Commission on Population and Development 2014: IPPF written statement

Submission to the Commission on Population and Development - 47th Session Agenda item 5

Statement on behalf of the International Planned Parenthood Federation

About IPPF

The International Planned Parenthood Federation welcomes the priority theme of the 47th Session of the Commission on Population and Development.

Through its 152 Member Associations in over 170 countries IPPF strives for a world in which all women, men and young people have access to the sexual and reproductive (SRH) information and services they need; a world in which sexuality is recognized both as a natural and precious aspect of life and as a fundamental right; a world in which choices are fully respected and where stigma and discrimination have no place. IPPF has had general consultative status with Economic and Social Council since 1973 (E/2010/INF/4).

Introduction

The International Conference on Population and Development was a milestone in the history of population and development. By demonstrating the interrelationships between population, sustained economic growth, health, education, economic status and women’s empowerment, the International Conference on Population and Development recognises the need to promote policies which support sustainable development. It was also the first time world leaders recognized the concept of ‘reproductive rights’ and committed to ensure access to reproductive health, including sexual health for all, without discrimination.

 

2014 marks a significant year, as the operational review of the implementation of the International Conference on Population and Development draws to a close it presents an opportunity to re-affirm and to prioritise the emerging issues of the International Conference on Population and Development. The Commission on Population and Development remains the primary platform to address and advance these issues, and to hold member states accountable for their implementation of the Programme of Action.

The International Planned Parenthood Federation calls on Member States to recognise that the five challenges identified below are priority areas for action; to save lives, empower individuals and improve sustainable development outcomes. We urge Member States to work with civil society, communities, parliamentarians, the private sector, and the international community to ensure that the policies, resources and programmes are in place to realise the sexual and reproductive rights of individuals, ensuring access to information and services and that all individuals are empowered to make informed choices about their bodies, lives free from discrimination.

Challenges

1.      Sexual Rights and Human Rights

Sexual rights, which embrace the right to a safe and full sex life, as well as the right to take free, informed, voluntary and responsible decisions on their sexuality, sexual orientation and gender identity, without coercion, discrimination or violence, and that guarantee the right to information and the means necessary for their sexual health and reproductive health[1] are fundamental to sustainable development. In many parts of the world these rights are denied or discriminated against.

Currently one in three women have experienced violence, making gender based violence one of the most pervasive human rights violations. Women who have experienced violence tend to be more than twice as likely as non-abused women to have poor health, including reproductive health, and both physical and mental problems. They also have an increased risk of contracting sexually transmitted infections including HIV.

Although 158 countries have implemented laws to increase the legal age of marriage to 18, an estimated 67 million girls are married before their eighteenth birthday. 90 per cent of the 41 priority countries, where early marriage affects more than 30 per cent of girls, have expressed a commitment to address the issue[2]. Turning commitments into reality requires civil society, parliamentarians, legislators, communities and other stakeholders to implement policy which protects the sexual and human rights of girls and young women. Between 2005 and 2012 we contributed to 556 policy or legal changes in support of sexual and reproductive rights in 136 countries.

2.      Access to family planning services

Throughout the world, disparities in income, geographic location and migration, limit access to sexual and reproductive health services. Worldwide, 222 million women want to space or limit childbearing but cannot access the contraceptives to do so. Meeting this unmet need for contraceptives will avert 218 million unintended pregnancies in developing countries, which in turn would avert 55 million unplanned births, 138 million abortions (of which 40 million are unsafe), 25 million miscarriages and 118,000 maternal deaths[3]. A failure to meet unmet need for sexual and reproductive health services and family planning contributes to mortality, morbidity and reduces women’s social and economic participation. In 2012, we provided services to 45 million people, 80 per cent of whom are marginalised and underserved. Including 52.7 million contraceptive services, which averted 4.9 million unintended pregnancies. This demonstrates the critical role of civil society as a service provider, providing services to communities beyond the reach of health systems.

 3.      Access to abortion

Every year 47,000 women die of unsafe abortion, and since 2003 the incidence of unsafe abortion has increased[4]. Contributing to 13 per cent of maternal mortality, it is one of the three leading causes of mortality.[5]. Removing legal and policy barriers to increase access to abortion services will have a huge impact in reducing maternal mortality and accelerating progress to Millennium Development Goal 5.

 

With few exceptions, most countries' criminal laws contain restrictions on the grounds on which an abortion is legal. Service providers and women’s lack of awareness of the legal status can severely limit access to services. This places women at risk when seeking to access abortion services. Restrictive laws are not associated with lower abortion rates; they only lead to unsafe abortions. Restrictions mean the well-off can buy safe services, while the poor resort to dangerous methods. The high costs for treating complications from unsafe abortions force women and their families into even greater poverty. In addition to the risks to women’s health and lives, legal prohibitions on accessing abortion services can place women at risk of imprisonment. 

The International Planned Parenthood Federation supports access safe abortion services and promotes a woman’s right to choose. In 2012 we successfully advocated for 20 national legislative and policy changes which increased access to safe and legal abortion services. Civil society has a vital role to play in monitoring and protecting the rights of individuals, and working with governments to ensure rights based policy.

