Press Releases

    POP/922
    5 April 2005

    Maternal Mortality Unacceptably High, Population Commission Told, as It Opens Current Session

    HIV/AIDS Continues to Take over 3 Million Lives Annually; 40 Million Currently Living with HIV

    NEW YORK, 4 April (UN Headquarters) -- Implementation of the Programme of Action agreed upon during the 1994 International Conference on Population and Development (ICPD) in Cairo, Egypt, had not advanced equally in all countries, the Under-Secretary-General for Economic and Social Affairs, José Antonio Ocampo, said at the opening of the thirty-eighth session of the Commission on Population and Development, with the special theme:  HIV/AIDS, poverty and development.

    Maternal mortality continued to be unacceptably high, and HIV/AIDS continued to take over 3 million people annually, he said.  The ICPD Programme of Action recognized that in developing countries, where population continued to increase, slower population growth would improve the ability of countries to combat poverty, protect the environment and set the necessary conditions for sustainable development.  Full implementation of the Programme of Action would contribute to slower population growth in developing countries by reducing fertility levels, which would lead to favourable age composition and increase women’s participation in the workforce.

    Currently, over 40 million people were living with HIV, at least 25 million of them in sub-Saharan Africa, he said.  The Millennium Development Goal of halting or reversing the spread of HIV was crucial for the development prospects of many countries.  Full implementation of the Programme of Action of the ICPD had much to contribute to helping reduce the spread of the disease, particularly by ensuring that people got the information and means to protect themselves against contagion.  Fighting the spread of HIV/AIDS demanded constant vigilance and sustained effort.

    Thoraya Obaid, Executive Director of the United Nations Population Fund (UNFPA), said one could not overstate the importance of advancing gender equality throughout the processes of development, humanitarian response and peace-building.  Experts agreed that ensuring access to reproductive health information and services, including voluntary family planning, was absolutely essential to gender equality, reducing child and maternal mortality, combating HIV/AIDS and reducing poverty.  For international AIDS strategies to be more effective, it was necessary to ensure that HIV/AIDS and reproductive health and family planning were linked.  Prevention of HIV required the availability of condoms as part of the comprehensive approach adopted by the United Nations special session on HIV/AIDS.

    Om Pradhan, speaking on behalf of the High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States, urged both the least developed countries and their development partners to strengthen their plans and programmes to fulfil the objectives of the Millennium Development Goals and the 2001 Brussels Programme of Action for Least Developed Countries.  They could be achieved through making available the already internationally committed resource and technology flows, through debt cancellations for all least developed countries, and through the successful elimination of subsidies and unfair trade practices, he said.

    During the following general debate, speakers stressed the importance of HIV prevention and empowerment of women as two main pillars of the fight against HIV/AIDS.  Links between poverty and the spread of HIV/AIDS, access to treatment and the necessity of a human rights-based approach were also emphasized.

    The representative of Jamaica, speaking on behalf of the “Group of 77” developing countries and China, said ensuring universal access to reproductive health care would make a major contribution to improving maternal health, combating HIV/AIDS and reducing poverty within families and nations.  Stronger links between reproductive health and HIV/AIDS policies, programmes and services would result in more relevant and cost-effective programmes with greater impact.  Gender equality was a powerful tool in the fight against HIV/AIDS.  “Protecting women’s rights protects them from HIV/AIDS”, she said.

    Speaking on behalf of the European Union, the representative of Luxembourg emphasized that the fight against HIV/AIDS could not succeed without universal access to quality reproductive health services.  There was an urgent need to link the fight against AIDS with support for reproductive and sexual health and rights.  It was key for governments to continue working with all partners, including international agencies, civil society and faith-based organizations, organizations of people living with HIV, young people, women’s groups, the private sector and the media.  Access by young adults to sexual and reproductive health information, education, services and commodities, including condoms, was essential.

    In other business, the Commission elected Crispin Grey-Johnson (Gambia) as Chairman of the thirty-eighth session; and Olivier Chave (Switzerland), Ewa Fratczak (Poland) who would also serve as Rapporteur, Majdi Ramadan (Lebanon) and Alfredo Chuquihuara (Peru) as its Vice-Chairpersons.  The Commission further adopted its provisional agenda and programme of work.

    At the beginning of the meeting, a minute of silence was observed to commemorate the passing of the late Pope John Paul II.

    Hanna Zlotnik, Director, Population Division, Department of Economic and Social Affairs, also made an opening statement, as did the Commission’s departing Chairman.  Larry Heligman, Chief, Population Studies Branch, Population Division of the Department of Economic and Social Affairs; Steven Kraus, Chief, HIV/AIDS Branch, UNFPA; François Farah, Chief, Population and Development Branch, UNFPA; and Mary Beth Weinberger, Chief, Population and Development Section of the Population Division, Department of Economic and Social Affairs, introduced the Secretary-General’s reports before the Commission.

    Peter Anyang’ Nyong’o, Minister for Planning and National Development of Kenya, addressed the situation in his country regarding population policies and HIV/AIDS.

    The representatives of the Russian Federation, Egypt, Japan, China, South Africa, India, Peru, United States, Switzerland, El Salvador, Ghana and Morocco spoke, as did the Observer for the Holy See.

    The Commission further heard from a technical officer for Gender and Reproductive Rights Department of the World Health Organization, as well as from two non-governmental organizations:  International Women’s Health Coalition and Inter-American Parliamentary Group on Population and Development, and the intergovernmental organization Partners in Population and Development.

    The Commission will meet again tomorrow, 5 April, at 10 a.m. to continue consideration of the contribution of the implementation of the ICPD Programme of Action to the achievement of the internationally agreed development goals.

    Background

    The Commission on Population and Development will open its thirty-eighth session today with election of officers, adoption of the agenda and general discussion on the reports before the Commission.  For more background, see Press Release POP/920 of 31 March

    Election of Officers

    In a short statement, the departing Chairman, ALFREDO CHUQUIHUARA (Peru), said that, during this year, all countries of the world had reaffirmed the Cairo Programme of Action.  The message was clear: all countries recognized reproductive rights as a key factor to combat poverty and strengthen democratic institutions.  Among implementation of the Programme of Action, attention should be paid to public policies on population and development and to reproductive health and strategies to combat HIV/AIDS and combat violence against women. 

    The Commission then elected Crispin Grey-Johnson (Gambia) as Chairman of the thirty-eighth session.

    A minute of silence was observed to commemorate the passing of the late Pope John Paul II.

    The Commission further elected Olivier Chave (Switzerland), Ewa Fratczak (Poland) who would also serve as Rapporteur, and Majdi Ramadan (Lebanon) as its Vice-Chairpersons.

    The Observer for the Holy See, Archbishop CELESTINO MIGLIORE, thanked with appreciation the participants for the moment of silence observed.

