COMMISSION ON POPULATION AND DEVELOPMENT OPENS 35TH SESSION AT HEADQUARTERS
| Press Release POP/818 |
Commission on Population and Development
Thirty-fifth Session
1st & 2nd Meetings (AM & PM)
COMMISSION ON POPULATION AND DEVELOPMENT OPENS 35TH SESSION AT HEADQUARTERS
The Commission on Population and Development today opened its thirty-fifth session, with reproductive rights and reproductive health with special reference to HIV/AIDS as its theme. The session will last through 5 April.
In opening remarks, Thoraya Obaid, Executive Director of the United Nations Population Fund (UNFPA), said reproductive rights, as defined by the International Conference on Population and Development (ICPD) (Cairo, 1994), were basic human rights. The fact that the world’s population had not grown as fast as had been expected was an affirmation of the vision and success of the Cairo agenda. The slowdown in population growth did not mean, however, that efforts for population and reproductive health could slow down. While people were ageing, the world had more young people than ever before. The world was faced with a paradox; the need for reproductive health services was great and growing, and the funding for such services was declining.
To address those needs, the UNFPA had spearheaded a global campaign for reproductive health essentials, she said. The ICPD $5.7 billion financial target was far from being met, and more resources were urgently needed if its goals were to be achieved. She hoped the recent Conference on Financing for Development would result in greater funding for reproductive health, which was so crucial to women, families and sustainable development.
Comparing population estimates to weather forecasts, Joseph Chamie, Director of the Population Division, Department of Economic and Social Affairs, said that the extended long-term population projections remained unsettled. While for some areas it was “partly sunny”, unstable conditions were expected to persist in many regions for some time. Scattered clouds were also forming on the horizon due to intensifying ageing, mortality disturbances and migration streams. The Commission had kept the international community visibly mobilized and committed to addressing population and development issues, and that tradition needed to continue into the twenty-first century.
Nitin Desai, Under-Secretary-General for Economic and Social Affairs, stressed the interconnection between the agendas of the Commission and such other United Nations bodies as the Commission on the Status of Women and the Commission on Sustainable Development. One prominent issue of the current session was how to handle the review process of the Cairo Conference, for there was a high degree of overlap with various other processes dealing with social, environmental and human rights issues. A single coherent framework was needed for monitoring implementation of the goals set by major international conferences of the 1990s.
1st and 2nd Meetings (AM & PM)
The debate on the concise report of the Secretary-General on world population monitoring, 2002, was launched by the special discussant for the current session, Amy Tsui, Professor from Johns Hopkins University, who stressed the importance of the macro-level development implications of improved reproductive health, and national responsibility for the right to health.
In the following discussion, several speakers supported the statement by the representative of Egypt who called into question the credibility and objectivity of the report. When referring to reproductive health, family planning and maternal mortality, the document failed to make reference to the ethical behaviour and the preventive aspects of HIV/AIDS, he said. Its authors should also have adhered to the language adopted at the special session on HIV/AIDS as far as vulnerable populations most at risk of sexually transmitted infections were concerned. Such a report should not be even referred to in the resolutions to be adopted by the Commission.
While supporting the report’s coverage of efforts to address the HIV/AIDS epidemic, the United States’ representative said that the lack of current, accurate and comprehensive data in its section on abortion raised questions regarding the validity, purpose and intent of the analysis. In fact, the ICPD Programme of Action had called upon governments to help women avoid abortions, but progress in that area was absent from the report. The United States also did not accept the use of the term “reproductive health services”, because it could be interpreted to include promoting the legalization or expansion of legal abortion services.
During the organizational part of today’s meeting, the Commission elected by acclamation Antonio Golini (Italy) as Chairman of its current session, and Makato Atoh (Japan) as one of its three Vice-Chairmen. It further adopted its provisional agenda for the session and took note of the report on the inter-sessional meeting of the Commission’s Bureau, held at Headquarters in New York on 7 and 8 November, which was introduced by Mr. Atoh (Japan), the Chairman of the Commission’s thirty-fourth session. The Commission also agreed on its organization of work for the session, which was introduced by Mr. Chamie.
Reports before the Commission were introduced by Birgitta Bucht, Assistant Director and Chief of the Demographic Analysis Branch of the Population Division; France Donay, Chief of the Reproductive Health Branch, Technical Support Divisions, UNFPA; and Mari Simonen, Director of the Technical Support Division, UNFPA.
Statements were also made by representatives of Spain (speaking on behalf of the European Union and associated States), Iran, China, Yemen, Japan, Mexico, Pakistan, Syria, Ghana, Algeria, Indonesia and Canada.
The President of the Economic and Social Council, Ivan Simonovic (Croatia), also addressed the Commission, as did Steven W. Sinding, Director-General Designate of the International Planned Parenthood Federation.
The Commission will meet again at 10 a.m. Tuesday, 2 April, for its general debate on national experience in population matters.
Background
The Commission on Population and Development opened its thirty-fifth session this morning to elect officers, adopt its agenda and consider other organizational matters and follow-up actions to the recommendations of the International Conference on Population and Development.
