COMMISSION ON POPULATION AND DEVELOPMENT TO MEET FROM 1-5 APRIL
Theme: Reproductive Rights, Health with Special Reference to HIV/AIDS
NEW YORK, 28 March (UN Headquarters) -- Reproductive rights and reproductive health, with special reference to HIV/AIDS will be the theme of the thirty-fifth session of the Commission on Population and Development, to be held at Headquarters from 1 to 5 April.
Under this theme, a general debate will be held during the session, which will include an exchange of views and national experiences. The Commission will also address follow-up actions to the recommendations of the International Conference on Population and Development (ICPD), as did the twenty-first General Assembly special session to review the implementation of the ICPD Programme of Action, which took place in New York in 1999.
[The ICPD, held in September 1994 in Cairo, Egypt, built a consensus on integrating family planning programmes into a new comprehensive approach to reproductive health services. Educating and empowering women was recognized as the most effective way to reduce population growth rates and promote sustainable development. With the adoption of the Programme of Action, the international community set specific resource targets for international population assistance, to enable countries to make reproductive health and family planning accessible to all by no later than 2015. It also reaffirmed the global consensus that voluntary family planning decisions are a basic human right of all couples and individuals.]
According to the documents before the Commission, much progress has been achieved in establishing the basis for reproductive rights since Cairo, which defined "the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of … regulation of fertility that are not against the law".
Another right proclaimed by the Conference is access to appropriate health-care services that would "enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant".
The challenge now is to concentrate on translating those rights into policies and programmes. The broad international consensus reached at the Conference and the continued endorsement of the concepts of reproductive rights and health at the 1999 five-year review of the implementation of the ICPD Programme of Action make it likely that reproductive rights will be a major focus of population policies of the future. For that reason, the Commission will address programme implementation and the future work programme of the Secretariat in the population field and the provisional agenda for its thirty-sixth session. The Commission’s officers will be elected at the opening of the session.
Reports before Commission
Submitted in connection with the current session's special theme -- reproductive rights and reproductive health, with special reference to HIV/AIDS – the Secretary-General’s concise report on world population monitoring, 2002 (document E/CN.9/2002/2) covers such topics as reproductive behaviour, family planning, abortion, HIV/AIDS and policy issues related to reproductive rights.
The report states that, although the attainment of reproductive health goals is challenged by a wide variety of factors, perhaps none is more threatening than the global epidemic of HIV/AIDS. The General Assembly special session on HIV/AIDS, (New York, June 2001), recognized that the epidemic constitutes a global emergency, presenting one of the most formidable challenges to human life and dignity. HIV/AIDS affects not only adults, but also infants and children, who get the disease through vertical transmission from their mothers or become orphaned after the death of infected parents.
As a result of continued monitoring by the UNAIDS, substantial data exist on the levels and trends in HIV prevalence and AIDS mortality worldwide. However, the monitoring of the reproductive health agenda in this respect is still limited by the dearth of information on young adolescents, the levels and trends of sexually transmitted infections, as well as maternal and neonatal mortality. Within the context of such data limitations, the report updates the findings of World Population Monitoring, 1996 (United Nations, 1998), and adds a specific emphasis on the HIV/AIDS epidemic.
The document identifies such factors as the age of entry into reproductive life, initiation of sexual activity and marriage as important markers defining transition to adulthood in various societies. The summary of young women’s and men’s age and marital status at sexual initiation for selected regions demonstrates that the proportion of young women sexually active before the age of 20 is highest in Africa and in the more developed countries (79 and 72 per cent, respectively) and lowest in Latin America and the Caribbean (58 per cent). Sexual initiation during the teen years is also the dominant pattern among men. The average proportion of young men who start their sexual activity before the age of 20 is 69 per cent in Africa and 82 per cent in Latin America and the Caribbean. For many adolescents, sexual initiation occurs before they receive adequate information on potential health risks, the skills of self-protection and full access to reproductive health services. An additional concern is that sexual activity at very early ages is often involuntary or coerced.
International human rights conventions provide that marriage shall be entered into only with the free and full consent of each spouse, but according to the report, many women are married without exercising their right to choose, or are simply too young to make an informed decision. Regional averages of women’s age of marriage are 21.9 in Africa, 23.4 in Asia and Oceania, 25.5 in Latin America and 26.1 in Europe and Northern America. Men’s age at marriage, ranging from 26.6 in Asia to 28.8 in Europe and Northern America, is considerably higher.