    Opening Statement by Under-Secretary-General

    The Under-Secretary-General for Economic and Social Affairs, JOSÉ ANTONIO OCAMPO, said this week’s session would focus on the special theme of HIV/AIDS, poverty and development.  The series of United Nations conferences and summits held during the 1990s set out an ambitious development agenda that provided the foundation for the Millennium Declaration.  In September, a high-level plenary meeting of the Assembly would conduct the first five-year review of that Declaration.  The Department of Economic and Social Affairs was a key player in that process and was also a major partner in monitoring progress made in achieving the Millennium Development Goals and in dissemination of information regarding the indicators of that progress.  The review of progress made in implementing the International Conference on Population and Development (ICPD) Programme of Action last year and deliberations on how such implementation could contribute to the achievement of the development goals would provide key inputs for this year’s high-level segment of the Economic and Social Council.

    He said since people’s well-being was the goal of development, population trends conditioned development prospects.  The ICPD Programme of Action underscored the importance of those trends and recognized that in developing countries, where population continued to increase, slower population growth would improve the ability of countries to adjust to future population increases, combat poverty, protect the environment and set the necessary conditions for sustainable development.  Full implementation of the Programme of Action would contribute to slower population growth by reducing fertility levels.  Reducing fertility also lead to favourable age composition, increase women’s participation in the working force, and boost the number of workers.  Those changes produced a context beneficial for economic growth.

    Such a “demographic bonus” had contributed to the rapid economic growth of a number of industrializing countries in Asia, Mr. Ocampo continued.  However, in countries where the creation of employment had not kept pace with the increases in the working-age population, poverty levels had not declined, such as in several Latin American countries.  In addition, poverty remained a major challenge in most of the countries where fertility remained high, especially among the least developed countries and in most of Africa.

    He said that, although the ICPD Programme of Action offered useful guidance on actions that could lead to the achievement of key development goals, its implementation had not advanced equally in all countries, or in all regions.  Every year, 11 million children died before their fifth birthday.  Maternal mortality continued to be unacceptably high and HIV/AIDS continued to take over 3 million people annually.  Since the United Nations had adopted the Declaration of Commitment on HIV/AIDS in 2001, the epidemic had continued to expand, with both rich and poor countries being affected.  The hardest-hit countries were among the poorest in the world.  Currently, over 40 million people were living with HIV, at least 25 million of them in sub-Saharan Africa.  By placing heavy economic and social burdens on families and eroding inter-generational support systems, HIV/AIDS reinforced poverty.  The increasing number of infected people was threatening food and agricultural production and straining resources in the health and education sectors.

    The Millennium Development Goal of halting or reversing the spread of HIV was crucial for the development prospects of many countries.  The international community’s success or failure in meeting that would profoundly affect the ability of many countries to reach other development objectives.  In that respect, full implementation of the ICPD Programme of Action had much to contribute to helping reduce the spread of the disease, particularly by ensuring that people got the information and means to protect themselves against contagion.

    In response to the epidemic, most governments had implemented programmes focusing on HIV prevention, including a variety of strategies, including information, education, communication campaigns and voluntary counselling and testing, he said.  Programmes often targeted high-risk groups, including women and young people.  Experience indicated that programmes were most effective when tailored to the specific risk factors and situations prevalent in each country.  Fighting the spread of HIV/AIDS demanded constant vigilance and sustained effort.  Effective prevention programmes to reduce mother-to-child transmission, for instance, were still far from being universal.  More also had to be done to expand access to anti-retroviral treatment.

    Concluding, he said that, given those major challenges, it was all the more important that in June a high-level meeting on HIV/AIDS was scheduled to review progress achieved in realizing the commitments set out in the Declaration of Commitment on HIV/AIDS.  The Commission’s deliberations would be an important input to that meeting.  Over the next few days, some of the most critical issues stalling development and perpetuating poverty would be considered.

    THORAYA OBAID, Executive Director of the United Nations Population Fund (UNFPA), said that, at the tenth anniversary of the Cairo Conference, governments had reaffirmed their commitment to its Programme of Action and the achievement of universal access to reproductive health by 2015.  They had acknowledged that the issues of population and reproductive health were central to the Millennium Declaration and to the creation of a world where people lived free from fear and want, in dignity and peace.  There was a widespread agreement that the ICPD agenda made a significant contribution to the reduction of poverty and the achievement of the Millennium Development Goals.  Population issues constituted a major part of the broader development, peace and security agenda.  The degree of respect for human rights, the status of women, movement of people, the density of people, the age structure, and fertility and mortality rates were among the key factors of development.

    She said that the greatest improvements in reducing extreme poverty had been registered in East and South Asia, where more than 200 million people had been lifted out of poverty since 1990.  In that regard, one could not overstate the importance of advancing gender equality throughout the processes of development, humanitarian response and peace-building.  Of utmost importance were the benefits of reproductive health, especially as it related to women and their very right to life and general well-being.  Next week, the Government of Sweden and the UNFPA were co-sponsoring a high-level meeting in Stockholm, where ministers of finance, planning and health would discuss the inter-sectoral benefits of investing in reproductive health and rights.  Experts of task forces of the Millennium Project agreed that ensuring access to reproductive health information and services, including voluntary family planning, were absolutely essential to gender equality, to reducing child and maternal mortality, combating HIV/AIDS and reducing poverty.

    One of the “quick wins” endorsed by the 250 experts of the Millennium Project was to expand access to sexual and reproductive health services, including family planning and contraceptive information and services, and to close funding gaps for supplies and logistics.  It was also recommended that governments incorporate universal access to reproductive health as an integral part of their response to HIV/AIDS.  That relatively inexpensive, high-impact “quick win” held the potential to generate major gains and save millions of lives.  The Millennium Project had recommended that an additional target -- universal access to reproductive health -- be added to the Goal on improving maternal health.

    During this year, the international community had an opportunity to lay the groundwork for bolder action to bring about far-reaching change, she said.  That was the message contained in the report just released by the Secretary-General.  “Yes, we must be bold.  Yes, we must achieve results, and increase aid effectiveness and system coherence.  And yes, we must have as our guiding light the needs and hopes of all people”, she said.  Gender equality, education and health, including reproductive health, were critical investments and political priorities.  In addition, the Secretary-General called on governments to recognize the special needs of Africa and reaffirmed the solemn commitments to address those needs on an urgent basis.  That had been further elaborated in the recent report by the Commission for Africa.

    Regarding AIDS, she said that, for international strategies to be more effective, it was necessary to ensure that HIV/AIDS and reproductive health and family planning were linked, as appropriate.  That would allow women at the community level to benefit directly from such services, and the services would be more efficient in reaching the vulnerable group of women and young people.  That needed to be reflected in national plans and budgets, including health-sector reforms and poverty-reduction strategies.  Prevention of HIV required availability and accessibility of condoms, as part of the comprehensive approach adopted by the United Nations special session on HIV/AIDS.  It was important to reach the vulnerable groups with information and services that addressed the realities they faced.  “We must confront the poverty, human rights violations and gender inequalities that drive the epidemic among women.  By doing so, we will enable women and girls to protect their health, and that of their families and communities”, she said.

