COMMISSION ON POPULATION AND DEVELOPMENT FOCUSES ON REPRODUCTIVE HEALTH, RIGHTS, WITH SPECIAL REFERENCE TO HIV/AIDS
| Press Release POP/819 |
Commission on Population and Development
Thirty-fifth Session
3rd Meeting (AM)
COMMISSION ON POPULATION AND DEVELOPMENT FOCUSES ON REPRODUCTIVE HEALTH,
RIGHTS, WITH SPECIAL REFERENCE TO HIV/AIDS
Measures to address the issues of reproductive rights and reproductive health, with special reference to HIV/AIDS -– the main theme of the current session -- were discussed in the Commission for Population and Development as it held its general debate on national experience in population matters this morning. The Commission had before it several important documents, including the Secretary-General’s concise report on world population monitoring, 2002.
Summarizing the discussion, the Commission’s Chairman, Antonio Golini (Italy) said that the statements drew a very important picture of population issues both at the global and national level, listing many challenges and problems still before the Commission. The 2004 review and appraisal would highlight the progress made since the International Conference on Population and Development (Cairo, 1994) and lessons learned. Population issues and problems would not end with 2004, however. He therefore asked the Commission to look ahead and to consider themes and proposals to reinforce the activities of the Population Division of the United Nations Secretariat and to have a fruitful interplay with all United Nations agencies, funds and programmes through the Economic and Social Council and General Assembly.
Now in its second day, the Commission’s thirty-fifth session will last through 5 April. In addition to the evaluation of the world situation as far as reproductive rights and health are concerned, the Commission is expected to address follow-up actions to the recommendations of the ICPD.
Among the issues raised in the debate were falling fertility rates in many countries, high incidence of induced abortions and national efforts to combat the HIV/AIDS pandemic. Most representatives agreed that education was of particular importance in reducing the rate of HIV/AIDS and sexually transmitted infections, as well as unwanted pregnancies. Many countries noted positive trends as far as reductions in their maternal and infant mortality rates were concerned.
Many demographers saw the decline of fertility in Brazil as an unintended consequence of overall economic and social transformations, with urbanization and industrialization leading that process, said the representative of that country. The academic debate notwithstanding, the fact was that both the Government and civil society must prepare for that demographic transition and forge a partnership conducive to the exercise of reproductive rights, which –- like the enjoyment of reproductive health -- required an integrated approach to social policies.
3rd Meeting (AM)
The representative of Sweden said that his country’s national experience confirmed the importance of improving the status of women and enhancing their participation in society. Swedish women had one of Europe’s highest rates of participation in the workplace, which also influenced the attitudes of men. Sweden also had one of the highest rates of abortions, partly because of reports emphasizing the risks of using “the pill”. That showed a persistent need to involve men in all activities aimed at avoiding unwanted pregnancies.
Carla Abu-Zahr, Coordinator, Advocacy Communications and Evaluation, Office of the Executive Director, Family and Community Health of the World Health Organization (WHO), said that despite progress since the ICPD, too many people continued to suffer and die prematurely from conditions that were readily preventable or treatable. Maternal and perinatal mortality, reproductive tract cancers, curable sexually transmitted infections and HIV/AIDS currently accounted for some 15 per cent of the global burden of disease, most of it occurring in developing countries.
AIDS had become the most devastating disease humankind had ever faced, she said. However, evidence from Cambodia, Uganda and countries in Central Europe had shown that early interventions could reduce the risk of HIV spread. It was clear that care and prevention were linked elements of a comprehensive HIV/AIDS strategy. There were important synergies between addressing HIV and dealing with other aspects of reproductive health, such as reproductive health services, antenatal and delivery services and care. Information and services targeted to young people were also critical. A rights-based approach to reproductive health was vital for addressing sexual and reproductive health issues, such as violence against women.
Based on the latest HIV/AIDS estimates, it was likely that the needs would grow before they began to decline, said Desmond Johns, Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). Aside from the serious conditions in sub-Saharan Africa, the report recorded an alarming situation in Eastern Europe, the countries of the former Soviet Union and Asia. It was important to use the small window of opportunity that existed now to avoid the repetition of the African scenario there.
