[dropcap]I[/dropcap]n recent decades, the international development agenda has changed dramatically. Historic United Nations conferences and summits throughout the 1990s and early 2000s have established a new vision for development as creating an equal, just and sustainable world. This shift towards a broad and people-centered approach to development is evident in watershed international agreements including the UN Conference on Environment and Development in Rio de Janeiro (1992), the International Conference on Population and Development in Cairo (1994), and the Beijing Fourth World Conference on Women (1995).
In September 2000, world leaders came together at United Nations Headquarters in New York to adopt the United Nations Millennium Declaration, committing the international community to a new global plan to reduce extreme poverty and setting out a series of time-bound goals and targets, with a deadline of 2015 that have become known as the Millennium Development Goals (MDGs). The eight MDGs have since formed the international/global framework for development policies and funding at the country level. This agenda encompassed a range of linked issues ranging from poverty reduction to human rights and gender equality, and ensuring access to education and health. Sexual and reproductive health & rights were initially missing from the MDG framework; an omission only partially remedied in 2007 with the addition of the target of universal access to reproductive health by 2015.Since that time, millions of lives have been saved through reproductive health services, particularly in low and middle-income countries, including India. Similarly, in many regions of the world, laws and policies are now in place to protect reproductive rights and prevent discrimination against women and girls. The UN Global Strategy on Women’s and Children’s Health and the 2012 London Summit on Family Planning, are high-level initiatives aimed at leveraging political will and funding for programs which will significantly reduce maternal deaths and accelerate universal access to contraception.
However, in the years since the MDG Declaration, sexual and reproductive health and rights landscape has changed. Global health funding for sexual and reproductive rights & health has declined significantly, and in every region of the world, a maturing HIV/AIDS epidemic increasingly affects women and girls. Rising conservative tides have threatened hard-won sexual and reproductive rights victories and compromised the safety and well-being of all, particularly of young women in poor communities. Despite increased political and media attention, among women of reproductive age in developing countries, 57% (867 million) are in need of contraception because they are sexually active, but do not want a child in the next two years. Of these 867 million women, 645 million (74%) are using modern methods of contraception. The remaining 222 million (26%) are using no method or traditional methods. Perhaps most significantly, today is the largest-ever generation of young people.
Similarly, several global processes - the MDG review on the Post 2015 Development Agenda, a twenty-year review of progress towards achieving the Cairo Program of Action, and a discussion on the Sustainable Development Goals initiated at the Rio + 20 conference - are happening now and in forthcoming years, all with implications for the future of the global sexual and reproductive health & rights agenda. It is of the utmost importance that advancing sexual and reproductive rights is central to the international/global development framework that will succeed the MDGs, and will determine policies, priorities and resources allocation worldwide for the decade ahead.
In the second decade of the 21st century, the more than seven billion people sharing the planet face a number of global challenges: threats such as climate change and growing inequalities among and within countries persist alongside the unfinished agenda of poverty elimination at a time when the global financial crisis has reduced the funding available for international development. A range of demographic challenges, including increased migration in a more globalized world, and, in some countries, ageing, are increasingly significant, while the largest-ever generation of young people is in urgent need of education and employment opportunities, and poverty remains a reality for far too many.
On the other hand, at present, the international community faces a historic opportunity. Nearly 20 years ago, in 1994, 179 nations committed to protect the reproductive health & rights of women and girls at the landmark UN International Conference on Population and Development Cairo. Those basic rights, which include the ability to make free and informed decisions about one’s body, health, relationships, marriage and childbearing, form the cornerstone of efforts to protect human dignity and promote the sustainable development of our planet.
Twenty years later, a major UN review of progress towards those progresses gives us the chance to ask, “Has life really changed for women and girls?”The answer is decidedly mixed and an urgent action is called for.
On the positive side, a number of countries have implemented new laws and policies that provide at least partial protection for reproductive health and rights. Maternal mortality has declined in some countries that have improved access to reproductive health care. Access to information and services that can prevent and treat HIV/AIDS has also increased in various countries.
For hundreds of millions of women and girls, however, and for poor and marginalized communities, the promise of Cairo is far from fulfilled. Maternal mortality remains the leading cause of death for adolescent girls in the developing world, with the poorest and most disadvantaged women most at risk. One in nine girls in developing countries such as India will be married before her 15th birthday. As many as seven in 10 women experience physical and/or sexual violence in their lifetimes. Women are injured and die every day at the hands of their husbands and partners, and legal systems often protect rather than punish their assailants.
We still live in a world where more than 200 million women lack effective access to modern contraception, and comprehensive sexuality education for young people remains rare. As a result, 20 years after Cairo, only about one in three young people in developing countries knows how to prevent HIV infection, an estimated 40 percent of pregnancies worldwide are unintended, and there are at least 20 million unsafe abortions every year.
Access to sexual reproductive and maternal health services is both a fundamental human right and a critical developmental issue. Supporting sexual, reproductive health and maternal health & rights is therefore central gender equality, reducing global poverty. Thus, it is high time for all individuals to collectively respond to reverse these disturbing statistics, and time for governments to match their rhetorical commitments to sexual and reproductive health & rights with action. Apparently, building upon what has already been accomplished through the ICPD Program of Action; efforts must be strengthened to ensure universal access to sexual and reproductive health information, services and education, especially comprehensive sexuality education for young people and emergency services for survivors of gender-based violence, amid a vision of inclusive development that is genuinely rooted in equality, dignity and social justice demands.