4.      Adolescents/ Comprehensive Sexuality Education

The world is home to the largest generation of young people in history, presenting many opportunities for the future. However today’s adolescents face many challenges to their rights. Most young people in developing countries live in poverty, and lack access to youth-friendly health care services. Worldwide 1 in 5 women has given birth by the age of 18, rising to 1 in 3 girls in the poorest parts of the world.[6] Half of new HIV infections occur among those aged 15-24; in sub-Saharan African, young women are three times more likely to be living with HIV than young men[7]. Increasing access to youth friendly sexual and reproductive health services, a policy and legislative environment which recognises and protects the rights of young people and access to Comprehensive Sexuality Education will go a long way to reducing the burden of ill-health and ensure the next generation are healthy, empowered and able to make informed life choices.

Comprehensive Sexuality Education should recognize the emotional dimension of human relationships, with respect for the evolving capacity of the child and the informed decisions of adolescents and young people regarding their sexuality, from a participatory, intercultural, gender-sensitive, and human rights perspective[8]. Comprehensive Sexuality Education should be provided in a diverse range of settings including, but not restricted to, school and recognizing children and young people as subject of rights in accordance with their evolving capacity as stated in the UN Convention on the Rights of the Child. “The ICPD Review Bali Global Youth Forum Declaration” recommends that the rights of young people are upheld and are at the centre of the development agenda. Member States have an obligation to ensure the social, economic, political and sexual and reproductive health and rights needs of young people are addressed, if we are to empower the next generation to determine their own development outcomes. We contribute to this by ensuring that four out of ten services provided in 2012 were to people under the age of 25.

5. Gender and Discrimination

Investing in gender equality ensures healthier and more prosperous societies. When women have control over their bodies, access to education, decision-making roles and meaningful employment, and can live lives free of violence, they will be able to participate in the sustainable development of their communities. Addressing root causes of inequality aiming at gender parity at all levels and in all areas is a means to eradicate poverty. The International Conference on Population and Development drew historic attention to the relationships between women’s position in marriage and relationships, sexuality and reproduction, their position in society and how this impacts their health, wealth and well being. 20 years later the discrimination of women is still universal. Women generally earn less than men, and whilst 89.5 per cent of countries have legislation to support paid maternity leave, only 53.5 per cent have such a provision for paternity leave[9], making it harder to combine family and economic life.

 

Although discrimination based on gender is ubiquitous, in many parts of the world individuals face discrimination, stigma and violence based on their sexual orientation and gender identity. 76 countries have discriminatory laws which criminalize private, consensual same-sex relationships – exposing individuals to the risk of arrest, prosecution, imprisonment. In at least 5 of these countries the death penalty is applicable[10]. As recognised in the International Conference on Population and Development Operational Review, discrimination of any kind, including hate crimes should be eradicated. We have developed and promoted a Declaration of Sexual Rights, articulating principles which both rights holders and duty bearers must adhere to, to build a world free from discrimination.

Conclusion

Moving beyond the International Conference on Population and Development operational review it is crucial that governments continue strengthening their efforts to ensure that all women and men, girls and boys, are empowered to make informed decisions about sex, relationships and reproduction. To make this happen, we call on Member States to implement the following three recommendations:

  1. Build on the successes from the International Conference on Population and Development Operational Review and prioritise the following issues in national policy, resource allocation and programming:
  • Adolescents’ access to sexual and reproductive health services and Comprehensive Sexuality Education
  • Access to contraception information,  services and supplies and safe and legal abortion services
  • Universal access to sexual rights and reproductive rights, including measures to eliminate all forms of discrimination and violence based on gender identity or sexual orientation
  • Gender equality and the empowerment of women.

 

  1. Prioritise sexual and reproductive health and rights under a health goal and a stand-alone gender goal in the Post 2015 development agenda. It is only when sexual rights and reproductive rights are realised and women and girls have control over their futures and bodies that development will be truly sustainable and meaningful.

 

  1. Ensure that national and regional accountability mechanisms with clear time-bound targets to oversee the fulfilment of the outcomes of the operational review of the implementation of the International Conference on Population and Development are put in place with a clear timeframe.

 

[1] UN ECLAC, Montevideo consensus on population and development (2013)

[2] UNFPA,  Messages and preliminary findings from the ICPD beyond 2014 global review (2013)

[3] Guttmacher Institute, Adding it up (2013)

[4] WHO, “Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008” (2011)

[5] Ibid

[6] WHO, “Adolescent pregnancy Fact sheet N°364” (2012) [http://www.who.int/mediacentre/factsheets/fs364/en/index.html] accessed on 6 January 2013

[7] WHO Young people, sexual and reproductive health and HIV. Bulletin of the World Health Organization 2009;87:877-879.

[8] UNECLAC, “Montevideo consensus on population and development”, 2013

[9]  UNFPA “Messages and Preliminary Findings from the ICPD Beyond 2014 Global Review”

[10] UNOHCHR,  “Speak up stop discrimination” [http://www.ohchr.org/EN/Issues/Discrimination/Pages/LGBT.aspx] accessed on 6 January 2013