The representative of the Republic of Korea said that the repercussions of the HIV/AIDS epidemic were extending far beyond the health sector. The epidemic was capable of changing the demographics of a society, increasing the death rate among the young and increasing the number of orphaned children. To cope with the new challenges, the Republic of Korea had been shifting its population policy since 1996 to enhance the quality of contraceptive services, reduce the rates of induced abortions, integrate reproductive health programmes into other social welfare programmes, achieve gender equality and curb the spread of sexually transmitted diseases and HIV/AIDS. In its fight against AIDS, his country was emphasizing prevention and education geared to promoting healthy and responsible sexual behaviour.
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Also speaking this morning were the representatives of Chile, Croatia, Algeria, Russian Federation, Netherlands, United Kingdom, Spain, Dominican Republic, Botswana, China, Norway, Germany and Indonesia.
A number of representatives echoed Belgium’s sentiments when its representative deplored the continued and unwarranted allegations against the United Nations Population Fund (UNFPA), concerning its assumed involvement in forced abortion and genocide. They expressed their support of UNFPA.
The Commission will hold a panel discussion on reproductive rights and reproductive health at 3 p.m. today.
Background
The Commission on Population and Development met this morning to hold its general debate on national experience in population matters: reproductive rights and reproductive health, with special reference to HIV/AIDS, as contained in the Programme of Action of the International Conference on Population and Development.
For more background information on the Commission’s thirty-fifth session and the reports before it, see Press Release POP/817 of 28 March 2002.
Statements
DESMOND JOHNS, Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), reported on last year’s special session of the General Assembly on HIV/AIDS. Like many before it, the session had been “not without moments of high drama” but, in the true United Nations tradition, it had produced an important document –- the Declaration of Commitment, which made an attempt to mount a global response to the epidemic. For international efforts to be successful, a crucial set of enabling factors was needed, including political commitment, community involvement, gender empowerment and, of course, financial resources.
The international community had taken practical steps to address the need for financial resources through the establishment of a Global Fund for AIDS, malaria and tuberculosis, he continued. Intended as a low-cost funding mechanism, the Fund had just issued its first call for proposals. To date, the fund had received around $2 billion, of which over a third would be available for disbursement this year. There were assertions that the amount raised fell far short of the anticipated $7-10 billion. In generating that estimate, UNAIDS had sought to arrive at a global figure for comprehensive HIV/AIDS care, recognizing that the money would have to come from a range of sources, including bilateral and multilateral aid and civil society. It was too harsh to characterize the fund as a failure, especially as this year’s disbursements represented an increase of up to 50 per cent over what would have been otherwise available.
It was likely that the needs would grow before they began to decline, he continued, based on the latest HIV/AIDS estimates reflected in the report. Aside from the serious situation in sub-Saharan Africa, the report recorded an alarming situation in Eastern Europe, the countries of the former Soviet Union and Asia. It was important to use the small window of opportunity that existed now to avoid the repetition of the African scenario there.
In conclusion, he said that halting the HIV/AIDS epidemic constituted one of the Millennium Development goals. The adoption of the Declaration of Commitment had enabled the international community to expand on that goal, which was consistent with the Millennium goals and the overall aspirations of the major conferences of the 1990s.
CARLA ABU-ZAHR, Coordinator, Advocacy Communications and Evaluation, Office of the Executive Director, Family and Community Health of the World Health Organization (WHO), said that since the International Conference on Population and Development (ICPD) in 1994, there had been numerous advances in knowledge and understanding of what was needed to address the reproductive health needs of the world. However, too many people continued to suffer and die prematurely from conditions that were readily preventable or treatable. Maternal and perinatal mortality, reproductive tract cancers, curable sexually transmitted infections and HIV/AIDS currently accounted for some 15 per cent of the global burden of disease, most of it occurring in developing countries.
AIDS had become the most devastating disease humankind had ever faced, she said. Africa continued to be the worst-affected area, but Eastern Europe was experiencing the fastest-growing epidemic. The Caribbean was the second most affected region. In countries of Asia and the Pacific, relatively low national prevalence rates masked localized epidemics. Even in high-income countries in North America, parts of Western Europe and Australia, rising infection rates suggested that advances in treatment and care had not been matched by progress in prevention. HIV/AIDS continued to disproportionately affect the most vulnerable members of society, perpetuating a cycle of poverty.
