TRADITIONAL MALE BEHAVIORAL MODELS MUST BE RECOGNIZED AND CHALLENGED, ASSEMBLY SPECIAL SESSION ON IMPLEMENTATION OF CAIRO PROGRAMME OF ACTION TOLD

1 July 1999

Press Release
GA/9575

TRADITIONAL MALE BEHAVIORAL MODELS MUST BE RECOGNIZED AND CHALLENGED, ASSEMBLY SPECIAL SESSION ON IMPLEMENTATION OF CAIRO PROGRAMME OF ACTION TOLD

19990701 Demographic Pressure, Effects of War And Need for International Economic Aid Reform Also Addressed

Traditional male behavioral models must be recognized and challenged, the General Assembly was told today as it took up a broad range of issues during the fifth and sixth meetings of its twenty-first special session to review implementation of the Programme of Action of the International Conference on Population and Development (ICPD), held in Cairo in 1994.

Women's empowerment was imperative for gender equality and for achieving sustainable development, continued Lise Bergh, State Secretary for Gender and Equality Affairs of Sweden. Gender equality was at the heart of the Programme of Action; it demanded that male violence against women and irresponsible male sexual behaviour be challenged. Women's empowerment would lead to changes in traditional male roles and behaviour. Swedish experience indicated that men had much to gain from that process.

Haiti's Secretary of State for Population, Jean André, said that demographic pressure made it difficult to provide basic needs and considerably affected the quality of the environment in his country. At its current rate of expansion, Haiti's population would rise from 7 million today to 10 to 20 million in 2040, or three times its current figure. About 22 Haitians were born every hour -- a rate of 2.3 per cent annually -- in a land where only 1.5 per cent of land surface was covered by natural vegetation and the annual per capita income was $250.

Angola's Permanent Representative, Afonso Van Dumen "Mbinda", said 29 years of war had plunged about 65 per cent of Angolans below the poverty line. Maternity mortality rates were among the world's highest -- over 1,200 for every 100,000 births. Life expectancy was under 43 years. More than 2 million children were out of school, and women and children accounted for most of the almost 2 million displaced persons in the country. In developing countries, the goals of the ICPD would be attained only when financial and human resources were mobilized, and national capacity developed.

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Direct aid alone would not provide a lasting solution to the development needs of recipient countries, Donald Buchanan, Minister of State in the Ministry of Finance and Planning of Jamaica, said. It was also necessary to reform international economic and financial institutions to promote equitable relationships between countries, particularly in the area of trade, so as to avoid dependence on aid.

The Minister of National Unity and Social Development of Malaysia, Datin Paduka Zaleha Ismail, said that the effects of the financial crisis were visible in a breakdown of economies, job retrenchment, interruption of basic social services, food shortages and even civil and political unrest. A comprehensive solution to the crisis required global action, as well as reform of the entire international financial architecture.

The Minister of Planning of Senegal, Ibrahima Sall, said one area in which Cairo's goals had fallen short was the mobilization of resources. Progress achieved to date was basically due to domestic efforts, while international efforts had largely amounted to unkept promises. He hoped the special session would help reverse the negative trend of international financial assistance.

The representative of Suriname said it was commendable that the current review process had been successful in resisting attempts to re-open discussion on what had already been agreed upon in Cairo in 1994. "The current review now enables us to focus our attention on furthering the goals of the ICPD, rather than distracting us from doing what is right for our respective peoples."

Statements were also made by Ronald Knowles, Minister of Health of the Bahamas; Nobutaka Machimura, State Secretary for Foreign Affairs of Japan; Imankadyr Rysalieyv, Minister and Head of Department on Social Issues of the President Administration, Kyrgyzstan; Ali Nagiyev, Minister of Labour and Social Security of Azerbaijan; Abdelhamid Aouad, Minister of Economic Forecast and Planning of Morocco; Tran Thi Trung Chien, Minister and Chairperson of the National Committee for Population and Family Planning of Viet Nam; Ibrahim Hussain Zaki, Minister of Planning and National Development of the Maldives; and Gloria Valerin, Minister for the Status of Women of Costa Rica.

Also, Leonardo Santos Simao, Minister for Foreign Affairs and Cooperation of Mozambique; Nassoro Malocho, Minister of State for Planning of the United Republic of Tanzania; Petar Boyadjiev, Minister of Public Health of Bulgaria; Vladimir Hotineanu, Deputy Minister of Health of the Republic of Moldova; Billie Miller, Deputy Prime Minister and Minister for Foreign Affairs of Barbados; Miguel Abdon Saguier, Paraguay's Minister of Foreign Affairs; Eduardo Latorre, Secretary of State for Foreign Affairs of the Dominican Republic; Mrs. Bruce Mariama Aribot, Minister for Social Affairs, Advancement

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of Women and Childhood of Guinea; Elhadj Seydou Gassama, Secretary-General of the Ministry of Youth of Mali; Nabih Salameh Al-Zenat, Secretary-General, National Population Commission of Jordan; and Carlos Santos, Permanent Secretary of Belize.

In addition, the representatives of Kuwait, the Democratic People's Republic of Korea, Uzbekistan, Uruguay, Angola and Papua New Guinea addressed the Assembly.

The Assembly will meet again at 10 a.m. tomorrow, Friday, 2 July, to continue its special session.

General Assembly Programme of Work

The General Assembly met this afternoon to continue its twenty-first special session overall review and appraisal of the implementation of the Programme of Action of the International Conference on Population and Development (ICPD) (Cairo, 1994).

Statements

RONALD KNOWLES, Minister of Health of the Bahamas: The Government has initiated programmes for the elderly that will ensure their increased access to health care, improved housing, greater economic opportunity and participation in intergenerational and culturally-specific educational and recreational activities.

Regarding reproductive health and family planning, comprehensive family planning services, including counselling, physical assessments and relevant educational materials are available at all primary health care community clinics throughout the country. The provision of anti-retroviral therapy to all HIV-positive pregnant women is highly successful in saving lives. Additionally, a strong public education campaign and increased public awareness of vaccine-preventable diseases have contributed to the reduction in infant morbidity, mortality and improved care to women and their families. Since December 1996, all expectant women have been eligible for free antenatal and postnatal care at public hospitals and all community health clinics.

