Commission on Population and Development to Focus on Contribution of ICPD to MDGs

This week (30 March- 3 April) the forty-second session of the Commission on Population and Development will meet at the United Nation's headquarters in New York. The theme this year is "The 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."

Founded by the Economic and Social Council in 1946, the Commission is most recently involved in monitoring and assessing the implementation of the International Conference on Population and Development (ICPD 1994). This year's session will focus on lowering population growth, and effective family planning in the least developed nations of the world, in order to reduce overall poverty and remove the barrier to achieving Millennium Development Goals (MDGs).

Since the 1960's, the least developed nations, many in sub-Saharan Africa, have been unable to reduce their overall fertility rates, leading to rampant population growth. On average, these countries have fertility rates of 4.6 children per woman, which is significantly higher than the estimated goal of 2.17 births per woman to achieve "near-replacement-level fertility." Hindered by their inability to reduce population growth, the Commission will emphasize the necessity for these least developed nations to ensure a quicker decline in fertility, in order to "reduce maternal mortality, improve child survival, promote women's empowerment and contribute to poverty reduction." The Commission on Population and Development's second focus this year is on effective family planning, helping to contribute to poverty reduction. By reducing the number of births within a family, the ability to save money becomes more easily attainable and a greater investment in the health and education of each individual child born into the family can be achieved. Furthermore, improved access to efficient family planning contributes to enhanced maternal health and a greater survival rate of young children.

Although efforts are underway to improve the implementation of both population reduction and family planning, the forty-second session this week will express the need for a stronger political commitment and increased funding, in order to achieve significant progress on the ICPD PoA. In addition, the Commission recommends continued implementation of successful programs, an emphasis on national leadership and ownership, the development of effective health systems, and an investment in pro-poor policies.

The Commission explicitly points to South-South cooperation as vital in order to identify what programs are working, and what policies are most efficient, stating that "South-South cooperation is valuable, especially for the identification of best practices and the exchange of lessons learned." A continuous exchange of information between countries will help to improve the overall trend in reaching the MGDs.

Population growth and family planning are crucial topics that must quickly be addressed, and it is the PPD ARO's hope that the this year's session of the Commission on Population and Development will be able to bring to light this year's crucial issues and further encourage South-South cooperation in population and development. Keynote speakers this year include David Canning (Harvard School of Public Health), Jean-Pierre Guengant (Representative from Institut de Recherche pour le Développement, Burkina Faso), and Zeba Sather (Country Director of the Population Council in Pakistan).

To learn more about the Commission on Population and Development, you can access a summary of the session at http://www.un.org/News/Press/docs//2009/pop970.doc.htm

You can also read the keynote address, official statements, and agenda items in English and French for the Forty-second session at: http://www.un.org/esa/population/cpd/cpd2009/comm2009.htm

International Women’s Day: The Status of Women’s Health and Rights

Of the 8 Millennium Development Goals (MDGs), Goal 3 explicitly calls for empowering women and promoting gender equality, specifically setting targets to eliminate gender disparity in all levels of education by 2015, with additional indicators on employment of women and the proportion of women in parliaments. However, gender equality is an essential cross-cutting component for meeting all the targets. According to Kofi Annan, Former Secretary-General of the United Nations, "In our work to reach those objectives, as the Millennium Declaration made clear, gender equality is not only a goal in its own right; it is critical to our ability to reach all the others . . . Study after study has shown that there is no effective development strategy in which women do not play a central role".

Gender gaps in access to and control of resources, in economic opportunities and in power and political voices are widespread. To date, only four countries (Sweden, Denmark, Finland, and Norway) have achieved a combination of approximate gender equality in secondary school enrolment, at least a 30 per cent share for women of seats in parliaments or legislatures, and an approximate 50 per cent share of paid employment in non-agricultural activities for women. In most countries, women continue to have less access to social services and productive resources than men. While the last two decades have seen some progress in many parts of the world in gender inequalities in schooling (as of 2006, the world was on track to meet the primary target of MDG 3: Gender Parity in School). Yet, women remain vastly under-represented in national and local assemblies, on average accounting for only 14 per cent of the seats in national parliaments.

And of particular concern to women’s health and rights is maternal mortality, MDG target 5. Pregnancy should be full of hope and joy--yet for so many women in Africa, pregnancy come with unnecessary danger. As a result, women in sub-Saharan Africa have a 1 in 16 chance of dying from complications of pregnancy or childbirth during their lives; comparatively, the lifetime risk to women in developed countries is 1 in 3,800.

