Commission on Population and Development
5th and 6th Meetings (AM & PM)
1994 CAIRO CONFERENCE PROMPTED ‘NO LESS THAN A REVOLUTION’,
POPULATION AND DEVELOPMENT COMMISSION TOLD
“Out of Cairo came no less than a revolution”, Barbara Crossette, former United Nations Bureau Chief of The New York Times, told the thirty-seventh session of the Commission on Population and Development this morning, as she delivered a keynote address on the theme “Has the Cairo Consensus Lost Momentum: A Journalist’s View”.
Referring to the 1994 Cairo Conference on Population and Development, she said that revolution acknowledged that people –- women and men, mothers and fathers –- and not governments were the best judges of how many children to bring into the world, and where and when. A broader theme that ran through the Conference was the realization that, in talking about curtailing population growth and the complex relationships between population and development, or population and the protection of the environment, women had to be a central factor.
At “Cairo+10” [the 10-year anniversary of Cairo], she said, the same wide range of people and opinions heard in Cairo were beginning to be heard again. Some inside the United Nations system feared that a lobby led by an unlikely combination of conservative Middle Eastern nations, the United States and the Holy See would mount a major drive to dilute or undo the language. Others were more optimistic, as Cairo had been a seismic shift not easily reversed.
New policies and laws were being put in place, in many places because of the influence of Cairo and women would know about them because of the Internet, she continued. “Networking is now phenomenal among women widely separated by geography and culture”, she said. That newfound sharing of ideas and experiences was a trend that could not be easily reversed.
Women, she said, were not afraid to insist that they held the key to the solution, if the problem was too many people causing low health standards, poor education levels and a scarcity of natural resources. With education and choice, women all over the world were proving that they could “talk fertility down”, as she quoted Joseph Chamie. It was now clear, she said, that promoting the rights of women was essential for sustainable development. Extremists on both sides of the discussion should end their debates. With the right approach, the good sense of people everywhere can surprise experts, as shown by the willingness of many societies to take on the once-taboo subject of female genital mutilation.
The time seemed right, she concluded, to shift the emphasis of Cairo’s legacy away from the threats traditional social structures could face if women’s lives were improved. It should be shifted to the threats that the world at large may confront if they were not. The spirit of consensus that was forged in Cairo was still strong enough to foster future progress.
In the ensuing discussion, moderated by Joseph Chamie, Director, Population Division, who also introduced Ms. Crossette, questions were asked by representatives of Bolivia, Philippines, India, Uganda, United States, Sweden and Kenya.
The Commission also addressed its agenda item “Programme implementation and future programme of work of the Secretariat in the field of population”. Mr. Chamie, introducing the Secretary-General’s report on “Programme implementation and progress of work in the field of population in 2003: Population Division, Department of Economic and Social Affairs” (document E/CN.9/2004/5), and a note by the Secretary-General on the “Proposed strategic framework for the period 2006-2007” (E/CN.9/2004/6), said demographics were not merely about numbers. It was about development of human society. Development, in turn, related to low mortality, which was an indicator of the well-being of a society.
He then highlighted several activities of the Population Division, including production of a document on world population policies, a report on urbanization and two wall charts –- one on urban agglomerations and one on urban/rural movements. A chart on world contraceptive use was also available, he said, as well as an extensive database on trends in marriage since 1960.
In the ensuing discussion, the representative of China stressed that the spread of HIV/AIDS in the world highlighted the urgency of integrating reproductive health and family services into prevention programmes for HIV/AIDS. A representative of the United Nations Centre for Human Settlements (UN-HABITAT) addressed the problem of the 32 per cent of the world’s urban population living in slums, both in developing and developed countries.
The representative of the Russian Federation also spoke on the item, as did representative from the non-governmental organization International Planned Parenthood Federation, who drew attention to the withdrawal of major donors from supplying such essential commodities as contraceptives, IPAS, noting the alarming situation of unsafe abortions in the world, and the International Union for the Scientific Study of Population.
Also today, the Commission finished its general debate, with statements from the representatives of Philippines, Kenya, Uruguay, Argentina, Australia, Peru, Jamaica, Ghana, Sweden, United Republic of Tanzania, Portugal, Cuba, India, Ireland, Zambia, Lithuania, Malaysia, Colombia and Syria addressed their national experience in the implementation of the 1994 Cairo Plan of Action. The representative of Switzerland addressed the working methods of the Commission. A representative of the Joint United Nations Programme on HIV/AIDS (UNAIDS) also spoke under the agenda item.
The Commission will meet again at 11 a.m. Thursday, 25 March.
The Commission on Population and Development continued its thirty-seventh session today, during which it will conclude its general debate and start consideration of programme implementation and the future programme of work of the Secretariat in the field of population. Barbara Crossette, former United Nations Bureau Chief of the New York Times, will give a keynote address this morning on the theme “Has the Cairo Consensus Lost Momentum: A Journalist’s View”.
[For more information, please see Press Release POP/892 of 17 March.]
TOMAS M. OSIAS (Philippines), aligning himself with the statement on behalf of the “Group of 77” developing countries and China, said his country was still faced with socio-economic and demographic challenges that demanded resolute and holistic approaches, with a population of 76.5 million and a growth rate of
2.36 per cent. The Philippine Population Management Program was being implemented in a sustainable fashion with a comprehensive health programme dedicated to maternal and child health with vigorous participation of the non-governmental and private sectors.
