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Mpox is a viral zoonotic disease which typically occurs in tropical areas in central and west Africa. From May 2022-July 2023, multiple cases of mpox were identified in non-endemic countries, and the World Health Organization declared the mpox outbreak a Public Health Emergency of International Concern. This marked the first time many mpox cases were reported concurrently in non-endemic and endemic countries in different geographical areas. During the outbreak, nearly 100,000 people were infected, primarily gay and bisexual men, and approximately 200 people died.  This statement was prepared by Nathalie Kapp, Chief Medical Advisor with support from the International Medical Advisory Panel (IMAP) members: Arachu Castro, Michalina Drejza, Gail Knudson, Zozo Nene, Prof. Pascale Allotey, Janet Meyers, Professor Michael Mbizvo (Co-Chair), Chipo Gwanzura (Co-Chair), Paul D. Blumenthal, and Edmore Munongo. We thank the panel for their valuable and timely guidance and reviews offered during the development process. 

Commonly dubbed “the digital generation”, young people are driving innovative digital solutions to lead critical conversations related to sexual and reproductive health, rights, and justice (SRHRJ). These solutions do not come easy, as many young people still feel the brunt of the gender digital divide which further marginalises women, girls, and gender expansive people. Young people also face challenges in navigating social media platforms whose content moderation policies increase censorship on content related to SRHRJ, particularly comprehensive sexuality education (CSE). Navigating this, young content creators have created new slangs and euphemisms that help convey their messages without experiencing the impact of censorship. They also use a range of platforms to build and sustain communities of practice that enable knowledge sharing, solidarity, and best practices for delivering CSE and promoting youth-friendly sexual and reproductive health (SRH) services in hostile contexts. Youth Day 2024 honours the resilience of young people who are creating digital pathways for sustainable development. The United Nations Department for Economic and Social Affairs (UN DESA) has partnered with several UN agencies to highlight the role of young people in driving change. Actions like these are critical to affirming the power of young people who are collectively working to overcome the barriers they face daily, to increase access to information for all. It is no secret that young people, across various cultural and social contexts, are demanding comprehensive sexuality education and SRH services. Research has also shown that CSE is important for developing young people particularly in creating positive identities and sense of self and wellness, increased knowledge of their rights, and decision making. Globally, CSE is not delivered in its entirety as some topics are seen as taboo. To challenge this, youth-led organisations, inclusive of regional youth networks of the International Planned Parenthood Federation, are producing innovative digital solutions to meet their needs. From social media advocacy campaigns to virtual out-of-school CSE delivery, they are filling the gaps to improve the quality of learning for youth and ensuring that no one is left behind. "Delivering CSE in digital spaces is beneficial as it helps to foster transnational solidarity while also demonstrating the similarities in contexts and realities. More importantly, it can create a safer space to ask questions without the fear of being judged. These solutions are becoming increasingly important as across several contexts, the classroom is an unsafe space for learners, particularly of those who have been historically marginalised; LGBTQIA+ learners, learners with disabilities, and racialised people. While there are several concerns of the replacement of digital tools for real life educators, there is significant opportunity to use these tools to ensure a holistic and safe experience for learners, adequately meeting their needs and countering the spread of misinformation and disinformation."- Ashlee Burnett, Global Lead, CSE This learning brief provides an overview of the work led by youth and for youth to engage in digital advocacy and delivery of CSE in their contexts. It shows strategies for using digital solutions as a supportive tool for diverse types of CSE delivery, displaying the power of innovative digital solutions in further advancing CSE. It offers a list of five recommendations of best practices to ensure successful efforts and five case studies across four regions.

