MDGs and reproductive health: “the final push”
The transnational reproductive health lobby claims that MDG 5 and target 5b “show the least progress” and are the less likely of the MDGs to be achieved by 2015: the wealth differential in reproductive health is allegedly the largest among MDGs, according to UNFPA. It belongs to the strategy of the lobby to forever lament about the slowness of “progress” made towards the realization of its goals and about the lack of political will to implement the Cairo platform for action and MDG 5. In fact, reproductive health has been, since Cairo, one of the highest items on the UN political agenda, with priority funding as a result.
Sexual and reproductive health activists are determined to take advantage of the High Level Meeting of the Plenary Assembly next September in New-York to push for “urgent” implementation of MDG 5.
Let us take a look at some of the arguments they use to justify the pressure they put on the international development community:
1.- They take the moral high ground, posit themselves on the side of moral responsibility, transparency and accountability: “Maternal death is one of the greatest moral challenges of our times and is the world’s largest health inequity” (1). As the rationale goes, reproductive health must therefore be prioritized, and those who do not support MDG 5 are criminal.
2.- They instigate a sense of urgency: 2015 is “the deadline”. There is no time to waste. We must hurry up, mobilize ourselves and give the agenda a “final push”.
3.- They argue that implementing MDG 5 and the Cairo platform for action is smart economics, “especially during the financial crisis” (1). Family planning would be one of the most cost-effective development investments: “If we ensure access to modern contraception, we can prevent up to 40 % of maternal deaths”, and “if we invest in adolescent health, education and livelihoods, we will accelerate progress” (1). Let us remember that this argument has been used ever since the 1970s. Contraception is presented as “one of the most trusted, most cost effective and proven poverty reduction interventions” (4). They view family planning “as an investment, not an expenditure” (1).
4.- They have a multistakeholder approach: they call on presidents and ministers, parliamentarians, development partners and donors, civil society, young people and the private sector: every actor would have a stake in reproductive health.
5.- They insist on the interdependence of MDGs and on the critical importance of reproductive health to reach all MDGs. They consider reproductive health to be “the ultimate linkage amongst the MDGs” (2). MDG 5 would be the “mother of all MDGs” (1). Reproductive health would be a “pillar for supporting the health of communities” (3), a “key indicator that mirrors the level of development in society” (3).
6.- They create linkages to emerging global concerns, such as climate change, the food crisis and the economic crisis.
What is the content of the pressure they exercise on all stakeholders - what do they want to obtain? Let us mention a few of their claims:
1.- They want presidents and ministers to “ensure that by the end of 2010, national and district health plans prioritize sexual and reproductive health”, “allocate resources to implement health and education plans and policies and institute gender budgeting”, “integrate MDG5 target 5b into national development plans and budgets”, “ensure that health systems create demand to provide effective… safe abortion”, “provide comprehensive sexual and reproductive health, education, information, services and supplies, including female and male condoms as well as emergency contraception, with the full involvement of young people”, “address as a matter of urgency the high number of deaths from unsafe abortion and ensure access to safe abortion” (1).
2.- They want parliamentarians to use their position to “break the silence” and “mobilize constituents to promote gender equality and the right to sexual and reproductive health”, “increase budget allocations for reproductive health services and supplies”, “organize discussions with young people to help shape reproductive health and rights policies and laws that address young people’s needs, and remove restrictive laws”, “promote and strengthen partnerships with other parliamentarians, donors, NGOs and the private sector to leverage human and financial resources to achieve the MDGs” (1).
3.- They want development partners and donors to “provide predictable, long-term additional resources from now to 2015 to achieve MDG 5”, “place MDG 5 at the centre of global health initiatives and funding mechanisms”, make use of target 5B “to mainstream reproductive health into all development and poverty reduction plans” (1).
4.- They want “civil society” to “share best practices … to create a strong policy community to galvanize political resolve and counter opposition to advance the ICPD agenda and achieve MDG 5”, “identify strategic partners outside of traditional advocates to build political commitment and alliances”, “create an evidence-informed campaign to highlight MDG 5 as the mother of all MDGs”, “gather and use evidence-based information to develop adolescent and youth programs to reflect the diversity of young people’s needs according to their age, sex, education, living arrangements and marital status” (1).
5.- They want young people to “expand countrywide youth networks to ensure participation and representation, especially the marginalized, in policy dialogues to advance … sexual and reproductive health”, to “speak out against the lack of access to youth-friendly sexual and reproductive health information and services”, to “ensure your peers are aware of their right to sexual and reproductive health” (1).
6.- They want the “private sector” to “partner with governments and civil society to strengthen health systems for sexual and reproductive health, as a corporate social responsibility and win-win strategy” and to use their stature to “promote the health and rights of women and girls as a vital investment to improve economic growth, equity and stability” (1).
© Marguerite A. Peeters 2010 – Permission needed for any public or semi-public use of this module.
Sources:
1. Addis Call to Urgent Action for Maternal Health. October 26, 2009.
2. UNFPA powerpoint presentation. ICPD at 15. The Final Push: Accelerating Implementation of the Cairo Consensus on Population and Development.
3. WHO Briefing note. Achieving MDG 5: target 5A and 5B on reducing maternal mortality and achieving universal access to reproductive health.
4. IPPF. Contraception at a crossroads. December 2008.