What have been the trends in international thinking on reproductive health?
The 1994 UN International Conference on Population and Development in Cairo saw a major shift in the predominant thinking on reproductive health.
The debate moved from a narrow, medical agenda towards a greater recognition of the sexual and reproductive rights of women. This approach affirms the basic right of all couples and individuals to:
- decide freely on the number, spacing and timing of their children
- be given the information and means to do this
- make decisions free from discrimination, coercion and violence
- enjoy a high level of reproductive and sexual health.
Has there been progress since then?
The resulting 20-year ‘Cairo Programme of Action’ has faltered because donor governments have failed to back their commitments with anything approaching the money required.
Some governments still shy away from accepting the fact that many young people are sexually active and need access to health services, while many decision-makers do not want to open up a debate about the unequal status of women that often prevents women from claiming their rights.
As a result some important international agreements have steered clear of sensitive issues in order to reach consensus. For example, the Millennium Development Goals (MDGs) frame women and children’s health in biological terms rather than the more controversial language of inequality and rights. Sexual and reproductive health was left out of the original MDGs altogether.
However, in 2005 a new target of universal access to reproductive health by 2015 was added to the maternal health goal.
What happens next?
Reviews of the Cairo action plan took place in 1999 and 2004 and another review will take place in 2009, to mark and review progress over the past 15 years.
It is becoming harder and harder for world leaders and health experts alike to ignore the terrible toll that poor sexual and reproductive health takes every day. However, there are also signs of a move back to consider population control as a development issue, which would signal a move against the idea of individual choice in the original Cairo plan.
Why have US aid policies on abortion been criticised?
Under President George Bush Jr. a policy was re-instated that banned the use of US funds by foreign non-governmental organisations (NGOs) for abortion. It also prevents US-funded NGOs from using grants from any other source to provide counselling and referral for abortion; to carry out abortions in cases other than those which threaten the mother’s life, rape, or incest; or to lobby to legalise or increase availability of abortion in their country. This ‘global gag rule’ was overturned by President Barack Obama in one of the first actions of his administration.
Last modified: 16/12/2010