He said the Medium Term Development Plan of 1993 was guided by respect for life, responsible parenthood, birth spacing and informed choice. Significant gains had been achieved in terms of legislative directions, including the 2004 Anti-Violence against Women and Their Children Act which classified that kind of violence as a public crime. Another act was the 1997 Anti-Rape Law and the 1996 Paternity Act, which enabled men to take responsibility for their sexual and reproductive behaviour and participate equally with women in all areas of family and household responsibilities. In 2004, a fatwah was issued by Muslim religious leaders supporting population and reproductive health issues and concepts, declaring that reproductive health and family planning were not against Islam.
He emphasized the urgency of addressing migration and called for continued interest and support of the international community for programmes and interventions and adopting carefully studied policies to further integrate population concerns in all development initiatives and in addressing other population and reproductive health concerns.
RICHARD MUGA (Kenya), aligning himself with the statement on behalf of the Group of 77 and China, said his country still upheld the 1994 Cairo Plan of Action as a road map for improving the life of the Kenyan people. It took a rights-based approach and invited open debate on controversial issues. There had been an open debate on changing the law regarding abortion as illegal except when a woman’s life was in danger. Achievements in policy sectors had been made with the cooperation of civil society and the private sector.
Other policies had been developed, he said, including for youth, gender and the elderly. An HIV/AIDS policy was also in place. That disease was a major threat to his country, and there was high advocacy for prevention, care and treatment, but more resources were needed. A 2000 Children’s Act guaranteed children’s right to good health and education. Gender policy was being debated. The Government was committed to free primary education, which had been introduced last year. Intensified advocacy against female genital mutilation had been undertaken, which was supported by all groups in communities where it was being practiced. The fight against corruption had also been improved.
He said the total fertility rate had increased, and the contraceptive prevalence rate had remained at 39 per cent. There was need for additional resources for the United Nations Population Fund (UNFPA), as that organization had cut funding to Kenya by 50 per cent. Personnel could not be recruited because of donor conditionality, and the shortage of human resources would stop the country from achieving the Millennium Developments Goals. There was contraceptive insecurity as well. The Cairo goals would be achieved only with new commitment to support countries like his.
NURY BAUZAN (Uruguay) reaffirmed her country’s commitment to the outcomes of the International Conference on Population and Development (ICPD). She said that it was essential that financial commitments made in that context be met.
Uruguay had developed a comprehensive population profile that showed high poverty, migration and ageing problems, she said. The ICPD Programme was a guideline for dealing with those challenges. Free family planning had been instituted, and assistance for reproductive health issues was built into the legal system, as was the struggle against HIV/AIDS. One challenge was involving men in reproductive issues.
Given the magnitude of the challenges, international assistance was needed to support such national programmes. She was concerned about the decreased financial support for the region and called on the international community to reverse that trend.
GUSTAVO AINCHIL (Argentina) said he endorsed the statement delivered by Qatar on behalf of the Group of 77 and China. The new Government had set a priority of fair development and social progress in the country, with a participation strategy based on joint responsive management. Food security and local development were prioritized along with social and economic development of the family. Handicapped and indigenous communities were taken into account.
He said a right to education was guaranteed to all citizens without respect to gender. A law on responsible reproductive health had been passed, along with laws to protect girls, boys and adolescents in that regard, as well as legal instruments countering domestic violence and gender inequality. More equitable distribution of benefits was also being addressed. Women were well represented in the national assembly.
AIDS programmes had been implemented, and bilateral agreements were being made to regularize the situation of migrant workers. He pledged the constructive engagement of his delegation in the Commission’s future work.
SUE KELLY (Australia) said her country continued to support the outcomes of the ICPD and to develop innovative measures to achieve its goals. Australia itself had one of the world’s healthiest populations, and its major population issue was ageing. A life-course approach to active and healthy ageing was being pursued to address chronic disease, disability and life expectancy.
She said that one of the highest priorities was improving the health of indigenous people, who had lower life expectancy, higher infant mortality and higher fertility levels than the general population. The country would continue to improve their access to health care and monitor the situation.
Neighbouring countries, she said, had quite different problems, facing high population growth, a “youth bulge” and early marriage prevalence. Facing the threat of AIDS and slowing population growth were priorities. In 2003-2004, approximately AU$225 million would be spent on health assistance for regional countries, including support for safe childbirth, pre-and post-natal care and safe, voluntary and affordable family planning.
Nearly a quarter of Australia’s current population had been born overseas, she said. Immigration policies focused on ensuring that migrants had useful work skills and on enabling them to reunite with close family members. In general, Australia believed that a responsive, country-specific approach that gave priority to good governance was the best way to achieve sustainable development.
CESAR RODRIGUES RABANAL (Peru) said that in his country, State policy included a commitment to poverty reduction, promotion of equal opportunity and health. Legislative actions had been taken regarding HIV/AIDS and violence against women. All those actions reflected language from the 1994 Cairo Plan of Action and acknowledged the priority status of adolescents in all actions involving them. Norms had been adopted to protect the rights of children and adolescents and to protect them from trafficking.
His country had also been implementing the programme “My Home”, intended for people with limited resources, he said. Also, implementation of the Wawa Wasi programme provided attention to 40,000 children up to the age of three years. The Defender of the People was in charge to protect women from violence. Regarding HIV/AIDS, the Government would be implementing antiretroviral treatment and developing campaigns to prevent sexually transmitted diseases. An AIDS preventing commission within the military and police had also been established.