Unfortunately, despite global progress on many of the MDGs illustrated in the Figure: Progress Against Targets to Meet the MDGs, less than 1/10th of the distance to be covered to meet the MDG 5 of reducing maternal mortality has been made. The chart shows how far behind the world is on MDG 5. The MDG target for maternal mortality will unlikely be met globally, and particularly in sub-Saharan Africa, without concerted efforts. The Maputo Plan of Action (PoA) for the Operationalisation of the Continental Policy Framework for Sexual and Reproductive Health and Rights 2007- 2010 states that that “African countries are not likely to achieve the Millennium Development Goals (MDGs) without significant improvements in the sexual and reproductive health of the people of Africa.”

On International Women’s Day, PPD encourages its member and collaborating countries to support implementation of MDG 5 by advocating for improved reproductive health services. Universal access to reproductive health (as called for by the ICPD PoA) is essential to achieve gender equality, combat HIV/AIDS, and reduce maternal and child mortality.

Find out more information (including what you can do) by reading PPD ARO’s policy brief on RH in the MDGs:
In English: http://ppdafrica.org/docs/RH-MDGs.pdf
In French: http://ppdafrica.org/docs/RH-MDGsf.pdf

More information on the MDGs is online at:
UN: http://www.un.org/millenniumgoals/
MDG Indicators: http://mdgs.un.org/

South-South Cooperation in Maternal Health and HIV/AIDS

“The Tunisia – France – Niger: The Kollo Project for safe motherhood and reproductive health project” was presented by Mr. Fethi Ben Messaoud, PCC for Tunisia and Senetaire General, Office National de la Famille et de la Population at the September 2008 PPD Partner Country Coordinators' Meeting for the Africa Region.

South-South Approaches to Innovative Health Solutions
MediaGlobal: Voice of the Global South
By Lucy-Claire Saunders

22 December 2008 [MEDIAGLOBAL]: At the United Nations Development Programme (UNDP) Special Unit for South-South Cooperation’s first ever Global South-South Development (GSSD) Expo, experts presented four successful projects on HIV prevention and maternal health that exemplify South-South cooperation.

Among the four projects, Campaign to End Fistula was recognized as a model for championing collaboration between countries in the Global South, receiving an award of excellence from the United Nations Development Programme.

“Fistula requires our attention because it is a condition that takes away the dignity and the self-esteem of those who are affected by it,” Bunmi Makinwa, the Africa regional director for the campaign said. “It leaves women incontinent, ashamed and isolated from their communities. Fistula is a stark example of our failure in the public health system in poor countries.”

Fistula is a condition where a woman cannot control the flow of her urine and/or feces due to an injury brought about by prolonged labor. The Campaign to End Fistula, which aims to makes the debilitating condition as rare in developing countries as it is in the industrial world by 2015, is active in more than 45 countries in Africa, Asia and the Arab world.

“We are casting the net wider to incorporate more countries,” Makinwa said. “Recent training sessions in Mali highlight country-level efforts to develop the capacity of fistula service providers though South-South cooperation.”

For example, in Liberia’s surgical wards, they use specialized nurses to assist the surgeon during the operation. This is a service that does not exists in Mali so the program had a Liberian specialist train counterparts in Mali so that hospitals can introduce the new technique in the way they do business.

Three other projects exemplifying South-South cooperations in the health sector were also featured at the afternoon session. Dorcus Phiri, coordinator of the Teacher Capacity Building Project, gave an update on a program that uses live television broadcasts to reach out to teachers and students about HIV/AIDS in Botswana. Using a Brazilian model, the daily television program empowers teachers to break down the silence associated with HIV and AIDS by facilitating an open dialogue in a classroom setting.

“The program increased levels of conversation between teachers, pupils and parents on sexual reproductions health,” Phiri told MediaGlobal. “If we empower teachers with the skills, knowledge and the relevant attitudes for addressing HIV, then they would be better placed to deal with HIV issues in the classroom.”

Named, “Live Talk Back,” the program features a different panel every day who talk about HIV/AIDS and other reproductive health issues. Teachers, students and parents across the country are invited to participate in a live discussion using phone-ins, Short Message Services and e-mails.

Speaking about another project across the world that also deals with AIDS, Mariangela Simao, director of the National STD/AIDS Programme in Brazil, described a multi-country program that address HIV prevention throughout Latin America.

“For us in Brazil, the words of the famous archbishop, Dom Helder Camara, summarize how we think of South-South cooperation: ‘No one is so poor that he has nothing to offer. No one is so rich that he never needs help,’” she said.

The program, which is called, “Lacos –Sul-Sul,” works with partnering countries to ensure universal access to prevention treatment, HIV prevention with adolescents and children, generate demand for services and mobilize participation of those who use the service.

The results have been encouraging, said Simao. In two of the more remote regions in Nicaragua, where LSS support has been provided, HIV testing for pregnant women has increased from 20 per cent to 42 per cent and from 5.3 per cent to 24 per cent. On a side note, Simao mentioned that in regions where LSS is not active, this rate has actually dropped form 3.4 per cent to two per cent.

