to play an active role in promoting the human rights of women and to ensure their full participation in society as equal partners with men, particularly in supporting and encouraging sexual and reproductive health rights and the rights of women. Most recently the country took a constructive approach towards the development of an optional protocol to the Convention on the Elimination of All Forms of Discrimination against Women.
When families are healthy and able to support themselves, our nations will prosper. Sexual and reproductive health is central to the development of healthy and productive nations. Poor sexual and reproductive health comes with a cost to nations, communities and people. Population issues are at the very heart of balanced and sustainable development. The essential message of the Cairo Programme of Action is that population issues are development issues, and the Programme of Action should be considered as part of a global framework for sustained and sustainable development.
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New Zealand is committed to the implementation of the Cairo Programme of Action in its official development assistance and has participated actively in a number of international population activities. It has substantially increased its contributions to the UNFPA and the International Planned Parenthood Federation, and is now also supporting the work of the Population Council. One of the clearest violations of women's fundamental human rights and freedoms is violence against women. This is universal and yet many countries have no policy or legislation on violence against women. In New Zealand we have introduced such legislation. In addition, we support programmes to combat domestic violence in other countries.
MERVAT TALLAWY, Minister for Social Affairs of Egypt: Cairo was honoured to host the International Conference for Population and Development in 1994. Egypt holds dearly the fact that it originated the idea of a parallel conference for non-governmental organizations, based on its belief in the importance of civic organizations. The 1994 conclusions must be maintained. As the host country, Egypt is very interested in the results yielded over the past five years, as well as in the remaining challenges and constraints, on both the international and national levels.
The international community plays a number of important and inter- related roles regarding population and development. Pledges made in Cairo regarding assistance to developing countries must be fulfilled. Contrary to those pledges, assistance has even declined in some areas. The World Bank should use social indicators when setting up rules for loans, rather than using economic criteria alone. This will facilitate developing countries balancing economic and social development, since there is no automatic relationship between the two. Further, there is need to safeguard programmes of international cooperation, and encourage active cooperation between the countries of the south. Government, private sector and civil society groups must work together to implement national policies without disrupting the balance between them. Also, international attention must not be diverted from population and development programmes to political questions as the result of civil wars and other events.
At the national level, the multiple aspects of development must be addressed. Egypt is preparing for a national conference for social development, in partnership with social and economic development partners. National programmes have led to increased use of contraceptives and reduced illiteracy rates for women and girls. The country's five-year plan includes an increased component for women and children. Her Ministry is involved in programmes to eliminate poverty. The State is particularly interested in addressing youth, through programmes to improve education, health, and work opportunities. Population and development constitute a real challenge to the entire world. Governments should commit to implementing the pledges they made at the Cairo conference.
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JOSE SERRA, Minister of State of Health, Brazil: Brazil's first step to implement the Programme of Action was to establish, in 1995, a National Commission on Population and Development, with representatives from governmental bodies, universities and non-governmental organizations, to coordinate Brazil's implementation of the Cairo action plan. The national health system is State-financed, universal and free of charge. Reproductive and sexual rights are fully recognized as basic human rights in Brazil. The number of free pre-natal care visits in Brazil increased from 2.8 million to 7.6 million from 1995 to 1998. The Government recognizes the importance of additional resources and further collaboration with civil society organizations to meet growing demands for information, counselling and services. Since 1996, the Ministry of Health has been providing free and universal access to all approved anti-retroviral medications against AIDS. Today, 58,000 men and women receive those drugs, and mortality rates have declined about 50 per cent between 1994 and 1999.
In many countries, women are unable to exercise their rights because of legal provisions. The international community must press for the removal of any obstacles against the empowerment of women arising from poverty, intolerance, illiteracy, limited access to education, inadequate remuneration, a patriarchal mentality and the dual burden of domestic tasks and occupational obligations. The girl-child must be protected against harmful traditional practices and cultural attitudes, which often promote sexual servitude and the low valuation of girl-children. There is need for a more humanitarian approach to the issue of the AIDS pandemic, with more affordable prices for all related drugs for prevention, testing and treatment. The international community must promote an enabling economic environment, supporting developing countries' quest for sustainable human development, poverty eradication and the advancement of women. Globalization cannot be an asymmetric, Darwinian process. Development assistance resources are needed for implementing the outcomes of the series of United Nations world conferences.
NOELINE JAOTODY, Minister of Population, Status of Women and Childhood of Madagascar: Madagascar attaches great importance to the Cairo Programme of Action and has taken a number of steps to implement its goals. Among them, efforts have been made to improve equality between men and women and to ensure better health care for women. A national office was established to impose national priorities for population and development after consultations with other bodies, including civil society. In regard to the status of women, Madagascar's constitution guarantees the rights of all women and protects them from discrimination.