    She added that the funding for population and reproductive health activities was on the rise.  The ICPD Programme had estimated that carrying out programmes in the area of reproductive health and the collection and analysis of population data would cost $17 billion annually by 2000 and $18.5 billion by 2005.  Approximately two thirds of the costs would come from developing countries and one third from the international donor community. According to the latest figures, the donors had provided some $4.5 billion in 2004, up from $2.6 billion in 2000, and projections for 2005 were encouraging.  She urged the donors to remain on track by living up to their commitments and continuing to increase funding levels, as promised.  She also urged all countries to contribute to the UNFPA Trust Fund on Reproductive Health Commodity Security.

    HANNA ZLOTNIK, Director of the Population Division, addressing the Commission for the first time since her appointment following the retirement of her predecessor, Joseph Chamie, said that in recent years the world population had grown at speeds unprecedented in human history.  Remarkably, most of the increase was, and would continue to be, concentrated in the developing world.  Despite major reductions in fertility achieved by most developing countries, population growth today was six times faster in the less developed regions than in the more developed ones.  The least developed countries, which accounted for 12 per cent of the world population, were expected to absorb a quarter of all population growth during the next decade.  By contrast, the population of Europe had begun a slow decline.

    Countries with moderate or high levels of fertility, whose populations were young and growing, faced the challenge of providing education, health services and gainful employment to large and increasing numbers of young people, she continued.  However, many of them were least developed countries where levels of extreme poverty were high.  Those countries were most likely to reap major benefits from full implementation of the ICPD Programme of Action.  Policies that would effectively increase child survival, reduce maternal mortality and provide the means for people to have the number of children they desired would likely speed or trigger fertility reductions.  As the Programme stated, “the transition to low fertility in developing countries ... would produce slower population growth, which, in turn, would improve the ability of those countries to adjust to future population increases, to combat poverty, protect and repair the environment and set the conditions for sustainable development”.  All countries would also benefit from programmes to satisfy the basic needs of the poor and vulnerable segments of the population, especially with regard to health care and education.

    About 45 out of every 100 young people in the developing world today lived in countries that were already highly affected by the HIV/AIDS epidemic, she said.  The international community had set the goal of reducing the spread of the disease among those young people.  Preventing the further spread of HIV required a coordinated and multifaceted approach.  In highly affected countries, HIV/AIDS had already erased decades of progress in combating mortality.  Furthermore, as the disease affected adults in their most productive years, it had a particularly destructive effect on families and households and on the long-term economic development of societies, exacerbating poverty and reducing human capital.

    Although governments were increasingly adopting comprehensive policies and multi-sectoral programmes to combat the disease, much remained to be done.  The most effective programmes included appropriate education, information and communication efforts to promote the adoption of responsible behaviour.  The ABC strategy involving abstinence, being faithful, and correct and consistent use of condoms had become a key component of programmes to modify behaviour.  Also effective were programmes that contributed to the reduction of partners.  As women were more susceptible to HIV than men and many married women were being infected by their spouses, it was crucial to emphasize men’s shared responsibility.  In all countries, it was urgent to provide legal protection from discriminatory practices to those living with HIV/AIDS.  It was also important to combat the discrimination and stigma that increased the vulnerability of groups at the highest risk of infection, and devise interventions that would reduce the spread of the disease among those groups.  Among other priorities, she also listed the availability of HIV therapies.  The growing availability of such therapies should not lead to a neglect of prevention efforts, however.

    Even if all new infections could be prevented as of today, the expected toll of the disease would hardly change over the next decade because of the large number of persons already infected, she added.  It was, therefore, more important than ever that international solidarity be brought to bear in addressing that ongoing human tragedy.  In that context, the deliberations of the Commission in the coming days could make an important contribution by reaffirming such solidarity and mapping the way forward.

    OM PRADHAN, Representative, UN Office of the High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States, said that when it came to population statistics and projections for the least developed countries until 2050, loud alarm bells were to be heard, with populations projected to more than double from about 800 million to

    1.7 billion by 2045.  Although the current high fertility rates in the least developed countries were expected to decline, they would remain higher than in the rest of the world.  The population dynamics would also undergo changes due to an increase in life expectancy from 50 to 66 years.  At the same time, economic productivity would depend on the implementation of effective programmes to prevent and treat HIV/AIDS, malaria, tuberculosis and other debilitating diseases.

    In southern Africa, the region with the highest prevalence of HIV/AIDS, life expectancy had fallen, on the other hand, from 62 years to 48 years and was projected to decrease further to 43 years over the next decade, he said.  In Botswana, Lesotho and Swaziland, the population was projected to decrease as deaths outnumbered births.  Another critical demographic feature would be that by 2050 the least developed countries would have larger youth populations.  That could be a highly productive resource, provided that least developed countries could contain HIV/AIDS, provide the requisite health and welfare facilities, education and training, with appropriate employment opportunities.  Because of all those factors, it was increasingly difficult for the least developed countries to achieve the Millennium Development Goals and the goals set out in the Brussels Programme of Action for those countries.

    He said, as part of the solution to the growing population problem, the Brussels Programme of Action first called for appropriate health care for all individuals no later than 2015.  It also called for making available the widest achievable range of family planning and contraceptive methods.  Least developed countries had committed themselves to strengthen population policies consistent with the expectations of the international community.  They had also agreed to strengthen basic health-care systems and to promote reproductive rights as defined in the ICPD Programme of Action, with particular emphasis on maternal and child health.  However, least developed countries faced severe capacity constraints, as well as a lack of technology and financial means, to undertake those commitments and required strong support from the international community.

    He urged both the least developed countries and their development partners to strengthen their plans and programmes to fulfil the objectives of the Millennium Development Goals and the Brussels Programme.  They could be achieved through making available the already internationally committed resource and technology flows, through debt cancellations for all least developed countries, and through the successful elimination of subsidies and unfair trade practices, he said.

    Introduction of Reports

    The Chairman of the thirty-seventh session of the Commission, ALFREDO CHUQUIHUARA (Peru), then introduced a report of the bureau on its inter-sessional meeting, which had been held in Lima, Peru, last October (document E/CN.9/2005/2).

    The Commission then took note of the report and approved the recommendations contained therein.

    Ms. ZLOTNIK introduced the reports before the Commission on the “Follow-up actions to the recommendations of the ICPD”.

    LARRY HELIGMAN, Chief, Population Studies Branch, Population Division of the Department of Economic and Social Affairs, introduced the Secretary-General’s report on world population monitoring, focusing on population, development and HIV/AIDS, with particular emphasis on poverty (document E/CN.9/2005/3).  He said the HIV/AIDS epidemic had been a tragic force for nearly a quarter century.  Although the epidemic affected both rich and poor countries, the highest HIV/AIDS prevalence rates were found in poor countries.  The poor often lacked the knowledge that would enable them to protect themselves from the virus and, once infected, they were less able to gain access to care and life-prolonging treatment.