The 14 per cent teen birth rate is unacceptably high. Adolescents, aged 14 to 19 years, account for the fastest-growing new HIV cases and other sexually transmitted infections. The government is supporting a major adolescent reproductive health education project which is being executed by the Bahamas Family Planning Association and sponsored by a donor agency. There are plans to expand the interministerial programme "Providing Access to Continuing Education" (PACE), which allows pregnant teenagers to attend school during their pregnancy. This programme, provided free, has proven to be very successful in terms of recidivism, completion of high school and employment record.

Another major challenge is the issue of international migration. The Bahamas has been for many years the recipient of unprecedented numbers of undocumented migrants, who place a severe strain on limited resources. This burden is felt more so in the health sector and the Government has continually brought this matter to the attention of this Assembly. I reiterate the call made by the Minister of Foreign Affairs of the Bahamas at last year's fifty- third General Assembly session for increased international recognition or assistance to enable small countries to effectively and adequately deal with such challenges.

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NOBUTAKA MACHIMURA, State Secretary for Foreign Affairs of Japan: Population issues must be addressed by taking a comprehensive approach that promotes basic health care, education and the advancement of women, fully recognizing the interdependent relationship between development, population, food security and the environment. Japan supports the "proposals for key actions for the further implementation of the Programme of Action", as they expressly designate areas that should be given high priority and set specific targets, including the lowering of maternal mortality and morbidity rates, and the reduction of HIV infection rates.

Japan has been successful in lowering its infant and maternal mortality rates, and has implemented a variety of measures based on the concepts and spirit of reproductive health services proposed at Cairo. It has been making concerted efforts both to alleviate problems arising from the strains of balancing work and childcare and to enhance societal support for raising children. Moreover, a basic law passed recently is expected to provide the foundation for the realization of an equal partnership between men and women and to advance gender equality and the empowerment of women.

Japan has been the largest contributor to the United Nations Population Fund (UNFPA) from 1986 to the present, and contributes funds to the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). In recognition of the importance of ensuring reproductive health, Japan's Global Issues Initiatives on Population and AIDS (GII) calls for a comprehensive approach, covering primary health care for women and children, primary education and the empowerment of women. Population and HIV/AIDS needs to be urgently addressed by the international community as a whole. Therefore, Japan will continue to give them priority in its official development assistance (ODA) policy, focusing more on population control and measures against HIV/AIDS.

DATIN PADUKA ZALEHA ISMAIL, Minister of National Unity and Social Development of Malaysia: In 1994, east asian economies, including Malaysia's, were enjoying rapid economic growth. Today, this situation has changed. The effects of the financial crisis, beginning in mid-1997, are visible in a breakdown of economies, job retrenchment, interruption of basic social services, food shortages and even civil and political unrest. Programmes for basic development and survival must be protected and strengthened to minimise the impact of the crisis on all vulnerable groups. While a comprehensive solution to the crisis requires a global solution, there is need to reform the entire international financial architecture. Globalization has opened new opportunities for sustained economic growth and development of the world economy, yet the global community is threatened by environmental degradation, food crises, epidemics, discrimination, intolerance, violence and the risk of losing cultural diversity. There is need for increased solidarity and

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information exchange, to be expressed through multilateral programmes and strengthened international cooperation.

Malaysia has introduced a series of policies to address the economic and social impact of the financial crisis and ensure the continued implementation of the ICPD Programme of Action. It shifted its focus towards preventing further contraction of the economy, reactivating economic growth and ensuring the continuation of socio-economic projects so that living standards and quality of life, particularly for the poor, are not adversely affected. A comprehensive and integrated family development programme was developed to address the impact of socio-economic development on family structures, relationships and lifestyles. Partnerships between government, non- governmental organizations and civil society will be enhanced to complement efforts in achieving the goals set in Cairo.

Let us work together to advance the ICPD goals. We should make every effort to mobilise national and international resources, ensuring that the donor community fulfils its financial commitments. The current Asian crises and its implications on population programmes require urgent attention. This special session should be a time to strengthen and reaffirm our commitment so that all people can enjoy the benefits of development.

IMANKADYR RYSALIYEV, Minister, Head of the Department of Social Issues of the President's Administration of Kyrgyzstan: Among the responsibilities that governments undertook in connection with the Cairo Conference were guaranteed universal access to healthcare, family planning, reducing child and maternal mortality, access to family education, and elimination of the gender gap. Over the past 5 years, important progress has been achieved in reducing the birthrate and infant and child mortality, as well as promoting reproductive health, although the world financial crisis, wars and ethnic conflicts have hampered progress.

Like many other countries, Kyrgyzstan has felt the excesses of globalization. The situation is exacerbated by the inheritance of the past. The Government of the country has undertaken comprehensive reform within all spheres of social life. It pays great attention to family and health care, as well as poverty eradication. State programmes are endeavouring to improve the life of the elderly, the labour situation, public healthcare and so on. Those efforts are reflected in the country's legislation. A strategic plan of reproductive health has been elaborated. The country has also held its first population census.

The natural population growth and the birth rate have gone down. Infant mortality, however, has remained relatively high. Child mortality is primarily caused by infectious respiratory diseases and post-natal complications. Maternal mortality also remains high. Also, the problem of

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educating and training the population is acute. A Department of Youth Labour has been established to provide jobs for young people. The average life expectancy in the country was 67 years in 1998. The main reasons for death are cardiovascular diseases, accidents, respiratory, oncological and infectious diseases.

The main goal of State policy is to create the conditions for overall development of every human being and improvement of the standards of life. The Government of Kyrgyzstan is firmly committed to the Cairo Programme of Action. However, economic difficulties have made the implementation of plans difficult. Today, the United Nations Population Fund (UNFPA) remains the only source of financial assistance in the population field. Kyrgyztan calls on the donor countries to allocate a minimum of 4 per cent of official development assistance (ODA) to population resources. Otherwise, the objectives of Cairo could be unattainable.

ALI NAGIYEV, Minister of Labour and Social Security of Azerbaijan: As a result of Armenian aggression over the last 10 years, implementation of economic reform, formation of statehood, development of a multi-structural economy and its integration into the world market are taking place at a difficult time for the country when its every seventh citizen is either a refugee or internally displaced person. These factors have also substantially aggravated the population and development problems in the country. Current political and macroeconomic stability and an increasing level of investment have created a favourable environment for social reforms. These reforms are being supported by the firm commitment of the Government of Azerbaijan to implement agreements achieved at the series of important international conferences which took place in the 1990s, including those adopted in Cairo in 1994.

