Commission on Population and Development

Thirty-fifth Session

5^th Meeting (AM)

ABORTION, CORRELATION BETWEEN POVERTY, FERTILITY RATES AMONG ISSUES DISCUSSED

AS COMMISSION CONCLUDES DEBATE ON NATIONAL EXPERIENCE IN POPULATION MATTERS

The issues of family planning, correlation between poverty and fertility rates, abortion, reproductive health and rights education, and HIV/AIDS were high on the agenda of the Commission for Population and Development this morning as it concluded its general debate on national experience in population matters.

Portugal’s representative pointed out that his Government considered family planning not as a population policy measure, but as a human right and part of a healthy lifestyle.  Free access to all types of family planning was available to everyone, regardless of age or socio-economic status.  The treatment of infertility was also considered part of family planning services.  Abortion, with the consent of the pregnant woman, was not penalized in restricted circumstances related to the health of either the mother or the foetus, or the violation of the pregnant woman’s sexual freedom or self-determination.

In France abortions were legalized in 1975, the representative of that country said.  By now, their number had stabilized at around 220,000 a year per 750,000 live births.  Drug-related abortions accounted for some 13 per cent of the total number.  The legally permissible time for performing abortions had recently been extended from 10 to 12 weeks.  Forty per cent of French women had had at least one abortion in their years of fertility.  Sexually active adolescents’ right to contraception was now recognized under the law, and the provision for parental consent had been removed.

Agreeing with the assertion of the Cairo population conference that abortion was not a family-planning tool, the representative of Lithuania said that his Government intended to pay more attention to that issue.  Abortions had a highly negative impact on women’s health and on future generations.  There were

17.2 legally induced abortions per 1,000 fertile-age women in Lithuania.  Since 1995, the abortion rate in the country had declined almost twofold, but was still three times higher than in the Scandinavian countries. 

Exchanging information about national efforts to combat HIV/AIDS, several representatives emphasized the importance of disseminating information regarding HIV/AIDS and other sexually transmitted diseases, counselling and testing services, syringe exchange programmes, and provision of condoms to the general population.  Also addressed in the debate were the issues of access to drugs, mother-to-child transmission and training of medical personnel, as well as addressing the stigma, still associated with the disease.

5^th Meeting (AM)

Ghana’s representative said the challenge of maintaining and raising HIV/AIDS awareness required significant investments in information and communication programmes.  In Ghana, no communication strategy could afford to ignore traditional attitudes and socio-cultural practices.  Generally accepted communication strategies needed therefore to be fitted to his country’s particular situation.  That would require continuous research and testing of culturally sensitive messages.

At the opening of the meeting, Gediminas Serksnys of Lithuania was elected as Vice-Chairman and Richard B. Turkson of Ghana as Vice-Chairman and Rapporteur of the Commission.

Statements were also made by the representatives of India, Italy, Bangladesh, Poland, Malaysia, Philippines, Jamaica, Austria and South Africa.

The Commission will meet again at 3 p.m. today to take up programme implementation and the future programme of work of the Secretariat in the field of population.

Background

The Commission on Population and Development met this morning to conclude 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 (ICPD).  (See Press Release POP/819.)

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.

Election of Officers

At the opening of the meeting, Gediminas Serksnys of Lithuania and Richard B. Turkson of Ghana were elected Vice-Chairmen of the Commission.  The Commission was informed that the election of the rest of the Bureau would be held following further consultations.

Statements

Mr. BISHNOI (India) said that India had been among the first countries in the world to introduce a national family planning programme.  As a result of the Government’s efforts, the country had significantly reduced its birth and fertility rates, as well as infant mortality.  The national policy emphasized informed and voluntary choices, while also addressing the issues of child survival, reduced birth rate and health.  The immediate object was to meet the needs for contraception and medical services and personnel and provide prenatal and child care.  The long-term objective was to achieve stable population along with sustainable rates of growth and sustainable development. 