    Prevention was the central pillar for action against HIV/AIDS, he said. Although most governments had reported having implemented prevention programmes, in many of those countries those most in need still lacked access to basic prevention services.  When prevention efforts failed, the next line of action was treatment.  Advances in treatment with anti-retroviral drugs could mitigate the effects of the disease.  Despite drastic reductions in the prices of those drugs, however, only about one in 10 of those needing treatment currently had access to them.

    He said the international community had responded to the challenge of AIDS with unprecedented resources, but more funding was necessary.  The eventual course of HIV/AIDS depended on how individuals, families, communities and nations responded today and tomorrow.  The most effective approach to thwart the HIV/AIDS epidemic was to implement a combination of strategies that reduced risks, diminished vulnerability and mitigated impact.

    Introducing the Secretary-General’s report on monitoring of population programmes, focusing on population, development and HIV/AIDS, with particular emphasis on poverty (document E/CN.9/2005/4), STEVE KRAUS, Chief of the HIV/AIDS Branch, UNFPA, said that the plague of the modern world, AIDS, had killed over 20 million people.  Today, the number of people living with HIV had surged to over 40 million. The epidemic was having an astounding impact on health and socio-economic stability of nations. HIV/AIDS must be treated as both an emergency and a long-term development issue.

    The international community’s commitments to combat the AIDS epidemic had been communicated through a number of documents, including the Key Actions for the Further Implementation of the ICPD Programme of Action, the Declaration of Commitment on HIV/AIDS of the General Assembly’s special session and the Millennium Declaration. The report before the Commission highlighted the effect that HIV/AIDS had on population dynamics, including population losses and decreasing life expectancy, slowing economic growth and increasing extreme poverty.  The document paid particular attention to the feminization of the epidemic and its impact on women and girls. It also emphasized that progress in responding to the epidemic was hindered by the preponderance of poverty, gender inequality, stigma and discrimination, as well as the lack of respect for the universality of human rights. The report also contained a clear message on young people.  Indeed, over one half of new infections were among young people under the age of 25.

    “Not all on the horizon is bleak”, he added.  The good news was that HIV/AIDS was a problem with a solution.  The international community knew what needed to be done.  Awareness of HIV/AIDS and the need to take vigorous action to combat the epidemic was growing.  Governments were adopting policy reforms and developing multi-sectoral strategies. Countries were increasingly implementing the “Three Ones” principles:  one national HIV/AIDS action framework; one national AIDS coordinating authority; and one monitoring and evaluation system.  A recent high-level meeting hosted by the United Kingdom, in partnership with France, United States and the Joint United Nations Programme on HIV/AIDS (UNAIDS), on “Making the Money Work” had outlined the actions needed.

    The report focused on prevention, care, treatment and support, he said.  Simply said, prevention and treatment needed to work hand in hand. Strong linkages between sexual and reproductive health and HIV/AIDS resulted in more relevant and cost-effective programmes with greater impact.  Strong linkages benefited from existing infrastructure for delivering maternal health, sexually transmitted infection management, family planning and community-based outreach.  It was also important to address the underlying causes and consequences of the epidemic, including gender inequality, poverty, stigma and discrimination. The international community needed to engage with marginalized groups, meet the needs of the most vulnerable and ensure that programmes worked together with populations most directly impacted by the epidemic.

    To summarize, he said that today there was increasing political commitment around the world, and more funds than ever before.  “What we need is a more rigorous upholding of the universality of human rights, including respect for women and girls, young people, and vulnerable populations.”  Greater action was needed on evidence-informed strategies that had proven to work.  In short, it was necessary to translate the knowledge and commitments into concrete and effective action in each country and in each community.  Concerns and conclusions reached today should have bearing on the discussions at the General Assembly in June and September to assess the progress towards the General Assembly special session and Millennium Declaration goals and targets.

    FRANÇOIS FARAH, Chief, Technical Support Division, Population and Development Branch, UNFPA, introducing 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.9/2005/5), said the present report analysed international and domestic financial resource flows for family-planning services, basic reproductive-health services, sexually transmitted diseases and HIV/AIDS activities, and basic research.  There was concern that the ICPD target of $17 billion for 2000 had not been met and that both donors and developing countries had fallen short of the agreed targets.  It was, however, heartening to note a concerted effort to bridge the funding gap.

    He said the international community must sustain and increase funding efforts and remain on track to reach the target for 2005.  Although not explicitly mentioned in the Millennium Declaration, population and reproductive health was central to development and the achievement of the Millennium Development Goals.  They must figure prominently in development programmes and poverty-reduction strategies and in donor and national budgets.  Without a firm commitment and adequate resources to implement population and reproductive-health programmes, it was unlikely that the goals of the Cairo Conference and the Millennium Summit would be met.

    Statements

    NORMA TAYLOR ROBERTS (Jamaica), speaking on behalf of the “Group of 77” developing countries and China, said the implementation of the ICPD Programme of Action was crucial for the eradication of extreme poverty and the achievement of other Millennium Development Goals.  Last month’s review of the Beijing Fourth World Conference on Women, and the Platform for Action, was an important contribution to the process leading up to the September Summit.  The Group of 77 fully supported the advancement of women as a guiding principle for development.  Ensuring universal access to reproductive health by 2015, as agreed in Cairo, would make a major contribution to improving maternal health, combating HIV/AIDS and reducing poverty within families and nations.

    She said 95 per cent of all population growth was absorbed by the developing world.  That gave rise to concerns regarding the provision of social services and prospects for human well-being.  The poorest people had the least access to social services, education and health services, including reproductive health.  Speedier and deeper debt relief, along with increased flows of official development assistance (ODA) and fairer terms of trade would further enable developing countries to make greater progress in meeting their needs and hopes for a better future.

    She said that, while AIDS treatment was expanding through the “3 by 5” initiative, prevention must also be urgently increased.  She emphasized the importance of building on existing systems in the delivery of AIDS programmes.  In many countries, there was an urgent need to strengthen health systems and take measures to retain trained health workers.  Stronger links between reproductive health and HIV/AIDS policies, programmes and services would result in more relevant and cost-effective programmes with greater impact.  Gender equality was a powerful tool in the fight against HIV/AIDS.  “Protecting women’s rights protects them from HIV/AIDS”, she said.

    Regarding the reform of working methods of the Commission, she said it should adopt a multi-year work programme structured to ensure that the issues in the ICPD Programme of Action could be reviewed within every five-year framework, using broad categories such as population growth and composition, health and migration.