For background information, see Press Release POP/817 of 28 March 2002.
Statements
In his opening remarks, NITIN DESAI, Under-Secretary-General for Economic and Social Affairs, stressed the interconnection between the agendas of the Commission and other bodies. For instance, next Monday, the Second World Assembly on Ageing would begin its work in Madrid, Spain. While generally the aspects of the ageing of the world population had been handled by the Commission for Social Development, they were connected with the work of the Commission on Population and Development. The demographic, social and economic dimensions of the issue were coming together, and it was important to recognize such interaction. Other examples that came to mind were the links with the work of the Commission on the Status of Women and the Commission on Sustainable Development. Clearly, such links would figure prominently in the work of the Commission during the current session.
Demographic issues were also part of Agenda 21, he continued, and it was important to ensure coherence in the work of various bodies on them. He also emphasized the importance of coordination and coherence of policy development at both global and national levels, when the same issues were discussed in various bodies.
One prominent issue of the current session was how to handle the review process of the International Conference on Population and Development (ICPD) (Cairo, 1994), he said, for there was a high degree of overlap with various other processes dealing with social, environmental and human rights issues. The question was how to connect the discussion of those issues in various organs. Some mechanisms were becoming available in that respect, at least where the goals of development were concerned. Some of them had been addressed in the Millennium Declaration -– an overarching framework for the international community’s work. Now, a single coherent framework was needed for monitoring implementation of the goals set by major international conferences, including the Copenhagen meeting on social development and the special session on HIV/AIDS.
He went on to say that many of the issues, which had been discussed separately by various conferences, had been brought together at the just concluded Monterrey Conference on Financing for Development, which provided new commitments on resources needed, including those for official development assistance (ODA). He hoped that it would allow for more effective implementation of the ambitious goals of the 1990s international conferences. It would be increasingly difficult to take an isolated view of each of those conferences, and that was one of the challenges before the Commission in its work during the current session.
THORAYA OBAID, Executive Director of the United Nations Population Fund (UNFPA), said this year’s theme had important implications for all of humanity, which was about ensuring that people could protect their health, their lives and their futures. Reproductive rights, as defined by the ICPD, were basic human rights. In Cairo, eight years ago, 179 countries had agreed on the goal of universal access to reproductive health services by the year 2015.
She said that the fact that the world’s population had not grown as fast as had been expected was an affirmation of the vision and success of the Cairo agenda. The decline in fertility was due to improved levels of schooling, higher survival rates of children, and better access to contraceptives. The slowdown in population growth did not mean, however, that efforts for population and reproductive health could slow down. Today, there were more than 120 million women who wanted to space the births of their children. Demand for contraception was expected to increase by a further 40 per cent in the next 15 years.
The condition that would allow the decline in population over a long period of time depended on the implementation of the Programme of Action. Over the next 25 years, the world would add as many people as it did the past 25 years. While people were ageing, the world had more young people than ever before. The world was faced with a paradox; the need for reproductive health services was great and growing and the funding for such services was declining. Developed countries needed to raise development assistance in line with the Cairo agreement.
Despite increased awareness and commitment, HIV/AIDS continued to spread, she continued. Most poor women and adolescents still did not have the education and health services they needed. If further progress was to be made, reproductive health and rights must be placed high on the agenda of the upcoming global meetings, such as the World Assembly on Ageing, the children’s summit and the World Summit on Sustainable Development.
She said the UNFPA had spearheaded a global campaign for reproductive health essentials, such as condoms. Funding for contraceptives for family planning and condoms to prevent HIV/AIDS would double in the next 15 years. Despite that growing need, donor support for contraceptives was at its lowest level in five years. The UNFPA was facing a serious financial situation, as a shortage of
$50 million was projected for 2002. The ICPD financial targets were far from being met. More resources were urgently needed if the goals were to be achieved. She hoped the recent conference on financing for development would result in greater funding for reproductive health, which was so crucial to women, families and sustainable development.
JOSEPH CHAMIE, Director, Population Division, Department of Economic and Social Affairs, said that at the time of the establishment of the Commission, the world population had stood at 2.3 billion and was growing at roughly 40 million per year. In the early 1950s, governments were not at all prepared to take up the sensitive issues of population and development in a global format.
The 1954 and 1965 United Nations conferences on population and development had been scientific gatherings, which represented a big step forward, he continued. The first one emphasized the importance of the collection of data to facilitate population and related research, as well as the need for economic and technical assistance to developing countries to establish accurate and comprehensive databases. The second conference covered a wide spectrum of population and development issues, including fertility and family planning, which had previously not been addressed.
By the end of the 1960s, the climate at the United Nations had changed dramatically, he said. The world community of nations was now ready to take up population and development. In 1974, the first United Nations intergovernmental world conference on population and development was held in Bucharest, at which a ground-breaking World Population Plan of Action was adopted. The Plan stressed the urgency of accelerating social and economic development and the need to bring about a new international economic order. Many of the principles that were now taken as given had been formally adopted in Bucharest. The second United Nations intergovernmental conference on population and development had been held in Mexico City in 1984. By that time, most developing countries had actively embraced many of the principles and recommendations adopted in Bucharest.