In the past five years reforms have been taking place in the field of labour relations, social protection, education and health. Population issues are being considered in the process of building a democratic State, based on the Azerbaijan Constitution which guarantees equal rights and freedoms for men and women. Basic principles agreed in international conventions have found their reflection in more than 30 laws, determining the basic of the social protection of the population, health and education. In the meantime, the considerable decrease in the population growth rate and increasing mortality -- including able-bodied and maternal mortality -- abortions, the decreasing number of marriages and increasing number of divorces, the negative growth of migration and declining fertility are all characteristics of the deepening demographic crisis in Azerbaijan.

These characteristics have been determined the necessity for the development and implementation of a national demographic policy and population development programme. In view of these characteristics, active measures are

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being taken to implement a comprehensive approach to address the issues of population and development in the context of the Programme of Action adopted at Cairo. However, a comprehensive population development policy -- one which recognizes the interrelationship and interdependence of various social factors and the impact of these factors on population issues -- is yet to be developed. The country is missing sufficient financial and human resources, as well as expertise in design and implementation of programmes in the area of population and development. There is, however, a strong political will to develop and implement these.

IBRAHIMA SALL, Minister of Planning of Senegal: Five years after Cairo, the international community is meeting to examine the road travelled, evaluate progress made and determine future needs. Controlling population, education for all and combating poverty are among the objectives to be achieved. Senegal's national strategy has been defined in its Political Declaration on Population. Among the principles of its policy are: the respect for fundamental human rights; the empowerment of the individual; national development; the right of individuals to choose the size of their family; and the right of children to survival and education.

Senegal had set out, even before Cairo, a bold policy for the promotion of women. It was pursuing its crusade against the detriments to women's health, and intends to strengthen its policies by elaborating legislation on reproductive health, matrimonial rights and a revision of the family code.

Economic and social development, based on combatting poverty, must remain at the core of our joint action. An area in which the goals of Cairo have fallen far short is the mobilization of resources. Progress achieved five years later is basically due to domestic efforts. International efforts have largely amounted to unkept promises. Senegal hopes that this gathering will provide the necessary momentum to reverse the negative trend of international financial assistance and provide strong support and the necessary resources. An honest diagnosis of the road travelled since Cairo will show the many challenges that still exist. Meeting those challenges will require, more than anything else, political will.

ABDELHAMID AOUAD, Minister of Economic Forecasting and Planning of Morocco: Morocco has remained faithful to the spirit of consensus that guided the Cairo Conference. The five years since the Conference have been marked by the pre-eminence of financial considerations, the pressure of foreign indebtedness, reduced international assistance and the acceleration of open markets. These have led to a worsening of human development indicators, particularly in developing countries.

Still, those countries have achieved considerable progress in terms of the Conference, relying primarily on their own national resources. Morocco

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has achieved notable successes. Measures were adopted to lend impetus to the Higher Population Commission, restructured at the national and regional levels. Work began on defining a comprehensive national population policy. A national congress was held on the rights of the child in 1994 and in 1996, an institute for the rights of the child was put in place. Draft laws to harmonize legislation on children's rights with international instruments would be introduced in autumn.

Further, since 1994, we have intensified our efforts in mother and child health care, particularly in improving access to and quality of reproductive health services, with emphasis on rural and disadvantaged areas. Strategies have been implemented to raise awareness on the importance of reproductive health, and resources in that area have been increased from 9 to 13 per cent between 1991 and 1998. Morocco is convinced that strengthening the status of women is a prerequisite to human rights. From the juridical perspective, Morocco is improving judiciary procedures and accelerating implementation of reforms. The strategy for women includes literacy programmes and support for women in economically precarious situations. The overall purpose is to empower women to exercise their political, social and economic rights. Violence against women is considered a human rights violation, and the Government has organized a national campaign to combat that phenomenon, working in collaboration with women's groups and relevant non-governmental organizations.

TRAN THI TRUNG CHIEN, Minister-Chairwoman of the National Committee for Population and Family Planning of Viet Nam: In recent years, Viet Nam's fertility rate has declined as have the infant and maternal mortality rates. Maternal and child health care and family planning services have been improved considerably. The present population growth rate of 1.8 per cent -- compared to 3.2 per cent at the beginning of the 1990s -- and its trend of further decline give a realistic hope that the replacement level fertility will be reached by 2005.

Although a number of significant achievements have been recorded in the field of population and family planning, difficulties and challenges still remain on the way to achieve population stabilization with high population quality and sustainable development. In the years to come, while maintaining efforts to reduce the fertility rate, the national population programme will focus more on population structure, population distribution and quality of population.

The key orientations will include: developing a comprehensive strategy on population and development; integrating the population and reproductive health/family planning programme into other socio-economic development programmes; promoting population education among young people; improving the quality of reproductive health/family planning services and clients' access to

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them; and improving the status and empowerment of women in the family and society. In the immediate future, the population programme will concentrate on remote, isolated and poor areas where the fertility rate is still high, so as to reduce the population growth rate on the one hand, and to create favourable conditions for socio-economic development and improved living conditions on the other hand.

IBRAHIM HUSSAIN ZAKI, Minister of Planning and National Development of Maldives: Population is of great concern to the Maldives, which as a small island developing State has unique problems. While its population of just over 250,000 is not big, the challenges are daunting. The wide and uneven distribution of the population across vast expanses of ocean makes it difficult to provide basic infrastructure and social services. Limited space in the emerging urban centres has led to overcrowding and housing problems. However, strong economic growth has enabled the Government to allocate approximately one-third of capital expenditures to social services. Improvements in health services has led to a substantial reduction in infant and maternal mortality. The literacy rate has reached 98 per cent and primary education is near universal.

While these are laudable achievements, much more needs to be done to cater to the growing number of youth. Also, we need to further reduce infant and maternal mortality and achieve higher levels of human resources development. In addition, we need to intensify efforts towards protecting and preserving our environment, on which we depend for our very survival. Consolidating the widely dispersed island population and reducing the cost of providing basic infrastructure is an important part of our population policy. We are also working towards diversifying our economy and creating greater opportunities for income and employment for all.

In a globalizing world, island nations such as ours, with limited natural resources and human capital urgently need the support and assistance of the international community in overcoming our inherent vulnerabilities and realizing the hopes and aspirations of our people for achieving lasting and meaningful development. In that context, it is regrettable that the world community remains far from meeting the funding goals that were agreed to at Cairo. We look towards the United Nations to ensure the creation of a just social and economic order that will lead to a future of hope and prosperity for all people.