He said that challenges included non-attainment of all goals due to limited resources, the gap between urban and rural areas, and general poverty. A sociocultural change was necessary in traditional perceptions of the role of the women. Fertility rates had not been dropped among rural women and adolescents and maternal mortality also had to be addressed. There had been a reduction of international support for reproductive health which had decreased the effectiveness of family planning.
Mr. WILLIAMS (Jamaica) said his country was determined to achieve greater cooperation with partners at the national, regional and international levels. Partnerships with non-governmental organizations and the private sector were being strengthened, and progress had been made in domestication of the 1994 Cairo Plan of Action. Several successful programmes had been elaborated with human rights as an integral part. Also, a programme for poverty eradication had been elaborated, and all child-related matters had been brought under a single agency. A national youth policy had been promoted, and steps were being taken to mainstream gender considerations into all Government programmes. Sexual and reproductive health policies for adolescents had been integrated into national initiatives, and awareness on HIV/AIDS and human rights issues had been promoted among youth.
However, he stressed, many challenges threatened to erode successes. One challenge was the right of adolescents to information about sex. That had an impact on the increasing prevalence of HIV/AIDS infections. Other challenges included: reductions in allocations for population and social development programmes, the effects of HIV/AIDS on social and economic resources, the heavy debt burden, ageing of the population, violence against women and children, inadequate involvement of women on the national level, the mixed effects of migration, and the adverse effect of natural disasters on economic growth.
VIRGINIA OFOSU-AMAAH (Ghana) said her country had revised its National Population Policy in 1994 to take the Cairo action plan into account. Its policies had been translated into action for the benefit of adolescent services. HIV/AIDS prevention and monitoring programmes were being undertaken by a range of organizations, and vulnerable groups were specifically targeted in that effort.
She said that primary health care and reproductive health care had been improved, with incentives for health workers to work in rural areas. Life-choices programmes had been re-launched and intensified in recent years, and clinical programmes had been developed to manage pregnancy complications. As a result of all those programmes, the country had experienced a decline in the total fertility rate and the infant mortality rate.
In order to integrate development concerns into population efforts, she said training had been provided to relevant workers. Gender and development had been a focus, with, for example, microcredit programmes to empower women in the economy. Other measures had been taken to protect women’s and girls’ rights. Overall, allocation of government resources to population issues had experienced a moderate increase.
Thanking the UNFPA, she said that Ghana looked forward to increased international assistance to help meet future challenges, such as behaviour change to combat HIV/AIDS, as well as making sure that the focus on that disease did not affect other population efforts. She finally associated her delegation with the statement made by Norway yesterday on the working methods of the Commission, and proposed a mechanism that would compile Member States’ input to the Commission for lessons learned and other purposes.
ULRIKA CRONENBERG-MOSSBERG, Minister in the Government of Sweden, aligning her statement with that of Ireland on behalf of the European Union, saluted the ICPD, saying it had been a watershed achievement. She said her country had made sexual and reproductive health and rights, along with the fight against HIV/AIDS, top priorities in its development cooperation for 2004, increasing support to United Nations agencies and non-governmental organizations for that purpose. Approximately 4 per cent of Swedish development aid was devoted to sexual and reproductive health and rights and education issues.
Large challenges remained in eradicating poverty, reducing maternal and infant mortality, combating HIV/AIDS, and addressing the needs of poor men and women, she said. She welcomed increased official development assistance (ODA) from donors for those purposes. She said Sweden’s new policy for global development stressed equitable and sustainable global development, through a rights perspective and a poverty-oriented perspective. Both perspectives reflected the centrality of population and development issues.
She said the right of all people to make life decisions freely was emphasized by her country, including women’s right to free and safe abortions. The highest rates of abortion mortality occurred where abortion was outlawed and where women had little control over their fates. Openness in sex education was also important for the fight against AIDS and in favour of responsible sexuality.
She said that gender equality remained an important concern. There was also a need for a global discussion on migration, to encourage its positive effects and minimize its dark sides, such as trafficking in human beings. She finally reaffirmed Sweden’s strong commitment to the Cairo Programme of Action.
AUGUSTINE MAHIGA (United Republic of Tanzania) said his country had embarked on concerted efforts to integrate population issues into the economic and social development planning process. The national population programme included a five-year programme of capacity-building, reproductive health services and education, mainly supported by the UNFPA. The 2003 annual review of the programme showed notable progress, but Tanzania was still lagging behind in the implementation of the Cairo Plan of Action because of a shortfall in expected resources from partners.
HIV/AIDS had become the leading cause of death among adults in the United Republic of Tanzania, he said. Public health and reproductive health services in the country had instituted awareness programmes to combat that pandemic and other diseases. The government had also launched a strategic framework on fighting the pandemic, closely linked to other national development initiatives including Vision 2025, the Poverty Reduction Strategy Paper and the Medium-Term Expenditure Framework. He called upon the international community to continue assistance and prevention and, in particular, for continued support to the UNFPA.
GONÇALO AIRES DE SANTA CLARA GOMES (Portugal), aligning himself with the statement made on behalf of the European Union, said his country had made progress in population-related areas, in particular ageing, family planning, reproductive health and maternity and paternity issues. It was essential to continue worldwide efforts to enable all persons to make informed choices about their reproductive life, family and maternal health. His country had promoted participation of boys and men in family planning and reproductive health, and recently, a new plan for the protection of the family had been discussed. Sexual education in schools and prevention projects for schools were being addressed.
He said his country attached great importance to the protection of women’s right and the empowerment of women. A commission for equality and women’s rights and been established, and in 1997, a global plan for equal opportunities had been adopted. Also, measures had been taken to address gender-based violence.