Last year saw a relentless assault on human rights, leaving many feeling anxious and pessimistic about the prospects for people from all walks of life to come together. It was a year of wartime atrocities livestreamed onto billions of smartphones in real time. And if climate, security and human rights fared poorly, the economy did not do much better and many countries cut their aid budgets.  Against this backdrop, we launched our new strategy, Come Together 2028. IPPF Member Associations (MAs) were still able to deliver a total of 222.4 million sexual and reproductive health services during 2023. We served 71.2 million clients. Pretty impressive in such a challenging year in which we embarked on our new strategy.  Read more by downloading the 2023 IPPF Annual Performance Report. 

What is menopause? Menopause is a retrospective diagnosis: it is defined after a woman or person who can menstruate is amenorrheic for 12 months. At this time, estrogen levels are diminished, the ovaries no longer ovulate and spontaneous conception is no longer possible. The average age of the final menstrual period (FMP) is between 46-52 years of age globally. Early menopause occurs between the ages of 40-45 and premature ovarian insufficiency refers to menopause occurring spontaneously before 40 years of age. Of note, although most professional societies define menopause occurring following 12 months of amenorrhea, the United Kingdom Faculty of Sexual and Reproductive Health defines it as 12 months in people over the age of 50 years of age and 24 months in those between 40-50 years of age. The menopause transition is the start of menopausal symptoms and/or menstrual irregularities until the FMP. Perimenopause includes the menopause transition, during which time contraception may continue to be needed, and one year after the FMP, when menopause is officially diagnosed. Both menopause and perimenopause are a time of great transition. Perimenopause is associated with significant hormonal fluctuations with an eventual reduction in ovarian estrogen production. In the initial years after the FMP, estrogen levels may still fluctuate but, over time, will diminish to a persistent low estrogen state. These hormonal changes can have significant physical, emotional, and mental effects. Menopause occurs naturally but other types exist. Surgical menopause occurs when both ovaries are surgically removed. Menopause can also be induced after medical treatments, such as with chemotherapy, that result in cessation of ovarian function which may be permanent or reversible. Globally, life expectancy is increasing, albeit varying by geographical location. Some people may spend decades in perimenopause and menopause. Often the needs of those in perimenopause/menopause are unmet; recognizing and addressing these needs are essential to ensure the health and wellness of this often-overlooked population. Purpose of the Statement The purpose of this statement is to define the health impact of perimenopause and menopause and review therapeutic options to address the healthcare needs of this population.

Recognizing the significant global impact of sexually transmitted infections (STIs), this statement affirms IPPF’s commitment to people-centred STI care as a critical aspect of comprehensive sexual and reproductive health and well-being. A holistic approach to sexual and reproductive health and rights acknowledges that true sexual and reproductive well-being extends beyond the prevention and treatment of diseases. It emphasizes the importance of promoting healthy, satisfying sexual and reproductive experiences. This includes advocating for personcentred care, encouraging self-care strategies, and supporting the development of innovative healthcare delivery models tailored to meet the diverse needs of individuals in various circumstances and contexts, particularly reaching those who are often excluded and marginalized. This statement updates the latest information on STIs. It provides practical recommendations for IPPF Member Associations on how to develop a comprehensive, people-centred approach to STI care, emphasizing integrated services, adherence to guidelines, rights-based care, community engagement, advocacy, and a positive perspective on sexual health and well-being.

