DELEGATES IN COMMISSION ON POPULATION AND DEVELOPMENT SHARE NATIONAL EXPERIENCES OF REDUCING MORTALITY, EMPOWERING WOMEN
DELEGATES IN COMMISSION ON POPULATION AND DEVELOPMENT SHARE NATIONAL EXPERIENCES OF REDUCING MORTALITY, EMPOWERING WOMEN
|Department of Public Information • News and Media Division • New York|
Commission on Population and Development
5th & 6th Meetings (AM & PM)
delegates in commission on population and development share national
experiences of reducing mortality, empowering women
As the Commission on Population and Development continued its general debate today, speakers shed light on their respective national strategies and programmes to curb population growth, reduce maternal and infant mortality, and empower women -- all of which were necessary to meet the ambitious Millennium Development Goals by 2015.
The Executive Director of the Commission on Population of the Philippines expressed optimism that his country would reach the Millennium targets, saying that the national population growth rate had declined steadily and would likely slow to 1.8 per cent by 2015. The Government had integrated population management into its flagship anti-hunger programme in an effort to encourage smaller families which would be better equipped to meet basic family and education needs. Local authorities were also providing reproductive health and family planning services.
Thanks to policies to make the labour force healthier and better educated, life expectancy had risen while infant and child mortality rates had declined from 30 per 1,000 live births in 2003 to 24 per 1,000 in 2006, he said. The FOURmula One for Health initiative offered critical health interventions in a single package. Reproductive health was a precondition for economic development, and the Government had adopted programmes on maternal health and safe motherhood, family planning, adolescent health and youth development, and women’s empowerment.
Uganda’s representative said his country was also working hard to implement the reproductive health goals adopted at the 1994 Cairo International Conference on Population and Development, incorporating them into the National Population Policy for Sustainable Development and the medium-term Poverty Eradication Action Plan. National gender and affirmative action policies had helped improve the socio-economic status of women and their role in decision-making, while a road map to reduce maternal and neonatal mortality, as well as safe motherhood campaigns had generated greater awareness of family planning rights at the community level.
Still, contraceptive use was low, at 18.5 per cent, and unmet family planning needs were high at 40 per cent, he said. Illiteracy and maternal mortality remained unacceptably high and the infant mortality rate stood at 76 per 1,000 live births, owing largely to cultural and gender challenges that still posed obstacles to the empowerment of women.
The Vice-Chairman of Qatar’s Permanent Population Committee said his country’s unprecedented progress in social services, health and education had caused life expectancy to rise and maternal and child mortality to drop. Qatar’s demographic situation placed population issues at the forefront of development, and the living standards of foreign workers and their families back home were also rising.
He stressed the importance to Qatar’s National Vision 2030 of solidarity and communication between generations, as well as coexistence and tolerance between different races, religions and cultures. Regional and international partnerships, collaboration among rich and poor countries, and new institutions addressing population and development issues would be needed to implement development policies.
Malta’s representative, while joining the chorus of speakers voicing support for the Cairo agenda, emphasized, however, that the Commission’s recommendations on women’s empowerment and gender equality in relation to population and development should not oblige any party to consider abortion as a legitimate form of family planning, reproductive health rights, services or commodities. Induced abortions were illegal and not a form of family planning.
While supporting Cairo Programme of Action, the Beijing Platform of Action and the Convention on the Elimination of All Forms of Discrimination against Women, Malta maintained its reservations regarding the use of such terms as “reproductive rights”, “reproductive services” and “control of fertility”. It also objected to the phrase “such abortions should be safe”, which could lend itself to multiple interpretations and imply, among other things, that abortion could be completely free of medical and other psychological risks, while altogether ignoring the rights of the unborn.
A representative of IPAS, an international organization working to reduce death and injury to women from unsafe abortion, strongly disagreed with that position, stressing that access to safe abortion was a public health issue and a matter of ethics, social justice and human rights. Since 1994, some 24 countries had liberalized abortion laws and eight more had broadened access to safe legal abortion by revising health sector regulations, developing national standards and guidelines for abortion care and court rulings.
The Permanent Observer for the Holy See said the reports before the Commission gave the impression that populations were seen as the obstacle to greater social and economic development rather than vital contributors to the success of the Millennium Development Goals. Priority seemed to have been given to population control rather than education, health care, access to water, sanitation and employment. Fifteen years after the International Conference, population growth had begun to slow as food production continued to rise to the point where it was being diverted to the production of fuel. Hopefully, public efforts would be redirected towards human-centred approaches to attaining the Millennium Goals.
Senior officials from the Population Division of the Department of Economic and Social Affairs introduced the reports of the Secretary-General on world demographic trends, and programme implementation and progress in population issues during 2008, as well as a note by the Secretariat containing the Division’s draft programme of work for the biennium 2010-2011.
Taking part in today’s meetings were representatives of the Russian Federation, Portugal, Japan, Brazil, Morocco, Kenya, Cuba, United Republic of Tanzania, Nigeria, Tunisia, Mexico, Saint Lucia, Jamaica, Israel, Finland, Sweden, Uruguay, Zambia, Sri Lanka, Ghana, India, Kazakhstan, Indonesia, United States, Norway and Brazil.
Senior officials from the International Organization for Migration, World Health Organization, Economic and Social Commission for Asia and the Pacific (ESCAP) and the Economic Commission for Latin America and the Caribbean (ECLAC) also addressed the Commission, as did the Permanent Observer of Partners in Population and Development.
Several non-governmental organizations also addressed the Commission, including representatives of the International Planned Parenthood Federation, World Youth Alliance, World Population Foundation, AARP, Inter-European Parliamentary Forum on Population and Development, No Youth No Change “in partnership” with Action Canada for Population and Development, Latin American Caribbean Women’s Health Network, and Population Action International.
The Commission will meet again at 10 a.m. Thursday, 2 April, to take up the contribution of population and development issues to the theme of the Annual Ministerial Review in 2009.
The Commission on Population and Development met to conclude its general debate on national experiences in population matters: contribution of the Programme of Action of the International Conference on Population and Development to the internationally agreed development goals, including the Millennium Development Goals. For yesterday’s coverage, see Press Release POP/972.
Expected also to consider programme implementation and its Secretariat’s future programme of work in the field of population, the Commission had before it reports of the Secretary-General on world demographic trends (document E/CN.9/2009/6) and on programme implementation and progress of work in the field of population in 2008 (document E/CN.9/2009/7). For background information on the Commission and a summary of the reports before it, see Press Release POP/970 of 26 March.
OLGA RODIONOVA ( Russian Federation) recalled that, two years ago, her country had adopted a long-term national demographic policy aimed at stabilizing the population. In the past two years, following implementation of the demographic policy, the birth rate had jumped from 10.4 per 1,000 live births to 12.1 per 1,000 live births. The Government was taking measures to strengthen positive economic results despite the current financial crisis. It had decided that all State obligations would be honoured and programmes implemented despite the crisis.
She said the Government made payments to women following the birth of a second child and any children after that, which they could use to pay off mortgages, among other things. In the last two years, the infant mortality rate had fallen by 14 per cent and the maternal mortality rate by 10 per cent. From 2000 to 2005, the population had decreased by 816,000 people annually and, in the next two or three years, it would stabilize. Demographic and social programmes to develop health care for families with children would be focused fully on achieving those goals.
PEDRO COSTA PEREIRA ( Portugal) said his country’s ministries coordinated activities in health, education, employment and social services in order to promote synergies and coherence. The Government had restructured grade school curricula using innovative methods for life-long learning, education and training in an effort to combat illiteracy. The school dropout rate had fallen by 23 per cent in the last 10 years, and advances in education had led to greater knowledge of health issues, especially HIV/AIDS prevention and family planning.
