ICPD AT 15 The Final Push: Accelerating Implementation of the Cairo Consensus on Population and Development 10 March 2009 Bern, Switzerland Leyla Alyanak UNFPA GENEVA

A bit of history  1994ICPD  1999 ICPD + 5: Governments reaffirm support  2000 Millennium Summit Declaration and MDGs  2004 ICPD + 10  2005 World Summit  2007New MDG framework and new RH target 5B  2009 ICPD + 15

 Broad view of population  Human rights approach  “Reproductive health and rights”  Life cycle approach  Development dimension  Objective rights  Integrated into MDGs  New issues  Principle of equity, especially for vulnerable groups  Multisectoral involvement: CS/PS/Govts  Recognition of longer timescales (demographic processes take time)  Governments could at last measure progress ICPD: a unique event

ICPD: the new target Target 5A: reduce by three-quarters, between 1990 and 2015, the maternal mortality rate Target 5B: achieve, by 2015, universal access to reproductive health Indicators for monitoring progress: 5.3 Contraceptive prevalence rate 5.4 Adolescent birth rate 5.5 Ante-natal care coverage 5.6 Unmet need for FP

ICPD and the MDGs 1.Social determinants 2.Equity 3.Human rights 4.Interrelationships 5.Demographic issues A few examples…

MDG 5 Improving Maternal Health No woman should die giving life  maternal deaths per year  Little progress  Disparity: among countries, within countries  Youth at risk: 5 times higher for girls under 15 Yet we know what works:  Family planning saves lives  Skilled attendance at birth  Emergency obstetrical care

Maternal mortality continues

Africa: government policies on contraceptive access

MDG 6 Reversing HIV/AIDS Universal access to RH is critical in fighting HIV/AIDS  Prevention is key to reversing the epidemic and huge progress in treatment  Epidemic is increasingly young, increasingly female  Half new transmission in young under 25

HIV prevalence among year-olds % HIV prevalence Swaziland South Africa Zimbabwe Central African Republic Côte d'Ivoire Sierra Leone Rwanda Haiti Guinea Ethiopia Benin DR Congo Niger Senegal Cambodia India Uganda Chad Dominican Republic Mali Female Male Source: 2008 Global report on the AIDS epidemic, UNAIDS

MDG 4 Reducing child deaths What kills mothers kills babies  10 million children die before the age of 5 4 million die in the first 28 days. 3 million stillbirths. Linked EmOC  Up to a third of child deaths preventable by spacing min 2 years Yet 50% of children less than 2 years spacing  Adolescent mothers 30% more likely to have infant die Yet, up to 30% married by age 15, 60% by age 18  Children of mothers who die 3-10 higher risk of dying by age 2

ICPD at 15 anniversary: Key objectives 1.Raise visibility of ICPD-MDG linkages 2.Promote the use of the new target 3.Expanded action and increased funding 4.More effective implementation of PoA 5.Promote better monitoring 6.Advance knowledge on emerging issues

ICPD at 15: The challenges  MDG 5 shows the least progress – wealth differential in RH largest among MDGs  Full integration of RH into national health plans  Integration of 5B into policy and country-level monitoring  How to link with 5A: consolidation of gains  Reinforce linkages to emerging global concerns

ICPD at 15: The challenges  Not enough attention to FP  Active opposition  Women’s movements  Attention to equity  Demographic issues  Reinforce participatory development and increased accountability

 Commission on Population and Development (on the contribution of the ICPD PoA to the internationally agreed development goals, including the MDGs) – 30 March- 3 April 2009, New York  International Parliamentarians’ Conference on the Implementation of the ICPD – “15 th Anniversary of the PoA” – October 2009, Cairo  Commemoration during the 64 th session of the United Nations General Assembly, Fall 2009, New York Key Global Events 1

Key Global Events 2  An ICPD at 15 Global NGO Forum for NGOs to assess progress, identify opportunities and constraints and devise strategies for more effective support for ICPD implementation – September, Berlin  The XXVI Conference of the International Union for the Scientific Study on Population: ICPD at 15 panel and side events - 27 September- 2 October 2009, Marrakech  Possibly some additional side events, for example during the CPD, the Executive Board Session in September, etc.

Key Global Events 3 Technical Meetings Under Consideration  Family Planning – the way forward  HIV prevention  Increasing the impact of education in shaping adolescent’s health, social and economic assets  “Emerging” issues and the ICPD: climate change and food crisis

Other important events in 2009  World Health Assembly review of progress on health-related MDGs (for the 1st time to include UARH target)  ECOSOC Thematic Session of the Annual Ministerial Review on Implementing the internationally agreed goals and commitments in regard to global public health  Other MDG related events

ICPD at 15 Regional Processes  ECA: Regional survey; Ministerial meeting under discussion  ESCAP: Expert Group Meeting early 2009, possibly a high level meeting in fall 2009  ECLAC: Regional survey; Regional meeting under discussion  ECE: a work in progress  ESCWA: Expert meeting and high level meeting – in collaboration with LAS  EECA: Conference on Population and Development More details will soon be available

Summing it up  SRH is the ultimate linkage amongst the MDGs.

The MDGs and ICPD SRH is of essential importance in reaching all MDGs, especially for women, and in particular young women

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