    ELISABETH COLOTTE (Luxembourg), speaking on behalf of the European Union and associated States, reaffirmed the Union’s full and broad support for the entire agenda of the ICPD.  Members of the Union fully acknowledged their responsibility to bear an appropriate share of the financial burden identified in the ICPD Programme of Action.  The exceptional dimension of the fight against HIV/AIDS required an exceptional response.  An enhanced response to the pandemic should be tackled under the overarching framework of the achievement of the Millennium Development Goals, also drawing on the outcome of Cairo.

    The international community needed to explicitly recognize and stress the linkages between sexual and reproductive health and rights and HIV/AIDS at the upcoming General Assembly annual review on progress in meeting the targets of the special session, as well as during the high-level review of the implementation of the Millennium Development Goals in September.  It was necessary to enhance the inclusion of responses to HIV/AIDS into national poverty strategies, knowing that the impact of HIV/AIDS deepened poverty and income inequalities, and poverty exacerbated HIV/AIDS.  The advance of HIV/AIDS, especially in the least developed countries and in sub-Saharan Africa, was of great concern to the Union.

    She emphasized that the fight against HIV/AIDS could not succeed without universal access to quality reproductive health services.  There was an urgent need to link the fight against AIDS with support for reproductive and sexual health and rights.  It was necessary to maintain a strong political commitment and funding for sexual and reproductive health information, services and research, extend treatment and care, and ensure reproductive choices to people affected by HIV, in accordance with the ICPD Programme.  Special attention should be given to groups that were especially vulnerable, such as the young, men who had unsafe sex with men, intravenous drug users and persons in prostitution.  All responses should be comprehensive and integrated, including prevention and access to treatment and care, where most appropriate.

    Far greater resources were needed to ensure universal access to sexual and reproductive health care and fight HIV/AIDS, she said.  Governments and donors must meet their commitments to fund those services.  Further international assistance for AIDS and sexual and reproductive health must be harmonized and aligned behind a coherent, national multi-sectoral response, coordinated by national authorities and based on a single national strategy.  That approach had been strongly promoted under the “Three Ones”, which the Union supported.  Programmes on AIDS must include prevention, treatment, care and research.  There was also a need to strengthen national competence to analyse the impact of the epidemic.  It was key for governments to continue working with all partners, including international agencies, civil society and faith-based organizations, organizations of people living with HIV, young people, women’s groups, the private sector and the media.  Access by young adults to sexual and reproductive health information, education, services and commodities, including condoms, was essential.

    Among the main priorities, she also listed awareness of behaviours that increased the risk of contracting HIV and resultant behavioural change, which was key for prevention.  Strategies must ensure that HIV/AIDS and sexual and reproductive health programmes contribute to the overall sustainability of health systems.  Scaling up HIV testing and counselling services provided a crucial entry point for both prevention and treatment.  Countries must also step up efforts to assist families and communities in caring for orphans and children affected by the epidemic, ensure that they remained in school and protect orphans from exploitation.  Access to treatment and care, going beyond access to drugs, was crucial.  The Union had been instrumental in establishing, funding and promoting the effectiveness of the Global Fund to fight AIDS.  It also strongly welcomed recent positive developments in relation to the provision of anti-retroviral drugs at affordable prices in the world’s poorest countries.

    PETER ANYANG’ NYONG’O, Minister for Planning and National Development of Kenya, said that the issue of population and development had always been of great concern to his Government.  Kenya had made significant progress in addressing most of the actions contained in the ICPD Programme of Action.  The Government had recently launched its report on the progress made in implementing that document.  Kenya had adopted policies, frameworks, guidelines and plans of action in most major areas of concern, with others currently under way.  Some of those policies were backed by legislation, for example, the children’s act of 2001, and the environmental management and coordination act of 1999.  Significant progress had been achieved in lowering fertility rates and the overall population growth rate in the late 1990s.  Following the adoption of free primary education in 2003, Kenya had made a strong leap to meet the pledge in education.  The country was working towards the provision of universal primary health care.

    Despite those achievements, Kenya had seen many important development indicators deteriorate over the decade, he continued.  Infant mortality, maternal mortality, life expectancy, school completion rate and poverty levels had worsened.  Economic growth had virtually stagnated for much of the decade.  The HIV/AIDS pandemic, malaria and tuberculosis took their relentless toll on the economy, the health system and individual families.  It was, therefore, uncertain whether some of the ICPD goals would ever be attained.  Among the main challenges, he mentioned the slow and ineffective pace of implementation of programmes, particularly those meant to address poverty reduction; failure to fully integrate population, gender and environmental concerns in development planning; weak institutional capacity; low domestic resource allocation for reproductive health programmes and, hence, over-dependence on donor funding; inadequate linkage of HIV/AIDS prevention strategies with care; and social and cultural barriers.  It was, therefore, important to reassess the strategies used to address the ICPD Programme and the Millennium Development Goals.

    To that end, he said Kenya intended to accelerate the implementation of the interim investment programme for its economic recovery strategy for wealth and employment creation, as well as other poverty-reduction programmes, and improve the effectiveness of management structures, including information systems, capacity-building and provision of services.  The Government was committed to global and regional initiatives aimed at fostering development through the rule of law and good governance.  It would continue working with other partners to ensure that reproductive health and population issues were integrated into national development and poverty-reduction strategies.  That called for enhanced resource allocation.  To date, the financial commitment for the programme had not been met, particularly by the donors.  Therefore, greater advocacy and efforts to raise awareness were needed to secure additional resources.  Unless international assistance rose to the levels agreed at Cairo, the goals of the Conference would remain elusive.  Time was also ripe for developing nations to adopt home-grown strategies for mobilizing domestic resources.

    VASSILY NEBENZIA (Russian Federation) opened his statement with a complaint about the fact that a number of his country’s delegates to the Commission’s session had not received the required visas.  Agreeing with the Secretary-General’s conclusion on the need to increase the effectiveness of partnerships among donors, recipient countries, multilateral institutions and civil society towards realization of the ICPD goals, he said one of the priorities was strengthening the role of the private sector in resource mobilization in the areas of population and development.

    He said Russia’s complex demographic situation was characterized by the loss of working-age population and the general ageing.  It was, therefore, important to preserve the existing demographic potential and establish a positive demographic trend.  As the Secretary-General had emphasized the links between the ICPD Programme of Action and human rights, particularly in the area of universal access to education, taking into account religious and cultural traditions, he underlined the importance of preserving the rights of the Russian-speaking populations in post-Soviet countries.  Through migration, Russia could mitigate the negative population trends.

    He advocated development of international cooperation at all levels to ensure effectively combating the threat of HIV/AIDS.  Last week, there had been a conference of co-sponsors on the UN joint programme on AIDS/HIV, with the participation of United Nations and Commonwealth of Independent States (CIS) representatives.  There was a need for goal-oriented actions at all levels, particularly at the grass-roots and community levels.  Education was especially important.  There was great potential for interaction between the UNFPA, the United Nations Children's Fund (UNICEF), the World Health Organization (WHO) and UNAIDS to devise standardized education regarding HIV/AIDS.  Social and human rights aspects were also important and policies should be developed to prevent discrimination against those who had HIV/AIDS.