Background IPPF offers a comprehensive approach to sexual and reproductive health and rights through its Integrated Package of Essential Services (IPES) which is offered at affiliate service delivery points. The IPES includes HIV testing, HIV prevention, HIV care and treatment, services for sexually transmitted infections and reproductive tract infections, contraception, abortion care, obstetrics and gynaecology, fertility support, and support for sexual and gender-based violence Purpose The purpose of our HIV Theory of Change is to clarify the goals and vision of IPPF’s HIV programme and to articulate the different pathways and strategies IPPF uses to contribute towards its HIV goals and vision. This Theory of Change endeavours to represent a conceptual model that is complex and non-linear in the format of a readable diagram. Therefore, this Theory of Change diagram is a simplified representation of a complex process which cannot be fully captured in this format. Our Theory of Change describes causal pathways for how the work in our HIV programme contributes to the ultimate goals and vision. The purpose of this conceptual model is not to provide a detailed description of the components of our HIV services, as these are described in the 2020 ‘IPPF Comprehensive HIV Services Package’ and the IPPF 2022 ‘Client-centred-clinical guidelines for sexual and reproductive health care’. Reading the diagram Our Theory of Change diagram is read from left to right, representing movement in time from the world we currently live in (left side) towards the future we would like to see, which is represented by our vision (right side). There are 7 pathways (page 1), each with a set of strategies (shown on pages 4 and 5 as close-ups of the diagram), whose work contributes towards achieving our HIV goals and vision. The 7 pathways are divided into cross-cutting pathways (community engagement, evidence and learning, capacity strengthening and sharing, strategic partnership building) and core pathways (advocacy, empowerment, comprehensive service delivery). The cross-cutting pathways are iterative and intersecting, contributing to each other and collectively contributing to the 3 core pathways. The core pathways represent the 3 main areas of our HIV programme, which, like all elements of the diagram, also interact with each other synergistically. The strategies of all 7 pathways working together contribute towards a set of outcomes. The outcomes interacting together contribute towards our goals, which in turn interact with each other, and contribute towards our ultimate vision.

Frontline workers for sexual and reproductive health and rights (SRHR) provide life-changing and life-saving services to millions of people every year. From accompanying the pregnant, delivering babies and caring for the newborn to supporting those subjected to sexual violence; from treating debilitating infections to expanding contraceptive choices; from enabling access to safe abortion services to countering homophobia: all over the world frontline SRHR carers and advocates make it possible for so many more to experience dignity in sex, sexuality and reproduction. Yet they are also subjected to hostility for what they do, for whom they provide care, for where they work and for the issues they address. From ostracistion and harassment in the workplace to verbal threats and physical violence, hostilities can extend even into their private lives. In other words, as SRHR workers seek to fulfil the human rights of others, their own human rights are put at risk. Yet, as grave as that is, it is a reality largely undocumented and thus also underestimated. This scoping review sets out to marshal what is known about how hostilities against frontline SRHR workers manifest, against whom, at whose hands and in which contexts. It is based on review of six sources: peer-reviewed and grey literature, news reports, sector surveys, and consultations with sector experts and, for contrast, literature issued by opposition groups. Each source contributes a partial picture only, yet taken together, they show that hostilities against frontline SRHR workers are committed the world over—in a range of countries, contexts and settings. Nevertheless, the narratives given in those sources more often treat hostilities as ‘one-off’, exceptional events and/or as an ‘inevitable’ part of daily work to be tolerated. That works in turn both to divorce such incidents from their wider historical, political and social contexts and to normalise the phenomena as if it is an expected part of a role and not a problem to be urgently addressed. Our findings confirm that the SRHR sector at large needs to step-up its response to such reprisals in ways more commensurate with their scale and gravity. Authors: Victoria Boydell, Kate Gilmore, Jameen Kaur, Jessica Morris, Rebecca Wilkins, Frieda Lurken, Sarah Shaw, Kate Austen, Molly Karp, Sally Pairman, Maria Antonieta Alcalde

This IMAP Statement aims to present the sexual and reproductive health needs of very young adolescents, explain the barriers they face when accessing these services, and explore factors that can help facilitate pathways to rights-based services.  Download in English, French, Spanish and Arabic below.

In most countries in Europe (and in many other countries around the world) two forms of emergency contraceptive pills are accessible: both levonorgestrel and ulipristal acetate pills are available in pharmacies without a prescription. In this situation, pharmacy teams play an important role in facilitating access for women. Yet, significant variances in dispensing practices have been identified, leading to access disparities. This consensus statement aims to present the best evidence to support women’s right to choose which ECP to use, as well as pharmacists’ role in supporting their choice with accurate information and counseling. Download in English Below.