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DEVELOPMENT: Poor Countries Footing Reproductive Bill

Stefania Bianchi

BRUSSELS, Sep 15 2004 (IPS) - Developed countries are failing to live up to their commitments to fund sexual and reproductive health care leaving poorer countries to pick up the bill, says a new UN report released Wednesday.

The United Nations Population Fund (UNFPA) report titled ‘The Cairo Consensus at Ten: Population, Reproductive Health and the Global Effort to End Poverty’ says poor countries themselves are providing around 40 percent of the money spent on reproductive health programmes and HIV/AIDS prevention and treatment.

This shortfall in funds by international donors is undermining critical efforts by developing countries to provide family planning services, reduce maternal deaths, prevent HIV/AIDS and meet the needs of young people and the poor, the report says.

Marking the half way point between an International Conference on Population and Development (ICPD) in Cairo in 1994 – when some 179 countries adopted a landmark 20-year Programme of Action (PoA) plan for reproductive rights – and the target date for such goals, this year’s UNFPA report examines the progress countries have made and the obstacles they have encountered in implementing what they decided.

In Cairo, donors agreed to provide 6.1 billion dollars a year for population and reproductive health programmes by 2005, a third of total needs. However the UNFPA, the world’s largest multilateral source of assistance to developing countries for reproductive health, says in 2002 donors only achieved approximately half of their commitment with around 3.1 billion dollars worth of contributions.

With the commitments made at the ICPD, the worldwide budget for reproductive rights should now stand at 18.5 billion dollars by 2005. However, so far 15 billion dollars has been raised.

Of this, 12 billion dollars has come from developing countries themselves, while the remainder is from donors, who are paying about 40 percent of what they committed ten years ago.

The UNFPA says the response of the international community has been ”inadequate” and insists that the Cairo agenda is more important than ever.

”Ten years on from the ICPD, the world needs its vision of human-centred development more than ever. Today’s challenges – including security concerns, the continuing spread of HIV/AIDS, and persistent poverty alongside unprecedented prosperity – make it imperative to carry out the Cairo agenda so that its dream of a better future for all is realised,” the report says.

Presenting the report in Wednesday in London, UNFPA executive director Thoraya Ahmed Obaid said the lack of funds could be devastating for the developing world.

”Lack of reproductive health care will continue to be the leading cause of death and disability for women in the developing world and the AIDS pandemic will continue to expand and wreak havoc,” she said.

Highlighting the report’s core message Obaid said that unless international assistance achieves what it set out to do at the Cairo conference, ”the numbers of people who need family planning, maternal health care and HIV/AIDS prevention, testing and treatment will continue to grow”.

The UNFPA says that this sense of urgency has much wider implications for the developing world and can help to achieve the United Nations Millennium Development Goals (MDGs).

The attainment of these Goals, which include action to halve extreme poverty and hunger by 2015, reduce maternal mortality and stem the HIV/AIDS pandemic, ”depend on the full implementation of the ICPD plan”, the report states.

Commitments to provide development assistance must move from declarations of good intentions to active partnerships and investments, Obaid says. ”This year’s report is, above all, a call to mobilize the political will and the resources needed to make the Cairo vision of a better world a reality,” she said.

Although many developing countries have made ”significant strides” to integrate reproductive health services into primary health care and adopt national strategies on HIV/AIDS, the report says progress has been ”uneven” and much more needs to be done to ensure reproductive health and rights.

Glaring gaps between rich and poor in the availability and quality of health care persist throughout the world.

Ten years after Cairo more than 350 million couples lack access to a range of family planning, complications of pregnancy cause chronic illness and shorten women’s lives and each year 529,000 women dieámostly from preventable causes.

Women are also disproportionately affected by AIDS in some of the world’s poorest countries of sub-Saharan Africa.

”In just over two decades the AIDS pandemic has claimed 20 million lives and infected 38 million people,” says the report. ”This number could rise greatly if countries do not pursue strategies to prevent HIV.”

Donors’ share of funding for contraceptives and condoms for HIV prevention has also declined over the past 10 years even though the UNFPA estimates that demand will increase by 40 percent by 2015.

Obaid says that without these essential supplies, individuals cannot exercise their reproductive rights.

”In sub-Saharan Africa, the average number of condoms for each man is three per year. The number speaks for itself,” she said.

Joanne Csete, director of the HIV/AIDS programme at the non-governmental organisation (NGO) Human Rights Watch says an important factor behind the lack of support for reproductive health programmes is the ”hijacking of the policy agenda on women’s health and women’s rights by the United States”.

The U.S. government had put large amounts of money behind programme approaches that are ”not respectful of women’s right to health information and services, including information on sex and sexuality and services related to sexually transmitted diseases,” she told IPS.

Washington had invested ”to the tune of hundreds of million of dollars” in supporting the preaching of sexual abstinence to men, women and young people. And this in spite of a large body of scientific evidence that such approaches are not only ineffective but potentially counterproductive to women’s health, she Csete told IPS.

For her, the answer to this trend lies with the European Union (EU). ”The role of the EU in the future of reproductive health services for women in developing countries is crucial. The EU is perhaps the only entity that can hope to bring a counterweight to regressive U.S. policies and to support work on women’s health by the United Nations agencies that is undermined by the United States,”she said.

Hedi Jemiai, head of the UNFPA office in Brussels urged the donor nations to reverse the present trend. ”It is vital that donors meet their commitment because women’s lives and health are at stake,” he told IPS.

The report is full of example on the implications of this financial gap, he said. ”This is particularly alarming and very much unjustifiable when we know that the budget required for financing the whole programme of action is not more than one-day-and-a-half of what the world spends on armament,” Jemiai said.

The ICPD goals and particularly those related to the reduction of maternal mortality, infant and child mortality and the universal access to reproductive health by 2015 are an essential condition for meeting the UN’s Millennium Development Goals to reduce global poverty by 2015, Jemiai said.

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