At the start of the 1990s, world population had reached 5 billion and was adding 87 million people annually, he continued. The September 1994 International Conference on Population and Development, which was held in Cairo, introduced a large number of innovations, with new issues, new approaches and new activities. Perhaps one of the greatest contributions of the Cairo Programme of Action was the expansion of agreed language, which helped facilitate consensus on a set of norms that were increasingly being embraced by both governments and people all over the world.
Turning to the current population trends, he said that the forecast for the next five decades was for demographic growth, especially in urban areas in the South. Among other trends were declining fertility rates, widespread ageing and continuing migration. In 2050, the world population was expected to reach
9 billion people, but the figure could stand at 8, or 11 million, depending on the developments. In contrast to the demographic accumulation of around 3 billion people in such countries as India, China, Pakistan, Nigeria, Bangladesh and Indonesia, most areas of the northern hemisphere would see little, if any, population growth.
Some places, he said, including Italy, Germany, Japan and Russia, were likely to experience demographic shortfalls. Notable exceptions, however, were Australia, Canada and the United States, which were expected to have demographic accumulations of 30 to 40 per cent by the end of the five decades. Elevated rates of mortality would result in reduced life expectancies at birth in some less developed countries. The HIV/AIDS epidemic was ravaging much of sub-Saharan Africa and some parts of South and East Asia.
Comparing population estimates to weather forecasts, he said that the extended long-term forecast remained unsettled. While for some areas it was “partly sunny”, unstable conditions were expected to persist in many regions for some time. Scattered clouds were also forming on the horizon due to intensifying ageing, mortality disturbances and migration streams.
In conclusion, he said that hindsight provided a perspective on past efforts, and foresight offered a vision of what was likely to develop in the future. Much work still lay ahead. The Commission continued to have a critical role to play in the international debate on population and development. It had demonstrated courage in addressing major population and development challenges, and its invaluable leadership and guidance to the world community had contributed to remarkable progress during the past five decades. It had kept the international community visibly mobilized and committed to addressing population and development issues, and that tradition needed to continue into the twenty-first century.
Adoption of Agenda and Other Organizational Matters
MAKOTO ATOH (Japan), Chairman of the Commission’s thirty-fourth session, introduced the report on the inter-sessional meeting of the Bureau, held at Headquarters in New York on 7 and 8 November (document E/CN.9/2002/CRP.1). The items discussed at the meeting covered the proposed agenda and organization of work of the Commission in 2002, the special theme and agenda of the thirty-sixth session of the Commission in 2003, the second quinquennial review and appraisal of the implementation of the Programme of Action of the ICPD, and other activities that might take place to mark the tenth anniversary, and other matters.
Mr. Atoh said Annex III of the report gave some recommendations. Among them were the designation of a special discussant to launch the debate on concise report of the Secretary-General on world population monitoring 2002 (document E/CN.9/2002/2), and convening of a panel to discuss the special theme of reproductive rights and reproductive health. The Bureau had also taken note of the work programme of the Population Division of the United Nations Secretariat.
The Commission took note of the report and adopted the provisional agenda (document E/CN.9/2002/1).
The document on the draft organization of work for the session was introduced by Mr. CHAMIE. He also said that a draft resolution on reproductive rights and reproductive health, as well as a draft on review and appraisal of the progress made in achieving the goals and objectives of the ICPD Programme of Action, had been distributed to the members of the Commission this morning.
The CHAIRMAN made several procedural proposals regarding the format of work for the current session.
The Commission then agreed on its organization of work for the session.
Introduction of Reports
BIRGITTA BUCHT, Assistant Director and Chief of the Demographic Analysis Branch of the Population Division, introduced the Secretary-General’s report on the world population monitoring (document E/CN.9/2002/2).
FRANCE DONNAY, Chief of the Reproductive Health Branch, Technical Support Division of the UNFPA, introduced the report on monitoring of population programmes, focusing on reproductive rights and reproductive health with special reference to HIV/AIDS (document E/CN.9/2002/3).
MARI SIMONEN, Director of the Technical Support Division of the UNFPA, introduced the report of the Secretary-General on the flow of financial resources for assisting in the implementation of the Programme of Action of the ICPD (document E/CN.9/2002/4).
Statement by Special Discussant
AMY TSUI, Professor of Johns Hopkins University, said that the Population Division’s World Population Monitoring report for 2002 focused on reproductive rights and reproductive health and made a substantial contribution by empirically advancing the understanding of that sub-area. It summarized recent information on the “behavioural epidemiology” of reproductive health, reviewing global trends in key events of the reproductive life cycle and examining the risks associated with adverse phenomena.