Portugal sustained a positive and constructive approach to migration, including combating trafficking, he continued. Last year, a new policy concerning the full integration of documented immigrants in the Portuguese society had been adopted. Legislation granted migrants free access to reproductive health care services and ensured that everybody, independent of their nationality or legal situation, had access to health services. He added that his country would contribute $1 million to the HIV/AIDS Fund.
Keynote Address “Has the Cairo Consensus Lost Momentum: A Journalist’s View”
Introduced by Joseph Chamie, Director, Population Division, BARBARA CROSSETTE, former United Nations Bureau Chief of the New York Times, said when she attended the Cairo Conference, she saw the passionate lobbying, energy and exhilaration there, generated by the very uncertainty of its outcome. “Yet, out of Cairo came no less than a revolution” she said, which acknowledged that people -– women and men, mothers and fathers -– and not governments were the best judges of how many children to bring into the world, and where and when.
She said a broader theme that ran through the Conference was the realization that, in talking about curtailing population growth and the complex relationships between population and development, or population and the protection of the environment, women had to be a central factor.
As a journalist, she had gone to Cairo with years of experience in Asia, Central America and the Caribbean and Africa. Population problems and prospects were a preoccupation almost everywhere, and the reality of people trying to cope with dwindling resources was evident for all to see. At the Cairo Conference all those disparate images came together, she said.
She noted that many advocates of the Cairo Programme would like to mesh its guidelines with those of the Millennium Development Goals, but, she said, that could be a struggle. Sometimes the United Nations spawned too many lists of aims and targets. The Organization had been accused of holding too many conferences in the United States. “But what a lot of Americans do not understand is how important action plans -– even unreasonably optimistic ones –- can be to people in other, smaller nations”, she said, adding, “I would argue that no set of priorities is as important to half the world’s population –- its women –- as the legacy of Cairo”.
At Cairo+10, a lot of stock-taking was going on, she said. The same wide range of people and opinions heard in Cairo was beginning to be heard again. For some, there would be a call to roll back the gains of Cairo. For others, there would be a concerted effort to keep that from happening. Some inside the United Nations system feared that a lobby led by an unlikely combination of conservative Middle Eastern nations, the United States and the Holy See would mount a major drive to dilute or undo the language. Others were more optimistic. As Thoraya Obaid, Executive Director of the Population Fund, said, “[Cairo] changed the international debate about population from human numbers to human beings”. That was a seismic shift not easily reversed. New policies and laws were being put in place, in many places because of the influence of Cairo.
Noting that a women’s bill of rights was pending in Sri Lanka which would insure for women “the right to control their bodies and rights relating to childbirth”, she said there were many other examples about which women would know because of the Internet. “Networking is now phenomenal among women widely separated by geography and culture”, she said. That newfound sharing of ideas and experiences was a trend that could not be easily reversed.
The concerns of women were not hypothetical, she continued. In Southern Africa, where AIDS was now a women’s disease, a task force had produced some tragic findings -- 34 per cent of girls between 15 and 19 years old said that their first sexual experience had been the result of trickery, rape or persuasion against their judgment. Often that had economic roots.
Women, she said, were not afraid to insist that they held the key to the solution, if the problem was too many people causing low health standards, poor education levels and a scarcity of natural resources. With education and choice, women all over the world were proving that they could “talk fertility down”, as she quoted Joseph Chamie. Women needed help in those efforts, with or without good government social policies. Condoms and other contraceptive supplies were particularly important.
It was now clear, she said, that promoting the rights of women was essential for sustainable development. Extremists on both sides of the discussion should end their debates. The discussion should be continued in a spirit of practicality, and programmes should be shaped to social conditions and beliefs. With the right approach, the good sense of people everywhere could surprise experts, as shown by the willingness of many societies to take on the once-taboo subject of female genital mutilation.
The next step, she said, was to address women’s status in the context of national and international security. That was already happening, with a realization of the connections between women’s empowerment, lower birth and death rates and reduced conflict. The demographic transitions involved owed much to the ability of women to control the size of their own families, through access to safe contraception and competent help throughout their reproductive lives.
The time seemed right, she concluded, to shift the emphasis of Cairo’s legacy away from the threats that traditional social structures could face if women’s lives were improved. It should be shifted to the threats that the world at large might confront if they were not. The spirit of consensus that had been forged in Cairo was still strong enough to foster future progress.
Questions and Answers
Bolivia’s representative asked what factors had caused the democratization of the Programme of Action. Ms. CROSSETTE replied that there had been more diversity of media attention on population issues. In addition, the delegations were also more diverse, including many representatives of civil society. Global networking of non-governmental organizations had also helped transform many conferences. Concerning news coverage of population issues, she said that demography was often a subject buried in other kinds of stories.
In reply to a question by the Philippines’ representative about cultural difference, Ms. CROSSETTE said the world had learned a lot in the last 10 years about not creating cultural barriers where they did not exist, and about allowing societies to find their own solutions to cultural conflicts.
The representative of India said that the emphasis on rights by women’s advocacy groups might hamper delivery of services in the field. In agreement, Ms. CROSSETTE said that there was a growing understanding that some approaches worked in some places and some did not. Each country had to decide what its approach would be and how much direction to give to non-governmental organizations and other groups.
In response to a question by Uganda’s representative regarding the failure of donors to meet their commitments under the ICPD, she said that, for whatever reasons it existed, $3 billion was a large shortfall. On this anniversary year, the progress made by national governments such as Uganda might encourage donors to give more.
