A quarterly international newsletter on sexuality, sexual health, and sexuality education.
Volume 4, Issue 1 - Spring 2005
The Underlying Millennium Development Goal: Universal Access to Reproductive Health Services
The Millennium Development Goals (MDGs), derived from the Millennium Declaration and adopted by world leaders at the United Nations Millennium Summit in 20001, articulate objectives for resolving some of the most complicated and urgent social problems of our time.2 According to the United Nations, the MDGs are a test of political will to build stronger partnerships and offer the world a means to accelerate the pace of development and to measure results.3 The MDGs are commonly accepted as a framework for measuring development progress and as a tool to help governments and advocates mobilize resources and implement programs that ensure sustainable and equitable development worldwide. The eight MDGs call on countries to increase their efforts and collaborate to achieve the following:
Despite the seemingly exhaustive scope of the MDGs, they actually fail to acknowledge a critical component necessary for achieving all of these goals: universal access to reproductive health services. This omission has led to less attention paid to and less funding available for reproductive health programs. Steven W. Sinding, director general of the International Planned Parenthood Federation in London, explained the importance most succinctly: "if you're not an MDG, you're not on the agenda. If you're not a line item, you're out of the game."4
This year marks the 5-year anniversary of the MDGs and the United Nations will be re-evaluating their implementation and making new official recommendations on moving forward. Advocates for sexual and reproductive rights worldwide will be working to ensure that sexual and reproductive health and rights gain the recognition they deserve.
Access to Reproductive Health Services and Information Underlies all the MDGs
Some of the MDGs, such as ending HIV/AIDS, obviously cannot be accomplished without addressing SRHR, yet the evidence also shows that all of the MDGs are advanced when all people have access to comprehensive sexuality education, family planning, and other reproductive health services. For example, targets under MDG #5 call for a three-quarters reduction of the 1990 maternal mortality ratio by 2015; reducing early pregnancy and empowering women to space their pregnancies are necessary components of improving maternal mortality.
Likewise, eradicating extreme poverty and hunger (MDG #1) also relies on universal access to reproductive health services. According to a report by the Global Health Council, "poor reproductive health among youth is a poverty issue. Low levels of youth reproductive health can and do negatively impact economic development."5 The report goes on to explain, "early pregnancy contributes to intergenerational transmission of poverty through a variety of pathways. Pregnant girls may be expelled from school, either by law or from the failure of schools to enforce the rights of girls. Without education or employable skills, unmarried pregnant girls are often poorly prepared to take on the responsibilities of childrearing and face diminishing prospects for income generation. "6 In fact, access to education (MDG #2), the empowerment of young women and girls (MDG #3), and the eradication of poverty (MDG#1) are all interrelated.
The Millennium Development Project (MDP), an independent advisory body commissioned by the UN Secretary-General to advise the UN on strategies for achieving the MDGs, released a report described by experts as the "cost-effective blueprint for achieving Millennium Development Goals by 2015."7 The report recognizes "sexual and reproductive health" as a key element in "adequate human capital" for "the means to a productive life" and that core rights include "equal rights, including reproductive rights, for women and girls."8 The report goes on to explain that SRHR have both a micro- and macro-level effect on global well-being generally and poverty reduction specifically. Access to family planning and other reproductive health information and services affects the allocation of resources within the family, including choices about funding for education and healthcare for individual family members.9 At the macro-level, ensuring SRHR correlates with positive population trends that create "an opportunity to escape poverty traps and to accelerate economic and social development."10
The MDP recognizes that achieving the Goals is a complex and long-term task, but it has also provided a list of "Quick Win interventions for the Goals, ones that can and should be implemented right away if the world is serious in its commitment." Alongside the call for immediate elimination of school fees and access to clean water, the MDP calls on countries to "expand access to sexual and reproductive health information and services, including family planning and contraceptive information and services, and close existing funding gaps for supplies and logistics."11
Progress on Incorporating SRHR into the MDGs
Despite clear evidence that access to comprehensive reproductive health information and services is at the intersection of the problems articulated by the MDGs, programs that provide SRHR remain under-funded and under-promoted. The MDP discusses SRHR in the section "Areas of Specific Policy Neglect," and states, "despite its life-saving potential, there has been a pervasive underinvestment in this service and in the health systems to deliver it."12
In September 2005, the United Nations General Assembly will convene in New York for a three-day summit to review the MDGs.13 At this high-level meeting, heads of state will review progress and challenges in reaching the goals as well as MDG-related funding. This meeting provides an opportunity to explicitly incorporate sexual and reproductive rights and health in official MDG processes.
NGOs worldwide are working on this issue in advance of the summit. For example, 110 international NGOs, including SIECUS, recently sent a letter to the Secretary-General urging him to take the following steps in preparing his report for the September summit:
Despite clear evidence and the best advocacy efforts on the part of NGOs, the process of integrating SRHR into the MDGs at the summit will be touch-and-go at best. The Bush Administration presents a serious obstacle to any progress on SRHR at the international level. In fact, the Administration has applied massive diplomatic and even economic pressure to other governments in an effort to roll back current standards.
It is unlikely that the Bush Administration will suddenly relent at the MDG summit in September. Therefore it is all the more critical for the G-77 countries-the largest coalition of developing nations at the UN15 -to work in tandem with the European countries to block possible U.S. maneuvers that would undermine what little recognition of SRHR the MDG process has done. Optimistically, if these countries present a united front for advancing SRHR, the U.S. will be appropriately trumped and SRHR will get the recognition required to actually achieve the MDGs.
References
Web Master: siecus@siecus.org