In order to combat poverty, partnerships were formed with technical and financial partners, such as United Nations bodies, to create a fund to help young people set up their own businesses. In regard to fertility rates, the goal of Madagascar's policies was to achieve a better balance between
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population and food supply. New steps set forth in the text on further initiatives, from the Preparatory Committee for the special session, will be important in implementing the goals of Cairo.
The international community must be aware of the population problems being faced, especially in poor countries. Without sufficient resources, poor countries would not be able to overcome population problems and other financial constraints. Financial assistance was needed to address mortality rates due to infectious diseases such as HIV/AIDS. Such funding is also needed to ensure maternal health for women.
FRANCISCO LOPEZ BELTRAN, Minister of Health, El Salvador: Since the adoption of the Programme of Action five years ago, many countries have made significant advances towards achieving the goals set in Cairo. In the case of El Salvador, advances included: public policies that focused on children, adolescents, women and older persons; the creation of a Salvadorean institute for women's development and the formation of a national women's policy; the coordination and implementing of a programme to prevent family violence; a national reproductive health plan including the prevention of sexually transmitted diseases such as HIV/AIDS; and the implementation of standards of health care for adolescents.
The New Alliance Plan (1999-2004), which the current Government is implementing, is wide-based and transparent and aims to create conditions for sustainable development, peace, democracy and the rule of law. It also aims to reinforce the value of national identity and promote the personal development of all Salvadoreans. The goals of this plan are compatible with all the goals of the United Nations international summits and conferences, in particular the Cairo Conference.
The Government of El Salvador proposes sharing responsibility and work with several sectors of civil society to promote the New Alliance in the area of population and development. The Government is strengthening the policy of decentralization at the state level to make it possible for the state to be more effective in its delivery of public services. The Government is also improving the educational level of the population. In the area of sexual and reproductive health, education for teenage girls is being emphasized. Equal opportunities are also being promoted for women in development. There is also a stepping up of measures that deal with the implementation of national policies for women.
MISA TELEFONI RETZLAFF, Minister of Health of Samoa: Samoa is unique in the Pacific region because its strong culture is central to its way of life and impacts its system of government. The people's affinity with the land and the sea is based on the love of tradition, and strong Christian principles, which motivate and sustain the country both spiritually and physically. Samoa
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believes that the main lesson of Cairo was that people should be put first in development. Sustainable economic growth must not only focus on the speed of that growth, but the equitable access of the poorest sector to growth. Samoa recognizes that there can only be so much growth -- the earth and its resources are finite while human needs are not. What is needed is the proper management of the important but necessary coexistence between population, resources, the environment and development.
With a more educated, assertive and politically active female population, the stage is now set for Samoa to achieve progress in attaining Cairo's goals. Samoa has 100 per cent access to health services. Reproductive health and family planning are integral parts of its primary health-care system and immunisation coverage is at 99 per cent. Samoa recognises that prevention is the only long-term formula to curtail burgeoning health costs. It has declared war on tobacco use and is targeting non- communicable diseases, such as diabetes and hypertension, as a national priority.
Samoa's HIV/AIDS Council has so far kept incidences of HIV/AIDS minimal; however, an aggressive awareness campaign is ongoing. There is now a workable partnership with religious clergy on family planning and HIV/AIDS strategies. Samoa embraces the church's basic principle that sexual intercourse should only take place in wedlock; however, it promotes the practice of safe sex and the use of condoms when that spiritual goal is unachievable. It has been realized that to go against the church's moral premise would result in a negative impact on campaigns for safer sex. Sexual health and family planning policies need the church's cooperation if they are to be universally acceptable.
OLEXANDER CHALYI, First Deputy Foreign Minister, Ukraine: The Programme of Action approved in Cairo aimed to integrate demographic issues into the global agenda. Globalization and liberalization of the international economy, along with increasing integration and interdependence, are the defining trends of the 1990s and they cannot help but influence demography. The highly valued open market of today must address population problems that are attendant with it, such as the growth in migration, including transit migration; the outflow of the young, productive social strata from less developed to more prosperous economies; and the increase in drug trafficking and dangerous diseases.
The recent global financial crisis highlighted the need for integrating strategies that are aimed at national prosperity and those that are aimed at sustainable development. The Cairo Programme of Action could well be the strategy for survival. In Ukraine, it has been translated into a population strategy that is an integral part of a social and development policy addressing the most acute demographic problems. Improving public health care, social and economic support of the family, and public assistance to the
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vulnerable social segments are priority issues incorporated into the Constitution.