Delayed marriage and childbirth were among the priorities, he continued.  So was sensitizing people to the issues of protection against sexually transmitted infections and HIV/AIDS.  Civil society and local communities participated in the programmes.  To be successful, sex education, information and reproductive health programmes needed to be culturally sensitive. 

BRUNELLA BORZI CORNACCHIA (Italy) said her country’s maternal and infant mortality rates were among the lowest in the world.  Most deliveries took place in hospitals, free of charge to all, including undocumented migrants.  In 2001 life expectancy for men was 77 years and for women 83.  The fertility rate was also very low.  That, combined with high life expectancy, had resulted in one of the oldest populations in the world.  Low fertility was also a fact among adolescents: only nine births per 1000 girls.

She said information and education of youths on responsible sexual behaviour were the best tools for bringing down HIV/AIDS and other sexually transmitted infection rates, as well as unwanted pregnancies.  Abortions had declined to about 135,000 in the late 1990s, thanks to a large counselling network to which everybody had free and easy access.  Birth control and family planning were well established.

She stressed that reproductive health and the fight against HIV/AIDS were priorities in her country’s development objectives.  Her Government contributed to the Fund to fight HIV/AIDS, malaria and tuberculosis and had constantly increased its contribution to United Nations Population Fund (UNFPA).  Italy deplored the unwarranted allegations against UNFPA and expressed its full support for that organization and its staff.

GEDIMINAS SERKSNYS (Lithuania) said that in his country, the goals and undertakings of the ICPD Programme of Action and the resolutions of ICPD+5 had been integrated into the national strategy on health and social policies.  The Government had initiated legislation to ensure that reproductive rights were promoted, protected and enforced.  Lithuania had fundamentally reorganized its health care system during the past decade, introducing radical changes in the legal framework and the financing of health care.  As a result, there had been improvement in many areas of health in the country.  Mortality rates had started to decrease and life expectancy was on the rise. 

Although HIV infection remained low, compared to many European countries, he continued, the number of HIV carriers was growing.  The driving force of the epidemic was intravenous drug users.  The Government’s efforts to address the problem included the creation of a national AIDS centre and a strong partnership with civil society, media and non-governmental organizations (NGOs). 

Regarding abortions, he said that they had a highly negative impact on women’s health and on future generations.  There were 17.2 legally induced abortions per 1000 fertile-age women in Lithuania.  Since 1995, the abortion rate in the country had declined almost twofold, but was still three times higher than in the Scandinavian countries.  Lithuania currently had few laws addressing reproductive health, and the Government had formed several working groups to strengthen the national reproductive health programme and introduce the draft national reproductive health law.  Among the urgent issues of great importance to his country were integration of the population and social development dimensions, securing equal opportunities for men and women, and availability of reproductive health care services.

IFTEKHAR AHMED CHOWDHURY (Bangladesh) said his country, with a population of 120 million, had achieved remarkable progress in the area of health and family planning in the last 30 years.  The fertility rate had declined to 3.3 per

2,000 from 6.3 in 1973, and the contraceptive prevalence rate had reached around 54 per cent.  The infant mortality rate had also declined.  The success of Bangladesh’s “Universal immunization programme” had been cited as a model for developing countries.

He said reproductive rights and health could not be dealt with in isolation. They were interlinked with issues such as poverty and development, education and employment and empowerment of women.  A woman could not possibly attain a healthy reproductive life without fundamental improvement in her quality of life.  A nationwide informal education scheme had therefore been put in place.  Government-NGO collaboration in family planning programmes and other developmental efforts, such as education, environment, sanitation and hygiene, was exemplary.  Millions of women had successfully used micro-credit programmes and formal and non-formal education programmes.

Despite significant progress, all population indicators were still far below the Cairo Plan of Action targets, he said.  However, positive societal transformation was best achieved when it took place within the matrix of pluralism, democracy, human rights and a commitment to good governance.  It became more sustainable when such transformation was based on home-grown ideas and concepts, and it achieved lasting value when it was accompanied by gender mainstreaming.  It must also be based on the country’s broad cultural heritage.  The combination of such factors had enabled his country to overcome many constraints.