In particular, she continued, it demonstrated that repeated exposure of individuals to the dual risk of unwanted pregnancies and sexually transmitted infection from unprotected sexual intercourse could be followed by such harmful consequences as unsafe abortion, life-threatening pregnancy complications, male or female infertility, HIV transmission to partners and newborns, and mortality. Exposure to sexually transmitted infection, unplanned pregnancy and such health assaults as malaria, tuberculosis and malnutrition -- whose levels were unacceptably high in poverty-striken areas -– compromised the individual’s right to a healthy existence and enjoyment of life.
Highlighting the course of sexual and reproductive life of an individual, she said that it illustrated two points that she wished to make: the macro-level development implications of improved reproductive health and national responsibility for the right to health. Summarizing the outcome of the United Nations population conference, she said that she had personally lamented the divergence between directions of population policy discourse at Bucharest and Mexico City and those of Cairo -- enough to have mulled writing an essay as to whether in 2004 the world would be at “Bucharest+30” or “Cairo+10”, pluses being used frequently these days to signify presumed progress. Her own frustration with the Cairo agenda had been its highly gendered and micro-level arguments. Cairo+10 was, in fact, Bucharest+30, meaning that the global community increasingly believed that investing in health was an investment in development.
Poor health outcomes were strongly correlated to poverty, she said. The two conditions were reinforcing and reciprocal, with countries burdened by disease tending to have low and unstable economic growth. Income inequalities were also associated with health inequalities, both across and within populations. Embracing reproductive health care as a component of essential health services in the context of poverty reduction reflected commitment to investing in health as a means to improving human capital and economic welfare. The connection between the micro aspects of reproductive health and the macro issues of development was now established. It was also important not to forget the demographic bonus of the expansion of and access to contraceptive services.
On 28 March, the Government of Malawi had disseminated its first Reproductive Health Policy, which supported comprehensive reproductive health care, addressing each event in the behavioral epidemiology sequence, she said. Developed as an integral part of the national development policy, the document identified reproductive health as a major component of the Government’s poverty reduction plan. Her suggestion to the Commission was that Malawi, an impressively poor and disease-afflicted country, had managed to connect the micro- and macro- concerns of reproductive health and national development. She was confident that other governments had or would soon follow that course of legislation. Reproductive health and rights were about human development and freedoms.
Statements
JUAN MARIA LOPEZ-AGUILAR (Spain), speaking on behalf of the European Union and associated States, said reproductive and sexual health, as well as reproductive rights, were a cornerstone of any effective strategy for the eradication of poverty and of achieving other development goals of the Millennium Declaration. The Cairo consensus had embraced the right of individuals to attain the highest standard of sexual and reproductive health, recognizing the right of couples and individuals to decide freely and responsibly the number, spacing and timing of their children. Gender equality was at the heart of the ICPD’s Programme of Action.
At Cairo, he said, it was agreed that appropriate mechanisms should be established to respond to the special needs of adolescents, and that much more was needed to protect and promote the rights of adolescents to reproductive health education, information and care. Governments should renew their efforts to establish and strengthen national statistics and gender and age data collection concerning sexual and reproductive health, as well as reproductive rights, particularly regarding maternal morbidity and HIV/AIDS. He encouraged governments to take appropriate steps to help women avoid abortion, which in no case should be promoted as a method of family planning. He also encouraged governments to prevent and end unethical practices, such as prenatal sex selection and all forms of violence against women, including female genital mutilation, rape, incest and trafficking of women for sexual work.
The fight against HIV/AIDS required an appropriate, comprehensive and coherent structural response at all levels, which demanded urgent human and financial resources. The European Union was the greatest contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Prevention was the mainstay of the response to the AIDS epidemic. Education, information and openness were the main tools in that regard. A special priority should be the increase of capacities of adolescents to protect themselves from the risk of HIV infection.
The European Union did not believe that there should be a major conference 10 years from Cairo, he said. The review of the ICPD should take place in the Commission. International cooperation was a key issue for the implementation of the Cairo commitments. The Union was aware of the need for additional resources and, therefore, welcomed the spirit of the International Conference on Financing for Development. He expected that the World Summit on Sustainable Development in Johannesburg would also contribute to that process. With sustained effort, partnership and goodwill, he believed that progress could and would be made in achieving the objectives of the ICPD.
HAZEM M. FAHMY (Egypt) stressed the importance of the section of the report on world population monitoring relating to reproductive health, family planning and maternal mortality. Pointing out a certain imbalance in the report, he said that, despite the detailed analysis of the issues, it contained a limited number of recommendations, in particular, regarding the influence of diseases. One section in question had failed to make reference to the ethical behaviour and the preventive aspects of HIV/AIDS. For instance, the report contained reference to an increase in the rate of STI among young people, because they started their sexual life at an earlier age, but there was no suggestion concerning the importance of establishing criteria or guidelines for education to explain the dangers of early sexual activity to young people.