    Action

    The Commission further elected Alfredo Chuquihuara (Peru) as Vice-Chairman.

    Statements

    MOHAMED ABDELSATTAR ELBADRI (Egypt) said the African continent was the most affected by the disease, as it had 65 per cent of the world’s affected people.  The illness had eroded the basic economic infrastructures, as well as the continent’s progress, towards a market economy.  It had destroyed any possibility for economic progress in addition to the negative social effects, such as the increase of orphans.  African countries had developed effective programmes, such as the Declaration of the 2001 Abuja Summit which, among other things, called for putting an end to the obstacles preventing the countries from combating the disease.

    He said the last summit meeting of the African Union had emphasized the need for further commitments, and the international community’s efforts had given rise to a number of initiatives such as the Global Fund to Combat AIDS, Tuberculosis and Malaria.  Objective 6 of the Millennium Declaration called for a halt to the spread of the pandemic by 2015.

    Egypt had made major efforts to combat AIDS, he said, which had focused on combating the spreading of the disease.  A hotline had been established, and measures had been taken to maintain the quality of hospitals and protect the blood supply from HIV.  The Ministry of Health had established a number of programmes for blood analysis and training of health workers, as well as for promoting awareness.  The way to combat the pandemic required more efforts and sustained action.  The Secretary-General’s recommendations in that regard were important, in particular, the need to improve health services and increase international funding.

    KAZUO SUNAGA (Japan) said that four of the Millennium Development Goals -- universal primary education, reducing infant and child mortality, improving maternal health, and combating HIV/AIDS, tuberculosis, malaria and other diseases -- were directly related to the ICPD Programme of Action.  Clearly, the Goals could not be achieved without the Programme’s full implementation.

    HIV/AIDS had a major impact on mortality, population growth and the number of orphans in the world, as well as on overall economic and social development, he continued.  In February, Japan had announced its medium-term policy on official development assistance.  In it, the country focused on the individual, emphasizing the concept of human security and the need to take cross-cutting approaches to break the vicious cycle of HIV/AIDS.  Japan’s approach towards infectious disease reflected its own experience:  the country had implemented measures ranging from universal access to primary health care to water and sanitation.  Highly successful, those measures had contributed to making Japan the country with the longest life expectancy in the world.

    Among the main priorities, he listed prevention along with medical treatment.  Information and education programmes aimed primarily at young people, voluntary counselling and testing and prevention of mother-to-child transmission needed to be promoted.  Also important were the issues of HIV/AIDS among women and girls, reproductive health care and prevention of sexually transmitted diseases.  Care and support needed to be strengthened for people living with HIV/AIDS and their families, and adequate primary health-care systems must be put in place in developing countries.  With those points in mind, Japan was providing financial and technical assistance to developing countries in the fight against infectious diseases, including HIV/AIDS. In addition, his Government had taken the initiative in creating the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2002.  Last month, his Government had announced a new initiative on gender and development, under which it would address the specific needs of women and girls, who suffered disproportionately from the impact of HIV/AIDS.

    RU XIAOMEI (China), associating herself with the statement made on behalf of the Group of 77, said the spread of HIV/AIDS had become a grave global challenge.  Although the impact of HIV/AIDS was universal, the most vulnerable were those who had less access to socio-economic resources and who lived in the developing world.  Integrating HIV/AIDS efforts with poverty alleviation was a response of strategic importance.  Poverty, discrimination, gender inequality and migration were major factors that increased the vulnerability of people.  Special attention, therefore, needed to be paid to disadvantaged groups in combating the disease so as to achieve social equity, justice and harmony.

    She said integrating reproductive health/family-planning services with HIV/AIDS prevention and treatment had proved to be the most cost-effective best practice, and there was a need for further integration in that regard.  Population and reproductive health issues were central to efforts to eradicate extreme poverty, hunger and gender inequality and achieve the Millennium Goals.  Concerted efforts should be made to reinforce population, reproductive health and HIV/AIDS issues in the five-year review of the implementation of the Goals.

    JACQUE VAN ZUYDAM (South Africa), aligning himself with the statement made on behalf of the Group of 77, said that, over the past decade, the HIV and AIDS epidemics had changed the demographic maps of many countries with far-reaching consequences.  The epidemics fed off social and economic inequality, both within and between countries, exposed the continued vulnerability of women and children, and threatened to erode many development gains.  South Africa had worked tirelessly with the leadership of many African countries to ensure that population and development activities recognized the demographic impacts of the epidemic.

    At Africa’s ministerial review of the ICPD’s Action Programme last year, it had been agreed that governments should make efforts to reduce the risk environment for HIV transmissions, including poverty, gender inequality, social instability and conflict.  The review recognized the need for an integrated and human rights-based response.  Research, data collection and analysis, support for children end older persons, education, socio-cultural issues and media should also be addressed.  He emphasized that success in overcoming the epidemics would be determined by the ability to effectively address poverty, observe human rights, render sexual and reproductive health services, eliminate gender inequality and deliver a wide range of social and other services that prevented and mitigated the impact of the epidemics, among other things.

    A. GOPINATHAN (India) said that his country had been steadily broadening the scope of the national family-planning programme, which had been initiated in 1951.  The programme had always been fully voluntary, and the efforts of the Government had been directed towards provision of services and encouraging citizens to use them through information, education and communication.  The objective of the initiative had been to stabilize the population at a level consistent with the needs of national development.  Over the years, the programme had incorporated other aspects, including immunization and maternal and children’s health.  In 1997, a reproductive and child health programme had been formally inaugurated, which aimed at maximum coverage and promoted equity by improving accessibility and providing choices.

    Given the scale and diversity of India’s population, a decline in mortality and fertility was a significant achievement, he continued. The National Population Policy of 2000 had set the goal of achieving the total fertility rate of 2.1, or replacement rate of fertility by 2010.  Many States would attain that goal or would be very close to attaining it within that time-frame.  While there had been a significant decline in infant mortality, post-natal mortality had fallen at a faster rate than the neonatal mortality.  New programmes for increasing access to skilled birth attendance should have positive results.

    India had succeeded in combating some of the communicable diseases and was on the verge of eradicating polio.  At the same time, such diseases as measles, tuberculosis and malaria continued to exist, along with such lifestyle-induced illnesses as heart disease and cancers linked to the use of tobacco, alcohol and pollution.  The national health policy was being recast accordingly, and public spending on health and education was increasing.