ALEKSANDER NAUMAN (Poland) said his country was experiencing an important demographic transformation which would lead to negative population growth and acceleration of the ageing process.  Decline in the death rate among the adult and elderly population was still too slow because of cardiovascular disease and cancer.

Equal rights for men and women were enshrined in the Constitution, he said. Following the Nairobi Conference on Women (1986), the post of Government Plenipotentiary for Women was created in the Ministry of Labour.  The post was now called Government Plenipotentiary for the Family.  In the last few years, major changes had occurred in childbirth care and methods.  The tendency to use contraception was increasing, with easy access to various contraceptives for both men and women.  Since 1997, abortion had been restricted to situations in which, for example, the mother’s health was at risk.  Ninety-nine per cent of deliveries were assisted by professional medical staff.  Maternal mortality rates were decreasing.  Infant mortality had been reduced from 19.4 per cent in 1990 to

8.1 per cent in 2000.

Since 1985, 7,400 HIV infections had been recorded, of which 63 per cent were intravenous drug users.  Countermeasures taken in recent years included establishment of the National AIDS Centre and support for NGOs focusing on prevention.  An important feature of the National Programme of Prevention of HIV Infections and Care Offered to People Living with HIV/AIDS was its multi-sectoral character and multi-level structure.  Several years of research had confirmed that promotion and protection of human rights were essential components of prevention of transmission and reducing the impact of HIV/AIDS.  Exchange of needles and syringes had been practiced in Poland since 1991.

PIERRE-ALAIN AUDIRAC (France) said that each year, his Government and its Office for Population and Migration took stock of the situation in the country as far as the agenda items in the Commission on Population and Development were concerned.  His country's best experts had prepared a report on France’s national experience, which was available to the members of the Commission.  According to that document, contraception was widely available in France, and today, 97 per cent of sexually active women used some reversible type of contraception.  The high rate of use of the pill (41 per cent) cut across all socio-economic levels. Also widely used in the country were IUDs and female sterilization. 

Also according to the document, considerable progress had been made in combating sterility, he continued.  Mortality in the period surrounding birth was dropping, but only slowly –- it was now five per 1,000 live births.  Women gave birth at an older age.  There were more premature births. 

Abortions had been legalized in 1975, he continued, and by now, their number had stabilized around 220,000 a year per 750,000 live births.  Pharmaceutical RU abortions accounted for some 13 per cent of the total number.  The legally permissible time for performing abortions had recently been extended from 10 to

12 weeks.  Forty per cent of French women had had at least one abortion in their years of fertility.  Sexually active adolescents’ right to contraception was now recognized by law, and the provision for parental consent had been removed. 

Female genital mutilation was still practiced by some groups of the population, and it was now explicitly covered by the penal code, with perpetrators prosecuted under the law.  The transmission rate of HIV/AIDS from mother to child had significantly dropped as a result of the use of antiretroviral drugs.

MOHAMMED YACOB (Malaysia) said that to improve the quality of care, reproductive health services were now an integral part of health services in his country.  Family planning programmes were based on the concept of health for women, children and families.  Women could freely decide on the number of children they wanted and had a free choice of contraceptives.  Only when families were well and healthy, he said, could they exercise their reproductive rights and enjoy reproductive health.  Malaysia’s mental health and other relevant programmes were therefore incorporated in the health services provided to the population. 

Control of the spread of HIV/AIDS was high on his Government’s agenda, he continued.  By 2001, the cumulative number of HIV/AIDS cases exceeded 44,000, with intravenous drug use among the main causes of infection.  A national HIV/AIDS prevention programme had been established.  Training of adolescents, provision of information to the general population, professional care and support for those infected, and participation of civil society and NGOs, were part of those efforts. Of particular importance was the health of mothers and infants. 

The best option in the fight against AIDS was an effective health promotion strategy directed at high-risk groups and young people, he said.  Promotion of healthy lifestyles and responsible behaviour was of particular importance.  Peer education programmes had been put in place, and awareness campaigns had been initiated.  Treatment for certain population groups, including children under

12 and those who had contracted the disease through contaminated blood transfusions, was fully subsidized by the Government.

