Steven W. Sinding

In New York at the World Summit something important and unexpected occurred – something with the potential to redress one of the most glaring inequalities affecting millions of the world’s poorest people.

Against a backdrop of near chaos in the preparation of the consensus document, and against all expectation, the largest gathering of world leaders in history reaffirmed a commitment to providing universal access to reproductive health first made in 1994 at the International Conference on Population and Development in Cairo.

What makes the inclusion of reproductive health so noteworthy is that it was excluded from the original Millennium Development Goals in 2000.

This summit was meant, in part, to reaffirm the Millennium Development Goals from which reproductive health had been excluded because of the intransigent resistance by the Vatican and a few like minded states.

The Vatican, supported by the world’s most powerful country, the United States, tried to exclude reproductive health again this time around, arguing as it did in 2000, when the Millennium Development Goals were first adopted, that reproductive health is code language for abortion.

Indeed, US and Vatican opposition, while failing to keep reproductive health out this time, has ensured that the terms ‘sexual’, ‘sexuality’ and ‘rights’ are not included. But what this Summit has shown is that there is a deep consensus that reproductive health is essential to achieving the Millennium Development Goals.

As significant as the New York Summit has been for returning reproductive health to prominence, there is still much to do.

Specifically, the Millennium Development Goals cannot be met unless women and men actually have universal access to reproductive health services. The goals of reducing maternal mortality, achieving gender equality, reversing the spread of HIV/AIDS, cutting child mortality, and the overarching goal of reducing extreme poverty, will remain as distant as ever if the world does not fulfil its decade old commitment to meeting the unmet reproductive health needs of 130 million women.

Women and girls in too much of the world still lack the information, as well as the services, they need to protect themselves from HIV infection or to plan and space births.

Traditional societies are dragging their feet on women’s rights for the sake of preserving male power, but women’s low social, economic and legal status can no longer be treated as just a family matter – it is a matter of global shame and a major impediment to progress in far too many countries.

Over half a million largely preventable maternal deaths occur every year, the vast majority in developing countries and mainly due to lack of access to reproductive health services.

HIV/AIDS is predominantly sexually transmitted, with women now bearing the brunt of the epidemic. Yet funding for prevention efforts all too often excludes reproductive health organizations and clinics, even though they serve far and away the largest female clientele.

And despite the fact that a woman’s ability to delay and space childbearing is an essential precondition of gender equality and full social, economic and political involvement, millions of women remain without this control over their lives.

The World Summit has provided hope of renewed efforts to tackle these fundamental issues at the heart of the development agenda. However, none of this will make any difference without continued political and financial commitment from both rich and poor nations.

If the promises made in New York are not to ring hollow, the international community must act now to provide the funding they promised for reproductive health 10 years ago at Cairo.

Presently they are missing the mark by 50 percent - $9 billion annually rather than the $18 billion they reckoned would be required by 2005.

Getting reproductive health back into the Millennium Development Goals framework at New York was important to redress its exclusion five years ago – an essential first step. Now these same leaders must follow through back home with the essential political will and resources to make universal access to reproductive health services a reality.