Even so, Ukraine is spending $1 billion a year to minimize the ecologically and demographically disastrous consequences of the Chernobyl catastrophe. It is also incurring social expenditures to compensate for hardships related to market transformation of the economy. Ukraine is therefore experiencing significant difficulties in meeting the goals set forth in Cairo. Indicators such as those for national reproductive health still need considerable improvement to match international standards. International assistance, including in the form of relevant UNFPA programmes, is welcome.
MARGARETH MENSAH, Vice-Chairperson of the National Council of Namibia: Namibia's major national development goals include economic growth, creating employment, reducing inequalities and eradicating poverty. Realizing these goals, however, is hampered by factors including a population growth rate estimated at 3 per cent. Based on social, economic and demographic trends, that high growth rate is likely to continue and increase. The Cairo conference took place just four years after Namibia's independence. Today, a National Population Policy for Sustainable Human Development guides the country's population and development activities. Its success is largely attributable to wide consultation with different groups on the direction of population policy as well as on its acceptability to the population.
Namibia has in place a number of policies and laws with direct bearing on women, youth and disadvantaged groups. Financial concerns, however, are a major constraint to effective implementation. Still, the Government's budgetary allocation clearly indicates the importance it attaches to social development. For example, for 1999-2000, 26 per cent of total resources are directed to education, and 16 per cent to health. The number one killer in Namibia is HIV/AIDS; Namibia rates third among countries with the highest HIV/AIDS prevalence rates. With an increased number of women of child-bearing age infected with HIV/AIDS and a prenatal transmission rate of up to 35 per cent, childhood AIDS is expected to be a serious national problem. At the same time, the number of orphans increases with accelerated mortality rates among adults. There is a need for increased efforts to provide social services by Government and other sectors. Adolescent reproductive and sexual health requires urgent attention. Rates of teenage pregnancy are high and early sexual activity is linked with sexually transmitted diseases, including HIV/AIDS.
The major challenges to implementing Namibia's population policy and programmes are the lack of financial resources coupled with inadequate capacity. Since no developing country can implement the Cairo Programme of Action on its own, the Southern African Development Community members have been coming together to address common population and development issues.
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Namibia will continue to support regional and international efforts on population and development. The international community must exhibit increased solidarity and allocate the necessary resources for the full implementation of the commitments made in Cairo. Developing countries must be provided with development assistance and investment in productive sectors, to support employment and economic growth. For the sake of all humanity, those who are affluent today should support the majority who are currently more disadvantaged. That would ensure a better tomorrow for all.
CESAR HERMIDA BUSTOS, Under-Secretary for Health of Ecuador: Population and development are two priority components of the general national policy, and of health policy in particular. Significant migration to the United States and Europe by Ecuador's young people, for economic reasons, as well as high rates of maternal mortality, are among national trends requiring specific measures. Reproductive rights were incorporated in the Constitutional reforms that have been in place since August 1998. The Government is committed to promoting a culture of health and life. A decentralized national system of universal health coverage is based on the principles of universality and quality. A few weeks ago, the Ministry of Public Health introduced a national plan to reduce maternal mortality. A programme on maternal health includes free prenatal care, and healthcare for children under five years.
Adolescents are being addressed by measures including a sexual education programme administered by the Ministry of Education. The strategy is multidisciplinary, incorporating sexual education for youth, parents and teachers. Violence against women is considered a public health problem, and is being addressed through legislation, and the efforts of the national council on women, among other means.
The gender component is a cross-cutting consideration in designing national policies, and regional and local programmes. Regarding sexual and reproductive health, the participation of organizations, such as indigenous and youth groups, highlights the needs of targeted populations and the various factors involved in meeting those needs. Ecuador is advancing measures to enhance its citizens' quality of life, through coordinated inter-agency work in which multilateral and bilateral cooperation continue to play a primary role. The country aspires to enable all persons, and women in particular, to be able to develop their capacities to the fullest, on the individual level, in the family and collectively.
MOSES M. DLAMINI (Swaziland): The rate of population increase, given the fixed supply of land and limited resources, is one of the most serious threats to the Swazi people. Economic performance still does not match population growth. Evidently this situation should not be allowed to continue if sustainable development is to be realized. It is for this reason that Swaziland is developing a national population policy and a comprehensive
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reproductive health programme with the participation of representatives of religious leaders, traditional and community leaders, non-governmental organizations, academic institutions, youth and their special groups as well as experts, policy makers and planners.