In many of its paragraphs, the report referred to the social categories most exposed to contagious sexually transmitted diseases, he continued, including sex workers and their clients, as well as homosexuals. In that context, the report referred to the controversial part of the text, which had almost led to a failure of the special session on HIV/AIDS. There, agreement had been reached on a compromise text, and the authors of the report should have respected that consensus, adhering to the adopted language, instead of opening up a new controversy.
He added that in references to violence in relation to women’s health, the report referred to statistics on crimes against honour and virtue of women in some specifically mentioned States. At the same time, the report said that certain statistics presented in it were not reliable. That stood in contradiction to the accepted methodology and to the scientific approach to drafting such a report. That called into question the credibility and objectivity of the report in its various sections, and he found it impossible to adopt the report or even to refer to it in any resolution to be drawn by the Commission. He hoped that future reports would not include the unjustified weaknesses of that nature.
NASROLLAH KAZEMI KAMYAB (Iran) said his country had made tremendous achievements in the areas of education and health care during the past two decades. Those achievements had been the result of a comprehensive socio-economic and cultural process integrating all relevant actors, in particular, through emphasis on gender related policies. Education and family patterns were strongly linked. Educated people had more opportunities and options, preferred to postpone their marriage and preferred smaller families. At the end of the 1990s, 97 per cent of children were enrolled in primary education, with rates the same for boys and girls.
He said universal access to health-care services was another important factor for reproductive health and to size of population. In 1988, Iran had initiated a wide range of reproductive health- and family-planning programmes. As a result, the maternal mortality rate fell from 237 per 100,000 in 1988 to 37 per 100,000 at the end of the 1990s. That was the result of a well-developed and gender-sensitive health-care network. The Government was strongly committed to the promotion of education and health-care systems, in particular, the provision of reproductive health care. Some of the challenges: the high rate of unemployment; competition with other sectors for public funding; and the fact that children of the baby boom in the early 1980s would soon reach the age of marriage. Reproductive health and family planning will need more financial and human resources.
Commending the report on world population for the year 2002, he said certain issues should have received more attention, such as the reproductive needs of Afghan refugees. As for information technology, he said the question was how to strengthen the development role of the United Nations system and its support for
national development strategies and programmes by promoting the transfer of technology and access to knowledge. He was concerned that the resources available to the United Nations system to assist developing countries in establishing the basis for reproductive rights were simply inadequate.
ZHANG HANXIANG (China) said family planning had played an important role in preventing unwanted pregnancy, reducing abortion and improving women’s reproductive health. At present, the basic needs for family planning of many couples and individuals in various parts of the world had not been met. Governments and family planning workers should take more responsibilities in protecting couples and individuals’ reproductive rights and reproductive health. In China, cases of abortion had been reduced from 14 million in 1991 to
6.6 million in 2000, reflecting the remarkable achievements China had made in the quality of reproductive health care and family planning services.
He said special attention should be paid by the international community to the prevention and control of HIV/AIDS in the developing countries. Prevention should be an important strategy in controlling HIV/AIDS. Promotion of condom use and expansion of condom social marketing should be strengthened. To reduce the infection risk, male and female condoms should be made available for those people who might be easily infected.
International cooperation should be further strengthened for the mobilization of resources to support developing countries in their efforts to control HIV/AIDS, including the promotion of enabling AIDS patients in developing countries to get access to effective treatment and affordable medicines. He supported a comprehensive review and appraisal in 2004 of the further implementation of the ICPD Programme of Action. It was of great significance for the development of the world population programmes and for the realization of the goals and objectives set by the Programme of Action.
AHMED AL-HADDAD (Yemen) said that his country was following and monitoring the implementation of the recommendations of the ICPD, having included them in national development plans. Turning to the report on the world population monitoring, he noted the lack of mention of the ethical aspects that would prevent transmission of sexually transmitted infections (STI), as well as the moral and ethical dimensions of the question. It was important to warn the people against the risks and dangers of early sexual behaviour. In some paragraphs, in particular paragraph 148, on vulnerable groups of population that were at risk of STI, there was diversion from earlier agreed upon texts, and it was important not to reopen the contentious issues.
The report also contained reference to honour killings “reported in Lebanon and Yemen,” he added. That phrase should not have been included in the report, for there was no accurate data or information in that regard. If such information was reported, whom was it reported by? Accurate data should be presented, and it was important to correct the inaccuracies.
IVAN SIMONOVIC (Croatia), President of the Economic and Social Council (ECOSOC), stressed the significance of interaction between the ECOSOC and the Commission. He said it was important that the policy recommendations adopted by the Council be taken into account in the work of the functional commissions. He commended the Commission for systematically sharing information about its work through a letter from the Commission’s chairperson to chairpersons of the other functional commissions. The Commission could further enhance cooperation, for example, through the organization of joint bureau meetings. He also noted with satisfaction steps taken by the Commission to ensure continuity in the work of its successive bureaus.
He said a further area of interaction between the Council and the Commission would be the joint meeting of the two bureaus to be held during the current session. That meeting would allow the Commission’s bureau to highlight important aspects of its work in relation to the responsibilities of the Council, as well as to indicate contributions that could be made to the themes and issues being treated by the Council.