GLORIA VALERIN, Minister for the Status of Women of Costa Rica: The Conference on Population and Development achieved progress in recognition of different rights of individuals, designed to enhance the quality of life. Today the Government of Costa Rica is promoting strategic activities in the field of reproductive and sexual health. Different programmes are presently carried out. A comprehensive programme for cervical, uterine and breast

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cancer is undertaking preventive measures and conducting educational campaigns to reduce the occurrence of cancer. A laboratory has been set up to process 400,000 pap smears each year.

Another programme enacted by the Government is devoted to sexual education of children and teenagers. It creates opportunities for personal development and improvement of life of children and adolescents. Efforts are being made for social empowerment of teenagers and single mothers by providing character-building exercises, employment opportunities and child-care. The programme on prevention of sexually transmitted diseases in child prostitutes identifies the needs of those individuals and brings them into the mainstream of society.

Other endeavours include the programme on the prevention of HIV/AIDS and the programme devoted to the questions of migration. An amnesty regime and complementary regulations on an emergency regime constitute parts of legislation normalizing the legal position of migrants. The considerations that brought about this legislation arose from the social drama, which resulted from natural disasters. The Government together with NGOs and United Nations agencies has established a tripartite commission to monitor the implementation of the Cairo Conference. In the area of development, a national employment programme for women promotes equity and equality in the access to education, health and development.

LEONARDO SANTOS SIMAO, Minister for Foreign Affairs and Cooperation of Mozambique: In 1994, Mozambique was in a period of transition from war to peace. Since then we have taken political and economic steps to improve the condition of the Mozambican people. The positive impacts of political and economic stabilization, coupled with greater allocation of resources to the social sectors, have contributed to implementing the Programme of Action. Legislation was approved on issues including education, culture, health, employment, environment, youth and social welfare. Like other developing countries, however, Mozambique's population growth rate is high -- estimated at 2.7 per cent per year -- due to factors including declining mortality rates and persistently high fertility rates. Infant and maternal mortality rates remain high for reasons including inadequate infrastructure, lack of qualified personnel, lack of drugs and persistent cultural and traditional practices. Inadequate international financing, imposition of conditionalities and reduced ODA exacerbate internal difficulties.

Mozambique's main objectives are to eradicate absolute poverty, increase girls' access to education, eliminate gender disparities, increase access to reproductive health care, reduce cultural and legal barriers that discriminate against women and girls, and reduce maternal and infant mortality rates. Gender equity and equality are priorities for my Government, since no development policy can succeed when one important segment of population is

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sidelined. A number of measures have been directed at improving the status of women, including the establishment of a multisectoral group, to implement a national post-Beijing Plan of Action. Today, women comprise 28 per cent of Parliament and 13 per cent of the Cabinet. With continued resolve to increase women's participation in all sectors, and programmes to increase their access to education, those numbers will increase.

Regional and international partnerships are key for implementing the Cairo action plan. We greatly appreciate the efforts of the United Nations agencies, funds and programmes for providing financial and technical support in the field of population and development. We hope this example will be followed by similar actions from those partners who committed themselves to supporting the Cairo Programme of Action. Resource mobilization and international cooperation should remain high on the future agenda if we are to further improve the implementation of the Cairo action plan. Throughout history, joint efforts have resulted in triumph over some of the daunting challenges faced by mankind, including epidemics, natural disasters and wars. Let us keep alive this spirit to ensure that future generations can enjoy a better world.

NASSORO W. MALOCHO, Minister of State (Planning) of the United Republic of Tanzania: The Government has instituted legislative and institutional changes to enhance gender equity and empowerment of women, apart from establishing a Ministry responsible for Community Development, Women Affairs and Children. The United Republic of Tanzania has also mainstreamed gender into a macro-economic policy framework, including the budgeting process and procedures. The National Population Policy of 1992 is being reviewed to incorporate the emerging concerns of gender, youth problems, HIV/AIDS, environment, poverty alleviation and the broader concept of reproductive health that encompasses sexuality and adolescent concerns which were not perceived as social problems in the past.

The United Republic of Tanzania, like many other African countries, is faced with a number of daunting challenges in its efforts to implement the ICPD Programme of Action. Although the Government has been increasing the share of resource allocation to the social sector and population programmes, resources available have tended to be much less than those required. Debt servicing has been a major constraint also. By the end of 1998, the country's external debt was about $8 billion, equivalent to 110 per cent of its GDP. Currently, about 35 per cent of the total annual budget goes to debt servicing. The HIV/AIDS epidemic is another threat to our socio-economic development. The role of UNAIDS has to be reinforced in leading a more concerted and coherent response to the HIV/AIDS epidemic. The United Republic of Tanzania has intensified its fight against HIV/AIDS through a multisectoral approach.

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Given the existing constraints and challenges that exist in the country, measures to create an enabling policy and legal framework have been undertaken. The impact of the reforms, it is hoped, will be to enhance partnership with the private/NGO sector. Consequently, governance, accountability and people's participation will increase. Eventually, the rationalization of public sector functions will make available more Government resources for social services.

PETAR BOYADJIEV, Minister of Health of Bulgaria: Radical reform in health care was undertaken in Bulgaria in 1997. Primary health care occupies an essential place in relation to health services offered to the population. In conformity with the Cairo Programme of Action, the primary health care system shall offer a complete package of services in relation to reproductive health. Health promotion activities and the prevention of sexually transmitted diseases, as well as unwanted pregnancies, have an appropriate place and role in the general practitioner's package of services.

International cooperation and partnerships have been of exceptional importance in the last few years in relation to the implementation of health and social reform in Bulgaria. The foundations for improving the quality of family planning services were laid within the framework of the "Family Planning" Project implemented between 1995 and 1997 and an opportunity was provided for effective cooperation with the non-governmental sector and the mass media.

Bulgaria's present priorities include the development of a comprehensive reproductive health strategy, in cooperation with the UNFPA, and the further development and implementation of a national reproductive health policy and programme elaborated on the basis of the recommendations of the European Conference on Population Problems and the Cairo Programme of Action.