We strongly believe that the integration of population concerns in development, environment and poverty reduction strategies and resource allocation, at all levels, will promote social justice and eradicate poverty. It is, however, regrettable that, to a large extent, the progress made in these areas in most developing countries is modest. The reason for this status quo is largely due to limitations in financial capacity rather than to the lack of political will. This situation emphasizes the importance of international cooperation and the support for the development process of these countries, particularly in Africa
While Swaziland has recorded some achievements five years after Cairo, it is still faced with many challenges. The formation of the national population policy by May 2000 will usher in the real task of implementation, along with the implementation of other programmes, such as the poverty alleviation programme, and addressing the HIV/AIDS problem and its consequent negative socio-economic impact, such as the increasing number of orphans and female and child-headed households. These and many other issues are urgent and require financial support. Inadequate financial and human resources to implement these programmes, particularly in the immediate areas of advocacy, awareness creation, service provisions, and the shortage of commodities pose very severe constraints.
ALI HACHANI (Tunisia): The Programme of Action has taken a special position and gained importance among people of the world. It is considered an important framework for improving the lives of all. It calls for countries to provide family planning services and equal rights for women. It also draws attention to such problems as high infant mortality rates and HIV/AIDS. It also points out that multilateral and bilateral financial assistance was needed to achieve development. It is important to stress international cooperation for development, especially South-South cooperation. Tunisia believes in the link between population issues and development and it attaches great importance to development issues, such as providing adequate health care, clean drinking water, and other social services for all.
Population policies in Tunisia have changed lifestyles, including the adoption of family planning practices in order to ensure a better future for all. Steps have been taken to improve maternal and infant health, and mortality rates have decreased among women and children due to such actions. There have also been efforts to ensure early medical detection of sexually transmitted diseases and ovarian cancer. Tunisia has built a number of medical centres which provide health and family planning services, especially
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for women. All services are provided, with a subsidy from the State, for free or nearly free. Efforts have also been made to improve economic development resulting in improved unemployment rates and a per capita increase in Gross Domestic Product. In that regard, low interest loan programmes were established to provide funds for people wishing to start small businesses.
LOIS WILSON, Chairman of the Delegation of Canada: Five years after the Cairo conference, the issues being discussed are even more important than ever before. There are a number of interlinked issues, and there is a need to act on those linkages, by breaking down divisions between experts and non-experts, and also between different cultures and religions. Even if all the ICPD+5 commitments are implemented, tasks will remain unfulfilled if those linkages are not addressed.
Canada's health system is universally accessible and publicly funded; it strives to improve the health of the entire population. It recognizes that health care is but one factor that keeps people healthy. Education, employment, gender and culture also affect health. A number of programmes assist first nations, living on reserves and Inuit communities, in areas such as substance abuse and child health. Canada is also striving to promote the wellbeing and contributions of older persons in all areas of society.
Internationally, Canada contributes to meeting basic human needs, including family planning. Canada seeks to address the large unmet demand for family planning services, and has recently introduced a new plan aimed at achieving equality between women and men. The links between international and internal migration, and other population and development issues have to be addressed. The root causes of migration flows must be addressed, to make the option of remaining home a viable one.
At home and abroad, Canada works closely with civil society. It has widened partnerships with non-governmental organizations and the private sector. There are five representatives of civil society on the delegation to the special session. The special session is an excellent opportunity to review the international community's objectives and needs. Canada is determined to ensure that concrete achievements are reached. All sectors of society, particularly the poorest and most neglected parts of the globe, must realize tangible benefits from the process in which the international community is actively engaged.
JANIS PRIEDKALNS (Latvia): Latvia took an active part in the Cairo Conference and in the subsequent global review process. In December 1998 a conference was held in Latvia to assess the implementation of the ICPD Programme of Action. The country's birth rate has been steadily declining: the natural increase last year was minus 6.4 per 1000 population. Latvia's fertility rate of 1.1 is one of the lowest in Europe. In the spirit of the
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ICPD's Programme of Action, a Demographic Committee has been set up in the country.
Since 1998, a national programme, "Latvia's Population", has been compiling and analyzing information on the social protection system and assessing activities in that field. However, Latvia still lacks resources to fully implement the activities it foresees. A major achievement was the setting up of the National Health Promotion Center with its emphasis on reproductive health. Several project groups are collaborating with international organizations in that field, and many non-governmental organizations are involved in promoting a healthy lifestyle. The National Human Rights Office is also involved in addressing the needs of the country's vulnerable groups. The positive trends and still existent gaps in the field of reproductive and sexual health in Latvia are evident in the results of the survey on that matter carried out as part of a joint project of the Ministry of Welfare and UNFPA with close collaboration of several non-governmental organizations.