Despite that stark outlook, there was now evidence that early interventions could reduce the risk of HIV spread, she said, pointing to examples of success in Central Europe, Cambodia and Uganda. It was clear that care and prevention were linked elements of a comprehensive HIV/AIDS strategy. People who knew their HIV status, and who had access to care without fear of stigmatization and discrimination, were better able to protect their loved ones from infection.
The WHO’s contribution to ending the global epidemic focused on strengthening and supporting health sector responses, she said. It provided technical support to guide countries and regions in national HIV plans and strategies, and provided normative guidance in the form of standards, guidelines and other practical tools. The WHO also analyzed trends in the epidemic.
There were important synergies between addressing HIV and dealing with other aspects of reproductive health, such as reproductive health services, antenatal and delivery services and care and support for infected mothers, including antiretroviral drugs. Information and services targeted to young people were also critical. A rights-based approach to reproductive health was vital for addressing sexual and reproductive health issues such as violence against women. Such an approach provided an important framework for accountability that fostered more effective action to address the needs of people for information and services.
Last year, she said, the Commission on Macroeconomics and Health, established by WHO, concluded that not only did poverty cause ill-health, but that poor health itself lead to poverty. The Commission confirmed that measures to address key reproductive health concerns were both cost-effective and crucial to breaking the vicious cycle of poverty and underdevelopment. Further investments in improvement of reproductive health outcomes were needed to ensure the attainment of the common goals of poverty reduction and development.
BENONI BELLI (Brazil) said that many demographers saw the decline of fertility in Brazil as an unintended consequence of overall economic and social transformations, with urbanization and industrialization leading that process. The academic debate notwithstanding, the fact was that both the Government and civil society must prepare for that demographic transition and forge a partnership conducive to the exercise of reproductive rights. The ideal was for individuals and couples to be able to make informed decisions on their own, rather than being constrained to accept the fate imposed by social structures and economic considerations.
The exercise of reproductive rights and the enjoyment of reproductive health required an integrated approach to social policies, he continued. The main strategy to create a synergy in that field was the empowerment of women. His Government had made efforts to give women the means to claim their rights. In particular, it had moved to combat violence against women, improve health services for women and improve educational levels. Programmes to reduce cervical and breast cancer had become a priority. Community health agents were hired to reach distant localities to provide prenatal and vaccination services and ensure basic health care for older persons.
Brazil had adopted a rights-based approach to the problem of HIV/AIDS, he continued. The combination of prevention and treatment was at the core of its strategy. Since 1996, every Brazilian living with HIV or AIDS had had free access to the antiretroviral therapy. The death rate from AIDS had fallen by 50 per cent, and there had been a 75 per cent drop in the number of hospitalizations. The reason for the affordability of his country’s policy was local production of drugs. It was also important to combat the stigma still associated with HIV/AIDS and to eliminate other forms of discrimination that contributed to the spread of the epidemic.
The resources needed to combat HIV/AIDS worldwide still fell short of what was needed, he continued. The response to the Global Fund established by the Secretary-General had been disappointing so far. The international community had not met the required $5.7 billion target for population assistance in developing countries, which was set by the Cairo Programme of Action. He hoped that the Monterrey consensus (reached last month during the Conference on Financing for Development) would spur donor countries to increase their contributions and ensure the necessary resources for combating HIV/AIDS and fully implementing the Cairo decisions.
ANABELLA ARREDONDO (Chile) said her country attached major importance to policies associated with reproductive rights and reproductive health. It considered sexual and reproductive rights as human rights. Despite the fact that those rights were guaranteed by its constitution, the HIV/AIDS situation required specific legislation. Her country was working on a framework law. The issues of sexual and reproductive rights were leading to legislation.
Gender inequality in her country required a policy of empowerment to allow for reversal of the previous situation. Chile had had an erratic history in relation to such issues. It had incorporated programmes for family planning in the early 1960s. That programme had lost incentives in the 1980s. Chile’s participation in the Beijing Conference on women had resulted in a public debate. The Government had taken sexuality and sexual health of women as an important theme in designing and promoting public policies. Emphasis was placed on the need to reduce school drop-out rates for girls and women.
