Gill Greer, Director-General, IPPF
2nd July 2nd, 2008, Tokyo, Japan
Introduction
Distinguished friends and colleagues, it gives me great pleasure to be able to address you today in the lead up to the G8 Summit.
In particular, I would like to thank Madame Nohno for chairing this session.
She has always been a keen advocate and supporter of sexual and reproductive health and rights. She inspires us all and if the scientists of the world could learn to clone people, I would like to advocate for a Madame Nohno in every parliament of the world!
I have been asked to discuss reproductive health in the context of climate change and natural resource management. I would like to thank you for having this discussion. As the world becomes more interested in environmental issues – and where events like the G8 and the US presidential election are focussing more and more on climate change - it is one that is necessary and timely.
From the beginning of time, human activity and environmental impact have been intimately connected.
While this connection may seem obvious, like humanity itself, the situation is complex; it varies from the global to the regional, from the regional to the national, and from the national to the community, and requires a sophisticated analysis and response.
The growing debate about population rise and environmental degradation often feels like the elephant in the room, especially for organizations that adhere to a strictly rights-based agenda. It is difficult to talk about, yet to address some of the most pressing global challenges to human welfare and environmental sustainability, we must start to have the discussion.
As a Japanese government official said in a recent letter to IPPF “there is no doubt that climate change is one of the most challenging issues for mankind because of its character being linked to so many other issues such as energy, development, security, health, food, the economy and so on, with so many stakeholder involved. We can definitely say that a more multilateral approach is needed in order to reach a resolution”.
This is why it is so important to involve civil society in any discussions – decisions taken by governments should and must be infused by the voices of the people.
Coming from a large, community-based NGO like IPPF, I will try to highlight some of the work we are doing to bring reproductive health services to the poorest and most marginalized communities in the world. IPPF’s clients are the people who are often the most vulnerable to the negative effects of climate change and environmental degradation.
Yet, ironically, they are also the people least at fault and with the least control over global warming and the CO2 emissions of industrial nations.
Many of them live in countries that are experiencing rapid population growth which itself is impacting on critical resources (for food, water, employment and health) and is proving to be a significant challenge to sustainability.
The global and the local; the two cannot be separated, and no solution can hope to reverse global warming and bring environmental sustainability without addressing both.
Negative impact of climate change on reproductive health
Environmental degradation and climate change are having a profound impact on the lives of individuals and families in many countries, and will continue to do so, especially in the poorest regions.
Millions of people with barely enough resources to feed, clothe and shelter themselves and their children are being forced to adapt their behaviours and lifestyles as natural resources are depleted in order to survive. Climate change is not only driving migration, it is increasing poverty and gender inequality and compromising health.
1. Water
Clean, drinkable water is an indispensable resource for every one of us. It is a vital and necessary ingredient to sustain life – from hydrating 6.1 billion people every day, to growing crops, to enabling safe births. However, climate change means that accessible, clean sources of water are becoming scarce.
In northern Kenya, the increased frequency of droughts means that women are walking greater distances to collect clean water, often ranging from 10 to 15km a day. In their journeys, women are confronted with personal security risks, including robbery and sexual violence, which puts them at risk of unwanted pregnancy, unsafe abortion and HIV/AIDS.
In addition to the difficulty in maintaining a steady supply of clean water, droughts like those in Kenya present other serious challenges.
IPPF operates programmes in many regions to empower girls and women, and to increase gender equality; these efforts are compromised when families keep girls at home to carry water or secure other resources to care for the family.
When girls are kept out of school, they suffer – they are less able to engage in society, have fewer economic opportunities, they marry earlier and have more children and at an earlier age.
Young women between 15 and 19 years of age face the highest risk of dying of pregnancy-related causes of any age group. Uneducated girls and women are also less informed about how to protect their own sexual health and don’t know how to exercise their rights.
While water is becoming a scarcity in some areas, in others the sea level is rising and this too can reduce access to clean water as pollution penetrates existing sanitation systems.
Researchers at Imperial College London have found that saline intrusion in the River Ganges from rising sea levels caused by climate change is an increasing threat to the health of communities, and it is only going to get worse with climate change.
Increased salinity of drinking water can increase hypertension rates. It is therefore no wonder then that large numbers of pregnant women in the coastal areas are being diagnosed with pre-eclampsia, eclampsia and hypertension.
Shifts in temperature, rainfall patterns and sea levels may change the nature of epidemics of vector-borne diseases, such as malaria.
Carried by mosquitoes which breed in stagnant water, malaria may become more prevalent where water sources increase.