Progress in education could help reduce fertility and mortality rates and empower women, he said. In the next few years, Portugal aimed to reduce even further its already low maternal and infant mortality rates as well as the HIV infection rate. To ensure equal and universal access to reproductive health services, the Government had adopted measures to reduce infertility and prevent cervical cancer by developing a network to study and treat infertility, providing financial support for couples seeking fertility treatment, setting up an online system to ensure better and more equitable access to techniques, and introducing the vaccine to combat the human papilloma virus into the national immunization programme.
He said the national health services provided routine and voluntary testing for HIV/AIDS as well as access to reproductive health services for migrants, adolescents and other vulnerable groups. The Government had set up a network of shelters and a 24-hour emergency telephone line for female victims of violence. It had also established a gender statistics database. For the 2007-2010 period, it had launched the first ever national action plan to combat trafficking in human beings, the third national action plan for gender mainstreaming and the third national action plan to end domestic violence.
SHIGESATO TAKAHASHI ( Japan) noted that, according to the 2008 Millennium Development Goals report, the world was generally making progress towards meeting the targets, but sub-Saharan Africa was falling behind. Ways must be found to get that region back on track. Although the Millennium and other internationally agreed goals provided a set of benchmarks towards poverty reduction, it was ultimately up to the international community to identify specific ways to achieve that objective.
He said that, in its international cooperation, his country acted consistently in accordance with the concept of human security, which emphasized both protection and empowerment of individuals and communities. It also emphasized the importance of sustainable economic growth based on ownership by developing countries. Japan had announced several health-related initiatives over the years, and had made contributions to such organizations as the United Nations Population Fund (UNFPA) and the International Planned Parenthood Federation.
EDUARDO RIOS-NETO ( Brazil) said his country’s fertility rate had dropped from 4.4 in 1980 to 2.3 in 2000. However, the demographic dividend operated only partially, which suggested that institutional policy mattered. Opportunities could be lost due to a lack of proper State social policies and macroeconomic stabilization adjustments. Only through the adoption of integrated social policies could the Millennium Development Goals be achieved in an integral manner.
Underscoring his country’s support for the centrality of human rights, he said Brazil embraced the agenda of sexual and reproductive health and rights. Its Second National Plan for Women’s Policies, based on the principles of equality and respect for diversity, had been implemented and included a special section on reducing domestic and other forms of violence against women. The national policy for integral assistance to women’s health included strategies for reducing maternal and neonatal mortality and incorporated sexual and reproductive rights and health.
Family planning was understood as a matter of individual choice rather than a strategy for population control, he said. The national universal health system provided support to those facing fertility problems and contemplated the inclusion of specialized health services, including surgical procedures, for homosexuals, bisexuals and transsexuals. In 2006, the health system had treated 320,000 people living with HIV/AIDS, including the provision of antiretroviral therapy to 180,000 patients. The incidence of HIV/AIDS had started to show a small downward trend.
BELHACHMI EL HOUSSINE (Morocco), stressing that the principles of his country’s population policies reflected the recommendations of the International Conference on Population and Development and the Millennium Declaration, said that in 2005 Morocco had launched a national human development initiative that had resulted in improved social indicators. The number of those living on $2 a day had fallen to 8.2 per cent in 2007 from 30.4 per cent in 1990, but that improvement masked a rigid social distribution. Universal primary education had become an achievable objective and enrolment had grown to 74.8 per cent, especially among rural girls. However, dropout rates could erode the progress made and the Government had launched an emergency plan in 2008 to improve the quality of education.
While life expectancy now stood at 72 years, maternal mortality remained high, especially in rural areas, he said, adding that Morocco planned to ensure equality in rural and urban health services. The Government had undertaken several actions in the area of health: care during childbirth in public hospitals was free of charge; the sale of emergency contraception had been approved; and access to health services in the rural areas had improved. Actions had also been undertaken to integrate women into social and political activities, as demonstrated by changes in the Civil, Family and Civil Codes. The mainstreaming of gender had been incorporated into the budget. Meeting the Millennium targets would continue to depend on attainment of the eighth Goal: promoting partnership and solidarity in development.
EDWARD SAMBILI, Permanent Secretary, Ministry of Planning and National Development of Kenya, said his country’s Economic Recovery Strategy for Wealth and Employment Creation 2003-2008 and other programmes and funds had enabled the economy to expand from 0.5 per cent growth in 2002 to 7 per cent in 2007, with poverty declining from 56 per cent to 46 per cent in the same period. After 1994, Kenya had adopted the National Population Policy for Sustainable Development. The integration of population issues into all spheres of development had been undertaken by incorporating population variables into national, sectoral and district development plans. The Government had also strengthened the National Environment Management Authority. Policy and institutional arrangements had been put in place or strengthened to promote women’s participation in the development process.
He said high poverty levels and increasing numbers of orphans as a result of HIV/AIDS posed a serious threat to family stability. The Government had, therefore, introduced free primary education in 2003 and subsidized secondary education in 2008. Kenya’s high annual population growth rate of 2.5 per cent and its youthful age structure were core issues of concern in striving to meet the Millennium Development Goals. Morbidity and mortality rates remained high, especially among women and children. Malnutrition accounted for about 54 per cent of deaths among children and HIV/AIDS prevalence had stood at 7.4 per cent in 2007. About 25 per cent of the population lived in urban areas. Kenya appealed for the international community’s continued collaboration by investing in building capacity in data collection, advocacy and research on population dynamics.
KISAMBA MUGERWA ( Uganda) said his country’s population was growing at 3.2 per cent annually with children comprising 56 per cent of the population. Uganda had a high fertility rate, with women bearing children on average. Some 25 per cent of women bore children while they were still teenagers. Contraceptive use was low, at 18.5 per cent, and unmet family planning needs were high at 40 per cent. Illiteracy and maternal mortality remained unacceptably high and the infant mortality rate was 76 per 1,000 live births. The HIV/AIDS infection rate was also high at 6.4 per cent.
Cultural and gender challenges still posed obstacles to women’s empowerment, he said. To address population and development concerns, Uganda was working with development partners to enact many programmes to improve the quality of life, especially for women and children. The concept of reproductive health adopted at the International Conference on Population and Development had been incorporated into relevant Government policies, including the National Population Policy for Sustainable Development. Key elements of the Cairo Programme of Action had been integrated into the medium-term Poverty Eradication Action Plan.
Noting that primary school enrolment had almost doubled thanks to the 1997 Universal Primary Education policy, he said the Government had introduced the Universal Secondary Education policy in 2007. The national gender policy and affirmative action policies had helped improve the socio-economic status of women and their role in decision-making. Women now comprised 31 per cent of all parliamentarians and 40 per cent of elected local Government officials. In 2008, the Government had put in place a road map to reduce maternal and neonatal mortality, and safe motherhood campaigns had generated greater awareness of family planning rights at the community level. The Government had also adopted a multisectoral approach to HIV/AIDS, helping to reduce the prevalence rate from 29 per cent in some areas to 6.4 per cent.
SAVIOR BORG (Malta) emphasized that any position taken or recommendations made by the Commission on women’s empowerment and gender equality in relation to population and development should not in any way oblige any party to consider abortion as a legitimate form of family planning, reproductive health rights, services or commodities. The termination of pregnancy through procedures of induced abortion was illegal and not a family planning method. Malta had consistently expressed its reservations over the use of such terms as reproductive rights, reproductive services and control of fertility in the context of the Programme of Action, the Beijing Platform of Action and the Convention on the Elimination of All Forms of Discrimination against Women. While Malta supported those instruments, it maintained the reservations it had made at the time of their adoption.
Reiterating his country’s reservation with respect to the phrase “such abortions should be safe”, he said it could lend itself to multiple interpretations and imply, among other things, that abortion could be completely free of medical and other psychological risks, while altogether ignoring the rights of the unborn. Implementation of social and economic measures had always been the backbone of Maltese policy, he said. That included free medical care and comprehensive social security and welfare provisions. Education was also an important aspect of population development. In light of the current global crises, it was crucial to adopt coherent and cohesive policies that sustained the environment as they would have a direct impact on population and development. Malta noted UNFPA’s decision to focus its State of World Population 2009 on issues of environment and women in order to highlight the links between climate change and population factors.