The United States’ representative said that there might be a relationship between cultural change and media exposure. Ms. CROSSETTE replied that the interchange provided by the media had indeed been very important.
In response to Sweden’s representative regarding the role of the media in how people view abortions, she said that people needed to see the experiences of women in various situations of extreme poverty around the world. There might be a disconnect in the minds of Americans, for example, who could not understand the need for safe abortion now. It was necessary to view the situation from a more practical perspective.
Reacting to a question from Mr. CHAMIE, Ms. CROSSETTE said the major media in the United States still had a problem with development reporting. The United Nations was seldom covered, except when something happened in the Security Council concerning the United States. The United Nations was many things. United Nations people, for instance, had understood the Taliban, and some covering the United Nations were not so sure that nothing could have been done in the period leading up to 11 September. The United Nations could be a good source. She recalled saying that the diplomatic corps in New York was far superior to the one in Washington, but that had not made the press. The media had stopped covering institutions, as they had been dull. Celebrity driven journalism had more appeal.
The representative of Kenya remarked that the Cairo Consensus had not lost momentum, but that resources had been lost, and the media should help to highlight those problems. Instead, the media contributed to problems by reporting on negative things, resulting in loss of resources.
Reacting to that statement, Ms. CROSSETTE said she could not dispute the statement, but the problem started with the local media. Foreign correspondents often were responsible for several countries at the same time, and depended on local media and colleagues for their sources. There were some hopeful signs. Television, to some degree, could bring up some of the issues, as CNN international was doing, from local areas. That was good, as many people could not read. The vitality of local media had to continue.
RAUL TALADRID, Vice-Minister for Foreign Investment and Economic Cooperation of Cuba, said the Cuban model of development was based on the multidimensional character of development, with a close link to social and economic development. New social programmes had brought about a change in areas such as education, culture, social security, and protection of vulnerable groups. Cuba could be viewed as a socio-demographically developed country.
He said at the time of Cairo, levels of infant mortality were low but had continued to decline. Life expectancy was close to 77 years. Fertility stood at 1.59 children per woman, below the replacement level. Population growth was around 1 per cent and had been so for a decade. Therefore, there was a trend towards population ageing. The prospect was that Cuba would soon be among the oldest countries. There was one doctor for 165 inhabitants, and 29.9 per cent of births took place in hospitals or clinics, with 6.4 per cent of gross domestic product (GDP) spent on health.
Educational expenses had reached 10 per cent of GDP, he continued, and on health and education, 16.4 per cent of GDP or almost 42 per cent of the annual budget was spent. There was gender equality in his country as illustrated by the fact that more than 60 per cent of the total university graduates were women. In the labour force, for more than 40 years, the principle of equal pay for equal work had prevailed. Cuba was poor with few resources and suffering under the longest blockade in history. Still, some 40,000 foreign students from developing countries had graduated at Cuban universities for free. More than 156,000 Cubans had assisted other countries in various areas. At present 15,000 Cuban doctors were providing their services in other developing countries, resulting in improving health indicators in those countries.
PRASANNA HOTA (India) said his country was the first to formulate a national family planning programme, in 1952, with the objective of stabilizing its population. After five decades, several states in South India had reached, or were about to reach, fertility levels that would bring about zero growth. On the other hand, many northern states might take several decades to reach that point. There were similar differentials in infant mortality.
During the past decade, he said, India had made significant progress in implementing the ICPD Programme of Action, including the abolition of a contraceptive target regime in favour of a decentralized, client-centred reproductive health approach and a national policy that aimed at achieving population stabilization by addressing unmet needs and through reproductive health care services, emphasizing informed choice.
He said a National Commission on Population reviewed, monitored, coordinated, mobilized funds for, and gave direction to, national policy. A comprehensive reproductive child health programme increasingly focused on public-private partnerships and community participation in the delivery of services. Legislative measures ensured gender equity, and other measures ensured accountability of all levels of health providers. The HIV/AIDS programmes were integrated with reproductive health at primary health care institutions, and efforts were being made to integrate population concerns in development strategy in a range of endeavours supported by the UNFPA and other partners.
Regarding the Programme of Action, he said that a clear road map was still needed, in order to guide countries toward the Cairo goals in a step-by-step manner, and to differentiate between short-term objectives and long-term goals. There was also a need for prioritization, considering the anticipated shortfall in financial resources. He suggested a subgroup be formed to examine this question and also urged that a discussion of human resource needs for ICPD activities be undertaken.
MAURICIO SOLORZANO (Nicaragua) was currently experiencing both challenges and opportunities in demographic issues. Population growth had declined but was still very high and highest among rural groups. The National Development plan followed the ICPD in many areas, and its action plan directed much of the country’s demographic analysis.
He said that a relative increase in the working-age population was encouraging; however, it also made certain economic programmes necessary. To eliminate negative factors that resulted in an outflow of qualified workers, the country had been investing in job creation and other economic programmes. Much of the hard road to development remained to be travelled, however. He reconfirmed that the ICPD was highly relevant to his country’s situation.
JOHN JACKSON (Ireland), aligning himself with the statement on behalf of the European Union, said the development background in Ireland had been one of continuing economic growth and expanding employment. One of the key factors for that boom had been the growth in labour supply, averaging about 3 per cent per year, due to natural population growth, immigration, and increased participation of women in the formal labour force, accompanied by high education standards.