And it is a fact that pregnant women are especially vulnerable to malaria which can lead to miscarriage, illness and even death. Increased instances of malaria will impact the health of adults and children, undermining hard-won development gains.
2. Land use/agriculture - migration
As land becomes over-used, the soils become barren and the result is less arable land which means less food. And as people search for fertile farmland, more forests will be cut down and people will need to search further for firewood and fuel.
Subsistence farming will become a less viable choice for women, and their families, so they will need to migrate to urban areas for employment.
As a result, the number of internally displaced persons will rise, and these people will face higher risks to their health.
Women may go to the city in search of work in shops or markets, but faced with high levels of unemployment and gender discrimination, many of them will have no alternative but to enter the field of sex work. Sex workers face a high risk of unwanted pregnancy, violence and sexually transmitted infections, including HIV.
IPPF has seen this pattern unfold at first hand and runs many programmes to address the sexual and reproductive health needs of sex workers.
One such example is the IPPF Japan Trust Fund programme in Kampala, Uganda, called Breaking the Ice.
This provides vital health services to women, many of whom are migrants from rural Uganda, who came to the city seeking work but who found they had no other alternative but to engage in sex work.
3. Emergency / disaster situations
It is a fact that women, pregnant mothers and children are often more at risk of severe climactic events like the flooding in Bangladesh or the Asian tsunami in 2004, when 250,000 people were killed and hundreds of thousands more were left homeless and without the basic necessities.
Poor communities were hit particularly hard. The health service infrastructure was destroyed in many areas: hospitals and clinics were lost; doctors and midwives died or went missing.
In these situations, IPPF’s Member Associations in India, Indonesia, Sri Lanka and the Maldives responded quickly in the aftermath.
Working together with other aid agencies, our Member Associations’ health service providers and volunteers ensured that pregnant women had access to delivery and emergency obstetric services, and that others had access to family planning.
Increasingly, more of our resources are devoted to the needs of displaced people fleeing their homes or communities from the effects of natural disasters and climate change. Planning for these is impossible – as the last few months have shown us with emergency situations in China and Bangladesh.
Climate change, resources & inequity
There is an inherent inequality at the heart of climate change.
If we accept the impact that climate change is having on people’s lives, that it forces people to leave their homes and communities and restrict their access to the basic necessities, then we must also accept that this change affects the world’s poorest the most.
Living in rural areas and urban slums, the poorest billion people are highly exposed to climate change threats for which they carry negligible responsibility, an inequity to add to others.
Perversely, the carbon footprint of the poorest one billion people on the planet (just over 16% of the world’s population) is only about three per cent of the world’s total footprint.
It is a rich irony that the richest industrialized nations - which have contributed the most to environmental damage - are those best able to adapt and protect themselves and their populations from the worst affects of climate change.
At the same time, governments of many industrialized nations are trying to increase their own fertility rates to mitigate the perceived impact of population ageing.
The consumption of people in developed countries is not decreasing; consumption patterns and the environmental impact of people in transitional and developing countries are gradually increasing – particularly among the middle class.
In 2004, less developed countries accounted for 42 per cent of energy-related CO2 emissions, compared to around 20 per cent in 1990.
By 2030, developing countries are projected to account for just over half of total emissions. Crucially, however, those living in poverty and extreme poverty will still suffer the worse effects of climate change and contribute very little to its causes.
This phenomenon is perhaps best illustrated by the current global food ‘crisis’.
The tremendous rise in meat consumption in transitional economies such as China and India has seen vast tracts of land in developing countries turned over to grain production for animal feed; vast areas of primary forest is being lost daily to soya production for the same purpose. Of course the world is not short of food, but food inequity has increased dramatically and is affecting the poorest the hardest.
The outcome document of the fourth Tokyo International Conference on African Development (TICAD IV) acknowledges that “African countries have generally been extremely vulnerable to the negative effects of climate change, including increased environmental degradation, deforestation, loss of biodiversity, and droughts and desertification.” It also notes the link between human security and climate change.
The TICAD outcome document states that African countries continue to be inadequately equipped in terms of their mitigation and adaptation capacities.
In 2007, the Government of Japan made an impressive gesture of intent with their Cool Earth 50 initiative.
As most of you know, the initiative has three pillars: first, a long-term global strategy to reduce greenhouse gas emissions; secondly, the establishment of an international framework to address global warming from 2013 onwards; and lastly, a national campaign to ensure that Japan achieves the Kyoto Protocol target.
Strategies to attack the problem at the global level and within developed countries are vital to guide steps forward. Equally as important are efforts to work with developing countries to help the poorest people adapt to the changing natural environment.