DONALD BUCHANAN, Minister of State in the Ministry of Finance and Planning of Jamaica: The review process must, among other things, ensure that population strategies are geared towards achieving the goal of poverty eradication; address the linkages between adolescent fertility and the perpetuation of the poverty cycle; increase cooperation for capacity building in the area of reproductive health; and intensify efforts and commitments to address the AIDS pandemic. The purpose of the review is not to rehash old issues, but to work towards the achievement of the goals identified in the Programme of Action.

As a direct result of the ICPD, Jamaica revised its national population policy and formulated a national plan of action on population and development. My Government recognizes that sexual and reproductive health rests on the recognition of the basic rights of all couples and individuals to decide, freely and responsibly, the number, spacing and timing of their children, and

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to have the information and means to do so. Last year, we were pleased that a distinguished Jamaican Professor, Hugh Wynter, Chairman of the National Family Planning Board, received the 1998 United Nations Population Award in recognition of his role in shaping the family planning and reproductive health services in the Caribbean over the past 40 years. Due to the efforts of the Board and committed individuals like Professor Wynter, Jamaica today enjoys moderately low rates of population growth, fertility and infant mortality.

Adolescent fertility remains a serious problem in Jamaica, where about 25 per cent of total births are to adolescents 15 to 19 year old. Contraceptive use among them is low, which puts them at extreme risk of being infected by sexually transmitted diseases, including HIV/AIDS. Poverty is principally a youth phenomenon in Jamaica. Initiatives by Government, with assistance from UNFPA and USAID, targeting adolescents and youth in selected communities, have shown positive, but still limited results. The task ahead requires a much more comprehensive and integrated approach.

As a small island State, Jamaica's vulnerabilities lie not only in its susceptibility to natural disasters, but also to external macroeconomic factors. Indications are that related goals and objectives for fertility, life expectancy, primary health care, reproductive health, education and poverty eradication may not be achieved within the desired time-frame. Direct aid alone will not provide a lasting solution to recipient countries' development needs. It is also necessary to reform international economic and financial institutions to promote equitable relationships between countries, particularly in the area of trade, to avoid dependence on aid. Jamaica notes with special interest recent steps by the Group of 7 and some individual countries to reconsider strategies and to take tangible steps to alleviate the debt burden, particularly on the most vulnerable.

VLADIMIR HOTINEANU, Deputy Minister of Health of Moldova: The five years since the ICPD have been of great importance for Moldova. During that time, basic changes have occurred in all areas of social and economic activity, making irreversible the process towards democratization and a market economy. We have started a process for creating the legislative basis for gender equality, as part of efforts to implement the 1994 action plan. Further, efforts include reorganization of family planning services and the development of an educational system for young people. Thanks to close collaboration between Government, non-governmental organizations and United Nations funds and agencies, as well as collaboration with international organizations, there are positive trends in reducing maternal and infant mortality rates, and increases in use of contraceptives.

The Cairo Programme of Action was a milestone in terms of international development, and for that reason, Moldova supports the conclusions and recommendations contained in the report of the special session's preparatory

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committee, which includes key actions to be taken by the international community.

Moldova's limited financial resources have to some extent impeded implementation of the action plan. The international financial crisis has affected social protection programmes. Despite the fact that Moldova has given priority to issues of reproductive and sexual health, there are still deficiencies in terms of family planning. The numbers of abortions must be reduced and the provision of methods of family planning increased. The goals of the Cairo Programme of Action are of overriding importance for the entire international community. The Government of Moldova is making efforts to use all resources available to improve reproductive health. Ongoing support from the international community can have a positive impact on the creation of infrastructure and institutions for Moldova's development and population.

MOHAMMAD ABULHASAN (Kuwait): The international partnership at the high level shown here reveals the importance accorded by the international community to the issue of population and development. Kuwait views population issues, and how to deal with them, in light of a comprehensive development programme, and pays special attention to meeting human needs and uplifting the living standards of its citizens. Forty-two per cent of the Government's total expenditure is spent on the social sector. Kuwait's planning structure is reviewed through various studies. The level of expenditure on education in 1997 and 1998 reached more than 10 per cent of total public expenditures.

The State is keen on providing all types of health services to its citizens. Over the period from 1970 to 1990, the rate of expenditure on health amounted to over 14 per cent of total expenditures. Kuwait's efforts in providing adequate health services have resulted in a decline in infant mortality rates -- 11 per every 1,000 children. The services rendered by the State fulfil all the needs of the Kuwaiti population. The Government pays special attention to the housing programmes, as proper accommodation is a social necessity. In addition, Kuwaiti women enjoy all the rights guaranteed to them by the Constitution. Lastly, enforcing the recommendations contained in the Cairo Programme of Action is within the sovereign right of each State, corresponding to its national laws and development priorities, and taking into account its religious and cultural background.

LI HYONG CHOL (Democratic People's Republic of Korea): It is true that the primary responsibility for population and development lays with each country. However, serious economic stagnation and an unfavourable international economic environment makes it difficult for many developing countries to resolve the problem of lack of funds, resources and technical capabilities badly needed to achieve the goals of the ICPD. Since developing countries constitute the majority of the world population, without overcoming their serious economic difficulties and rectifying the unfavourable

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international environment that prevails for them, successful implementation of the Programme of Action is inconceivable.

It is imperative for the international community to facilitate the promotion of a supportive economic environment, particularly for developing countries in their efforts to eradicate poverty and achieve sustained economic growth in the context of sustainable development. To this end, ODA should be increased and active assistance provided for technology transfer and national capacity building as committed to by the developed countries in Cairo.

My Government considers the constant promotion of people's welfare as a matter of highest priority and has, for a long time, taken the resolution of the population issue as an important task directly related to the improvement of people's livelihood and future development of the country. Thanks to the Government's policies and the well-established socialist system, significant successes have been achieved, such as free medical care, 11 years of compulsory education, equality between men and women and a 150-day paid maternity leave.

ALISHER VOHIDOV (Uzbekistan): Representatives of more than 100 nationalities are living in Uzbekistan. This factor predetermines the constant attention of the Government to create all the necessary conditions for the free development of all people living in the country and harmonizing relations between them. Supporting socially vulnerable groups, assisting the population in adapting to new conditions, and neutralizing sharp social contradictions and inevitable difficulties must be the highest priority of the democratic State. Realization of a strong social policy directed towards providing reliable social guarantees and measures of social protection for the population at all stages of market transitions is the main principle of the approach towards the renovation of Uzbekistan.