As well as addressing AIDS, the South-South cooperation projects also addressed maternal and child health. Niger, for example, has one of the lowest life expectancies in the world. The infantile mortality rate is 247 for 1,000 live births while the maternal mortality rate is about 700 for 100,000 live births.

Source: MediaGlobal: Voice of the Global South at http://www.mediaglobal.org/article/2008-12-23/south-south-approaches-to-innovative-health-solutions

Linking RH and HIV/AIDS: Good Practices in Kenya

Linking sexual and reproductive health and HIV/AIDS policies and services presents many challenges for those on the front line of health care planning and delivery. A case study in Kenya of Family Health Options Kenya (FHOK) details a number of “lessons learned” in integration including:

• FHOK has demonstrated that providing antiretroviral therapy within sexual and reproductive health settings is plausible, possible and practical.
• Providing services for HIV/AIDS at sexual and reproductive health clinics attracts new clients and creates opportunities for promoting sexual and reproductive health to a wider population.
• In order to achieve their core aims, and to maximize the public health impact, sexual and reproductive health and HIV programmes should take specific steps to meet the needs and concerns of men as well as women in providing services.
• The best way to promote sexual and reproductive health among young people and to raise awareness of HIV is to make information and services available as part of a wider programme that addresses their social needs, and helps empower them to make healthy choices.
• By providing space for community groups to meet, or a base for their activities, clinics can strengthen the links with their client population to their mutual benefit.
  

Find out more about Kenya’s good practices here: http://www.who.int/reproductive-health/hiv/ippf_linkages_kenya.pdf

For more information on linkages between RH and HIV/AIDS policy and programming, a number of tools prepared by IPPF, UNFPA, UNAIDS and WHO offer guidance on how to link sexual and reproductive health with HIV/AIDS.

• Sexual and Reproductive Health and HIV/AIDS: A Framework for Priority Linkages, WHO, UNFPA, UNAIDS & IPPF, 2005.
• Linking Sexual and Reproductive Health and HIV/AIDS. An annotated inventory. WHO, UNFPA, UNAIDS & IPPF, 2005.
• Sexual and Reproductive Health of Women Living with HIV/AIDS, Guidelines on care, treatment and support for women living with HIV/AIDS and their children in resource constrained settings, UNFPA & WHO, 2006.
• Integrating HIV Voluntary Counselling and Testing Services into Reproductive Health Settings, Stepwise guidelines for programme planners, managers and service providers, UNFPA & IPPF, 2004.
  
• Meeting the Sexual and Reproductive Health Needs of People Living with HIV. Guttmacher Institute, UNAIDS, UNFPA, WHO, Engender Health, IPPF, ICW & GNP+, In Brief, 2006 Series, No. 6.
  
• Reproductive Choices and Family Planning for People Living with HIV – Counselling Tool, WHO, 2006.
  
• Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages: A Generic Guide, ICW, GNP+, IPPF, UNAIDS, UNFPA, WHO, Young Positives, 2008.
  

World Day of Social Justice: The Centrality of Reproductive Health and Rights

February 20, 2009 is the first observation of the World Day of Social Justice (UN). The daylong celebration of social justice encourages all UN member states to organize activities on the national level to support the objectives of the 1995 World Summit for Social Development.

As recognized by the World Summit, “social development aims at social justice, solidarity, harmony and equality within and among countries and social justice, equality and equity constitute the fundamental values of all societies.” To achieve “a society for all” governments made a commitment to the creation of a framework for action to promote social justice at national, regional and international levels. Governments also pledged to promote the equitable distribution of income and greater access to resources through equity and equality and opportunity for all. The governments recognized as well that economic growth should promote equity and social justice and that “a society for all” must be based on social justice and respect for all human rights and fundamental freedoms.

Reproductive health and rights are essential components of social justice and development. At the ICPD+5 Forum in 1999, Former WHO Director-General Dr Gro Harlem Brundtland argued that, "Failure to address people's reproductive health needs is a matter of human rights and social justice. People have a right to make free and informed decisions about their reproductive lives. They have a right to information and care that will enable them to protect their health and that of their loved ones. They have a right to benefit from scientific progress in health care. . . . Defining reproductive ill-health as not only a health issue but as a matter of social justice provides a legal and political basis for governments to act.”

For more information:
Statement by Dr Gro Harlem Brundtland, Director-General. ICPD+5 Forum, The Hague, Netherlands, 8–12 February 1999. Geneva, World Health Organization (Document WHO/CHS/RHR/99.8)

UN Reports on the World Day of Social Justice:
Social Justice in an Open World: The Role of the United Nations (2006)

Launch of the World Day of Social Justice New York, 10 February 2009

GA Resolution A/RES/62/10, 19 November 2007 in English and French

UN News Centre, 26 November 2007

GA Draft Resolution A/63/L.29/Rev.1,15 December 2008 in English and French