One fourth fewer babies in India are not wanted by their mother
but lack of family planning services, young women have to.

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MDGs: Reproductive Health not found place

The Millennium Declaration promoted the 8 goals that popularly known as Millennium Development Goals (MGDs). The most of the UN Agencies while planning its programmes they keep this goals in focus. But unfortunately, Reproductive health along with other ICPD goals was not included in these goals. This affecting the reproductive health services worldwide specially in developing and poor countries. Its directly effect the young people and their health. The short of funds left behind the target set in ICPD, the diversion and absorb the fund in HIV/AIDS make the situation more worst.

Mr Jyoti Shanker Singh in his statement during the 5^th International Medical Parliamentarians Conference on Family Health spoke about the relationship between the goals and objectives of the 1994 International Conference on Population and Development (ICPD) that dealt with the issues of reproductive health and population and the overall goals for the eradication of hunger and poverty that are contained in the Millennium Declaration adopted by the United Nations in the year 2000. The relationship needs to be examined because some but not all of the ICPD goals are incorporated in the Millennium Declaration.

International Medical Parliamentarians Organization (IMPO) organized the Conference from 4 to 7 December 2003 in Bangkok, Thailand. Mr. Singh addressed the Conference on topic ‘Reproductive Health: Population and Millennium Development Goals’.

Mr Singh said that four of the ICPD goals – achievement of universal primary education and elimination of the gender gap in primary and secondary education by 2015, reduction of child mortality, reduction of maternal mortality and improvement in maternal health, and combating HIV/AIDS are included in the Millennium Declaration. The goal on HIV/AIDS prevention was updated by the twenty-third special session of the General Assembly on ICPD+5 in 1999 and the Millennium Declaration adds malaria and tuberculosis to the list of diseases, which need to be eradicated. Chapter III of the ICPD Programme of Action on the interrelationships between population, sustained economic growth and sustainable development contains various elements of what became the Millennium goal on environmental sustainability; and several chapters of the Programme of Action contain recommendations, which have been grouped together under the Millennium goal on developing a global partnership for development.

He reminded that the ICPD Programme of Action notes that ‘‘widespread poverty remains the major challenge to development efforts. Poverty is often accompanied by unemployment, malnutrition, illiteracy, low status of women, exposure to environmental risks and limited access to social and health services, including reproductive health services, which, in turn include family planning. All these factors contribute to high levels of fertility, morbidity and mortality, as well as low economic productivity. Poverty is also closely related to inappropriate spatial distribution of population, to unsustainable use and inequitable distribution of such natural resources as land and water, and to serious environmental degradation.’’

This whole paragraph of Programme of Action provides a clear and comprehensive rationale for linking reproductive health and population programs to the elimination of extreme poverty – the overarching goal of the Millennium Declaration. Furthermore, the goal relating to the empowerment of women is to be found in both the ICPD Programme of Action and the Millennium Development Goals.

Mr. Singh further inform that the one major goal of ICPD that is not to be found in the Millennium Declaration is that on reproductive health. This goal was the subject of much debate before and during the ICPD and was ultimately adopted by consensus among the 179 countries participating in the Conference. Since the 1994 Conference, the reproductive health goal has been adopted by an increasing number of developing countries.

To quote the ICPD text:

"All countries should strive to make accessible through the primary health-care system, reproductive health to all individuals of appropriate ages as soon as possible and no later than the year 2015. Reproductive health care in the context of primary health care should, inter alia, include: family-planning counselling, information, education, communication and services; education and services for pre-natal care, safe delivery and post-natal care; prevention and appropriate treatment of infertility; abortion as specified in paragraph 8.25, including prevention of abortion and the management of the consequences of abortion; treatment of reproductive tract infections; sexually transmitted diseases and other reproductive health conditions; and information, education and counselling, as appropriate, on human sexuality, reproductive health and responsible parenthood. Referral for family-planning services and further diagnosis and treatment for complications of pregnancy, delivery and abortion, infertility, reproductive tract infections, breast cancer and cancers of the reproductive system, sexually transmitted diseases, including HIV/AIDS should always be available, as required. Active discouragement of harmful practices, such as female genital mutilation, should also be an integral component of primary health care, including reproductive health-care programmes." [Paragraph. 7.6 of the ICPD Programme of Action]

Those who were involved in the preparatory process regarding the Declaration indicate that the ICPD goal on reproductive health was not included to avoid protracted and difficult negotiations, even though it was clear that only a small group of countries were opposed to its inclusion. It should be noted, in passing, that this group, though it was small, was also very determined to hold up the adoption of the text of the Declaration if it did not get its way.