    In conclusion, he said that the provision of additional resources was essential to meet the Cairo goals, through the strengthening of delivery and other attendant systems.  While giving details of the positive trends regarding funding, the report before the Commission indicated that some of the increase had been due to a favourable dollar exchange rate.  The report revealed that the proportion of total population assistance for family-planning services had declined from 55 per cent in 1995 to 13 per cent in 2003.  If not reversed, the trend towards less funding for family planning would have serious implications for countries’ ability to address unmet needs and could undermine efforts to prevent unintended pregnancies and reduce maternal and infant mortality.  The international community’s commitment to the Millennium Goals needed to incorporate the universal reproductive health-services target.  Funding for those objectives should be secured along with increased funding for HIV/AIDS.

    Mr. CHUQUIHUARA (Peru) endorsed the position of the Group of 77 and China and the Rio Group and said that HIV/AIDS had raised enormous challenges for mankind.  Human rights, development and health were interlinked, and the problem should be tackled from a comprehensive perspective.  Peru had made efforts to put into practice the ICPD Programme of Action and achievement of the Millennium Development Goals.  Among the priorities, he mentioned recognition of reproductive rights, measures to improve the reproductive health of the population, and efforts to improve policies to fight HIV/AIDS and violence against women.  The efforts to combat the HIV/AIDS epidemic must be urgently integrated with reproductive and family health programmes.  Women and young people were among the most vulnerable groups, and it was necessary to urgently implement effective measures without delay, for it was a question of life and death.

    The Cairo Programme and the Millennium Goals were complementary, he said.  He believed universal access to reproductive health was essential to prevent the cycle of poverty throughout the world, especially in developing countries.  It was also important to incorporate universal access to reproductive health as part of Millennium Goal 5, which referred to the efforts to combat maternal mortality.  It was necessary to integrate measures to combat HIV/AIDS with public health goals.  Stressing the importance of mobilizing international resources for the fight against HIV/AIDS, he also emphasized the role of the Global Fund to combat HIV/AIDS, tuberculosis, malaria and other communicable diseases.  The Fund had approved an amount of some $50 million for Peru’s programme for the prevention of HIV and tuberculosis, of which some $23 million corresponded to the HIV/AIDS component.

    SICHAN SIV (United States) said AIDS continued to claim about 8,000 people a day.  In the hardest-hit regions, the disease tore apart families and communities with great consequences for social and economic development.  The United States was confronting the pandemic with unprecedented commitment.  President Bush’s emergency plan responded to the challenge with $15 billion over five years, the largest financial commitment any nation had ever made to a health initiative dedicated to a single disease.  The United States focused especially on 15 countries that accounted for one half of the total affected people.  It would provide programmes for treatment to 2 million people, prevent 7 million infections, and care for 10 million people affected by HIV/AIDS.

    He said prevention, care and treatment were the centrepiece of the plan.  Women and girls would be assured of access to programmes.  That was crucial, because the number of women and girls living with HIV/AIDS was growing dramatically.  While treating those with HIV/AIDS was crucial, so was prevention.  In that regard, the plan was based on what worked for the culture and circumstances of each place.  At the country level, the United States was coordinating activities with other donors to support national responses.  Approximately 12 million women were provided with knowledge and skills to make themselves safe.  Successful programmes must also work with men and boys to help them develop healthy relationships with women and support women in order to prevent the transmission of the disease to their newborns.

    The care part of the plan included clinical treatment, as well as care for orphans, he said.  The United States was also focusing on making counselling and testing fully accessible.  His country would continue to make comprehensive prevention and care services available to those who needed them and was contributing more than all other donors combined.  The Global Fund, to which the United States was the largest contributor, was a forum to come together to fight HIV/AIDS.  There was a need for increased financial commitments.  With countries working together, the fight against HIV/AIDS could be won, he said.

    JEAN-ROBERT MORET (Switzerland) said the Secretary-General had emphasized the vicious circle linking HIV/AIDS and development.  Indeed, HIV/AIDS was both a cause and consequence of poverty.  In the most affected countries, the pandemic was a heavy burden on education, social welfare, the economy, and peace and security, and on the availability of health care and gender equality.  There was a need to link the Plan of Action to combat HIV/AIDS with reproductive health issues.  Prevention was crucial.  The Millennium Development Goals would not be achieved if universal access to health services and reproductive health services was not guaranteed.

    It was crucial that AIDS programmes be broken down by sex, age and socio-economic factors, in particular those that exacerbated the vulnerabilities of women and adolescents.  Systematic attention should be given to the role of men and boys, in particular to behavioural change.  Only then could one deal with the root causes for women being infected with HIV/AIDS.  A too simplistic approach, such as abstinence, could only protect very few women.  There was, therefore, a need for an integrated approach based on health services and reproductive rights.

    ANA MARIA LIEVANO DE SOL (El Salvador) said that her Government reaffirmed its commitment to the goals of the ICPD, seeking to improve the quality of life of its population and ensure respect for all fundamental rights and freedoms in the country.  Its goals of ensuring access to health and education, reduction of poverty, generation of productive employment and achievement of sustainable development fully coincided with internationally agreed goals. The Cairo Programme of Action was closely linked to the Millennium Development Goals, particularly in the areas of maternal health, combating diseases such as HIV/AIDS, and reducing children’s mortality.

    In that connection, she believed it was important to emphasize the comprehensive nature of Cairo’s Declaration and Programme of Action and its contribution to the development goals.  For that reason, it was not necessary to emphasize just one of the components of the Cairo outcome.  Migration was another important area, which deserved international attention.  For that reason, she welcomed the main theme for the next session of the Commission.

    Mr. SAI (Ghana) said that his country had made major efforts to place its national development goals and targets within the context of the Millennium Goals and the ICPD Programme of Action.  The country had included 13 of the Goal indicators in its poverty reduction-strategy core list, and the Government was intensifying its nutrition, household food security and population management programmes.  While the desire to achieve universal access to primary education was high on the Government’s agenda, the gross primary enrolment ratio had remained constant at about 80 per cent, despite the reforms and increasing budgetary support.  The country’s gender equality and empowerment of women programmes were on course, but gender disparities were greater in the poverty-stricken areas.

    Measures were being taken to improve the health of its citizens, he continued.  Under-five mortality had declined from 155 to 105 per 1,000 live births between 1990 and 1998, only to increase to 111 in 2003.  He was very concerned about the high maternal mortality rate of 214 per 100,000 live births, which had been recorded in the northern parts of the country.  To address that situation, the Government was increasing supervised deliveries, expanding and improving the coverage for emergency obstetric care, and improving the nutritional status of women and access to antenatal and post-natal care.  The President supported a major effort to reposition family planning and sexual and reproductive health care as a priority in the country’s development agenda.

    The 3.6 per cent prevalence rate of HIV/AIDS was unacceptably high, he said.  Currently, the national framework was being revised to enhance the nation’s response to the disease and ensure a more holistic, multi-sectoral and multi-disciplinary approach.  An intensified preventive approach was to be combined with treatment for both adults and children.  Due attention was given to the fact that some 20 per cent of the country’s tuberculosis patients were estimated to be HIV positive.  Also, malaria continued to be a serious cause of morbidity.