He said the birth rate had been stabilized with 15.5 births per 1000. There had been an increase in population of 8 per cent over the previous six years. Half of that increase had been accounted for by net inward migration. Fertility and birth rates had declined significantly. About one third of all births now occurred outside of marriage. Mortality rates still remained a concern, as life expectancy was one of the lowest in the European Union. Addressing that problem was one of the key aims of a new Health Strategy for Ireland.
There had been considerable attempts to develop a realistic and appropriate set of policies that could secure the rights and needs of economic immigrants, asylum seekers and refugees, while balancing that with the expectation and aspirations of the domestic population, he said. Ireland had substantially increased the amount of its official development aid in its endeavour to move toward the 0.7 per cent of GDP commitment. In relation to population issues, mainstreaming of the cross-cutting issues of gender and HIV/AIDS had been established through all official aid modalities. Ireland was very conscious of the significance of the long-term effect of HIV/AIDS on the demographic structure and social fabric of societies and had been contributing on a multilateral basis to the Global AIDS Fund and other programmes.
PATRICIA KONDOLO (Zambia) endorsed the statement made by Qatar on behalf of the Group of 77 and China and said that the pattern of population distribution and growth was unique in Africa since approximately 44 per cent of its population lived in urban areas. That created a huge challenge in terms of providing jobs, health services, clean water, power and waste management. Striking a balance in the distribution of resources between urban and rural populations was a daunting task.
Mortality rates in the country, she said, remained unacceptably high due to many factors of which the common link was poverty. For that reason, it was important for the international community to complement national programmes through a multidimensional approach to health and population, one that did not just focus on the mere provision of medical services but on the overall quality of life of the population as a whole.
There was also, she said, a strong relationship between poverty and the crisis of HIV/AIDS in Zambia. That understanding had expanded the Government’s response into a multisectoral one through the establishment of a national council. In conclusion, she reiterated Zambia’s commitment to the Cairo Programme of Action and support for the United Nations Population Fund, and urged that overall official development assistance be increased and flexibility be granted on external debt so that population efforts could be more effectively pursued.
RIMANTAS SADZIUS (Lithuania), aligning himself with the statement on behalf of the European Union, said that in his country, rapid changes in the family structure, a decreasing fertility rate, an increasing high mortality rate, ageing, poverty and internal and international migration still remained important demographic problems. Commitment to the 1994 Cairo Plan of Action was reflected in a number of legal acts, including: the National Strategy on Population Policy, Strategy on Population Ageing Policy, and the National Programme on Equal Opportunities for Women and Men, as well as the National Poverty Reduction Strategy.
He said population ageing and depopulation trends were the most urgent demographic problems. At the beginning of 2030 population, would decrease by 9 per cent and reach 3.1 million. Since 1991, fertility had been decreasing continuously, with only a slight increase in 2003. The number of first and second live births was decreasing, but the share of the fourth and higher birth order was increasing. From 1990 to 2001 the annual number of marriages had steadily decreased, and birth of extramarital children had increased. Government measures included reforms of maternity social insurance and a system of child allowances.
He stressed that during implementation of the 1994 Cairo Plan of Action and of national strategies in the field of population and development, it proved to be very important to coordinate and unite efforts of governmental, municipal and non-governmental institutions and bodies, to undertake coherent action and to reconcile positions of social partners.
FATIMAH SAAD (Malaysia) said that with the International Conference on Population and Development (ICPD), integration of her country’s economic, social, demographic and environmental efforts had been strengthened within the country’s goals in sustainable development. That work had made much progress, as Malaysia had already achieved six out of eight Millennium Development Goals.
Among those achievements was a steep reduction in poverty from 1990 to 2002, she said, due to the Government’s poverty-eradication programmes, particularly income-generating projects. In addition, Malaysian women had made significant progress in almost all spheres of development in the last three decades. Since the ICPD, efforts to promote the participation of males in reproductive health and household responsibilities had also intensified, and it was hoped that, with more effective information dissemination, education and training, remaining inequalities could be eliminated.
Following the ICPD, she said, Malaysia had also undertaken several initiatives to ensure that family planning services were provided under the umbrella of reproductive health. Training updates for clinics had been intensified, and model clinics had been developed to foster high-quality, accessible care. Emphasis was now on high-risk groups, adolescents and specific categories of mothers. Education was an important part of those programmes.
She said that HIV/AIDS prevention and care was also a high priority. In addition, even though Malaysia was considered a young population, sensitisation on the issue of ageing had begun, along with measures aimed at improving the quality of life of older persons and integrating them into the mainstream of development. In conclusion, she said that the role of civil society in implementing population programmes was supported in Malaysia. She reiterated her country’s commitment to the ICPD.
WERNER HAUG (Switzerland), addressing the methods of the Commission’s work, said he found it regrettable that the Commission’s secretariat had not organized its activities in a way comparable to those of other functional commissions, such as the Commission on Sustainable Development or the Commission on the Status of Women. The intersessional activities of the Bureau could be energized if the Bureau were to hold more than just one meeting between sessions and would inform and consult Member States regularly about activities of interest. Also, he would favour election of Bureau members at the end of each session.
He wished the Commission would work in a more systematic way in selecting themes and consider regrouping themes in clusters. It was further necessary to overcome any felt divide between the work carried out in the Commission by demographers on the one hand, and by development generalists on the other. The Commission should keep its excellent scientific level and continue to offer itself as a forum where scientists felt at ease and useful. On the other hand, since Cairo, the Commission required additional competencies in the field of development. The two groups should work together and benefit from each other’s comparative advantages.