As more women enter the workforce, traditional family roles are changing, and more responsibility for the upbringing of the children has to be assumed by men. In recent years, the most important events to promote public awareness in connection with gender equality issues have been the 1997 Nordic- Baltic conference entitled "Women and Men in Dialogue", and the international seminar on the promotion of the status of women in Riga this year. At the Government level, adequately addressing gender equality issues is fundamental to the completeness of Latvia's integration into the network of European institutions and the implementation of the decisions of Cairo and other United Nations Conferences.
MOHAMMAD FARHADI, Minister of Health and Medical Education of Iran: Poverty is the most formidable enemy of human development policies in general, and population policies in particular. Creation and sustenance of an overall enabling environment at the international level is imperative, particularly in these times of unfettered globalization and its drastic economic, socio- cultural and even political impact on all societies, particularly developing countries.
Iran's population policy, including family planning, has been based on socio-cultural characteristics, development needs and requirements of the society. It is also based on the simultaneous promulgation of appropriate legislation, promotion of public awareness and the provision of necessary services. An important pillar of the strategy is the establishment of a nationwide primary health-care system, which now covers 95 per cent of the country's population. The empowerment of women is another important aspect of the overall policies of the Government. Women's active involvement in the
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health sector, including in reproductive health-related activities, represents an important aspect of their active and growing role on a national scale.
Iranian policies stand as a vivid confirmation of the compatibility between religion and the religious outlook and population policies and family planning. Our experience carries important theoretical and practical lessons for other developing societies, particularly those with similar socio-cultural characteristics. In addition, it is imperative to respect national cultures and various religious values in the implementation of the Cairo Programme of Action and the outcome of the review session. This type of approach would provide a solid basis for sustainable and genuine international cooperation.
HILDE JOHNSON, Minister of International Development and Human Rights of Norway: Greater investment in the social sector is key to addressing the population problems the world is facing. This means that investing in human capital and broader support given to the 20/20 Initiative is a step in the right direction. No investment is more important than that in primary health and education -- no investment yields higher return. Studies show that educating girls is the single most profitable investment of all. Investing in girls' education means lower infant and maternal mortality, lower fertility and higher productivity. Educating girls will give women more control over their own lives -- educating women and girls means educating the whole family.
Women must be given wider choices. The individual human being and her needs has increasingly become the focus of policies and also of health services. Legislation in this field has become much more favourable in many countries. There are still, however, serious problems to be solved. Among the most urgent challenges are: the high maternal mortality rate, the growing evidence of gender-based violence, the lack of appropriate information and services for youth, and the steep increase in HIV/AIDS. To address such problems, there is a need for renewed action and stronger and more coordinated efforts.
Gender-based violence throughout a women's life cycle is a problem of global dimensions. It is widespread, severe and sometimes leads to deaths. Such infringements against women's rights and health can and must be avoided. Also, sexual violence is becoming a weapon in armed conflict, and refugee women are in a particularly vulnerable situation, often subject to sexual violence and abuse. Maternal mortality among refugee women is often high. In spite of that, there are numerous examples that reproductive and sexual rights have been largely ignored in times of crisis. That is unacceptable and has to be addressed.
BRIAN COWEN, Minister for Health and Children of Ireland: Since Cairo in 1994, policy on family planning has been reviewed and new programmes developed and implemented. Each of the eight statutory regional health
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authorities is required to ensure that an equitable, accessible and comprehensive family planning service is available in its area. Persons in the lower socio-economic groups are entitled to family planning services free of charge from their family doctor. Non-governmental organizations play an important role in the provision of reproductive health services and work closely with the statutory authorities in doing so.
The issue of HIV/AIDS continues to be a priority for the Irish Government. Our strategy consists of four main components -- prevention, including risk reduction and education; care of persons infected with HIV/AIDS; HIV/AIDS surveillance; and anti-discrimination. Ireland strongly endorses the principles enshrined in the Cairo Programme of Action and in the review process that abortion must not be promoted as a method of family planning. It is, therefore, of great importance to Ireland, as it clearly is also to many other countries, that the document recognize that policy and legislation in relation to the circumstances in which the termination of pregnancy may be permitted -- if at all -- is a matter for each country to determine for itself.
Ireland is strongly of the view that the role of the United Nations is indispensable in the achievement of the agreed international development goals, and affirms its full commitment to the United Nations role in international development cooperation. The approach enshrined in the Cairo Programme of Action offers better health care and an improved quality of life for many millions. The support of the entire international community is crucial to ensuring that the agreement reached at Cairo five years ago represents more than just good intentions. The commitments made at Cairo cannot be fulfilled without an adequate and assured level of funding for population activities. Ireland's strong support for the leading role of the UNFPA Fund is underlined by our steadily increasing voluntary contributions to that organization, as well as through our membership of the UNFPA's Executive Board.