HASSAN IBRAHIM AL HOHANNADI, Vice-Chairman, Permanent Population Committee of Qatar, said his country devoted special attention to all humans in its continuous efforts to build a developed and coherent society. Qatar’s demographic situation placed population questions at the forefront of its concerns and its National Vision 2030, approved in 2008, accorded top priority to human development. The Constitution also considered the individual as the target and means of development.
He said that his country’s socio-economic policies had improved conditions in the social, health and education areas. In the health sector, unprecedented progress had led to a rise in life expectancy, a decrease in maternal and child mortality rates, and a considerable drop in the number of deaths resulting from fatal diseases. Literacy and school enrolment rates for men and women had risen and women were also participating in a growing variety of sectors, now constituting 33 per cent of the national work force.
The living standards of foreign workers and their families back home were also rising, he said, emphasizing the importance to Qatar’s National Vision 2030 of solidarity and communication between generations, as well as co-existence and tolerance between different races, religions and cultures. Partnerships would be needed within effective regional and international contexts, and among poor and rich countries, to implement development policies. Local development required the building of institutions, particularly those specializing in population and development. In that context, Qatar would host the upcoming Arab Population and Development Conference in May 2009.
TOMAS M. OSIAS, Executive Director, Commission on Population of the Philippines, said his country was optimistic about its chances of meeting its poverty reduction targets in 2015 despite the financial crisis. The proportion of people living below the national poverty threshold had fallen from 45.3 per cent in 2001 to 32.9 per cent in 2006 and the malnutrition rate among children aged five years and below had shrunk from 34.5 per cent to 24.6 per cent. Those gains had resulted from sustained economic growth and the prioritization of anti-poverty strategies in national development plans.
Meanwhile, population growth rate had declined steadily and, with projections for 2015 at 1.8 per cent, the country had gained some “breathing space”, he said. Recognizing, however, that a family’s capacity to meet its basic and education needs diminished as the number of its members increased, the Government had nevertheless integrated population management into its flagship anti-hunger programme. As it had crafted its national population policy, local Government units had been mandated to ensure the provision of reproductive health and family planning services.
In the area of human resources, the country was pursuing various policy and programme interventions to improve the quality of education and the health of its labour force, he said. As a result, male and female life spans had risen while mortality rates among infants and children had declined from 30 per 1,000 live births in 2003 to 24 per 1,000 in 2006 and from 42 to 32 per 1,000 among children aged up to four years. Under the FOURmula One for Health initiative, critical health interventions were being delivered as a single package.
Labour and Employment Chapters were also being incorporated into the Philippine Development Plan, he said. Although a growing number of Filipinos crossed borders to seek better economic opportunities, the country was working to ensure the protection, welfare and human dignity of migrant workers. The Government had adopted measures to maximize remittances from overseas workers and efficiently integrate returning labour migrants. In recognition of the importance of reproductive health goals as a precondition for economic development, additional programmes sought to ensure maternal health and safe motherhood; provide family planning; promote adolescent health and youth development; and improve women’s status in society.
ILEANA NUNEZ MORDOCHE ( Cuba) said that, since the Cuban Revolution 50 years ago, the Government had been implementing an economic and social development programme that had raised current socio-demographic indicators to a level similar to those in developed countries. Life expectancy in Cuba was 78 years while infant and maternal mortality rates stood at 4.7 and 30.2 per 100,000 live births respectively. The fertility rate was currently 1.5 and contraceptive prevalence stood at 70 per cent.
She said her country had achieved important results in providing universal education, gender equality, environment protection and international solidarity, among other things. The country’s entire population had access to consumer goods and services because employment was guaranteed for all. The illiteracy rate stood at 0.2 per cent and primary education enrolment at 99 per cent. Women were present in all areas of society and empowered to decide.
Some 99.9 per cent of all childbirths took place in health centres, she said, adding that HIV/AIDS prevalence rate was 0.1 per cent among those aged 15 to 49 years. More than 95 per cent of the population had access to drinking water and sanitation. Cuba collaborated with more than 150 countries in areas such as health, education, construction, sports and agriculture. Tens of thousands of foreign students, mainly from developing countries, had graduated in Cuba in the fields of medicine and engineering, among others.
MODEST MERO (United Republic of Tanzania), noting that population growth in least developing countries was high while economic growth remained in the single digits, said his country’s population was expected to jump from 40.7 million in 2002 to 63.5 million in 2025, growing at a rate of 2.9 per cent. Average life expectancy was 48 years and 45 per cent of the population was under 15 years of age. The country had made significant progress in improving primary education, promoting gender equality, empowering women, improving environmental sustainability and reducing child mortality.
However, the country needed to pay special attention to health-related Millennium Development Goals, among them improving maternal health and combating HIV/AIDS, malaria and other diseases, he said. Poverty also remained a serious challenge, particularly in the rural areas, where 83 per cent of the population lived below the basic needs poverty line. The Government was taking measures to address both rural and urban poverty. It had allocated significant resources and launched information campaigns to stress the importance of educating girls. It was likely that gender equality would be achieved by 2015.
He said it was also possible, thanks to good progress, particularly in controlling malaria in children under the age of five, that the Millennium Goal of reducing child mortality would be achieved. However, maternal mortality remained high and was compounded by the impact of HIV/AIDS, inadequate health facilities and poor health due to malnutrition. The HIV/AIDS prevalence rate had decreased in all age groups to less than 7 per cent from 12 per cent in the 1990s. The Government was scaling up HIV/AIDS prevention, care and treatment to cut the HIV/AIDS rate in half and provide patients with antiretroviral therapy.
SAMU’ILA DANKO MAKAMA ( Nigeria) said his country’s rapid population growth of 3.2 per cent was a great challenge to the eradication of poverty, adding that the need to slow that growth rate was recognized at the highest level. The National Strategic Health Development Plan and Investment Plan included strategies to improve reproductive health and rights. Nigeria had also developed an integrated maternal, new-born and child health strategy. More than half of the country’s 36 States were adopting and implementing policies on free maternal health care and abolishing harmful traditional practices. The Federal Government had launched the National HIV Prevention Plan in 2007.
He said emphasis was increasingly placed on strong partnerships between key stakeholders in the health sector, including donors, the private sector, local communities and civil society. Fostering closer interlinkages between health, education and gender equality and other poverty reduction strategies would greatly enhance prospects of achieving the Millennium Development Goals. Population, sexual and reproductive health and rights, and gender equality were central to development. Nigeria was committed to strengthening the National Population Commission and other relevant institutions in order to generate the data needed for monitoring improvements in maternal health and access to reproductive health.
NAHIBA GUEDDANA ( Tunisia) said that, for decades, her country had placed women’s rights and reproductive rights at the centre of its human rights policies. Tunisia was among the most developed countries on the African continent. In 2007, its poverty rate had been 3.8 per cent and it should fall to 2 per cent in 2015. Primary school enrolment stood at 97.3 per cent and should reach 99 per cent in 2015. Infant mortality rate had fallen by a factor of four since 1970, with a rate of 18.5 per 1,000 live births in 2007. Important efforts had been made through prenatal care and awareness-raising to reduce the maternal mortality rate, which now stood at 36.5 per 100,000 live births. The objective was to attain a rate of 25 per 1,000 live births in 2015.
As for reproductive health, Tunisia had developed innovative programmes in the most isolated areas for men and youth, relying on media, civil society and religious leaders, she said. Contraceptive prevalence was 60.2 per cent and the promotion of equality and empowerment for women was among the most important foundations of Tunisia’s policies on population and development. Girls comprised 48 per cent of pupils in primary school, and 53 per cent of secondary school students. Women were well represented in the political area and in the workplace. Tunisia was working to improve environmental conditions for the population, 96 per cent of whom had access to drinking water and 52 per cent to sanitation. Resources allocated by donors to family planning made up the lowest proportion of all programmes, and Tunisia stressed the importance of correcting that shortfall.