Moreover, he continued, the Commission and the Division would be well advised to organize and structure their work into two clearly defined segments. They should continue to be the forum where quality demographic work took place. On the other hand, the commission was the venue for review and follow-up processes carried out under the aegis of the UNFPA. Eventually, one could expect the coordination segment of the ECOSOC to benefit both from that scientific and analytical work, as well as from the bottom-up review activities carried out on the basis, among others, of feedback and observation gathered by the UNFPA.
ALVARO SANDOVAL BERNAL (Colombia) reaffirmed his country’s unwavering commitment to the action plan of the ICPD, which had been implemented to a very large extent on many fronts. Colombia had made significant strides in the stabilization of its population and in decreasing infant mortality. Those results had been obtained through lowered levels of fertility, an improved role of women in society and greater access to information, education and health care.
These achievements had been accompanied also by advances in security and in women’s participation in all spheres of society, he said. Colombia recognized an ethical framework of rights that was reflected in its reproductive health policy, which was consistent with the Cairo Programme of Action. For each area, such as adolescent health and HIV/AIDS, high goals had been set.
On migration, he said it was important to foster respect for migrants and regularization of remittances, along with other measures, could help bring about the benefits that could be obtained from migration.
HUSSEIN SABBAGH (Syria) said his Government had adopted many measures focusing on population matters according to the 1994 Cairo Plan of Action. A conference had been held on the balance between population growth and economic and social development in 2001. To attain justice and equality between the two sexes, many steps had been taken, and legislation had been adopted providing guarantees for women and girls. The percentage of children and adolescents as a total of the population still posed challenges, despite the fact that fertility had dropped to reasonable levels. The measures taken had led to a significant drop in infant and child mortality.
He said his country had adopted many initiatives to deal with the special needs of the elderly. The Government also had increased the number of health centres and had facilitated access to reproductive health advice. It had also provided health assistance to adolescents. Balance in the geographic distribution of population among cities and rural areas was being addressed by encouraging reverse migration to rural areas and improving infrastructure. The level of resources available at present was not commensurate with the needs to implement the programmes for population and reproductive health, but the Government was trying to increase those resources.
SONIA ELLIOTT, Liaison Officer, Joint United Nations Programme on HIV/AIDS (UNAIDS), said the HIV/AIDS pandemic had resulted in 40 million infected persons, had claimed the lives of 20 million people in the past 20 years, lowered life expectancy by 20 years in the worst affected countries, and had a significant negative impact on demographic trends and sustainable development prospects.
Regarding partnerships, capacity and mobilizing resources, she said UNAIDS had launched the initiative for the Global Coalition on women and AIDS to stimulate concrete action to improve the lives of women. Another initiative, in cooperation with the World Bank, had been the Global Fund to Fight AIDS, Tuberculosis and Malaria, based on the principles of the “Three Ones”: one agreed HIV/AIDS Action Framework; one national AIDS authority; and one agreed country-level monitoring and evaluation system.
Welcoming the Commission’s next year’s theme “Population, Development and HIV/AIDS”, with particular emphasis on poverty, she said UNAIDS and WHO were currently engaged in the two-yearly update of the global estimates for the epidemic. Next year’s session would be one of several linked meetings to consider HIV/AIDS-related issues. Consistent with calls for an integrated and coordinated follow-up of United Nations conferences, she said it must be reiterated that the objectives of the ICPD were integrally linked to achieving the goals of the Declaration of Commitment on HIV/AIDS.
Programme Implementation, Secretariat’s Future Work Programme
JOSEPH CHAMIE, Director of the Population Division, introduced the Commission’s item five. He said that demographics were not merely about numbers. It was about development of human society. Development, in turn, related to low mortality, which was an indicator of the well-being of a society.
He said the Population Division had produced a document on world population policies, a report on urbanization and two wall charts -– one on urban agglomerations and one on urban/rural movements. That represented an enormous amount of work. A chart on world contraceptive use was also available. There was an extensive database on trends in marriage since 1960. Reports were being prepared on infant and child mortality, international migration, population ageing and the impact of AIDS. All those reports were on the Internet.
Mr. WAY (United States) said the global understanding of population concepts, demographic trends, emerging demographic issues and programmatic achievements had been much enhanced by the work of the United Nations Population Division. He noted the recent document World Fertility Report 2003, on fertility, nuptiality, contraceptive use and national policies with respect to fertility and family planning for 194 countries and areas. The current measures contained in that report, as well as the historic trends would enhance understanding of that demographic process. He also commended the report, wall chart and database on World Contraceptive Use.
He said the Population Division’s Workshop in HIV/AIDS and Adult Mortality in Developing Countries provided a valuable technical meeting and training opportunity for the participants from developing countries. The Division had further produced targeted reports, conducted coordination meetings and published popular materials to highlight the impact of international migration on the world community. The Population Division’s work on population projections continued to demonstrate the Division’s leadership in international demographic analysis. It had released, among other things a series of long-range projections to the year 2300. He also highlighted the important global resources in the form of topical databases and Web sites that continued to be released by the Division.
RU XIAOMEI (China) welcomed the reports, which highlighted the progress in achieving the goals of integrating population growth into development strategies. The spread of HIV/AIDS was the most depressing population issue in both developing and developed countries. The spread of HIV/AIDS in the world highlighted the urgency of integrating reproductive health and family services into prevention programmes for HIV/AIDS. Women were most susceptible to HIV/AIDS.