GALUAK DEING GARANG, Minister of Survey and Construction Development and Chairman of the National Population Council of the Sudan: There is a need in reviewing and appraising implementation of the Programme of Action to uphold and be guided by the same principles of conscience and tolerance that prevailed in the ICPD negotiations five years ago. What was stated then is more valid today in most of our societies. Among the prominent statements made then was that, in Africa, "the most powerful contraceptive in the world is the confidence of parents that children will survive". How can the validity of such a logical conviction be disputed against the ongoing marginalization of the world's poor economies?
A comprehensive and holistic solution to population problems is one deeply rooted in faith and a commitment to basic human values enshrined in all
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religions and traditions. At the forefront of these values is the central role of the family as the basic unit and the foundation of society. Equally important, planned parenting and population control must not be viewed as a universal social charter seeking to impose the issues of puberty, abortion and sex education on individuals and societies with their own distinctive religions, social values and traditions. It is not for governments, non- governmental organizations and civil society to formulate a particular form of social conduct for the young generation, but for parents, notably mothers and grandmothers, who are society's primary socializing agents.
The international community has yet to pay attention to the provision of General Assembly resolution 53/183 that the agreements concluded at the ICPD shall not be negotiated, especially in light of the fact that the outcome of the Conference has received wide acceptance. The credibility of the whole process will be jeopardized if any attempt to act otherwise is introduced. No group of countries may impose a certain course of action on other groups or obstruct other groups from following a chosen course of action that is compatible with generally agreed international principles and norms.
With regard to poverty, economic development and the environment, the Sudan regrets that the draft document failed to address the crucial need for a better understanding and a higher level of international cooperation that would enable the developing countries in general, and the least developed countries in particular, to succeed in poverty eradication. The international commitment to address the problem of education must be reinstated, with particular emphasis on the existing gap between male and female education in sub-Saharan Africa and South Asia. We also note with concern the exceptional emphasis in the draft document on reproductive rights at the expense of lowering maternal and infant mortality rates as a matter of urgency to all, particularly sub-Saharan African States.
GERALD SSENDAULA, Minister of Finance, Planning and Economic Development of Uganda: Uganda has intensified its fight against the HIV/AIDS epidemic through a multisectoral approach and an open policy. For the last two years, a definite decline in HIV/AIDS has been witnessed. This should not make us complacent. The lesson we have learned is that, although HIV/AIDS has no cure, well-conceived, good and deliberate policies can be effective. Uganda's open policy has also helped to galvanize its development partners to come to its assistance. In order to make a decisive difference, efforts have to be intensified and applied persistently.
Besides starting to see the benefits of programmes for adolescents and youth, the Uganda Government has also identified women as a group that has been marginalized and which needs to be mainstreamed in our development process. In order to empower women, Uganda has put in place a process of politically emancipating women through the creation of special elective seats
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exclusively for women, from the village to national level. Uganda has a woman Vice-President, and the civil service is headed by a woman. Women have been promoted in the judiciary, police, prisons and other sectors of the civil service.
With regard to harmful traditional practices that impinge on reproductive health and reproductive rights of women, female genital mutilation has been tackled through a culturally sensitive approach. As a result, within two years, a remarkable decline in this harmful practice has been witnessed in the district of Kapchorwa where it was most prevalent. The people of Kapchorwa were awarded the 1998 United Nations Population Award in recognition of this major achievement.
In the field of advocacy, and in order to enhance reproductive health and advocacy activities, Uganda has enlisted the support of Members of Parliament, who are now outspoken advocates of reproductive health and other population-related issues. We have also reached out to religious and cultural leaders who, just like the rulers of the various kingdoms in the country, have lent a strong hand to our programmes. This has widened participation and involvement of communities, ensuring ownership, commitment and sustainability of programmes.
Although Uganda has registered modest achievements in the field of population, social indices remain poor by any standards. The maternal mortality rate remains high at 506 per 10,000, while the infant mortality rate was high at 97 per 1,000 in 1995. The contraceptive prevalence rate stood at 15 per cent in 1995, while the total fertility rate remained high at 6.8 children in 1995. Poverty stood at 46 per cent in 1996 and life expectancy is low at a mere 48 years.
SALAH UDDIN YUSUF, Minister of Health and Family Welfare of Bangladesh: The paradigm shift in Cairo from people's numbers to their needs resulted in the reorientation of our approach to the population problem. Soon after Cairo, Bangladesh constituted a "National Committee for Implementation of the ICPD Programme of Action" and pursued its goals through the formulation of a National Plan of Action. Among the factors that have contributed to the progress attained are maternal- and child-health-based family planning programmes, expansion of education with high priority to girls' education, and women's empowerment and income generation activities, especially through microcredit programmes.