In Chile, she said, primary health care included community prevention projects regarding AIDS. Young people still had difficulty accessing information and condoms. There was now a law establishing health, cultural and social objectives as a matter of national interest. HIV/AIDS was an emergency which challenged societies to find a global response, in which prejudices and ideological discussions had no place.
ZLATA PENIC IVANKO (Croatia) said that the endorsement of reproductive rights and health, as defined in the Programme of Action of the ICPD, was reflected in Government programmes and policies in the area of reproductive health in Croatia. The programmes were focused on the promotion and protection of women’s rights, including their reproductive rights. Women in Croatia participated in economic and social activities under equal conditions of work, pay and promotion. However, the interrelation of development and gender still testified to the need for continued efforts in the areas of human rights, gender balance and empowerment of women. The Government had established the Implementation Programme for the National Policy for the Promotion of Gender Equality for 2001-2005. The Health for All by 2005 programme had been devised in line with the principles of the Cairo Programme of Action.
As far as reproductive health was concerned, she said, special care was given to women’s reproductive health, especially family planning, pregnancy, delivery and maternity. Recent data showed that about 90 per cent of children in Croatia were born in wedlock. The age of women at marriage and at birth of the first child was rising. The number of legally induced abortions was in decline, while contraceptive use was on the increase, mainly due to the educational health programmes. The Government was concerned by the rate of population decline, for it had adverse consequences for the overall long-term development of the country.
The AIDS epidemic posed one of the most serious threats to humanity, she continued. It demanded a global response. With a total number of 180 cases registered between 1986 and 2001, Croatia was a country with a low prevalence of HIV/AIDS. With a strong and long tradition in public health, national policies for fighting AIDS had been devised in 1985. A number of essential programmes had been initiated, including institutionalization of treatment and awareness through establishment of Croatia’s Centre for HIV/AIDS. Many NGOs played an important role in raising awareness and fighting the disease. Among the factors that favoured the spread of HIV/AIDS were high unemployment, migration and the economy in transition.
In conclusion, she spoke about the 2001 nationwide census carried out in Croatia. The most significant change in the 2001 census methodology was the definition of the “place of usual residence”. According to the results of the census, the total population in Croatia stood at some 4.38 million.
JEAN DE RUYT (Belgium) said the level of contraceptive use in Belgium was quite high. The majority of couples had the number of children they wanted. As a side effect of the fact that girls studied longer and more women participated in the labour market, childbearing was increasingly postponed. Low fertility, in combination with low mortality at high ages, had resulted in an ageing society.
He said that in recent years the country had witnessed a slight increase in teenage abortions. Information, education and communication programmes to prevent unwanted pregnancies needed to be set up as on-going activities. Belgium had also been affected by the HIV/AIDS pandemic: 14,378 people had been diagnosed HIV-positive, with 2,800 suffering from AIDS. The infection incidence rate had not stabilized, which also illustrated the importance of ongoing information, education and communication programmes on sexual and reproductive health.
His country, he said, deplored the continued and unwarranted allegations against the United Nations Population Fund (UNFPA), concerning its assumed involvement in forced abortion and genocide. He underlined his country’s full support for and confidence in UNFPA. Reproductive health and the fight against HIV/AIDS were now major objectives of Belgian development policy. Drawing attention to two conferences organized in his country in a spirit of North-South partnership –- “Healthcare for All” and “Sexual and Reproductive Health and Rights and Development Cooperation; a Dialogue between North and South” –- he called on national governments, international organizations, agencies, non-governmental organizations and individuals to increase the solidarity between donor and receiving countries.
RACHIDA BENKHELIL (Algeria) reported on recent demographic trends and national policy in her country. The improvement of reproductive health conditions was a major challenge for her Government. Algeria was going through a period of demographic transition, seeing a drop in its rate of population growth. That demographic decline was linked to a drop of fertility to 2.5 children per woman in 2000. Later marriage, closer adherence to family planning, and the 64 per cent use of contraceptives were among the reasons for those trends.
Among the country’s priorities was its struggle against infant and maternal mortality, for 117 maternal deaths per 1,000 births continued to raise concern. There was a national screening programme for women as far as sexually transmitted infections were concerned. Reproductive health programmes resorted to education as a means of disseminating important information in that regard.