She said the population distribution in the world also highlighted the urgency of integrating HIV/AIDS prevention into population policies. China had made great efforts in that area and did everything possible to integrate HIV/AIDS prevention into family services.
AXUMITE GEBRE-EGZIABHER, Director of the New York Office of United Nations Human Settlements Programme (UN-HABITAT), spoke on population growth, urbanization and urban poverty. She said that about 924 million people, or 32 per cent of the world’s urban population, lived in slums in the year 2001. The majority of those were in developing countries, but 54 million people in developed countries lived in slum-like conditions.
During the period 2001 to 2030, the slum population was likely to more than double to over 2 billion, she said. That presented a huge challenge. The trend could be reversed by the upgrading of existing slums and by urban policies designed to prevent the emergence of new slums. Those two strategies had to be implemented concurrently. Decentralized urbanization, in addition, was a tactic that could work, but only within the framework of suitable national economic development policies.
It was clear, she said, that local authorities, governments and the international community would have to do much more than the minimum set by the Millennium Development Goals to improve the lives of slum dwellers. She hoped the rapid expansion of the world’s urban population was being taken into account by the Commission as it prepared its future programme of work. The UN-HABITAT would continue to collaborate on the issue with relevant bodies.
VASSILY A. NEBENZIA (Russian Federation) was pleased to note that documentation of the Secretariat had a summary of the reports in all languages. He requested, however, that the main report issued by the Secretariat would contain more information, as it was of particular interest to many agencies. He was aware that reports of the Commission should not exceed 16 pages, but at the same time, he said, it had been decided that reducing documentation should not have a negative impact on the substance of the reports.
JERROLD HUGUET, Chief of the Population and Social Integration Section of the Emerging Social Issues Division of the Economic and Social Commission for Asia and the Pacific (ESCAP), said that fertility and population growth in the region had declined. Eighty per cent of population increase between 2000 and 2010 would incur in urban areas. International migration, particularly for employment was rapidly emerging as an important issue within the region.
The ESCAP secretariat, he said, assisted countries in the region through capacity-building through training, technical assistance, inter-country research, information dissemination and the exchange of knowledge and experience. It also publishes a planning journal and an annual population data sheet, and provides technical assistance to countries upon request. The ESCAP and the UNFPA had agreed upon a regional population programme to be carried out by ESCAP over the next four years to contribute to more effective national and sectoral development plans that incorporate population issues.
Mr. VILLA, Latin American and Caribbean Demographic Centre (CELADE), Population Division of the Economic Commission for Latin America and the Caribbean (ECLAC), described the many activities of CELADE. The group had designed a regional system of indicators for the follow-up of the 1994 Cairo Plan of Action. The CELADE had also undertaken training and technical assistance activities, and, among other things, it had organized a special meeting of the Caribbean Development and Cooperation Committee (CDCC) to examine implementation of the Programme of Action in Caribbean countries.
Among the many activities, CELADE had continued to provide assistance enhancing national capacities for population issues. It had developed databases, using the REDATAM format which facilitated the possibility of a broader use of the 2000 census data. The organization had further addressed matters of ageing, migration and indigenous people. The main activities for 2004 included the regular meeting of the Commission in the framework of ECLAC’s thirtieth session in June 2004, which would discuss: ageing of the population and development, population and poverty, HIV/AIDS in Latin America and the Caribbean, and a strategic proposal for training human resources in the field of population.
CARMEN BARROSO, of the International Planned Parenthood Federation (IPPF), called on the Commission to reaffirm its commitment to the core goal of the ICPD that called for universal access to reproductive health services and to promote access of young people to reproductive health information, education and services. She also called on it to take all possible action to reduce maternal mortality, in particular by reducing the tragic toll of unsafe abortion, and to stress the importance of the ICPD in achieving Millennium Development Goals.
The IPPF, she said, was deeply concerned about the growing gap between the demand for contraceptives and their availability, particularly in developing countries. She viewed with alarm the withdrawal of major donors from supplying such essential commodities. Families could not escape poverty before they gained control over their reproductive lives; the world’s leaders must not renege on the ICPD goals.
JOHN CASTERUNE, of the International Union for the Scientific Study of Population (IUSSP), said his organization was the only international professional association of population specialists, acting as a catalyst for the development of scientific knowledge about a wide range of population issues. It was an active participant in the Cairo Conference and its lead-up, and many of the activities of the IUSSP were consistent with the goals of the ICPD, including a Mexico City seminar with an emphasis on population and poverty. He informed the Commission of an upcoming population conference in Tours, France that will focus on population trends and possible responses to them, and will include a session hosted by the UNFPA on progress toward the implementation of the ICPD action programme.
ELIZABETH S. MAGUIRE, President, IPAS, an international non-governmental organization dedicated to protecting women’s health and advancing their reproductive rights, said that, while abortion was legal under certain circumstances in all but a few countries, too often it was unavailable, resulting in unsafe abortions. The knowledge and technology to eliminate unsafe abortions was available, but political will was lacking. Unless unsafe abortion, resulting in 68,000 deaths and millions of injuries annually, was eliminated, the Millennium Development Goal of reducing maternal mortality by 75 per cent in the next decade would not be met.
She said it must be ensured that health systems embraced World Health Organization (WHO) guidance; that they trained providers; and that they made available improved technologies for induced abortion as allowed by law. Those efforts required both political commitment and resources. “When the CPD convenes again a decade from now, will many policy makers still be hesitant even to speak about abortion?” she asked. “Will women still die and suffer needlessly from unsafe abortion?”
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