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NGO Documents for ICPD+5

International Planned Parenthood Federation (IPPF) *

Cairo consensus reaffirmed
and future directions mapped out

After four months of often difficult and sensitive negotiations between 179 UN Member States, the final document on the five-year review of the International Conference on Population and Development (ICPD) was adopted by consensus at the UN General Assembly Special Session (UNGASS) held in June 1999. During the three-day Special Session, 159 high level government officials and ministers delivered statements on the review and appraisal of the ICPD Programme of Action. The Ad Hoc Committee of the Whole, with responsibility for finalizing the review document - Key Actions for the Further Implementation of the ICPD - ran parallel to the Special Session having been unable to complete negotiations on the document in the time allocated due to the difficulty of arriving at consensus on some of the more controversial issues. These included adolescent sexual and reproductive health and rights, emergency contraception, unsafe abortion and reproductive rights. The 106-page document reaffirms the international consensus agreed in Cairo in 1994 and builds in many parts on the language, targets and benchmarks. The document sets out a series of recommendations on population and development issues including gender equality, equity and empowerment of women, reproductive rights and reproductive health, resource mobilization, adolescent sexual and reproductive health and HIV/ AIDS. Specific benchmarks are also delineated in the text including the reduction of illiteracy of women and girls, maternal mortality, young people's vulnerability to HIV/ AIDS and provision of safe and effective family planning and contraceptive methods. These benchmarks are seen as an important and effective way of guiding individual countries in reaching the goals of the Cairo Programme of Action. A brief summary of the key issues in the document Key Actions for the Further Implementation of the ICPD follows;

Youth

Young people are given increased visibility in the document. Despite the frequent and delicate negotiations between balancing the rights and responsibilities of young people with the rights, duties and responsibilities of parents, addressing the needs of young people is a priority within the final document.
Governments agreed to "safeguard the right of adolescents to privacy, confidentiality and informed consent" and committed to meeting "the needs of youth, especially young women, with the active support, guidance, and participation, as appropriate, of parents, families, communities, NGOs and the private sector by investing in the development and implementation of national, regional and local plans".
References to reproductive and sexual health issues in education were also agreed with the call for the inclusion of "education about population and health issues, including sexual and reproductive health issues" in "formal and non-formal schooling" in order to "further implement the Programme of Action in terms of promoting the well-being of adolescents, enhancing gender equality and equity".
Another paragraph recognizes the rights of youth to "reproductive health education, information and care" calling for governments to "ensure that adolescents, both in and out of school, receive the necessary information, including (prevention education,) counselling and health services to enable them to make responsible and informed choices and decisions regarding their sexual and reproductive health needs, in order to, inter alia, reduce the number of adolescent pregnancies." This paragraph also recognises that there are "sexually active adolescents" and that they "will require family planning information, counselling and health services, as well as sexually transmitted diseases and HIV/ AIDS prevention and treatment".

Human Rights

The human rights context for sexual and reproductive health and rights was reaffirmed in the final document - despite having been under attack throughout the Cairo+ 5 review process. The "human rights framework" had been questioned consistently on the basis that Cairo did not have the authority to "create" new human rights. This was based on a misunderstanding - Cairo did not create any new rights; it applied already existing human rights to sexual and reproductive health and rights.
The document's Preamble includes that the "human rights of women and the girl child" and the "right to development" are both "universal and inalienable rights and an integral part of fundamental human rights".
Language on reproductive rights is maintained by reference to the Cairo Programme of Action (paragraph 7.3) and "affirms that reproductive rights embrace certain human rights that are already recognised in national laws, international human rights documents and other consensus documents".

(IPPF has produced a Charter on Sexual and Reproductive Rights based on recognized international human rights law including UN charters and conventions etc. The Charter is available from IPPF's Distribution Unit or downloadable on the IPPF web-site.)