In this regard, the new mechanism of social protection of the population has been developed on the basis of foreign experience and takes into account the national peculiarities of the country. A distinctive feature of the new system is a strictly differentiated approach to various groups of the population. The corner stone of Uzbekistan's social policy is its orientation towards support of the family. Assistance to families in need through local self-governing committees has received broad support. The Government has developed a programme of concrete measures on realization of interests of the person. It envisages the settlement of a complex of interconnected tasks directed to the: protection of the social and economic rights of the person; protection of human rights and legal support to persons; and the creation of conditions for the realization of cultural, spiritual and intellectual interests of the people. The realization of this programme renders special beneficial influence to the status of women in society and creates conditions for their increased involvement in social and political progress.

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The participation of women in political and public activities is one of the most important tools in achieving equal rights. The inclusion of women into different NGOs on the basis of their professional, social and cultural interests and their political goals has greatly expanded in the country. Presently there is a significant amount of NGOs in Uzbekistan. Most of them view their main goal as the realization of equal rights and opportunities for men and women, increasing the status of women in the family and society, and assisting in their adaptation to new social and economic conditions.

SUBHAS C. MUNGRA (Suriname): It is commendable that the current review process has been successful in resisting attempts to re-open the discussion on what was already agreed upon in Cairo in 1994. The current review now enables us to focus our attention on furthering the goals of the ICPD, rather than distracting us from doing what is right for our respective peoples. Suriname, with its diverse population, has reached a satisfactory level in dealing with all aspects of population issues. Notwithstanding the economic difficulties caused by the lack of financial resources as a consequence of fallen ODA and reduced export earnings, the country continues to strive to provide the needed services in the framework of the Cairo Programme of Action.

Within the framework of the overall implementation of the Programme of Action, progress has been made in the following fields: the establishment of a national office on gender policy and the advocacy of the ICPD principles; strengthening and expanding the NGO network involved with the implementation of the ICPD Programme of Action; implementation of a national programme for free cervix screening for five years; and establishment of a women's parliament forum and efforts to set up a youth parliament. In addition, priority areas of the Government population programme are: the promotion of gender equality, reproductive health, family planning, and the protection of human rights and the dignity of migrants. The second track is the guaranteeing of basic education, especially for girls and female adolescents.

BILLIE MILLER, Deputy Prime Minister and Minister of Foreign Affairs and Foreign Trade, Barbados: In the five years of implementing the Cairo ICPD Programme, much progress has been made worldwide in policy and programme design, legislative and institutional frameworks, and, to varying degrees, increased partnerships and collaboration. Still, many challenges remain -- the HIV/AIDS pandemic being a major one. Developed and developing countries alike are afflicted by its effects, not only in terms of mortality, but with regard to morbidity. There is a serious need to review the objectives and actions set out in Cairo and to evaluate new goals to arrest the spread of AIDS.

Adolescent reproductive health is another major challenge in implementing the Cairo Programme. Progress has been made, but the international community must continue to build on legal foundations based in

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the human rights of women and children, recognizing also that education is key to managing adolescent reproductive issues, along with the involvement of young people in programmes for them. Still another challenge is the phenomenon of population ageing, and the lessons learned in this area by developed countries can be passed on to the developing.

Recognizing the interdependence between poverty, economic development and the environment, Barbados, as a small island developing country with limited financial resources, has embarked on a social transformation programme embracing the most disadvantaged. A Ministry of Social Transformation has been established to eradicate poverty and reform the social sector. Inadequate resources for implementing the Cairo Programme remains a burning issue. Since the first enthusiastic flow of financial aid, donor fatigue set in and the flow ebbed. This development is a serious setback, particularly since the donor community plays an important role in financing population programmes in developing countries.

MIGUEL ABDON SAGUIER, Minister for Foreign Affairs of Paraguay: The country has established the basis for the institutional support for implementing the Cairo Programme of Action. Population and development programmes are promoted by the Population Fund whose underlying goals are viewed as being in the national interest.

Important progress has been made since the beginning of democratic reform in Paraguay, including the establishment of a new constitution as a legal basis for a reformed health system. Achievements include a plan to offer greater opportunities for women as a State policy. Another important measure adopted in the country's health reform system is the establishment of a National Council of Reproductive Health, set up to implement a national plan by the same name.

In 1987, 38 per cent of Paraguayans of reproductive age had access to reproductive health care, a figure which rose to 59 per cent in 1998. Another achievement is a training programme for midwives developed by the Ministry of Public Health and Social Well-being. Infant mortality is estimated at 40 deaths per 1,000 births; the armed forces and the police are part of efforts to eliminate gender stereotypes; new laws are being promulgated to promote women and the family. By the year 2000, the world will have over 6 billion inhabitants. In the future, cooperation and investment in critical areas will become key tools to achieve human development.

EDUARDO LATORRE, Minister for Foreign Affairs of the Dominican Republic: Population is the arena in which economic, social and cultural phenomena are expressed. The Dominican Republic has experienced dramatic changes in the last three decades. We have moved from 4 million to almost 8 million inhabitants since 1970. Life expectancy has increased from 64 years in the

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1980s to 70.3 years today, indicating an improved quality of life. Since 1996, the Dominican Republic has experienced sustainable development as a result of economic policies implemented by the Government of Leonel Fernandez, which resulted in an increase in the gross national product of 7.3 per cent. Further, social expenditures have increased to at least 30 per cent annually in areas of employment, education, health and housing.

The Dominican Republic's public policies are based on a recognition of the Universal Declaration of Human Rights. We start from the principles of placing human beings at the centre of development and women as the subject of human rights, and the actions of the population as indispensable components of sustainable development. The Dominican Government places reproductive health as an essential component in population and development. Strategies have been applied to meet the reproductive health needs of adolescents and youth. Among relevant legislative achievements, laws penalize domestic violence and violence against women and establish a quota of 25 per cent of congressional positions for women. The Government is committed to supporting the Programme of Action and the report emanating from The Hague International Forum. It commits to taking the necessary efforts to try to comply with the Programme of Action, with emphasis on promoting women's equality and empowerment, promoting reproductive health, strengthening organizations and mobilizing resources.

All countries should increase their contributions to programmes for development through the United Nations Population Fund (UNFPA). Non- governmental organizations must participate in implementing population and development programmes and in regional, national and international debates. Support from the UNFPA has contributed to the decrease of infant and maternal deaths and the development of local capacity for compliance with the Cairo agenda.