    The Government had embarked on a programme of training district-level personnel on how to integrate population factors into development planning, he said.  In need of support to improve the quality of life of its people, the country had sought debt relief under the enhanced Heavily Indebted Poor Countries (HIPC) Debt Initiative in 2001.  He was happy to report that with full support of its development partners, Ghana’s economy had shown vast improvement in many of the fundamentals over the past couple of years.

    MOHAMED MIJAAD (Morocco) said his country had conducted population policies in harmony with recommendations adopted by the international United Nations conferences with the aim of improving the living conditions of its people and preparing the country for globalization.  Those policies concerned charters on education, a charter for small businesses and a family code.  Another important development was the emergence of civil society, in particular, in the areas of social and human development and combating poverty.

    Addressing population trends of his country, he said that, although child mortality had decreased, maternal mortality, which had also decreased, continued to be a subject of concern as it remained at a high level.  In the area of reproductive health, remarkable progress had been achieved.  Use of contraceptives had increased dramatically.  The AIDS prevalence indicator currently stood at less than 0.6 per cent, and the fight against HIV/AIDS was based on prevention and treatment.  The new charter for education was designed to strengthen basic education.  School enrolment stood now at 92 per cent, and 100 per cent would be achieved in the years to come.  The family code had shown remarkable progress in the protection of women and children.  Programmes had been adopted to combat poverty.

    JANE COTTINGHAM, Technical Officer for Gender and Reproductive Rights Department, World Health Organization (WHO), said the continued spread of the HIV/AIDS pandemic, and in particular the sheer numbers of people involved, represented the greatest public health challenge of today, requiring extensive sustained action by the international community in concert with regional, national and local governments and organizations for prevention, treatment, care and support.  The Millennium Development Goals could not be achieved without substantial attention to sexual and reproductive health.  Member States of the WHO, in May 2004, had adopted a global strategy for accelerating progress towards achieving the international goals and targets related to sexual and reproductive health.

    Providing fertility regulation; antenatal, delivery and postpartum care; post-abortion care; and sexually transmitted infection screening and treatment were key in the primary prevention of sexual transmission of HIV.   With appropriate training, health-care personnel could carry out voluntary HIV counselling and testing, offer condoms and give advice on safer sex.  Integrating sexual and reproductive health services into HIV care and treatment services would help people living with HIV achieve their sexual and reproductive health goals and help contain the spread of HIV.

    The WHO/UNAIDS “3 by 5” initiative had set the target of reaching 3 million people with anti-retroviral treatment by the end of 2005, she said.  The initiative had galvanized significant support for providing access to treatment, and many countries had significantly increased their own domestic financial commitments.  Equity in access to HIV treatment was a critical element of the initiative to ensure that people who were particularly susceptible to exclusion were reached.  Those included people living in poverty, sex workers and migrants, many of whom were young women.  Gender-based inequalities often affected women’s ability to access services, so that particular attention was required to ensure that women and girls had equitable access to anti-retroviral treatment.

    ADRIENNE GERMAIN, President of the International Women’s Health Coalition, said her non-governmental organization appreciated that the vast majority of speakers today had acknowledged the importance of universal access to reproductive health services.  She endorsed the call for including an additional target of ensuring universal access to reproductive health by 2015 in the Millennium Development Goals.  That, after all, had been agreed in Cairo and reaffirmed many times since then.

    HIV/AIDS was “increasingly female and increasingly young”, she continued.  The international community must move much faster to protect the human rights of women, including their sexual and reproductive rights.  The UNAIDS Executive Director had recently said that prevention methods, such as ABC approach, were good, but not enough, where gender inequality was pervasive.  Women should be able to make their own decisions, including those related to marriage, having sex and using contraceptives.  Among important issues, she mentioned the rights of women living with AIDS, women’s empowerment and poverty alleviation, access to health services, and HIV prevention.

    She added that prevention used to be understood as education and distribution of information about the disease, abstinence and condoms.  Those interventions, as essential as they were, were inadequate in preventing HIV/AIDS in women and girls.  It was important to reassess the policies in that regard.  Her organization suggested two primary shifts to make prevention for all a reality:  to include in every strategy, at all levels, priority investment in sexual and reproductive health services; and promote and support comprehensive sexuality education -- not just HIV/AIDS education.  The underlying causes of the pandemic also needed to be addressed.

    TIMOPTHEE GANDAHO, Executive Director of Partners in Population and Development, a South-South initiative, welcomed the report’s finding that the implementation of the ICPD Programme of Action would significantly contribute to the universally agreed development goals, including the Millennium Goals.  The same conclusion had been reached by the participants of the most recent meeting of the Partners’ Board in China last September.  Many countries’ experience demonstrated how provision of family planning and reproductive health services to all couples and individuals who needed them, reduction of maternal and child mortality, and universal access to education would help combat poverty and have a major positive impact on the quality of life.  In follow-up, his organization was organizing a policy dialogue on renewing the commitment of to the ICPD to achieve the Millennium Goals on 6 April.

    Special attention should be paid to the high fertility levels and extreme poverty in most least developed countries, he continued.  It was also important to promote respect for human rights and gender equality in formulating and implementing policies and programmes in implementation of the Action Programme.  Many participants in ICPD+10 events last year, including the Partners meeting in China, had also stressed the importance of reproductive health in promoting the Goals.  Mobilization of adequate resources would be crucial to achieving those goals in many developing countries.  The international community needed to make every possible effort to ensure that the goal of 0.7 per cent of gross national product for overall official development assistance was finally realized.  South-South cooperation in the areas of research, training, policy dialogue and information exchange would be crucial to promoting further implementation of the ICPD outcome and contribute to the achievement of the Millennium Development Goals by 2015.

    Introduction of Reports

    The Commission then turned its attention to agenda item 4, entitled “Contribution of the implementation of the Programme of Action of the ICPD, in all its aspects, to the achievement of the internationally agreed development goals, including those contained in the UN Millennium Declaration”.  Ms. ZLOTNIK, Director, Population Division of the Department of Economic and Social Affairs, made a short introductory statement.

    MARY BETH WEINBERGER, Chief, Population and Development Section of the Population Division, Department of Economic and Social Affairs, then introduced the Secretary-General’s report on the matter as contained in document E/CN.90/2005/6.  She said the general conclusion of the report was that full implementation of the ICPD Programme of Action and the key actions for its further implementation would contribute significantly to the achievement of the internationally agreed development goals.  Furthermore, the Programme’s goal of ensuring access to reproductive health care was closely linked to achievement of other goals regarding poverty reduction, gender, mortality and health, including HIV/AIDS.  Highlighting some of the report’s findings, she said the ICPD Programme of Action and the key actions for its further implementation offered guidance on ways of addressing the major development challenges of the present and future.

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