FELIX VELEZ FERNANDEZ VARELA FERNANDEZ (Mexico) said his country’s fertility rate had dropped from 6 children per woman in 1974 to 2.2 in 2006 thanks to programmes to ensure universal access to reproductive health services, including family planning, and higher contraceptive use, which had increased among women of child-bearing age from 30 per cent in 1976 to 70.9 per cent in 2006. Demographic change was a long-term process and fertility was complex because it dealt with very private aspects of human life, including sexuality and reproduction. The Executive Survey for Reproductive Health indicated a drop in the fertility rate among adolescents from 45 per cent in 1997 to 39.4 per cent in 2006, and an increase in their unmet contraceptive needs from 26.7 per cent to 35.6 per cent over the same period.
Those indicators were calculated from data that included only married women or those in romantic partnerships, he said. The number of women aged between 15 and 19 years in romantic partnerships had dropped from 15.2 per cent in 1997 to 11.6 per cent in 2006. There was a need for demographic surveys and studies on sexual and reproductive health, coupled with social change, in order to adapt to new realities. The National Population Council had drawn up studies focusing on all sexually active women, not only those who were married or in romantic partnerships. Reducing maternal mortality was a complex challenge requiring not only efforts to reduce maternal deaths, but also extra efforts to obtain reliable records on mortality rates. Action in that respect was among the Government’s central public policies.
SARAH FLOOD-BEAUBRUN ( Saint Lucia), describing human capital as her country’s greatest resource, said people were the engine of economic development. Investing in human resources also meant taking affirmative steps towards ending discrimination based on race or sex. It also meant investing in education and the environment. The empowerment of women included implementation of flexible working conditions for working mothers to enhance their ability to fulfil family responsibilities. Commitment to the goal of reducing child mortality and improving maternal health meant investing in health care, assisting expectant mothers, prenatal care and caring for new-born and infant children.
She said a commitment to population and development meant HIV-testing for pregnant mothers. Saint Lucia had been very successful in reducing mother-to-child HIV/AIDS transmission substantially simply by investing in testing of all expectant mothers and in treatment for those who needed it. There had also been a steady decline in teenage pregnancy rates, achieved through the Health and Family Life Education Programme, which emphasized abstinence until marriage and fidelity afterwards. Saint Lucia had invested in continuing education programmes for teenage mothers aimed at arresting the poverty cycle and repeat out-of-wedlock pregnancies. Investments had also been made in programmes to educate young men about being responsible fathers committed to their wives and children, and always being respectful of women.
EASTON WILLIAMS ( Jamaica) said that, while the principles and objectives of the Programme of Action contributed significantly to current and emerging legislative, institutional and programmatic realities in his country, their implementation had been mixed. Using a multi-pronged strategic approach, the Government had reduced the proportion of people living in poverty from 30 per cent in the 1990s to around 10 per cent today. Having already achieved the upper limit of the Millennium Development Goals on child mortality, Jamaica sought to reduce that rate further by integrating programmes for maternal and child health, family planning and sexually transmitted infections; establishing baby- and mother-friendly clinics; and providing antiretroviral medications to prevent mother-to-child transmission of HIV, as well as free health care in public clinics and hospitals.
Jamaica had formulated a national HIV/AIDS strategic plan as part of a more systematic and comprehensive approach to the disease, but infection rates among people aged 15 years and above remained high, at 1.5 to 1.7 per cent, he said. The country had also embarked on a strategic programme targeting the reproductive health-care needs of adolescents and youth, who were largely excluded from the main focus of national family planning programmes. The establishment of youth-friendly clinics and the implementation of family-life education programmes in schools had resulted in substantially reducing unwanted pregnancies and high contraceptive use among youth by 2004. A second strategic programme targeting the reproductive health needs of persons with disabilities -– particularly youth –- was regarded as a best practice and was being designed for implementation in other countries. Further, Jamaica had already surpassed the targets for women and education. However, there was still a need to raise the share of employed women in the public and private sectors and in all areas and levels of political representation.
ILAN FLUSS ( Israel) said his country had witnessed a period of rapid population growth and high immigration, while continuing to absorb immigrants from diverse ethnic, cultural, racial and socio-economic backgrounds. Maintaining and streamlining health and social services, and education with a focus on early childhood education, for that diverse group of immigrants and other minority groups continued to be of the utmost importance. Israel had numerous laws, policies and programmes to maintain the health and safety of its population. Civil society and non-governmental organizations also took part in advancing health and education by initiating projects, lobbying the Government and educating the public about population and gender issues.
Israel had an excellent record on maternal and infant health, he said, noting that its maternal mortality rate was 4 women per 1,000 live births and infant mortality also 4 per 1,000 live births. The fertility rate stood at 3, which was high for a developed country and resulted from Israeli society’s religious and cultural values. At the same time, there were striking increases in women’s educational attainment, labour force participation and income -- a unique pattern among developed countries linked to a stable model for family planning. Extreme ageing was a cause of concern for the future equilibrium between productive human resources and the transfer of payments due to the elderly. Israel looked outward to creating more partnerships and sharing its models with others.
MIKKO KINNUNEN ( Finland) said the Programme of Action had borne uneven results around the world and high population growth rates in many instances threatened the Earth’s carrying capacity. In some places, providing services in tandem with population growth had become “practically impossible”, such as in rapidly growing urban areas. In turn, poverty tended to support high birth rates because people mired in poverty lacked information, were subject to poor health services and poor women had low status, among other things.
Finland provided an example of reducing unbalanced population growth and poverty by investing in people, services and security, he said. At a time when the economy had been largely agrarian and national income levels far below those of its neighbours, Finland had focused on gender equality as well as education and health for all. In comparison with other countries, Finnish people now enjoyed good health, according to indicators such as maternal and child mortality, abortion rates, the number of sexually transmitted infections and teen pregnancies.
He said that, by devoting attention to sex education for youth and providing access to related services at local health-care centres, Finland had been fairly successful in promoting sexual and reproductive health and rights. People realized the consequences of having families that were too large and there was a need for extra efforts to meet the “large unmet demand for effective means for choosing the right family size”. While most countries realized the importance of managing population changes and related issues -- age structure and regional distribution of population -- their population policies must be enmeshed with the concept of “ecologically, economically and socially sustainable development” in order to have the greatest effect.
HARALD FRIES ( Sweden) said human rights and gender equality were two priority areas for his country’s Government. Development, human rights, gender equality and women’s empowerment were interdependent and the cornerstones of implementation of the International Conference on Population and Development. Sweden continued to implement the Cairo Programme of Action in its country-specific activities, but it was important to ensure country or regional ownership and the need to develop national capacities.
He said that, in the international debate on the current global crisis, new calls had been heard for population control, which took the argument back to a more quantitative way of thinking about population, thereby undermining progress in promoting reproductive health and rights. Those were human rights because the choice of the individual must remain in focus when reasoning about sexual and reproductive health. Likewise, migration was a global trend with enormous development potential for both individuals and societies. It was an integral part of Sweden’s agenda for development and poverty eradication.
Expressing deep concern about prospects for attaining the fifth Millennium Development Goal, on maternal health, he stressed that important underlying factors of maternal health must be considered, including gender inequality, the roles of men and boys and issues of sexuality and gender-based violence. The feminization of HIV showed the need to strengthen respect for human rights and increase gender equality. Linking initiatives on reproductive health and rights to HIV and AIDS was, therefore, vital to responding successfully to the pandemic.