Mrs. BRUCE MARIAMA ARIBOT, Minister for Social Affairs, Advancement of Women and Childhood of Guinea: Guinea adopted a declaration on population policy in 1992, and revised it in 1996 to take into account the Cairo recommendations. It includes the following long-term objectives: controlling population growth, improving the status of women, protecting vulnerable groups, protecting the environment, integrating demographic issues into development planning, and support for data collection and analysis. The declaration was translated into a population programme adopted by the Government in 1999. To carry out that programme, structures and machinery have been set up based on a decentralized concept, to foster grass-roots participation.

The population programme identifies 59 projects, half of which pertain to health in general, reproductive health, fighting sexually transmitted diseases, including HIV/AIDS, maternal and infant health, and the well-being of adolescents. The projects also concern the socio-economic and political

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development of women, including their right to education and training. All the major development programmes take into account the objectives of the national population policy, and this is reflected in improved socio-economic indicators. Life expectancy increased from 45 year in 1984 to 52 years today, and contraceptive prevalence increased to 6.5 per cent compared to 2.5 per cent in 1990.

While progress has been accomplished, there is still a long way to go. The lack of financial resources is a primary concern. I am concerned at the modest amounts mobilized to implement the Cairo Programme of Action. Our economies are fragile. The spread of poverty does not favour the advancement of people. The heavily indebted developing countries need, more than ever, international assistance to help them carry out their population programmes. One tenth of Guinea's population are refugees from neighbouring countries. In some areas, the refugee population is greater than the indigenous population. They must be taken into account in addressing population and development programmes. I urgently appeal to donors to increase resources for such programmes. Only then will the children to be born in the third millennium live in a better world.

LISE BERGH, State Secretary for Gender and Equality Affairs of Sweden: The overarching issues on the ICPD agenda are crucial to development -- politically, economically and socially. One is the rights and needs of youth. It is important to realize that young people are living in a world where change is taking place at breakneck speed. On the threshold of an emerging millennium that will be theirs, young people have claims, expectations and hopes. Among the threats facing young people in early years are HIV/AIDS and sexually transmitted diseases. In and out of school, youth have a right to preventive means, such as education about sex and reproductive health, and to confidential reproductive health counselling and services. Sexuality is a reality and a strong force in life and needs to be recognized and addressed accordingly.

There is need for an environment and attitudes that can foster equality in relations between women and men. Traditional male behavioral models must be recognized and challenged. Male violence against women and male irresponsible sexual behaviour must be confronted. Another very important issue in this context is the empowerment of women. Great disparities remain in legal and traditional status, health and education between women and men. This is unacceptable. Especially the exposed and disadvantaged situation of girls and young women needs to be addressed. Gender equality is, thus, at the heart of the Programme of Action. Women's empowerment is, therefore, an imperative for gender equality and is absolutely essential for the achievement of sustainable development. But it is important to recognize that women's empowerment also leads to changes in traditional male roles and behaviour. Swedish experience indicates that men stand much to gain from this process.

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A persistent theme throughout most of the ICPD Programme of Action is the struggle against poverty. The allocation of resources to meet the ICPD agenda is, thus, a challenge nationally and internationally. Sweden's Government is committed to the United Nations target of 0.7 per cent for development cooperation and, in fact, aims to increase its allocations. Sweden will also step up its share of development cooperation resources for ICPD-related issues. The role of civil society organizations, such as non- governmental organizations and local community groups, is especially significant. They are partners in the task of putting the Programme of Action to work.

JEAN ANDRÉ, Secretary of State for Population of Haiti: At the dawn of the third millennium, the developing countries are still particularly preoccupied with the alarming living conditions of their populations, highlighted by indicators that have a great effect on socio-economic factors. In the majority of these countries, infant and maternal mortality rates, the spread of HIV/AIDS and unwanted pregnancies continue today to be a topic of major concern to officials.

In 1994, Haiti had an infant mortality rate of 74 deaths per 1,000 births, and a maternal mortality rate of 456 per 100,000 births. The prevalence of HIV/AIDS is estimated at 7 per cent of the total urban population, and 4 per cent of the rural population. About 22 Haitians are born every hour -- a rate of 2.3 per cent annually -- in a land that supports only 1.5 per cent of natural vegetation and where the annual per capita income is $250.

In Haiti, demographic pressure makes it difficult to provide basic needs and affects considerably the quality of the environment. If its rate of expansion remains the same, the population of Haiti will rise from 7 million to 10 million people in 2010 and to 20 million in 2040, or three times its current figure.

Among the measures taken by Haiti has been the creation of: a Ministry for the status and rights of women, part of whose task is to revise, develop or monitor the elaboration of laws guaranteeing respect for the rights of women; a Ministry of Environment, which has just completed a national Plan for the Environment with a large popular population; a national office for migration, which is currently establishing the conceptual basis for a national migration policy; and a Secretariat of State for Population.

ELHADJ SEYDOU GASSAMA, Secretary-General of the Ministry of Youth of Mali: Mali's levels of child and maternal mortality are among the highest in the world. The population is increasing rapidly, with uneven distribution. Further, Mali has intensive internal and external migration. These factors result in and are exacerbated by deterioration of environment, low levels of

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hygiene and low levels of literacy. Mali views the adoption of the Programme of Action as a decisive turning point in integrating population problems into development strategy. Since Cairo, Mali has achieved results in implementing the Programme of Action. It has drawn up a plan of action on population, emphasizing the operational aspects of population strategy with the aim of making more accessible basic services to the people.

Among other achievements, Mali has decentralized health services by creating community centres. A number of policies have been introduced to improve women's image in society, foster their access to productive and economic resources, and strengthen their access to economic resources. Efforts to strengthen women's groups have helped establish data on women, promote use of reproductive health care services, strengthen women's economic power and raise awareness on their status. Emphasis has been placed on improving girls' access to education and opportunities, with the larger aim of increasing women's participation in decision-making positions. In Mali, NGOs and various civil society groups are helping to create conditions favourable for individual and collective freedoms and to foster decentralization. Journalists are being organized in networks concerned with population matters.