The Government was emphasizing prevention in its HIV/AIDS programmes, she said. Since the first cases of HIV/AIDS were recorded in Algeria in 1985, the incidence of HIV/AIDS remained low. However, Algeria was at risk of seeing a spread of the disease, and prevention was at the root of its national efforts. A number of NGOs were also working in that area. In particular, actions had been taken by youth organizations to raise awareness of the problem. The national programme to combat STIs and AIDS was based on strengthening HIV monitoring through voluntary and anonymous screening, improving the professional level of staff and greater mobilization of financial resources at the national level.
Another important issue was violence against women, and studies were under way to help gain better understanding of the phenomenon and provide psychological support to victims. Also important was training of medical personnel. National population policy accorded a priority status to the promotion of women.
OLGA SHARAPOVA, Deputy Minister of Health of the Russian Federation, said that preservation and protection of the reproductive health and reproductive rights of citizens was becoming an important issue, given the evolving demographic situation in her country. The rights of its citizens in the reproductive sphere were ensured by the Constitution and other legislation. Significant improvement had been attained on most reproductive-health indicators.
She said the absolute number of abortions had been reduced by 50 per cent The number of criminal abortions had also diminished. The maternal mortality rate was progressively decreasing, but still remained high with 34 mortalities per 100,000 births. The infant mortality rate had also declined. Increasing premature mortality rate and mortality rate among young people was still a problem that had to be controlled.
The situation regarding diseases of social importance, in particular HIV/AIDS, had yet to be stabilized, she said. About 180,000 HIV positive people were registered in her country. The overwhelming majority of them were drug addicts. The year 2000 had marked a dramatic increase in the number of people infected after heterosexual intercourse. The proportion of women among HIV-positive patients was increasing rapidly. Her country was working hard to improve the demographic situation, she said. An important component of those efforts was improving the reproductive health of the population. It was important to use multisectoral approaches in reducing maternal mortality and sickness rates. Such approaches would envisage measures not only in the health care system, but also in education, legislation and advocacy. It was important to ensure synergy between activities in the sphere of population and the sustainable development agenda.
ELLIE LEEMHUIS (Netherlands) emphasized the importance of youth participation in the current discussion. In her country, a coalition of young people existed who were concerned about sexual and reproductive rights and health. It was called “the Dutch Coalition for Youth and Population”. Supported by the Dutch Government, the Coalition would provide assistance in the implementation of the ICPD and ICPD+5 agendas. Sexual and reproductive rights for adolescents were an integral part of the organization’s agenda.
She also informed the Commission about the Netherlands Network on Sexual and Reproductive Health and AIDS, which had been launched in 2001. It brought together most of the major Dutch organizations working in that field, both in the Netherlands and abroad, to pool information, enhance mutual expertise, stimulate research and provide input to the media and policy makers.
The Netherlands reiterated the importance of the role and mandate of UNFPA implementing the Cairo Programme of Action and the Millennium Declaration, she said. The Cairo agenda was still very valid, and the international community should focus on its implementation. She believed that a technical review meeting, focusing on lessons learnt and experiences worldwide would suffice as a review in 2004 at the Commission for Population and Development. She also called on all countries to provide adequate resources to ensure implementation of the Programme of Action. The Netherlands deplored the continued and unwarranted allegations that UNFPA was at all involved in forced abortions and genocide.
BJORN ANDERSSON (Sweden) said the ICPD had been a remarkable achievement, breaking new ground and recognizing that human rights included reproductive and sexual rights. Sweden concurred with that view. At the Monterrey conference on financing for development, his country had urged developed countries to raise levels of official development assistance (ODA). Sweden had been a member of the select “0.7 group” for a long time and had set a target of 1 per cent of gross domestic product for ODA. Sweden’s contribution to population assistance in 2000 was more than 4 per cent of its ODA. He deplored the continued and unwarranted allegations that UNFPA contributed to forced abortions and genocide.
Sweden’s national experience bore out the importance of improving the status of women and enhancing their participation in society, he said. But much remained to be done to achieve equality between men and women. Swedish women had one of Europe’s highest participation rates in the workplace, which had also had an influence on the attitudes of men. The birth rate had dropped below two per couple. The present report’s assertion that Sweden had one of the highest abortion rates had triggered an internal discussion. During the 1990s, the actual number of abortions had increased, in part because of reports emphasizing the risk of using “the pill”. That showed the persistent need of involving men in all activities aimed at avoiding unwanted pregnancies. The fact that abortion in Sweden was simple, virtually risk-free and free of stigma might also have contributed to the abortion rate.