NURY BAUZAN DE SENES, Director of Multilateral Affairs, Ministry of Foreign Relations of Uruguay, said that in March 2005 her country had presented its first report on progress made in achieving the Millennium Development Goals. In April 2006, it had signed the 2007-2010 United Nations Development Assistance Framework (UNDAF). In October 2007, Uruguay had partnered with the United Nations on a 2007-2010 joint capacity-building programme involving 11 projects that were currently being implemented on the basis of UNDAF’s four priority areas: social support, including education, decent jobs, health, social security and housing; poverty reduction and eradication, with an emphasis on women and children; combating inequity and discrimination, and preventing HIV/AIDS; and population policy, including questions of migration.
She said that, in 1995, the Government had begun to design sexual and reproductive health policies. In 1996, with help from UNFPA, Uruguay had set up two sexual and reproductive health programmes. In August 2004, it had established a UNFPA liaison office and had since made important progress in implementing the Cairo agenda in the areas of sexual and reproductive health, gender, population and development. Fertility reduction had not been uniform and less educated women still tended to have more children than their educated peers, 5.7 on average compared to 2.3. The prevalence rate of sexually transmitted diseases had increased among youth and the Government had recently created policies to promote sex education. It had set up the National Institute for Women in March 2005 and launched the first National Plan for Equal Opportunities in May 2007.
LAZAROUS KAPAMBWE ( Zambia) said his country had revised its 1989 National Population Policy, in line with the Cairo Programme of Action. The Policy aimed to manage population resources while speeding up economic development. It had established population units in line with ministries and provincial offices in order to integrate population concerns into development planning. The Government was strengthening emergency obstetric and neonatal care by upgrading existing infrastructure, scaling up the training of health care workers and installing new equipment. It had also introduced retention schemes for medical personnel. Those measures had resulted in a drop in the maternal mortality rate, from 729 per 100,000 live births in 2001 and 2002 to 591 per 100,000 live births in 2007.
He said that, according to Zambia’s 2007 Millennium Development Goals progress report, the country had the potential to meet the maternal health target, having set up a two-year midwifery training programme to increase the number of skilled birth attendants to complement conventional midwife training programmes. Despite such efforts, brain drain continued to deplete Zambia’s highly skilled workforce, which the Government had trained at great cost. That phenomenon was not limited to Zambia and unless addressed urgently, it would threaten attainment of the Millennium targets. Zambia called on the international community to set up mechanisms to help developing countries rectify the situation.
MUDITHA HALLIYADDE ( Sri Lanka) said the Millennium Development Goals and the Cairo Programme of Action were “mutually promotional”, both serving the cause of population and development. Unless population and reproductive health issues were addressed, Millennium Goals like eradicating poverty and hunger would be difficult to meet. For its own part, Sri Lanka had achieved a historical transformation of its population’s reproductive patterns while upgrading the standard of living. It had empowered small- and medium-scale farmers and developed a social safety net, all while maintaining a substantial economic growth rate. Sri Lankahad carried out progressive population and family planning programmes that were true to the Programme of Action in letter and spirit.
She said her country had been steadily promoting informed choice of contraceptive methods, while trying to establish universal access to reproductive health education. It had reinforced the prevention and control of serious diseases such as HIV/AIDS. As the general public had grown more conscious of family planning, the country’s health situation had gradually improved, resulting in lower maternal and infant mortality rates. Concurrently, by promoting other development goals in education and poverty reduction, Sri Lanka had been able to achieve high levels of male and female literacy, school enrolment and health outcomes, although more needed to be done on sustainable growth and peace and security.
ESTHER Y. APEWOKIN ( Ghana) said that improving the quality of life of Ghanaians had always been the Government’s primary concern and the Ghana Poverty Reduction Strategy aimed to ensure equitable sustainable growth, accelerated poverty reduction and protection of the vulnerable. It recognized the importance of population management while emphasizing human resource development and the provision of basic social services by addressing issues related to education, the development of skills and entrepreneurship, HIV/AIDS, health and population management.
She said the Government was finalizing a seven-year development plan that would integrate population variables. It had appointed women to high public positions, including those of Speaker of Parliament and Attorney General. The Government was implementing policies and programmes to enhance access to quality health services. The country’s infant mortality rate had dropped from 119 in 1993 to 111 in 2003, but maternal mortality remained a challenge at 214. Accordingly, the Government had come out with a strategic plan to reposition family planning. Another challenge was the fast rate of urbanization. By 2010, 52 per cent of the population would live in urban areas.
CELESTINO MIGLIORE, Permanent Observer of Holy See, said that, reading the reports, one could not help getting the impression that populations were seen as the obstacle to greater social and economic development rather than vital contributors to the success of the Millennium Development Goals. Priority seemed to have been given to population control rather than education, health care, access to water, sanitation and employment. Fifteen years after the International Conference, population growth had begun to slow as food production continued to rise to the point where it was being diverted to the production of fuel. It was almost ironic that destruction of the environment was perpetrated primarily by States with lower growth rates.
Calling for a greater commitment to providing economic assistance to Africa and to investing in human capital and infrastructure, he said the proper focus in addressing global development should be primarily on programmes and values that supported personal and social development, including access to education, political and economic opportunity, political stability, basic health care and support for the family. Throughout history, those priorities had provided the platform for economic and social growth and the accompanying increase in responsible parenthood. The Holy See reaffirmed its reservations -- made at the Cairo and Beijing Conferences –- and consistent position that abortion was not a legitimate form of sexual and reproductive health, rights or services. Hopefully, public efforts would be redirected towards human-centred approaches to attaining the Millennium Development Goals.
M.S. PURI (India), associating himself with the “Group of 77” developing countries and China, said inclusive growth was the objective of his country’s most recent Five Year Plan. Employment was a key weapon against poverty, particularly in countries with large populations like India. In that context, the Government was implementing the National Rural Employment Guarantee Scheme to ensure minimum employment levels. The Scheme, which was allocated $2.5 billion annually, guaranteed 100 days of work to every household.
The National Rural Health Mission, launched in 2005, was improving access to equitable, affordable, accountable and effective primary health care to more than 600 million people, he said. It included the Reproductive and Child Health Programme, which had so far benefited more than 10 million women in successfully reducing maternal and infant mortality. The Family Planning Programme provided reproductive health services, while HIV/AIDS programmes had been integrated with reproductive health care in primary health-care institutions.
India had also embarked on ambitious programmes for human resource development, he continued. The Government aimed to implement a phased increase in public spending on education at all levels to at least 6 per cent of gross domestic product, with half the total devoted to primary and secondary education. Gender budgeting had been introduced across all sectors of development planning, and constitutional amendments required that one third of seats in local authorities be reserved for women. However, the International Conference targets were simply not sufficient to meet the current needs of developing countries in family planning, reproductive health and STD/HIV/AIDS. Of particular concern was the steady decline in donor aid for family planning as a percentage of all population assistance, from 55 per cent in 1995 to 5 per cent in 2007.
LUCA DALL’OGLIO, Permanent Observer, International Organization for Migration (IOM), noting that the Millennium Development Goals were an important way to ensure that globalization’s benefits were evenly spread and shared, pointed out that migrants were part of those populations for whom they had not implied enough progress. Migrant women and girls, especially those forced to migrate in irregular circumstances, were disproportionately affected by the risks associated with migration because of their vulnerability to exploitation and violence. That vulnerability was exacerbated unacceptably by their lack of access to appropriate maternal and child health services in particular, which could have long-term public and social costs.
He cited studies that showed that lack of legal status, while increasing irregular migrant women’s risk to violence and sexual assault, also reduced their access to prenatal care. That situation was particularly worrisome given that irregular migrant women could be at higher risk of experiencing unwanted pregnancies due to lack of access to family planning services and education, and resulting from sexual violence. Even if reproductive health services were available, many could not access them for fear of deportation or because they were not available in culturally or linguistically appropriate ways. For women displaced by force, their vulnerability to violence, lack of shelter, food and sanitation, as well as the absence of basic health services could pose an enormous burden and risk to their health and that of their children.