Resource constraints had been and continue to be the main obstacle in attaining our desired goal, as is true for most developing countries. There was some increase in the level of international assistance in the immediate aftermath of Cairo. But after two years, the flow became stagnant, and since 1998, it has started to taper off. A notable factor has been the efforts of
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the developing countries themselves, who have been more forthcoming in mobilizing domestic resources compared to availability of international assistance. The donor community has a critically important role in financing population activities. In many countries, particularly in the least developed ones, funding for such activities is donor-driven. Without adequate resources, the implementation of the Cairo Programme of Action beyond this review will not be sustained.
Also, the implementation of the ICPD Programme of Action is, to a large extent, dependent on an active partnership with international and regional financial institutions and the United Nations agencies.
HUMAID BIN AHMED, Minister of Planning, United Arab Emirates: The United Arab Emirates is among those countries that place particular importance on the Cairo Programme of Action. It was given a special place in its policies and plans for development. The United Arab Emirates believes that development policies should be based on the principles of justice, equality, respect for religious faith and belief. In regard to development goals, the international community must respect the differences between countries and societies, and allow countries to implement their own population policies based on what would best suit their people. Development also requires peaceful policies and the settlement of disputes. The world must find solutions based on the United Nations Charter and international law. I wish the special session every success.
MEKONNEN MANYAZEWAL (Ethiopia): No matter how best we have done during the past five years, it is simply not significant compared with the enormity of the task of the ICPD as shown by the recent evaluations of the ICPD+5 in Africa. This is due to what we call structural constraints of our economies (human resources, institutional and financial) in the region in general, and our respective countries in particular. While we take note of the emphasis given in the Programme of Action, gender equality and equity will remain "paper tigers" and rhetoric unless we focus on changing the material and economic conditions of women in developing countries.
It is important to take note of the delicate balance required in priority setting and resource allocation between reproductive health and other components of the health sector: epidemic disease control such as malaria, infectious diseases like tuberculosis and others, which are equally critical health problems of most developing countries within the wider health system. Compounding these problems, the debt situation of the poorest countries remains heavy and does not provide conditions for addressing poverty or the resource needs of the social sectors. Although the programme of action calls for national capacity-building and transfer of appropriate technology and know-how to developing countries to be the core objective and central activities for international cooperation, a lot remains to be done. We have
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to save the ICPD Programme of Action from the fate of its predecessors -- that is, the risk of remaining on paper.
YIGAL BEN SHALOM, Director-General of the Ministry of Labour and Social Affairs of Israel: While we are greatly heartened by the progress reported from every continent, we wish to add our voice to those who urge yet greater determination to advance the issues addressed in the report of the Commission on Population and Development. The past decade has seen an extraordinary amount of immigration to Israel, even for a nation of immigrants. That presents Israel with both a unique challenge and an exciting opportunity. Israel's population numbers over 6 million, which is 10 per cent larger than at the time of the Cairo Conference.
Despite the challenges, Israel has been successful both in absorbing new immigrants and in integrating them into society, particularly into the labour force. Close to 100,000 immigrants have participated in vocational training at varying levels. Immigrants fleeing violent unrest receive significant benefits and aid packages. Israel also seeks to cooperate with other nations in overcoming demographic and social problems and has made recent strides towards bridging the gender gap. Parliament passed a law establishing the National Authority for the Advancement of the Status of Women and the law preventing sexual harassment in the workplace. In addition, new legislation has been enacted to protect women on maternity leave.
Israel has been placing special emphasis on investigating and fighting domestic violence, and in the past few years, legislation was passed to protect women in situations of abuse. Yet, an equally high priority must be placed on long-term measures to prevent violence before it takes root. This calls for a broad campaign to educate the public about domestic violence. A new project to combat domestic violence by working at the early childhood level focuses on kindergarten children to identify certain types of violent behaviour at this early stage.
In this context, Israel launched a separate national project aimed at protecting children's rights, focusing on advanced preventive, emergency and therapeutic care to children in danger of abuse. The country is also intensifying efforts to reduce unemployment. We are still coping with basic problems like unemployment, but, in the long term, the added value of broadening our education system and integrating new waves of immigrants is beyond calculation. We believe that the current strains are, if you will, the growing pains of a new society just beginning to emerge from the rich diversity of peoples and cultures that are everyday changing the face of Israel.