Fertility Rates Decline
The report finds that during the past decade, fertility rates continued to decline in most countries. Globally, fertility declined from 3.4 children per woman in 1985-1990 to 2.8 in 1995-2000. In the more developed regions, fertility declined from 1.8 children per women in 1985-1990 to levels far below replacement, averaging 1.6 children per woman in 1995-2000. Approximately 44 per cent of the world’s population now lives in countries with below-replacement fertility.
Noting significant diversification of fertility levels within and across developing regions, the document points out that Africa has become particularly polarized in that respect. Since 1980, total fertility has declined very fast in Northern Africa, while most of sub-Saharan Africa is yet to fully experience significant fertility declines.
Industrialization, urbanization and modernization of societies are cited as the major driving forces of fertility decline in the report. They involve the spread of education, improved child survival and increased adoption of contraception. The use of family planning has been steadily increasing worldwide. More than 60 per cent of couples residing in the less developed world use family planning today, compared with only 10 per cent in the 1960s. The report provides detailed information regarding such issues as the levels of contraceptive use in various regions, age patterns of fertility, adolescent childbearing and infertility. It also provides analysis of the recent trends in contraceptive use and the methods used.
Further according to the report, despite the rapid growth in the use of contraception, the problem of limited choice of methods is still widely spread in the developing countries. In as many as one third of them, sterilization or the pill still account for at least half of all contraceptive use. At the same time, about 20 per cent of couples in developing countries express a desire to space or limit their families and yet are not using any contraceptive methods. The unmet need for family planning is distinctly higher in sub-Saharan Africa that in other regions of the world.
Question of Abortion
Also covered by the report is the question of abortion, which proved to be one of the most contentions ones at the 1994 ICPD conference. The governments agreed, however, in their concern over the health impact of unsafe abortion. That approach was reflected in the key actions for further implementation of the Programme of Action agreed upon at the 1999 review conference. In its resolution S-21/2, the General Assembly resolution called upon governments to "take appropriate steps to help women to avoid abortion" and "provide for the human treatment and counseling of women who have had recourse to abortion".
According to the estimates provided in the document, approximately 26 million legal abortions and 20 million unsafe ones were performed worldwide in 1995. According to the latest data, reported legal abortions total about 15 million annually, with 80 per cent of the total being performed in four countries: China (7.4 million), Russian Federation (2 million), United States and Viet Nam (1.2 million each).
The Secretary-General’s report on monitoring of population programmes focusing on reproductive rights and reproductive health, with special reference to HIV/AIDS, as contained in the Programme of Action of the ICPD (document E/CN.9/2002/3) focuses on country operational experiences and progress towards the implementation of that programme. It also addresses the outcome of the twenty-first special session of the General Assembly, especially as it relates to HIV/AIDS and family planning, maternal mortality, sexually transmitted infections, adolescent reproductive and sexual health, and gender equality and women’s empowerment.
The review of policy and programme activities reveals a significant level of progress with respect to improving reproductive rights and reproductive health, particularly in connection with HIV/AIDS. A scaled-up global response to HIV/AIDS is focusing on the full spectrum of responses, including political commitment, prevention, care and support. Activities to integrate HIV/AIDS and sexually transmitted infections prevention into reproductive and sexual health programmes have intensified.
The report states that prevention should be the mainstay of any response in a country, regardless of the magnitude of the epidemic. It notes several national education campaigns to raise awareness, promote healthy lifestyles, and defuse stigma and discrimination associated with the disease, as well as programmes to increase the availability and promote the use of male and female condoms, which are integral to the prevention of HIV, as well as of sexually transmitted infections.
According to the report, family planning programmes are increasing the availability of contraceptives and services, creating greater opportunities for individual choice. Countries are striving to reduce maternal deaths by upgrading health care facilities, training health service providers, providing transportation for women, and mobilizing communities to fully use the services. The report also notes adolescent reproductive and sexual health programmes that have employed advocacy, information, education and communication, and youth-friendly services to reach young people and help them stay healthy.