School attendance of small girls is increasing dramatically. Many women who used to perform excisions no longer do so, and the creation of a national committee to combat harmful practices will further reduce the incidents. The State allocates financial resources to social sectors, but development partners have been crucial in financing population policy. External actors are the primary source of funding for population programmes. Overall, while Mali has made great strides in implementing the Cairo action plan, efforts have been hampered by the lack of human and financial resources, lack of sectoral mechanisms for coordination and the continuation of traditional and cultural practices.

JORGE PEREZ-OTERMIN (Uruguay): Having confronted economic and financial difficulties, Uruguay has focused on three main goals: the eradication of poverty; the promotion of reproductive health care; and gender equality. Without the right to life, other human rights would be meaningless. Infant mortality has been dropping drastically since 1985 and, at the end of this year, it will have been reduced by an estimated 50 per cent. This entire campaign aimed at improving the health of children has been supplemented by a programme to monitor maternal health care.

Although education had been provided by the State since the end of the last century, the emphasis now has been on pre-school education so that, by the year 2000, Uruguay can achieve the goal of schooling for all children. Educational reform entails the gigantic effort necessary so that even children in the poorest households can be provided with free textbooks and other needs that cannot be satisfied at home.

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Population problems can not be explained solely in terms of numbers of people, but also by the lack of such basic needs as health care, education and others.

NABIH SALAMEH (Jordan): The Programme of Action adopted at the ICPD in September 1994 has continued to resonate through all the population and reproductive health activities in Jordan. Since 1994, Jordan has carried out a Fourth Population Census, three demographic and family health surveys and two employment surveys. The data obtained was utilized in planning for activities related to population and development. A national population strategy was formulated and officially endorsed in 1996, and then revised this year in the light of new data with integrated reproductive health and gender components. A concomitant national family planning communications strategy was also developed to inform married women and men, religious and community leaders and service providers about a full range of reproductive health issues.

Today, a larger number of facilities in the public, private and NGO sectors throughout Jordan are providing better quality reproductive health and family planning counselling and services. In the last seven years, total fertility rate has declined by more than 1.2 births, and contraceptive prevalence has increased 53 per cent among married mothers from 15 to 49 years. More couples are currently informed and served so that they can freely take responsible reproductive health decisions. Last year, the Jordan National Population Commission participated in the Arab Conference on the Implementation of the ICPD Programme of Action in Beirut in September. The Conference recommendations emphasized, among other things, continuing the implementation of the ICPD Programme of Action; strengthening the political and institutional framework; and enhancing national capabilities and resource allocations.

CARLOS SANTOS, Permanent Secretary in the Ministry of Human Development, Women and Youth, Belize: Belize is an oasis of peace, justice and economic opportunity in Central America, an environment that attracts migrants from neighbouring countries and from as far away as Asia. At the same time, a continuing stream of educated Belizeans are migrating to more developed countries in North America and Europe. The Government, through the Ministry of National Security, is developing a comprehensive migration policy to address both immigration and emigration, presently implementing an amnesty programme that has so far enabled 16,000 persons to apply for permanent residency, most of them poor. This humane action will strain the already fragile economy, social services and environment. The assistance and support of partners in development is needed to cope.

One important area addressed by the ICPD Programme of Action in which Belize has made considerable progress is that of gender equality, equity and

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empowerment. The Government believes that one test of a society's value is the status its women enjoy, because wherever poverty prevails and opportunity is hollow, women bear the brunt of the suffering. The Government has passed such legislation in this area as a Families and Children Act of 1998 and a Gender Equity and Equality Strategic Plan of 1999. Unemployment among women is being combated through such steps as offering training in non-traditional areas and assuring access to capital. The Government has a target of 30 per cent for appointing women to key leadership roles.

Finally, to facilitate the work of a new Population Unit within the Ministry of Human Development, Women and Youth, Belize is working with international development partners to actively promote mechanisms that will establish more dialogue and closer collaboration among the social-sector ministries. Since taking office in 1998, the Government has kept its commitment to improve the economic and social well-being of all Belizeans and to honour and abide by all international commitments and obligations. It is no easy feat and it requires the cooperation, assistance and support of the international community. However, Belize sees challenges rather than obstacles in the work ahead.

JOSEPH DEMAS, Acting Director, Office of National Planning, of Papua New Guinea: The Constitution of Papua New Guinea recognizes gender equality and the empowerment of women. The Government has established a Women's Division mandated to formulate policies and programmes that address the status of women and, in 1994, the Government endorsed a National Women's Policy. The country's fourth national health plan was prepared for 1996 to 2000 and encouraged a shift in the delivery of health services to both urban and rural Papua New Guineans. Among other areas, the plan focuses on sex and reproductive health education, and a National HIV/AIDS Council has been established.

In 1995, Papua New Guinea endorsed an NGO policy that gave legitimacy and recognition to the role of churches in delivering health, educational and other social services. Also, a revised National Population Policy is expected to be in place later in the year.

Although the country has made progress in implementing the Cairo Programme of Action, there are still issues and problems that impede effective implementation of the programme. Among these are: lack of personnel and resources in the national population programme; gender equality; high maternal, infant and child mortality rates; a high incidence of sexually transmitted diseases, as well as HIV/AIDS. The private sector needs encouragement to become more involved in the programmes in reproductive and sexual health, and family planning.

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AFONSO VAN-DUNEM "MBINDA" (Angola): The scarcity of available data on the Angolan population is a matter of concern for the Government of Angola, since it hampers its ability to plan and implement social and economic development programmes. The ongoing war has severely affected the conduct of a general census of the population. The last one was conducted more than 29 years ago. The crisis has affected the social and economic sectors, plunging about 65 per cent of Angolans below the poverty line. Maternity mortality rates rank among the world's highest -- over 1,200 for every 100,000 births. Life expectancy is under 43 years old. More than 2 million children are out of school, and women and children account for most of the almost 2 million displaced persons in the country.

The Angolan Government, in collaboration with the UNFPA, has set as priorities for implementation, the recommendations issued at the Cairo Conference. It has already passed legislation to promote gender equality; strengthened the maternity health-care system; created a special agency to deal with population matters; introduced family education in public schools' curriculum; and included social and demographic factors in the implementation of all development programmes. The Government presently wishes to implement, among others, programmes that would improve children's access to school in an effort to eradicate illiteracy.

The goals of the ICPD programme of action could only be attained through mobilization of financial and human development resources, and through national capacity building. Donor countries should continue to provide financial support to the UNFPA so that the Cairo Programme of Action could be realized successfully, particularly in developing countries.

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