Migrant-hosting communities the world over should provide accessible, acceptable and affordable maternal and child health services, as a cornerstone of primary health care, to all migrant women, irrespective of legal status, he said. Addressing the health needs of migrant women and girls benefited not only their individual health, but also that of the general public. The current global financial crisis had the potential to undermine the social protection of vulnerable groups, including migrants. It was of paramount importance in that context to monitor the impact of the crisis on migrants, ensure that their rights were effectively upheld, and that they were protected from discrimination in the employment and social spheres. In that regard, there was a need for strong solidarity between countries of origin and destination to safeguard and continue to harness the benefits flowing from the relationship between migration and development as well as to migrants and their families.
JYOTI SHANKAR SINGH, Permanent Observer, Partners in Population and Development –- a South-South Initiative, said the group had been established at the Cairo Conference as an intergovernmental coalition of developing countries dedicated to the promotion and strengthening of South-South cooperation on population and development. Now with 22 members, the group noted with concern that family planning was losing its centrality in terms of budgetary allocations and population and reproductive health policies. International population assistance allocated to family planning had dropped from 55 per cent in 1995 -– or $723 million -– to 5 per cent in 2007 -- $338 million.
Noting UNFPA’s suggestion about the need to revise and update estimates adopted at the International Conference -– including $49 billion a year for sexual and reproductive health programmes -– he said those proposals should be debated in various meetings and conferences dedicated to the 15-year review of Cairo that consensus could be reached on what was needed now and how best to raise further support for reproductive health programmes. While recognizing the integral relationship between Cairo’s goals and the Millennium Development Goals, there were two other aspects of the Goals that were equally important: women’s health and the basic right of both men and women to decide freely and responsibly the number and spacing of their children; and having the information, education and means to do so.
WERNER OBERMEYER, World Health Organization (WHO), New York Office, said that, despite encouraging trends in some countries, for many others, the task of attaining the internationally agreed development goals remained more challenging than when they had seemed in 2000 as part of the Millennium Declaration. The initial push towards reaching the targets called for commitment and concentrated investment by the international community. While commitment and investments had grown, the need for accelerated effort was more urgent now than ever.
He said that, while the bigger picture remained one of overwhelming challenges, there were many glimmers of hope around the world. Communities across Africa and Asia had involved families and caregivers in formulating solutions to their own local challenges, succeeding in making skilled maternal and newborn care available to many women. Studies showed that some developing countries had dramatically reduced maternal mortality since 1997, and there was no longer any disagreement that childbirth with skilled attendants, access to timely emergency obstetric care and family planning when required were the way to avoid preventable deaths among women and newborns.
Although a comparison of maternal and newborn death estimates suggested a slight improvement in the global maternal mortality ratio between 1990 and 2005, that progress had been limited and slow, he said. An annual decline of 5.5 per cent was required in order to reach Millennium Development Goal 5 by 2015. The actual average annual rate of decline was less than 1 per cent whereas maternal deaths were estimated at 5,536,000 annually worldwide. Every year, more than 4 million babies died within 28 days of birth and at least 3.3 million were stillborn. Of those deaths, 98 per cent occurred in Africa and South-East Asia.
Malaria infection and HIV during pregnancy as well as HIV transmission from mother to child continued to pose substantial risks to the mother, her foetus and the newborn, he said. Despite considerable progress in malaria control over the past decade, the disease remained a serious public health problem during pregnancy, particularly in sub-Saharan Africa, where about 90 per cent of the clinical cases recorded worldwide occurred each year. The HIV epidemic had also had a devastating impact on maternal, newborn and child health, undermining efforts to achieve Millennium Goals in those related areas. As a priority starting point in the 40 high-burden countries, WHO aimed to reach every district to improve the quality of existing childbirth facilities and emergency obstetric and newborn care in order to prevent maternal and newborn deaths and stillbirths.
GILL GREER, Director-General, International Planned Parenthood Federation, speaking also on behalf of the German Foundation for World Population, said that, even with the enormous investments made in reproductive health over the past 30 years, due to the shortage of supplies in developing countries, millions of women, men and young people remained unable to get the contraceptives and information they needed to space births and avoid unintended pregnancies. Shortages of critical reproductive health supplies around the world were undermining progress towards achieving the Programme of Action and the poverty reduction and reproductive health targets included in the Millennium Development Goals.
Without reproductive health supplies, no health or poverty reduction programme could succeed because there could be no services, she said. Despite increased demand for reproductive health supplies, donor support was fading or stagnating, and many national Governments had not prioritized the question of ensuring access. In addition, the lack of access to modern family planning was a key driver of more than 60 million unintended pregnancies worldwide every year and the resulting annual net increase in the global population of 80 million people.
LAURA VILLA, a representative of IPAS, an international organization working to reduce deaths and injuries from unsafe abortion and to increase women’s ability to exercise their sexual and reproductive rights, said that unsafe abortion remained a pervasive and neglected reproductive health problem. Every year, 19 million women had unsafe abortions and, since the Cairo Conference, almost 1 million women, almost half under the age of 25, had died because they lacked access to safe abortion services. Many more had survived, but at great cost to their reproductive heath, including reproductive tract infections and infertility. Most of those women were poor, young and living in rural or marginalized urban areas. While such deaths were preventable, women and girls everywhere lacked access to sex education and reproductive health services. Many suffered from discrimination, violence and stigma, which hindered their ability to safely make their own reproductive decisions and enjoy healthy sexual relationships.
Many countries had taken positive steps to rectify that situation, including emergency treatment for complications arising from unsafe abortions, and family planning counselling, she said. Services to prevent unintended pregnancy and unsafe abortion were more widely available, but not nearly enough. Women had better access to safe, legal abortion thanks to new guidelines issued by the World Health Organization in 2003. New and low-cost technologies such as medical abortion were helping to make safe care available to women who lacked access to even basic health care. Since 1994, 24 countries had liberalized their abortion laws and eight more had broadened access to safe legal abortion by revising health sector regulations, developing national standards and guidelines for abortion care and court rulings. Access to safe abortion was a public health issue and a matter of ethics, social justice and human rights.
REBECCA AUSTIN, World Youth Alliance, said the intrinsic dignity of the human person was the only starting point for creating policies to alleviate poverty, hunger and disease. Such policies should prioritize basic health care and investment in education and infrastructure while seeking to support families. Underlying obstacles to education, such as malnutrition and a lack of qualified teachers, should be removed as part of efforts to boost formal and informal education in rural areas.
Men and women should be given real choices with respect to balancing domestic and professional life, she said. Women should also be given access to education, employment and alternative sources of income so they were not forced to reduce their fertility. Policies aimed at addressing maternal and child mortality should seek to strengthen health care systems, support families and build communities. Maternal health programmes should also focus on prenatal, post-natal and emergency obstetric care. The presumption that lower fertility equalled higher prosperity was demonstrably lacking. Instead, the real needs of the human person should be a priority in meeting the Millennium Development Goals.
HILDE KROES, World Population Foundation, stressed the importance of ensuring that a rights-based approach to sexuality and reproduction recognized all people as sexual and reproductive beings with the right to correct information and access to services, supplies and education, and to protection from sexually transmitted infections, HIV, violence, coercion, discrimination, stigmatization and unwanted pregnancies. More than 50 per cent of young people worldwide were sexually active by the age of 17, and increasingly affected by sexual health problems. They also suffered from gender inequality, exclusion for being HIV-positive and discriminated against on the basis of sexual orientation.
Against that backdrop, she said, it was clear that a healthy and enjoyable reproductive life started with prevention and access to health services, and that contraceptives and safe abortion were crucial. Because knowledge and information provided the foundation for prevention, there was an urgent need for evidence-based and comprehensive sexual education at a young age, covering all issues. It would enable choice and promote safe, consensual sexual behaviour. It had also been proven to delay sexual activity, improve contraceptive use when sex did occur, and have no effect on the number of sexual partners. That win-win-win situation must be scaled up globally, and promises of school-based sexuality and reproductive health education, made since 1995, should be fulfilled.