Among the threats young people faced in a fast-changing world was the threat of HIV/AIDS, he said. Young people must have access to information and confidential health care. In Sweden sexual education was integrated into school curriculums. Youth clinics provided information and care. Today, positive results were emerging in the sexual health of young people, as research showed that education tended to lead to safer sex and delay of sexual initiation. Openness around sexuality had also contributed to a negative trend in sexually transmitted diseases. Effective HIV/AIDS prevention activities were very important. Young people had to break new ground regarding HIV/AIDS, and the role of men and boys in that regard had to be addressed. Young people wanted to take a part in decisions regarding their sexual life and should be involved in policy development.
GERRY ASH (United Kingdom) said that his country strongly supported the work of the UNFPA and deplored allegations that that organization supported forced abortions. The United Kingdom firmly believed that in implementing the decisions of the ICPD, the emphasis should be placed on the main goals of the Programme of Action. Organizing a follow-up conference 10 years from Cairo would divert resources from the implementation of the programme itself.
JUAN MARIA LOPEZ AGUILAR (Spain) said the Spanish Constitution acknowledged the rights of all Spaniards to health protection. It ensured social, economic and legal protection of the family and the protection of children, regardless of their affiliation, and mothers, regardless of their marital status. The right to health was inseparable from the right to personal dignity. Health-care coverage was near 100 per cent. Regarding the rights to procreation and reproductive health, he reiterated Spain’s commitment to the results of the ICPD, which acknowledged the importance of women’s right to control their sexuality and to free decisions on those matters.
He underlined the importance Spain attached to the family as the basis of society. A 1999 law was designed to promote a conciliation between family and work life. It widened the protection of pregnant women, extended maternity leaves and prohibited the dismissal of pregnant working women or working men who took a paternity leave. Spain had one of the lowest maternal mortality rates in the European Union.
Regarding sexually transmitted diseases and infections, he stressed the responsibility of the individual to collaborate to control those diseases, as well as the elimination of any type of social discrimination associated with such diseases. The most worrying disease was HIV infection. In Spain, 62,000 people had developed AIDS, and an estimated 120,000 were living with HIV. However, the number of cases had decreased over the years, thanks to prevention and sanitary assistance and the new antiretroviral treatments. AIDS was considered a syndrome in Spain and was not a reason for discrimination. Greater attention was now paid to drug addicts, and more realistic alternatives had been developed to respond to their health needs. International cooperation was also part of his country’s efforts to fight the global problem, he said.
BOO-NAM SHIN (Republic of Korea) said that the repercussions of the HIV/AIDS epidemic were extending far beyond the health sector. The epidemic was capable of changing the demographics of a society, increasing the death rate among the young and increasing the number of orphaned children. HIV/AIDS also increased women’s vulnerability to reproductive health risks, including infertility and ectopic pregnancy. In that regard, he was pleased that a broad-based definition of reproductive health was gaining acceptance in more countries. He further stressed that reproductive health was not an issue relating exclusively to women of childbearing age. It concerned both women and men and affected the very fabric of society.
While his country had been successful in curbing the growth of the national fertility rate, it had come to face a wide range of new challenges, including a high rate of induced abortions and an increase in HIV/AIDS infection. To cope with the changing situation, the Republic of Korea had been shifting its population policy since 1996 to enhance the quality of contraceptive services, reduce the rates of induced abortions, integrate reproductive health programmes into other social welfare programmes, achieve gender equality and curb the spread of sexually transmitted diseases and HIV/AIDS.
He said the Government’s efforts to combat HIV/AIDS included the establishment of an AIDS Management Centre and monitoring network, as well as creation of the AIDS Information Centre, which provided housecalls and computer-based services. Civil society took part in efforts to raise public awareness of HIV/AIDS, and various NGOs provided counselling and education for AIDS patients and medical personnel.
In his country, he said, sexually active young people with high mobility were being categorized as a high-risk group. Therefore, efforts to prevent and control HIV/AIDS were accompanied by education geared to promoting healthy and responsible sexual behaviour.