He strongly encouraged the Commission to contribute to the Council’s deliberations at the high-level segment of 2002, which has as its theme “The contribution of human resources development, including in the areas of health and education, to the process of development”. He said the current session’s theme was a matter of great relevance, and the ECOSOC would closely follow the Commission’s achievements. In conclusion, he said that the increased interaction between the Council and the Commission showed that the two bodies did not work in isolation from each other, but benefited from each other's efforts and mutually reinforced the policies and action strategies developed in their respective areas of responsibility.
SICHAN SIV (United States) said that he supported elements of the reports before the Commission that discussed efforts to address the HIV/AIDS epidemic, including an integrated approach to prevention, care and treatment, as well as the need to involve a broad range of stakeholders. However, his delegation had serious concerns about other elements of the reports.
The special session on HIV/AIDS in June 2001 had demonstrated the profound impact of the epidemic and the growing political commitment to a global response, he continued. The same concerted, comprehensive approach was also required to make further progress in implementing other key components outlined in the reports before the Commission. The United States was committed to providing assistance to achieve the three principal goals adopted in the ICPD Programme of Action, including making reproductive health care accessible to all individuals of appropriate ages through the primary health care system; reducing maternal mortality; and ensuring universal access to primary education.
In order to achieve those goals, however, it was important to focus on sound, evidence-based strategies to improve the lives of women, he said, rather than using dated or non-existent data as the basis for analysis. That was most apparent in the section on abortion. The lack of current, accurate and comprehensive data in that section led to questions regarding the validity, purpose and intent of the analysis. In fact, key actions in the ICPD Programme of Action called upon governments to take appropriate action to help women avoid abortions, but progress in that area was absent from the report. Furthermore, his delegation did not view the terms “reproductive health care” and “reproductive health services” as interchangeable. The United States did not accept the use of the term “reproductive health services”, because it could be interpreted to include promoting the legalization or expansion of legal abortion services.
Continuing, he focused on the threat presented by the HIV/AIDS epidemic, saying that young women were particularly vulnerable to HIV infection. High-risk groups for the disease included very high numbers of young people, often due to economic stress. For instance, many involved in the sex trade were there to support themselves and their families or because they had been trafficked into prostitution. The programmes that showed the greatest promise in that respect focused on raising community awareness about the practice and the conditions that fostered it. Abstinence and postponement of initial sexual activity played important roles in the promotion of adolescent health, including the prevention of HIV/AIDS.
Turning to the issue of families, he stressed the value of strong and stable families in preventing risky behaviour among young people. The HIV/AIDS epidemic also underscored the need to expand access to voluntary family planning. The growing size of the population of reproductive age in many developing countries, combined with the desire for smaller family size on the part of an increasing number of couples was creating a surge in demand for family planning. A growing body of evidence existed to support President Bush’s statement that “one of the best ways to prevent abortion is by providing quality family planning services”.
Regarding the financial resources for assisting in the implementation of the ICPD, he said that his Government was committed to increasing funding to support new knowledge through research and development. However, even as the generosity of the United States grew, the needs continued to outpace the resources available. He hoped that the Commission would reaffirm the resource goals agreed to in the ICPD Programme of Action and agree to redouble efforts to achieve those goals.
YOSHIYUKI MOTOMURA (Japan) said his country had taken several initiatives in the area of reproductive health, such as the Okinawa Infectious Diseases Initiative, the Women in Development Initiative and its contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. In implementing those initiatives, his Government stressed among other things, ownership, human resources development, partnership with civil society and South-South cooperation.
Under the Okinawa Infectious Diseases Initiative, Japan pledged to enhance its assistance for measures against infectious and parasitic diseases, including HIV/AIDS and intended to provide $3 billion over the period 2000-2004, of which
$1 billion had already been disbursed. His Government had committed itself to a $200 million contribution to the AIDS, Tuberculosis and Malaria Fund and would continue to play a leading role on the Fund’s board. It was unfortunate that not many people were aware of Japan’s contributions towards control of infectious diseases. The Women in Development Initiative aimed to strengthen the education and health of women, as well as their participation in economic and social activities when development assistance was implemented.
His Government believed that problems posing threats to human life, health and dignity, such as HIV/AIDS, be dealt with from the viewpoint of human security, he said, and emphasized the need for capacity-building of individuals, as well as partnerships among many stakeholders, including civil society, in addressing global issues. In line with the ICPD Programme of Action, his Government attached importance to the participation of women in decision making and implementation of programmes. It was essential to cooperate with non-governmental organizations when providing assistance in the areas of population, reproductive health and other health issues. Japan had provided grant assistance to local non-governmental organizations for grass-roots projects.
LUIS ALFONSO DE ALBA (Mexico) said that in his country the right to decide on the number of spacing of children was recognized by the constitution. However, full exercise of that right required progress in achieving universal access to quality reproductive health services. It was also necessary to spread the required information to support free and responsible decision-making in regard to reproductive health issues. Mexican health institutions had started several programmes to take care of the population’s sexual and reproductive health, paying special attention to those living in poverty and taking into account the cultural diversity of the population. Education and communication activities were among the areas of priority.