JESSICA FRANK LOPEZ, Associate Director, AARP, said the capacity of Governments to assure a fundamental quality of life for hundreds of millions of older citizens would certainly be tested in the decades ahead. Population ageing, urbanization, the impact of HIV/AIDS, international migration and poverty among women -- particularly older ones -- would recalibrate the way in which support systems met the needs of the ageing.
It was time to ask whether older people’s communities would be liveable, she said. Would they have access to health care? Would they be financially secure? Addressing older persons’ needs would strengthen their ability to contribute to the well-being of their families, communities and societies. Globally, the number of people aged 60 and over was expected to triple from 739 million in 2009 to 2 billion by 2050. Although population ageing was less advanced in developing countries, a majority of them were poised for rapid ageing and the number of their older citizens was expected to increase five-fold.
Due to the enormous new social and economic challenges posed by increasing numbers of older people, it was important to promote intergenerational contracts, solidarity and mutual support systems, she said. The projected expansion of the working-age population in many nations over the next few decades provided a window of opportunity for accelerated economic development. But reaping its potential benefits depended on that development’s sustainability and on how the benefits were invested. Age-disaggregated research on the situation and needs of persons over 60 would also be needed.
LY BROWN, European Parliamentary Forum on Population and Development, said the promotion of women’s rights, sexual and reproductive health, and gender equality was absolutely fundamental to the fight against global poverty and attainment of the Millennium Development Goals. There had been clear progress towards realizing the Goals and many people had been touched and changed by supported programmes. More children were enrolled in developing-world schools than ever before and child mortality had declined globally. However, three women would die during the speaker’s time allotment from treatable and preventable complications arising from pregnancy and childbirth. The number of people dying from AIDS worldwide was increasing and access to contraceptives remained low, particularly in sub-Saharan Africa -– where coverage was just 21 per cent.
Stressing the need to revitalize commitment to the Millennium Goals, she said that, although the European Union was the largest worldwide donor of official development assistance, in real terms, its contributions had decreased by €1.6 billion between 2006 and 2007. While the financial crisis had hit hard, current aid levels must be maintained, as anything else would cost more lives and, in the end, more money. Members of the Forum had pledged to campaign for universal access to comprehensive information about sexual and reproductive health and the related services; allocation of 10 per cent of official aid for population as well as sexual and reproductive health and rights policies; inclusion of the new Millennium Goal 5 target in country health plans; addressing the democratic deficit; and improving access to reproductive health supplies.
SARA COUMANS, Youth Delegate, No Youth No Change, spoke “in partnership” with Action Canada for Population and Development, saying that she and her peers made up the largest young generation in history. While they may not have finished school, been married or shared all the values of older generations, their rights and needs must be addressed. More than 3,000 people under the age of 24 had been infected with HIV/AIDS, while young people aged 15 to 24 years accounted for almost half of all new HIV infections worldwide.
Among women 15 to 19 years old, she said, pregnancy and its complications were the leading causes of death, yet so many youth around the world remained misinformed about how to prevent pregnancy and unsure about how sexually transmitted diseases were spread. They lacked the skills to stand up for their own sexual and reproductive health and had insufficient access to contraceptives and youth-friendly health care. The world’s youth, therefore, demanded empowerment through comprehensive, evidence-informed sexual education, and claimed their right to access family planning services and safe abortions. They also demanded to be involved in designing, implementing, monitoring and evaluating policies affecting their lives.
LILIAN ABRACINSKAS, Latin American and Caribbean Women’s Health Network, expressed concern that, 15 years after the adoption of the Cairo agenda, Latin America remained the world’s most inequitable region. Despite some progress, most people still lacked the necessary conditions to exercise their sexual and reproductive rights. Governments lacked the political will to turn the Cairo goals into reality. They should redouble efforts to make good on their promises by guaranteeing sexual and reproductive rights for all people; ensuring universal access to sexual and reproductive and health services, including a broad range of contraceptive methods and emergency contraception; promoting comprehensive policies to reduce maternal mortality; promoting universal access to sex education; and guaranteeing access to legal and safe abortions as a necessary means of reducing maternal mortality.
She also urged Governments to guarantee universal access to HIV/AIDS prevention, treatment, care and support, and to give political and budgetary priority to people living in social, cultural or economically vulnerable situations, such as indigenous peoples, migrants, sex workers, domestic workers and victims of trafficking, among others. Governments should also provide sufficient resources so that Latin America could create the conditions necessary for women to exercise their rights without exception and ensure that their lives were not at risk. Governments should create permanent spaces for dialogue and participation by civil society in order to ensure their ability to monitor public policies as well as transparency and accountability in resource allocation, particularly for sexual and reproductive health services.
SUSAN ANDERSON, Population Action International, said shortages of contraceptive supplies were undermining achievement of the International Conference and the Millennium Development Goals. Without supplies, there could be no services and, despite increased demand for supplies, donor support was stagnating. Lack of access to modern family planning was a key driver of unplanned pregnancies, of which 52 million a year could be averted -– as well as 20 million abortions -– through the provision of contraceptives.
She urged the Commission, among other things, to acknowledge that universal access to supplies was fundamental to achieving the targets and that access to reproductive health was critical in exercising reproductive rights. Maternal mortality must be reduced by ensuring that women were able to control their own sexual and reproductive lives. Health needs in emergency situations, especially those resulting from sexual violence, should be addressed, and national budgets should have a dedicated budget line to ensure reproductive health. The Commission should also emphasize the necessity of building sufficient supply lines. There was a need to support comprehensive sex education for all and the provision of accurate information about contraception.
Introduction of Reports
THOMAS BUETTNER, Assistant Director, Population Division, Department of Economic and Social Affairs, introduced the report of the Secretary-General on world demographic trends 2008 (document E/CN.9/2009/6), noting that the world population today stood at 6.8 billion and was expected to surpass 9 billion by 2050. Most of the additional 2.3 billion people expected by that year would be added to the population of developing countries, and those of least developed countries were expected to double by 2050, reaching 1.7 billion, even though fertility was expected to decline from 4.6 to 2.5. The population of more developed countries was projected to increase from 1.2 billion to 1.3 billion.
Noting a global decline in fertility -- from 5 children per woman in the late 1960s to 2.6 today, mainly as a result of fertility reductions in developing countries –- he said the drop in developing countries had gone hand-in-hand with increases in contraceptive use among women who were married or in other unions. Contraceptive prevalence had stood at 63 per cent in 2003, but remained low in countries with high fertility, most of them in sub-Saharan Africa, where prevalence averaged 22 per cent.
One of humanity’s major achievements over the past century had been reducing mortality, he said. Life expectancy had risen from 41 years in the early 1950s to 65 years today. However, there was a large gap between developing and developed countries -- 77 years versus 65 years –- and expectancy in least developed countries was just 55 years, mainly because of HIV/AIDS. In many countries, infants and children under the age of 5 continued to experience unacceptably high mortality levels.
Because of nearly universal reductions in fertility and mortality, the populations of most countries were ageing, he said. Globally, the number of persons aged 60 or over was expected almost to triple, from 743 million in 2009 to 2 billion in 2050. By that date, the number of older persons would exceed the number of children under the age of 15.
Population ageing was more advanced in developed countries, but was occurring at a faster pace in developing countries, he said. It posed challenges to the financial sustainability of pension systems based on the redistribution of earnings from younger to older generations. Since women constituted the majority of the older population, and had lower labour-force participation than men, they were particularly likely to be poor in old age. Population ageing could also bring important benefits, especially during the four to five decades when the proportion of children declined and that of working-age persons increased. If sufficient jobs were created during that period, more resources might be used to spur economic growth.
The complex demographic trends documented in the report posed important challenges to Government, societies, communities and individuals, he stressed. However, they also opened opportunities that could be leveraged though appropriate policies, especially those aimed at improving human capital and promoting job growth. Such policies must be reinforced by strong population policies in order to succeed. To assess the impact of population dynamics, it was important to monitor development in the policy arena so as to identify best practices, lessons learned and outstanding challenges.