Unmet need
Developing countries have the fewest resources and are home to the largest population of young people.
Worldwide, there are over one billion young people between 10 and 24 years of age, many of them without education, prospects, or even knowledge to make choices that are critical to them and the planet.
Consequently, there is a huge unmet need for family planning and other sexual and reproductive health services that will enable these people to choose if, when and how many children to have, to have safe and healthy pregnancies and deliveries, and to protect themselves from STIs and HIV/AIDS. This need is only going to increase.
Today, 95 per cent of population growth is occurring in developing countries. The UN population division estimates that by 2025, there will be more than 284 million women of reproductive age in sub-Saharan Africa alone.
The most vulnerable people already live in countries where the health services are under pressure to prevent and control ill health.
Climate change is making matters worse by putting new stresses on already struggling public health systems. Health will be the front line in the fight against these changes, and the sexual and reproductive health of many millions of women and men will be put at risk.
Interventions that link community, conservation and SRH are the way forward
Many communities are now linking resource management with better public health, including increased access to sexual health services.
For example, in Kenya, a once-rich cropland is deteriorating through overuse, irregular rainfall and the loss of nearby wild vegetation.
The ratio of productive land per person is dwindling as Kenya’s population continues its rapid growth.
Yet in communities within and around the Kiunga Marine National Reserve, the World Wildlife Federation is finding ways to simultaneously improve community livelihoods and to enhance environmental stability in developing countries.
The WWF is promoting sustainable fishing techniques. At the same time the project brings health services directly to villagers who otherwise would not be able to access health care.
Among these health services is the provision of a range of contraceptives, including birth control pills and hormonal injections to help women and men achieve their ideal family size and to better space pregnancies to improve the health of a woman and her children.
In another part of the world – the Pacific – some family planning programmes address issues around sustainable resource management.
In 2001, a number of small grant projects (with funding from FPA International Development) were implemented in Kiribatu and Vanuatu – both of which have young, rapidly growing populations – to implement reproductive health interventions through conservation and agriculture projects.
The final evaluation of the projects found that people in Kiribati and Vanuatu had begun to make the connection between family size and the quality of their local environment.
A rights-based approach
IPPF advocates for a rights-based approach in all of our projects; this protects people’s human rights and safeguards human dignity.
We were a pioneer in bringing a rights-based approach to SRH services and our experience shows us that when women have the information they need, they will make decisions that are good for themselves and their families.
History shows that when human development has improved to the point that women can be confident their children will most likely survive, they will choose to have smaller, healthier and better provided for families. But this underlines the point that they also need to have access to contraceptive services and supplies.
Targets for development should therefore be focused on improving socio-economic indicators, including the indicators that monitor progress toward the achievement of the MDGs. These include – under the new target for MDG 5, universal access to reproductive health – the contraceptive prevalence rate and unmet need for family planning.
Approaches that prioritize fundamental human rights are the best for encouraging adaptation to climate change.
Policies that:
- promote equitable growth and the diversification of livelihoods
- expand opportunities in health and education
- provide social insurance for vulnerable populations
- fight child marriage; improve disaster management
- support post emergency recovery
- increase access to information and services for sexual and reproductive health and rights
will enhance the resilience of poor people facing climate risks. That is why planning for climate change adaptation should be seen not as a new branch of public policy but as an integral part of wider strategies for poverty reduction and human development. And it must involve those who are most affected – through civil society engagement – at the planning and implementation stages.
Summary - conclusions
Depletion of natural resources such as clean drinking water and arable land, reduced agricultural productivity and increased climate-related disasters have already caused tragic loss of life and increased illness and disease, especially among the most vulnerable groups.
Livelihoods have been lost and people have been forced to migrate to survive.
No less tragic are the hectares of forest that have been razed to make way for farms that must meet the needs of increasing populations, soil that is used too extensively and stripped of all fertility, and water sources that are polluted with toxins or salinated by rising sea levels.
The idea that climate change only presents potential for future disasters is a myth.
By increasing access to voluntary family planning and improving sexual and reproductive health, and by investing in programmes which empower women, women and their families will be able to make informed decisions about their families’ size, education and health.
These are global issues – they require not just local but global solutions in order to ensure equity of access and participation.
And this is where civil society, and community based organizations like IPPF, with Member Associations in 150 countries, can make a difference – by working with our national governments and parliamentarians.
Because, as New Zealand writer Robin Hyde said, “under the sea, all lands are joined together” – we can make a difference locally and globally – if we are unified in our approach and purpose.