Unsafe Abortion

The document states that in no case should abortion be promoted as a method of family planning. Governments and the international community are urged to strengthen their commitment to women's health, deal with the health impact of unsafe abortion as a major public health concern and reduce the recourse to abortion through expanded and improved family planning services. Significant additions to the Cairo language on unsafe abortion include calls for the training and equipping of health service providers and other measures to ensure safe and accessible abortion.
...in circumstances where abortion is not against the law, health systems are to train and equip health service providers and to take other measures to ensure that abortion is safe and accessible". The inclusion of "accessible" reflects a change in thinking on abortion since 1994.
During the negotiations, 48 countries publicly affirmed their support for the right to safe and accessible abortion where legal - including some countries that currently criminalize abortion including Nepal and Chile. Although not incorporated in the final document, these countries stressed the importance of reviewing their existing legislation, including punitive measures.
Reservations were made on this paragraph by Argentina, Nicaragua and the Holy See.

HIV/ AIDS

The text in the final document calls for governments to ensure that prevention of, and services for, sexually transmitted diseases (STDs) and HIV/ AIDS are an integral component of reproductive and sexual health programmes at the primary health-care level.
Gender, age-based and other differences in vulnerability to HIV infection should be addressed in prevention and education programmes and services.
Governments are called upon to ensure that by 2005 at least 90 per cent - and by 2010 at least 95 per cent -of young men and women aged 15-24 have access to the information, education and services necessary to develop the life skills required to reduce their vulnerability to HIV infection.
The increased impact of the HIV/ AIDS pandemic is recognized in the document calling for special attention to be given to providing promptly the necessary resources as called for in the Programme of Action for the prevention of STDs and HIV.

Resources

Throughout the Cairo+ 5 PrepCom and UN Special Session, the lack of resources was highlighted as the biggest obstacle to the full implementation of the Programme of Action.
In the final document, there are separate paragraphs on resource mobilization -one for developed countries and one for developing countries - reflecting what many developing countries felt should show the differences between the levels of financial resources made available since 1994. The paragraph on developed country resource mobilization urges these countries to strengthen their commitment to ICPD goals and objectives, in particular the cost estimates, make every effort to mobilize agreed estimated financial resources and give priority to least developed countries.
Many representatives of UN and international agencies stressed that the review process had revealed how many countries -particularly developing countries -have taken the Programme of Action seriously in financial terms, coming close to meeting their Cairo commitments to mobilize two-thirds of the estimated $17 billion per year necessary. Donor countries have not come nearly as close to fulfilling their financial commitments -the other third of this amount.
A balance is struck in the final document between calling for the "increased involvement of the private sectors" and ensuring that modalities such as "selective user fees, social marketing, cost sharing and other forms of cost recovery" are accompanied by "adequate social safety net measures to promote access to services by those living in poverty and other members of vulnerable groups".

Maternal Mortality

It has been recognized that improvements in maternal mortality rates have not been as good as expected and as a result the document reinforces the importance governments must give to this issue.
Governments are called upon to recognize the linkages between high levels of maternal mortality and poverty and promote the reduction of maternal mortality and morbidity as a public health priority and reproductive rights concern.
Also, governments should ensure that women have ready access to essential obstetric care, well-equipped and adequately staffed maternal health-care services, skilled attendance at delivery, emergency obstetric care and family planning.

Male Involvement

The promotion of men's understanding of their roles and responsibilities in regard to respecting the human rights of women was included in the final document.
Governments, in collaboration with civil society, including NGOs, donors and the UN system, are called upon to promote men's responsibility for protecting women's health, preventing unwanted pregnancy, reducing maternal mortality and morbidity, reduction of the transmission of STDs, sharing household and child-rearing responsibilities and promoting the elimination of harmful practices and sexual and other gender-based violence.

Provision of Services

A key recommendation in the text is that governments should take effective action to ensure the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information, education and means to do so.

Where there is a gap between contraceptive use and the number of individuals expressing a desire to space or limit their families, countries should attempt to close this gap by at least 50 per cent by 2005, 75 per cent by 2010 and 100 per cent by 2050.
The document adds that in attempting to reach that benchmark, demographic goals, while legitimately the subject of government development strategies, should not be imposed family-planning providers in the form of targets or quotas.

Roles of Civil Society

In two paragraphs relating to civil society, governments are to "recognize and support the important and complementary role that civil society at the national level can play".
Governments should include representatives of NGOs and local community groups in country delegations to regional and international forums where issues related to population and development are discussed.

* from the IPPF web-site at: http://www.ippf.org/cairo/issues/9908/index.htm#Cairo

 

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