ALDO CARRERAS, Under-Secretary for Population, Ministry of Internal Affairs of Argentina: The primary concern of development is the well-being of
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people. Therefore, the fundamental goals of poverty eradication and the fulfilment of the basic needs of all human beings and the protection of their universal human rights and freedoms -- including their right to development -- should not be forgotten. Hence, social progress cannot be subordinated to economic growth; the economy should be a tool for the individual and social development of human beings. It is the population and not the economy that should be the concern of development.
Reproductive health is an important concern within the primary health framework; however, it cannot just be understood as the regulation of fertility. Control of population growth should not be used as a "magic formula" for development. A broader concept of reproductive health should be taken into account in this special session. Too much time has been spent on the narrow interpretation of reproductive health and very little to issues related to real development.
A priority objective of population policies is the promotion and protection of the family. It should be recognized that the family is the basic group of society and constitutes a social good. Social policies have to be oriented in order to offer the most suitable framework for the development of the family. Among the rights of the family, it is of utmost importance to safeguard the right of parents on the education of children as proclaimed in the Universal Declaration of Human Rights.
JOSÉ-ANGEL PESCADOR, Vice-Minister for Population and Migration Services of Mexico: Mexico has put its Cairo commitments into action by launching in recent years national programmes on issues such as women, health and family planning and family violence. They involved multisectoral and humanistic approaches, reflecting a vision for the future and governed by the principle of respect of freedoms and rights of persons. Major changes in the last 25 years have resulted in a true population evolution in Mexico. The life expectancy rate went from 62 to 75 years. If a population policy, linked to the development process, had not been put in place, Mexico would have a population of about 142 million, instead of its present 98 million.
The Government is developing a set of actions for universal access to a broad range of high-quality reproductive health services for women and men. It rests on four pillars: family planning; perinatal health; sexual and reproductive health for adolescents; and women's health. It is redoubling efforts to combat the high rate of adolescent pregnancy and HIV/AIDS. It is also systematically reviewing the content of sex education in primary and secondary schools. Recent actions include: efforts aimed at including a gender perspective in public policies; the expansion of educational opportunities to permit more girls to attend primary and secondary schools; and the re-orientation of programmes of prevention and control of cervical and breast cancer. While much has been accomplished, many things remain to be
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done. There are myths and obstacles to overcome. The only guarantee for achieving the goals of the Cairo Programme of Action lies in joint efforts between the Government and civil society.
AGIS LOIZOU (Cyprus): Issues relating to gender equality and the empowerment of women are among the priorities of the Government. Reproductive health is integrated into the primary health-care system, and is provided free of charge by public-sector institutions and at affordable rates by the private sector. Family planning issues are entrusted to specialist doctors in the private sector, but more so to a non-governmental organization subsidized mainly by the Government. The services provided include access to information relating to sexual and reproductive rights, family law and sexual education.
In the last two decades or so, Cyprus has been experiencing an inflow of Cypriot expatriates and their families, as well as an influx of foreign workers coming to work on a temporary basis. The return of Cypriot expatriates is actively encouraged by the Government in an effort to address the overall labour shortage problem. Due to its small size and lack of absorptive capacity, the country cannot implement permanent immigration schemes. Hence, illegal immigrants are either repatriated, or sent to another country of their own choice, while some of them are accepted as genuine refugees and are given political asylum. Action is urgently needed at the international level to establish a new code of conduct for managing migration. Due to its small population, issues such as the fertility rate, implications of ageing, illegal migration, health issues and gender equality will continue to be matters of priority for Cyprus.
JASSIM MOHAMMAD BUALLAY (Bahrain): Population policies occupies a prominent place in the socio-economic policies of Bahrain. The Government accords importance to the question of population because it is responsible for the promotion of development. Bahrain has not embraced the message of comprehensive planning, but has adopted a simplified system of planning in view of the limited human and financial resources for expenditure and investment. It feels that population policies are part and parcel of socio- economic development. It seeks to upgrade and improve the quality of life for its citizens. For the third year in a row, it is the highest ranking Arab State in the human development index.
Bahrain's policy includes a combination of actions and programmes promoting the economic, social and democratic goals of the State. The formulation and execution of population policies depend on the evaluation of population variables. The implementation of the Cairo recommendations is among the priorities of the State. Intergovernmental cooperation and the high level of education and participation of women have contributed to the achievement of most of those recommendations.
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There is no need to renegotiate what was agreed to in Cairo or reinterpret it. The recommendations in the Programme of Action and in the working paper to be issued here is the sovereign right of each country. Due respect for the moral and cultural backgrounds of each country should be stressed. The final document must be based on the conclusions of the governmental and intergovernmental consultations undertaken under the auspices of the United Nations.
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