He said that his delegation shared the concerns expressed by several countries regarding the section on STIs in the Secretary-General’s report.  It was regrettable that the report did not use the agreed language, as contained in the Declaration of Commitment of the special session on HIV/AIDS.

RICHARD B. TURKSON (Ghana) said his Ministry of Health had established a National AIDS/STD Control Programme in 1987.  At that time, the problem was perceived as a health issue and the focus of prevention and control was the elaboration of public health approaches and interventions.  Over time, the epidemic’s multi-dimensional nature had become more apparent.  An expanded and well-coordinated multi-sectoral approach was necessary.

He said the current adult prevalence rate was estimated to be 3 per cent. Since 1999, after a visit by the International Partnership Against AIDS in Africa (IPAA), the Government had taken a number of measures to halt the spread of the epidemic.  A national policy on HIV/AIDS and sexually transmitted infections had been developed, which would also address relevant human rights and ethical issues. A Strategic Framework for HIV/AIDS prevention and control had also been developed and approved by the Government.  The World Bank had approved a credit facility of $25 million for the Ghana AIDS Response Fund.  Other grants had also been made available.

The human rights and ethical dimensions of the problem were receiving due attention, he said.  Human rights groups were actively encouraged to address issues relating to women and girls, particularly gender-based violence and discrimination.  By far the greatest challenge was how to ensure that the high rate of awareness, which was nearly universal, was translated into positive changes in behaviour and attitudes.  That challenge required significant investments in information and communication programmes.  In Ghana, no communication strategy could afford to ignore traditional attitudes and socio-cultural practices.  Generally accepted communication strategies needed therefore to be fitted to his country’s particular situation.  That would require continuous research and testing of culturally sensitive messages.

TOMAS OSIAS (Philippines) said recent years had seen the emergence of global challenges calling for a holistic response by the international community. Paramount were population issues.  Poverty afflicted more than 30 per cent of his country’s population, which also had a high fertility rate and high maternal and infant mortality rates.  Cognizant of the challenges, his Government was pursuing a population programme which included responsible parenthood and was geared towards sustainable development.  The Government pursued a reproductive health approach ensuring accessibility of information as a basis for informed decisions.  The approach also focused on gender equality.  Information, education and counselling services had been established to discourage premarital sex and teenage pregnancies.  An important component of that programme was parent education on adolescent sexuality.

On Women’s Day, his President had highlighted the need for a framework plan for women, which should include their reproductive health and rights.  Women should be able to decide on the number of children they could care for, exploitation of women should be avoided and empowerment of women promoted.  The Government’s plan recognized the need to limit the country’s population growth rate by responding to the need for family planning services.

He said HIV/AIDS was not prevalent in the Philippines, but that did not mean the country was complacent.  Government and civil society together were continuously pursuing an AIDS prevention programme.  Given the current challenges, his Government would continue to promote programmes on reproductive rights and health that would help sustain development.  He fully supported the UNFPA in helping countries achieve greater well-being for everyone.

FRANCISCO SEIXAS DA COSTA (Portugal) said that according to the

2001 national census, the total resident population of Portugal stood at some 10.36 million -– up an estimated five per cent from 1991.  A strong positive balance of international migration was responsible for the high growth.  But within the country, demographic trends indicated population ageing, a strong decline in fertility rates and longer life expectancy.  Life expectancy at birth was now 79.4 years for women and 72.4 years for men.  The fertility rate in Portugal was below the replacement level.  Both men and women were marrying and having children at a progressively later age. 

His Government considered family planning to be a human right and part of a healthy lifestyle, he said, and not a population policy measure.  Each couple was free in its choice of contraceptive methods.  Free access to all types of family planning was available to everyone, regardless of age or socio-economic status.  The treatment of infertility was also considered part of family planning services.  Abortion, with the consent of the pregnant woman, was not penalized in certain restricted circumstances, related to the health of either the mother or the foetus, or the violation of the pregnant woman’s sexual freedom or self-determination.