During the last three decades, the reproductive patterns of the Mexican population had changed significantly, he continued, favouring maternity delay and larger birth intervals. The increasing maternal and infant health coverage had contributed to making pregnancy and delivery safe for women. Complex challenges remained, however. For instance, unsatisfied family planning demand reached high levels in rural areas, among the indigenous people, those with poor education, and teenagers. The problem of HIV/AIDS was also growing. National public health institutions were committed to strengthening prevention practices and a self-help health culture to prevent the spread of HIV/AIDS. One of the Government’s aims was to guarantee the affected population access to medical care.
His Government acknowledged the need to strengthen public reproductive and sexual health services and reinforce their coordination with larger development strategies, including poverty alleviation, he said. It was also important to provide full access to reproductive health services for young people. Better information and education programmes were needed. To face those challenges, joint efforts of the Government and civil society were needed. Also, bilateral and multilateral international cooperation would continue to have strategic value.
ISHTIAQ HUSSAIN ANDRABI (Pakistan) said the report under discussion had mentioned it would cover selective aspects of reproductive rights and health. The report should have stayed within that scope. It included, however, two paragraphs of violence against women, including honour killings. That subject should be addressed by other bodies. References to honour killings in the report had transgressed the Commissions’ mandate. Paragraphs 221 and 222 should be expunged from the report.
He said those paragraphs singled out some countries, among them Pakistan, suggesting that honour killings were carried out there. The paragraphs were highly exaggerated and did not reflect the reality on the ground. The report did not take into account remedial measures taken by his Government. His country had taken steps to implement policies aimed at the empowerment of women and condemned the practices of honour killings. Those killings were not sanctioned by any religion or institution and were anti-Islamic. Crimes of passion, including honour killings, existed in almost any society. It was unfortunate that some developing countries were singled out for those crimes.
He said the report also contained references that irritated the social sensibilities of some countries, in particular Islamic countries. He hoped the report would be amended.
HUSSEIN SABBAGH (Syria) supported the statement by the representative of Egypt and regretted that the report on reproductive and health rights did not take into account the important points raised at the special session on HIV/AIDS. It also included inaccurate and unobjective references that he found unacceptable. The credibility of the report would be questioned in more than one place. Such a report could not be adopted or even referred to in the resolutions of the Commission.
Mr. TURKSON (Ghana) said that his delegation would have preferred to see more in-depth treatment of several matters in the reports, including the importance of migration as a critical factor in spreading HIV/AIDS. In many regions of Africa that question was of utmost importance, and it had been at the forefront of discussion at the special session on HIV/AIDS. Another issue that needed to receive more attention was the reproductive needs of internally displaced persons and refugees. Like other countries, Ghana had been a recipient of a refugee population, and the time had come to recognize their needs. In a revised edition of the report, he would also like to see the issue of cultural bias against the implementation of sexual and reproductive rights. It was not simply a matter of internal vigilance. It was more important to create social, cultural and other conditions for the enjoyment of such rights.
RACHIDA BENKHELIL (Algeria) said certain progress in access to reproductive health care had been achieved and the reproductive behaviour in various regions was evolving. Maternal health and health of infants were areas where major progress had been made. In the programme for reproductive health those issues should be of major priority.
Effective integration of other components of reproductive health, such as sexually transmitted diseases, was also important, she said. HIV/AIDS was an issue of grave concern, particularly for Africa. The lack of sufficient resources was a major constraint in addressing the issue. Access to treatment and prevention was problematic. Emphasis should be on mobilization of the necessary funds to implement programmes. The evolution of such indicators as fertility implied the need for new indicators on reproductive health, particularly for young people. There was a need for adaptation, taking into account social sensitivities, in particular regarding the importance of the family. She agreed with other speakers that some paragraphs in the report should be revised.
Mr. WILOPO (Indonesia) said that the ICPD had gone beyond the impasses to achieve a more holistic perspective, trying to achieve a balance between demographic and development approaches. At the current stage, review of progress made and lessons learned was of great importance, identifying ways of integrating the goals of the Conference into national programmes. While welcoming the progress made, he was concerned that, according to the report on world population trends, some countries had achieved only limited progress and others suffered setbacks in integrating health services into primary health care.
As for Indonesia, he said that it had adopted integrated population and development strategies, improved its reproductive health policies and begun implementing cost-effective interventions to reduce infant mortality. Efforts were also made to make pregnancy safer and reduce complications at birth.
Among the major challenges to the progress in reproductive health was the HIV/AIDS epidemic, which constituted a global emergency, he continued. It was increasingly recognized that poverty and underdevelopment were among the contributing factors in its spread. His delegation supported the declaration of the special session in June last year, stressing the importance of a coordinated response to the epidemic. An extraordinary global response was needed, which should include financial resources and political commitment at all levels. It was also important to stress the participation of civil society and non-governmental organizations (NGOs).