RAMON OSIRIS BLANCO DOMINGUEZ (Dominican Republic) said that throughout history, poverty had been defined in a thousand different ways, but it was basically an expression of hunger, illiteracy and health care. Extreme poverty had not decreased. Poverty eradication had become the greatest challenge, taken on by the community of world leaders in the Millennium Declaration and reconfirmed in the Monterrey Consensus. Poverty eradication was also an attempt to deal with the ills of underdevelopment in a holistic manner. His country had always been committed to the Programme of Action of the ICPD, in particular to those aspects relating to reproductive health, gender equality and empowerment of women.
His country was making progress in achieving the goals agreed on in the Special Aids Session, he said. According to statistics, his country had a current rate of 2.8 per cent. Her country and Haiti shared the island of Hispaniola which was the epicentre of the HIV/AIDS pandemic in the Caribbean region. In 2000, projections for the HIV/AIDS rate had been put at 5 per cent. However, efforts by the Government and NGOs had succeeded in reducing the incidence to 2.8 per cent. It remained a source of great concern, because it encroached on plans to combat poverty.
Sex education in the public schools was needed, he said. The Government promoted fulfillment of human rights to strengthen the capacity of women to freely elect, choose and keep their partners. Given the seriousness of the HIV/AIDS pandemic on the island, he requested inclusion of his country in any programme that gave support.
BATHO CHRIS MOLOMO (Botswana) said that there could not be a more relevant theme than the one chosen for the current session of the Commission –- reproductive rights and reproductive health, with special reference to HIV/AIDS. The problems of culture, poverty and HIV/AIDS were inter-related, and his Government was taking measures to improve the education of the country’s population. Work to combat HIV/AIDS was being carried out in cooperation with other partners, including international organizations.
In his country, the incidence of HIV/AIDS stood at 38 per cent in 2000, with a high proportion of young people among the infected, he said. HIV/AIDS accounted for 30 per cent of all admissions in pediatric wards, and up to 70 per cent of pediatric deaths. To address the situation, a programme of prevention of mother-to-child infection had been elaborated, and an antiretroviral drug programme had been launched this year.
The problem was exacerbated by the fact that most AIDS-related deaths were among adults of childbearing age who left behind dependents, he said. That situation presented the country with a number of challenges, diverting resources from national development strategies and putting health and education programmes under stress. Those challenges called for new and additional funds, which could not be fully met through national resources. He thanked those who had provided the country with the needed resources and made a plea for additional help.
ZHANG HANXIANG (China) said the reproductive rights of citizens were basic human rights to which his country attached great importance. His Government had promulgated and implemented the Law on the Protection of the Rights and Interests of Women, the Law on Maternal and Infant Health Care and the Programme for the Development of Chinese Women, providing a legal basis for the protection of women’s basic rights and interests.
His Government had adopted a series of measures to improve child health care, he said. It had an adolescent population of more than 200 million. The threat from accidental pregnancy, abortion, sexually transmitted diseases and HIV/AIDS had aroused more and more concern over the issue of adolescents’ reproductive health. Accordingly, reproductive health education had been carried out widely in middle schools and universities. With traditional intolerance for pre-marriage sexual behaviour, there still existed some resistance to providing adolescents with sexual and reproductive health education and services.
The situation of AIDS in China was grave, he said. By the end of 2001, China had 300,736 reported cases of HIV infection, with drug injection being the most important channel of infection. HIV/AIDS incidence had gradually been spreading from people with high-risk behaviour to ordinary people. Noting a number of measures his Government had undertaken to deal with the problem, he emphasized that China regarded the prevention of HIV/AIDS as an important part of its reproductive health services. Condom-vending machines had been installed in the streets, and television broadcast advertisements for condom promotion. China’s general goal in the prevention of HIV/AIDS was to contain the number of HIV-infected cases within the 1.5 million mark by 2010.
Mr. BRUNBORG (Norway) said that the total fertility rate in his country was among the highest in Europe, as a result of family-friendly policies. Consensual union had become accepted in Norway, and legislation had been passed on same-sex partnerships, largely equating them with marriage.
One of the most disturbing trends reflected in the report before the Commission was the persistent level of maternal mortality, he said. To overcome the problem, improved access to emergency services should be provided. The report noted that unsafe abortions were a cause of about one eighth of all female deaths. It was important to remember that according to the key recommendations for further implementation of the ICPD Programme of Action, in circumstances where abortion was not against the law, health systems should ensure that such abortions were safe and accessible.