Turning to the problem of HIV/AIDS, he said there were between 25,000 and 45,000 HIV-infected individuals in the country.  The national AIDS programme had been established in 1985, funded from the budget of the Health Ministry and through a percentage of lottery earnings.  The National AIDS Commission had established priorities in its 2001-2003 strategic plan against AIDS.  Other efforts included provision of information regarding HIV/AIDS, counselling and testing services, a syringe exchange programme, and provision of condoms to the general population, particularly to the most vulnerable groups, in a culturally and linguistically appropriate context.  STI-related education had been mainstreamed within the broader context of health education.  As the incidence of tuberculosis in Portugal was still nearly three times the European average, the Government was promoting a direct observed therapy programme, which addressed both HIV/AIDS and tuberculosis.

JOAN E. THOMAS (Jamaica) fully supported the call for more accessible quality reproductive health services, especially in light of declining population growth and fertility rates.  Those were not merely a matter of population growth and demographics, but a matter of human rights and the right to development and human well-being.

She said that over that past 40 years, approximately 68 per cent of total births had occurred in the 15-19-year age group, largely owing to the fact that the average age of first sexual experience for boys was 13.5 years and for girls 15.5 years.  As a consequence, national programmes had to directly address the issue of early child-bearing.  Recently, the Ministry of Health had formulated a policy for the provision of services and counselling to adolescents, which was expected to ensure the integration of adolescent reproductive health services into the existing health system.  Parliamentarians, the media, civil society including the Church, had been involved in the issue of adolescent sexuality.

Jamaica had an HIV/AIDS infection rate of 1 to 2 per cent of the adult population.  New HIV infections among adolescents since 1995 had been alarming, and adolescent females had a three times higher risk of infection than males of the same age.  The rate of HIV infection among women was increasingly more than among men.  Her Government had undertaken comprehensive measures to strengthen the provision of health care and had intensified its campaign to promote prevention, which should be the primary response.  HIV/AIDS was not only a health issue, but also a developmental one.  If the battle against the disease was to be won, adequate and sustained assistance to those in need must be accompanied by measures to increase awareness and reduce stigmatization.

ALICE ZAUNSCHIRM (Austria) stressed her country’s confidence in the UNFPA and its policies and said that her country would continue to fully support the valuable policies of that Fund.

LINDI MOLEFE (South Africa) said that reproductive rights and reproductive health in her country had been shaped by colonial influences and post-apartheid legacies.  The colonization of the country had resulted in the gross neglect and denial of reproductive health services to the majority of the population. 

The ICPD had coincided with national reforms on population development, she continued, which included the Termination of Pregnancy Act, Policy and Guidelines for Youth, Adolescent Health and Maternal Act.  Those policies promoted reproductive health and rights and extended freedom to the population.  They guaranteed safety to women and provided them with choice on the use of contraceptives.  Services extended to youth aimed at delaying the onset of sexual activity and creating an enabling environment for them to express their sexual requirements.  Progress in that regard was reflected in fertility declines and increased use of reproductive health services. 

Turning to the impact of HIV/AIDS, she said that in response to the epidemic, her Government had developed a national strategy which included prevention, treatment, care and support.  It also contained provisions for legal and human rights, research, monitoring and surveillance.  Programmes were being implemented to promote gender equality and economic empowerment of women.  Measures were being taken to reduce domestic violence and rape. 

Such demographic factors as fertility, migration and mortality were an integral part of poverty prevalence in South Africa, she said.  Therefore, silence on migration in the report before the Commission was a concern, since it was considered one of the contributory factors in the spread of HIV/AIDS. 

In conclusion, she acknowledged the important contribution of the UNFPA in her country, and said that there was a need to maintain and further encourage its initiatives to promote gender equality, reproductive health and reproductive health for all.  On the issue of the ICPD review, her delegation believed that it should be held within the context of the General Assembly so as to allow maximum participation by all Member States.

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