Greater attention has been paid to the empowerment of women as a means to improve their reproductive and sexual health. The report gives examples of partnerships that have been formed to capitalize on strengths of individual organizations, institutions, companies and governments. These global alliances will help ensure that women, men and families have the information, services and supplies needed to make informed and free choices about their reproductive and sexual health, in fulfilment of their human rights.
The Secretary-General’s report on the flow of financial resources for assisting in the implementation of the ICPD Programme of Action (document E/CN.9/2002/4) examines the trends in bilateral, multilateral and foundation/non-governmental assistance to population activities in developing countries for 1999. It also presents provisional figures for 2000 and estimates of domestic expenditures reported by developing countries for 1999/2000.
According to this document, the Cairo goal of mobilizing $17 billion for population activities by the year 2000 has not been met. The international community has not met the required $5.7 billion in 2000 for population activities in the developing countries, and the developing countries have failed to provide the required $11.3 billion in domestic funding for related programmes.
Lack of funding remains one of the chief constraints to the full implementation of the Programme of Action. The majority of developing countries have limited financial resources to utilize for population and reproductive health programmes and cannot generate the funds required to implement them. As a result, they rely heavily on international assistance. International population assistance stood at $2.2 billion in 1999, and provisional figures for 2000 show that the level of assistance increased to $2.6 billion. Developing countries’ domestic governmental and non-governmental expenditures were estimated at $8.6 billion in 1999. Most domestic resource flows originated in a few large countries, however.
The report further states that multilateral assistance to population activities provided by the organizations and agencies of the United Nations system decreased to $31 million in 1999 from the 1998 figure of $35 million. Development banks reported an expenditure of $9 million to intermediate donors for special grant programmes in population and reproductive health, of which $8.5 million was expended by the World Bank. The estimated level of multilateral assistance for the United Nations system in 2000 increased to $77 million.
The significance of population assistance from multilateral organizations and agencies can best be measured by identifying the amount of funds flowing through them for further distribution, the document points out. In 1999, that figure amounted to $355 million, and the preliminary figure for 2000 is $434 million. UNFPA is the leading provided of United Nations assistance in the population field, with $242 million flowing through it in 1999 and $326 million in 2000. Another important source of multilateral population assistance is represented by the development banks, which provide loans for developing countries.
The report concludes that increased political will and renewed commitment to the goals and objectives of the ICPD are urgently needed. The document lists such modalities to mobilize resources as advocacy for increased assistance from international financial institutions and regional development banks; increased involvement of the private sector; and cost-sharing and other forms of cost recovery. Other options include the sector-wide approach and the implementation of the 20/20 initiative, whereby donors commit themselves to allocating 20 per cent of their development assistance funds to improving basic social services and the goals of eradicating poverty, and the developing countries allocate 20 per cent of their development funds towards similar goals, which include population and social sector objectives.
The Secretary-General's report on Programme implementation and progress of work in the field of population in 2001: Population Division, Department of Economic and Social Affairs (document E/CN.6/2002/5) covers the activities and lists publications of the Population Division dealing with the analysis of demographic variables at the world level; world population estimates and projections; population policy and socio-economic development, monitoring, coordination and dissemination of population information; and technical cooperation in population, as well as other activities of the Division.
The Population Commission was established in 1946 by the Economic and Social Council to study and advise the Council on population changes, including through migration, and their effect on economic and social conditions. Following the International Conference on Population and Development in 1994, the name of the 47-member body was changed to the Commission on Population and Development, and it was decided that it would meet annually beginning in 1996 to assess implementation of the Programme of Action adopted at the Cairo Conference.
The Commission normally comprises 47 members, who are elected on the basis of equitable geographic distribution and serve a term of four years. In 2002, the members are: Algeria, Austria, Bangladesh, Belarus, Belgium, Brazil, Botswana, Burundi, Cameroon, Chile, China, Croatia, Egypt, France, Gambia, Germany, Ghana, Guinea, Haiti, Indonesia, Iran, Ireland, Italy, Jamaica, Japan, Kenya, Lithuania, Malaysia, Mexico, Netherlands, Nicaragua, Nigeria, Norway, Pakistan, Peru, Poland, Russian Federation, Turkey, Uganda, Yemen, United States and Zambia. Currently, there are three vacancies in the group of Asian States and two in the group of Latin American and Caribbean States.
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