The highest rates of infection were due to the lack of understanding of the nature of the disease and the risks involved, he continued. The availability of drugs must be assured to those infected, particularly in the developing countries. Addressing the issue of the particular vulnerability of women and girls would mean their empowerment. Among the constraints faced by the international community in fighting the disease was a shortfall of financial resources. The goals of Cairo had fallen far short of the mark in that respect, and it was important to revitalize the flow of resources. Together, countries must strive to overcome the impediments to implementing the goals of Cairo. In spite of its financial crisis, Indonesia remained committed to implementing those objectives.
GINETTE LACHANCE (Canada) said reproductive health and rights, with special reference to HIV/AIDS, was one of the most urgent items on the international agenda. As was learned over the last 20 years at great cost, fulfilling the right to the highest attainable standard of reproductive and sexual health, and in particular ensuring universal access to reproductive health care and services, was crucial in successfully addressing the HIV/AIDS pandemic. The groundbreaking outcome of the special session on HIV/AIDS clearly identified the promotion of gender equality, the empowerment of women, and respect for human rights of women and girls as fundamental elements in halting and reversing the spread of HIV/AIDS.
She believed that protecting and promoting the right to reproductive and sexual health was a crucial goal in and of itself, but was also a key contribution to effective and sustainable development, as it could reduce unplanned pregnancies, maternal mortality and infant mortality. The recent commission on macroeconomics and health had noted the positive correlation between high infant mortality and high fertility rates. Large families could only afford small investments in their children’s health, education and care. Such investments were crucial, as educating children, particularly girls, meant that they were more likely to delay marriage, exercise greater control over their reproductive choices, and know how to protect themselves from sexually transmitted infection.
She said the statistics from the HIV/AIDS pandemic had clearly shown that the right of adolescents to reproductive health education and care must be fulfilled to slow the spread of the pandemic, protect the health and future of adolescents and help them fulfil their potential. Her country continued to support programmes to improve reproductive health and sexual health and to address HIV/AIDS, which included: safe motherhood, provision of quality family planning services; and information, education and communication on reproductive health for men, women and youth.
STEVEN W. SINDING, International Planned Parenthood Federation Director-General Designate, said that 10 years after the ICPD, it was essential to assess progress at the mid-point of the 20-year Programme of Action. International Planned Parenthood was keen to add its voice to those calling for a 10-year review process, which might take the form of a discussion of successes and disappointments in implementation. The purpose would be to help all parties, governmental and non-governmental alike, to improve performance over the remaining decade of the Programme. The issues to be addressed should include expanding services to include a full range of sexual and reproductive health interventions; progress in realizing sexual and reproductive rights, comprehensive sexual education programmes; safe motherhood; and prevention and treatment of sexually transmitted infections, including HIV/AIDS.
During the eight years since Cairo, it had become clear that some aspects of its Programme of Action had encountered more difficulties than others in the translation to concrete activities, he continued. The issue of sexual rights was an example of the limitations of the trend to subsume much of the reproductive health agenda agreed in Cairo under the urgent need to address HIV/AIDS. While no one denied that efforts should be redoubled to tackle the challenges posed by HIV/AIDS, such core Cairo issues as gender-based violence and unsafe abortions would slip out of view if reproductive health was understood to mean addressing HIV/AIDS. The Commission had a responsibility to keep the totality of the Cairo agenda alive, and in focus.
The issue of abortion was addressed with notable prominence and clarity in the key background document for the session, he said. Unfortunately, the political environment within which global sexual and reproductive health and rights policy was framed was becoming more hostile, with attempts to remove reference to abortion from international consensus documents, global health goals, safe motherhood and other agendas. Even if that did not represent a violation of basic rights –- which it did -- there was a public health imperative to keep the issue of abortion alive, and Commission had a special responsibility to keep drawing to the world attention the health impact of unsafe abortion as a major public health concern, as identified in the Cairo Programme of Action.
Since Cairo, valuable work had been under way to ensure that civil society played its part in making the human rights treaty body system work, he said. That included human rights education by non-governmental organizations and encouraging civil society involvement in the preparation of country reports. Civil society involvement was crucial in rendering governments truly accountable for the promises they had made by ratifying human rights treaties. Also, among the core elements of the Cairo agenda that were currently unfulfilled was the concept of entitlement; for example, contraceptive security, and the shortfall between donor commitments and donations.
FRANCE DONNAY, Chief, Reproductive Health Branch, Technical Support Divisions, UNFPA, thanked all delegations for their statements, many of which reiterated the importance of implementing fully the ICPD Programme of Action and the linkage of reproductive health care and rights, on the one hand, and poverty eradication and attaining the development goals of the Millennium Declaration, on the other. She was also grateful for the expressed support for mobilization of resources.
BIRGITTA BUCHT, Assistant Director, Population Division, also thanked delegates for their comments. She said she would take those comments into account when revising the draft report, as those comments could only clarify and improve it. She would appreciate additional comments and data.
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