The report further pointed out the spread of the HIV/AIDS pandemic and noted recent trends, he continued. The reasons for the reversal of trends in some countries, including Uganda, were not clear, and systematic research was needed to understand the situation.
Norway, he said, wished to express its support for the UNFPA and its valuable work. He agreed with those members of the Commission who deplored allegations that the Fund had participated in forced abortions and genocide. As for the ICPD review conference in 2004, it should take place in the Commission on Population and Development and be open to all Member States. It was important to implement the decisions of the ICPD, and he did not see the need for a new negotiated text.
CHARLOTTE HOHN (Germany) said that to decide on the number and spacing of children in a free, responsible and informed manner, sexual self-determination and access to modern family planning methods were of great importance. Her country’s measures in that regard were also intended to help people adopt a comprehensive approach to sexuality (and to one’s partner) which was healthy and responsible.
Family planning, as it was understood in Germany, needed to be organized in a manner which catered to the individual’s needs, which required a certain freedom in decision-making. With new laws on parental leave and part-time work, her Government had further improved the framework for achieving a propitious balance between gainful employment and family obligations. In doing so, German society was steadily moving towards a distribution of tasks which was based to a greater extent on the concept of partnership. In that context, the German Government appealed to fathers to care intensively for their family and to engage in family work.
In view of the dramatic HIV/AIDS pandemic, implementation of the Cairo Plan of Action had become an even more significant part of Germany’s international cooperation policies. It had become obvious that sustainability of all other development programmes would heavily depend on how the Cairo Plan of Action continued to be implemented. The German Government expressed its support to the UNFPA following the serious allegations made against that organization. Only when men and women were able to exert their right to protection against unwanted pregnancies and HIV/AIDS, would they be in the position to exploit their full potential and have a role in promoting sustainable development. Her Government had therefore made implementation of the Plan of Action a specific aim of future bilateral and multilateral development cooperation.
SISWANTO AGUF WILOPO (Indonesia) said that adolescents represented a high proportion of his country’s population. Indonesia was beginning to experience the spread of HIV/AIDS, with the disease more prevalent in certain population groups. Early prevention and a multi-sectoral approach needed to be stressed in the fight against the disease, which constituted one of the most formidable global challenges today.
Nationally, the focus was on prevention, abstinence and promotion of safe sex for people with high-risk sexual behaviour, he continued. Informing those with high risk was also of great importance. Both the ICPD Programme of Action and the Declaration of Commitment of the special session on HIV/AIDS recognized the importance of the role of the family. Indonesia also stressed the key role of the family in prevention, care and treatment of those infected with AIDS. It was also an important factor in reducing risky behaviour among adolescents and providing information on safe behaviour. It was also necessary to recognize the role of people who were themselves infected with AIDS.
In its efforts to make reproductive health care accessible to all, his country had adopted a new reproductive health policy after 1994, emphasizing a comprehensive attention to various aspects of the problem. Vigorous action was taken to address the problems of the girl child, the ageing population and women. The unmet need for good-quality family services was being addressed. He hoped that by 2005, 80 per cent of all births in Indonesia would be assisted by skilled attendants. Indonesia also expected to dramatically reduce maternal mortality rates.
Closing Remarks
The Commission’s Chairperson, ANTONIO GOLINI (Italy), said the statements had given a very important picture of population issues, at both the global and national levels, listing many challenges and problems still facing the Commission concerning population issues. Those challenges and problems were also clearly reflected in the thematic World Monitoring reports discussed in recent years.
He said the 2004 review and appraisal would highlight the progress made and lessons learned since Cairo 1994. But population issues and problems would not end with 2004. He asked the Commission to look ahead and to consider themes, topics and proposals to reinforce the activities of the Population Division of the United Nations Secretariat on the one hand, and on the other hand to have a fruitful interplay with all United Nations agencies, funds and programmes through the Economic and Social Council and General Assembly. In 1946, the Commission’s
colleagues were able to look at population problems and issues for the second half of the 20th century. “We have the hard work, but also the full responsibility, to look at the population problems and issues for the first half of this century”, he said.
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