ARMINO MIRANDA, Senior Population Affairs Officer, Population Division, then introduced the report of the Secretary-General on programme implementation and progress of work in the field of population, 2008 (document E/CN.9/2009/7) and the note by the Secretariat containing the Division’s draft programme of work for the biennium 2010-2011 (document E/CN.9/2009/CRP.1). The report on programme implementation covered activities for monitoring and analysis of fertility, mortality and international migration; preparation of world population estimates; monitoring of population policies; and analysis of the links between population and development.
The Division maintained important databases on fertility, contraceptive use and marriage, he said, adding that, in 2008, the database had been updated to cover 224 countries or areas. The Division produced estimates on three indicators for monitoring the Millennium Goals relating to reproductive health: contraceptive prevalence rate, adolescent birth rate and unmet family planning needs. The Division also prepared the Secretary-General’s report on international migration and development, which presented options for follow-up to the 2006 High-Level Dialogue on International Migration and Development, for consideration at the General Assembly’s present session.
In response to the growing demand for data on international migrants, the Division had developed the web-based interactive United Nations Global Migration Database, he said. In 2008, it had issued the results of the 2007 Revision of World Urbanization Prospects, which contained estimates of urban and rural populations in all countries as well as projections until 2050. Also last year, the Division had launched the United Nations Tenth Inquiry among Governments on Population and Development. In terms of population ageing, the Division was collaborating with ECLAC to undertake research on ageing, intergenerational transfer and social protection in five Latin American countries.
AIDA ALZHANOVA ( Kazakhstan) said the demographic trends showed opposite processes in developed and developing countries. While developing countries were seeking ways to reduce population through birth control, developed countries were concerned about the sharp decline in fertility. Programmes to reduce fertility had more support from donors compared to programmes of enhancing fertility, but 86 countries, including 53 developing countries, had fertility levels below replacement. It was, therefore, necessary to provide expert assistance to developing countries that were in the process of population decrease.
While appreciating publications and databases of the Population Division, she said she hoped additional funding could be found for their translation into all official United Nations languages. She also proposed that the Population Division involve national experts in the ad hoc working groups to improve the quality of demographic data produced by the United Nations and national statistics, which were sometimes different. The report had noted a maternal mortality rate in Kazakhstan of 140 per 100,000 live births. According to national data, however, that number stood at 31. Such information adversely affected the image of the country.
NINA SARDJUNANI ( Indonesia) said the report on population trends showed substantial differences between countries and regions. Five countries, according to the report, were major contributors to the increase in world population until 2050, namely India, Indonesia, Pakistan, Brazil and Nigeria. Failure to control population growth in those countries would, thus, greatly affect the world population as a whole. Her Government was committed to implementing an effective population programme that emphasized family planning. Indonesia was decentralized, however, and that made it difficult to implement the programme at the local and grass-roots levels. It was imperative to have global partnership and support for the family planning programmes.
She said it was most unfortunate that global funding had dropped from 55 per cent to 5 per cent of total funding for population programmes. She urged the international community to strengthen its commitment for family planning programmes. She called upon the Commission to formulate strategies and policies that would mobilize the desired support and be implemented on the basis of strategic partnership values, resting on the principle of common but differentiated responsibility. She further encouraged the expansion of the role and initiatives of the United Nations in dealing with the funding challenges posed by population growth. It should focus, among other things, on innovative development schemes such as debt-swaps, particularly targeted on reproductive health programmes, including family planning, as part of official development assistance (ODA).
ROBERT HAGEN ( United States) said the Population Division continued to play an essential role as a source of policy neutral expertise, widely used by policy planners, academics and the public. In the area of fertility and family planning, the Division produced three indicators: contraceptive prevalence rate, adolescent birth rate and family planning. The collective understanding of progress made would be severely limited without the contribution of the Division. He also commended the Division’s outstanding work in the preparation for the session.
HELGE BRUNBORG ( Norway) said the reports introduced provided interesting and useful data. It was useful to document progress and setbacks in reducing maternal mortality, in order to see where further action was needed. He commended the efforts of the Population Division to make data available to other users, including its development of a human mortality database. He suggested the Division do the same for data on fertility. The data should be available on the Internet, free of charge to everyone and without the need for passwords.
EDUARDO RIOS-NETO ( Brazil) said the Population Division’s high-quality demographic analysis provided annually was very useful, and crucial for comparative analysis. He stressed the importance of working with the Economic Commission for Latin America and the Caribbean (ECLAC), and the Latin American and Caribbean Demographics Centre. It was necessary to design alternative scenarios for fertility projections. He stressed the relevance of the 2010 round of demographic censuses. Brazil was committed to compiling its national census. The financial crisis would present challenges for many countries, in that regard. He urged those countries, and the United Nations, to keep their commitments to ensure the censuses were conducted.
KEIKO OSAKI, Chief, Social Policy and Population Section, Social Development Division, Economic and Social Commission for Asia and the Pacific (ESCAP), said her organization had been playing a pivotal role in the Asian and Pacific region in addressing the demographic challenges. ESCAP had focused on selected priority issues of the region, such as youth and development, maternal mortality and international migration.
She said that, by 2005, the youth population in the region had grown to 726 million, 18 per cent of the total population. ESCAP had organized an expert group meeting in February to follow-up on the regional implementation of the World Programme of Action for Youth to the Year 2000 and Beyond, which focused on critical youth challenges under current recessionary economies.
Still, some 250,000 women in the region died each year during childbirth or from pregnancy-related complications, she said. The reduction in maternal mortality had been progressing slowly. ESCAP had organized a workshop entitled “Addressing
multisectoral determinants of maternal mortality in the ESCAP region”, which addressed medical, as well as non-medical, factors affecting maternal mortality.
She said ESCAP had also undertaken a number of activities to deepen the understanding of the linkages between human mobility and development. In September 2008, ESCAP and the Population Division had organized an expert group meeting on international migration and development in the region. That meeting had been followed by the Asia-Pacific High-level Meeting on International Migration and Development, which had provided a forum for dialogue for representatives from 22 Governments. Four round table discussions had focused on remittances for development; social dimensions of international migration; migration in least developed countries, landlocked developing countries and small island developing States; and data and research on migration.
ESCAP continued to coordinate its activities on international migration with relevant United Nations agencies and bodies, she said. As a Co-Chair of the Regional Thematic Working Group on International Migration, including Human Trafficking, ESCAP had taken the lead in identifying the most recent knowledge on the issue and had produced the Situation Report on International Migration in East and South-East Asia.
DIRK JASPERS-FAIJER, Director of the Population Division of ECLAC, said, last year, the Commission had published the document entitled “Demographic Changes and Their Influence on Development in Latin America and the Caribbean”, as well as publications on demographic dividend and youth demographics. The Latin American and Caribbean Demographics Centre continued working on the project financed by the International Development Research Centre on intergenerational links, population ageing and social protection, to examine links between demographic trends, public and private systems, and financial sustainability. Another publication entitled “Challenges” focused on advancements in mortality and fertility rates in the region. The Centre continued to provide technical support to countries to implement the regional strategy for the action plan of the Madrid Conference on Ageing. It was also providing technical assistance to Argentina.
Also last year, the Centre continued research on indigenous issues in the context of the Millennium Development Goals, he said. It published a book on “International Migration, Human Rights and Development in Latin America and the Caribbean”. It was also launching, in partnership with UNFPA, the first phase of a project on migration and sexual and reproductive health in five border areas in Latin America. In cooperation with the four other regional commissions and the Population Division of the Department of Economic and Social Affairs, it was launching a project on strengthening national capacities to address international migration. Further, it worked to help countries strengthen their capacity to conduct the 2010 census.
HANIA ZLOTNIK, Director, Population Division, thanked the delegations for their kind remarks and assured the representative of Brazil that there was growing cooperation with the region.
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