As the United Nations Secretary-General pointed out in his message to the Asia-Pacific regional conference in Bangkok in December 2002, “the Millennium Development Goals, particularly the eradication of extreme poverty and hunger, cannot be achieved if questions of population and reproductive health are not squarely addressed. And that means stronger efforts to promote women’s rights, and greater investment in education and health, including reproductive health and family planning.”

The fact of the matter is that the ICPD goals and objectives (including the goal on reproductive health) as endorsed by the General Assembly in 1994 as well as various other UN bodies remain valid in their own right and as integral components of the overall poverty eradication and development strategy reflected in the Millennium Declaration. This does not mean that they should not be updated as and when necessary. The goal on HIV/AIDS was updated by the ICPD+5 review; and the cost estimates for HIV/AIDS prevention included in the Program of Action are clearly inadequate ($1.3 billion in 2002, $ 1.4 billion in 2005). The HIV/AIDS pandemic affects more than 42 million individuals today and the United Nations Secretary-General estimates that more than $ 10 billion will be needed annually for HIV/AIDS prevention and treatment.

As a result of the initiative taken by the UN Secretary-General and following a special session of the General Assembly on HIV/AIDS, a Global Fund on HIV/AIDS, Malaria and Tuberculosis has been set up in Geneva, Switzerland and it has received pledges from several governments to the tune of more than $ 4 billion covering a period of 3 years. US President George W. Bush pledged earlier this year that the United States will provide $ 15 billion to fight HIV/AIDS particularly in Africa and the Caribbean over a period of 5 years; and several other countries, including Japan and UK, also have pledged large sums of money for HIV/AIDS.

The increasing contribution being made by several Western governments and Japan to combating HIV/AIDS and other infectious diseases is to be welcomed; though we remain far short of the annual target of $ 10 billion set by the Secretary-General. At the same time, I would like to submit that this worthwhile effort must not be undertaken at the expense of support for family planning and reproductive health programs. The trend in this regard is quite worrying. The tabulation of the financial resources for population activities in 2001 shows that the donors are contributing only about $ 2.5 billion as against the goal of $ 5.7 billion set by Cairo. Of the amount of $ 2.5 billion, 39 per cent was spent on STD/HIV/AIDS, while 30 per cent was spent on family planning services, 24 per cent on other reproductive health services and 8 per cent on basic research, data and policy analysis. The funding for family planning services has decreased from 55 per cent in 1995 to 30 per cent in 2001; while the funding for basic health services rose from 18 per cent in 1995 to 30 per cent in 1999 but has declined to 24 per cent in 2001.The funding for research, data and policy analysis has declined during the same period from 18 per cent to 8 per cent.

As the United Nations Population Fund (UNFPA) has repeatedly pointed out, the need and the demand for commodities and services in the area of family planning and reproductive health continue to grow, particularly in the poorest countries which can least afford to allocate the funds required. As we approach the tenth anniversary of the International Conference on Population and Development, the governments, NGOs and the international community should refocus their attention on how international assistance can be substantially increased to accelerate the implementation of the ICPD goals, particularly on reproductive health.

Mr Jyoti Shanker Singh is the President of ‘Population 2005’ and very old associate of ICYO movement. 134 representatives attended the Conference from 52 countries around the world including ICYO.

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Indian Committee of Youth Organizations (ICYO) is a registered non-profit, non-governmental network organization, committed in developing areas of mutual cooperation and understanding among different youth voluntary agencies, youth groups, clubs and individuals working in the field of youth welfare in India.  ICYO functions as an umbrella organization of youth NGOs in India. Its family consists of over 350 organizations spread in 122 districts of 22 states from different corners of India.

Affiliation:  Consultative (Roster) Status with ECOSOC, United Nations; Consultative Status with Commission on Sustainable Development; Full Member of World Assembly of Youth (WAY); Full Member of Asian Youth Council (AYC); Member of Youth for Habitat International Network (YFHIN); Affiliate group of ECPAT International, Bangkok, Thailand.