A respected medical journal and a leading American population research and policy organization have teamed up to create a commission to fill gaps and turn vague promises in the United Nations Sustainable Development Goals into real gains for women’s sexual and reproductive health and rights. The initiative, sponsored by the London-based journal The Lancet and the Guttmacher Institute in New York, has assembled 14 international experts “to turn vision into reality,” the announcement of the formation of the commission said in early January.
The new independent panel formation comes as an official expert group working under the UN Statistical Commission is defining indicators to measure progress in the new universal development policy, framed by 17 goals and 169 targets. These indicators are scheduled to be ready in March. Some vital signs, however, seem likely to go missing.
The new global goals do not, for example, endorse the rights of women to make decisions about their reproductive health, including the number of pregnancies they feel they can handle. The goals dwell only on the provision of and access to reproductive services, not the right to use them. There are numerous documented accounts of women being beaten or killed for seeking to use contraceptives. (As a reporter I heard such stories firsthand in countries as different as Liberia and India.)
The goals, born of numerous compromises in negotiations among many countries, also did not mention safe and legal abortion as a lifesaving tool, and deliberately did not address the rights and needs of LGBT people. The announcement about the new Guttmacher-Lancet Commission said that it “recognizes that the U.N. Sustainable Development Goals (SDGs) include, but do not address the full scope of, SRHR.” [Sexual and Reproductive Health and Rights]
The commission’s mandate is broad, encompassing areas such as family planning and contraception, maternal and newborn health and sexually transmitted infections. But the expert panel will also go beyond these into the tough subjects of abortion services and nondiscrimination based on sexual orientation or gender identity.
Over the next 15 years — the life of the SDGs — these issues cannot be totally ignored, however controversial. “Abortion is a sensitive and contentious issue with religious, moral, cultural and political dimensions,” the independent Population Reference Bureau said in a 2011 report, “Abortion Facts and Figures.”
The World Health Organization considers unsafe abortion a global public health threat that often goes underreported because governments do not have reliable statistics — or deny and repress them. Since abortions are illegal in many places, they are often not recorded.
In the United States, for example, efforts to end medically safe and guaranteed legal abortion through court challenges or attacks on clinics and doctors who carry out the procedure have soared in recent years under political pressure from conservative Catholics and the Evangelical Protestant right. But it is in the developing world where most unsafe abortions happen.
The “Facts and Figures” report suggested that 47,000 girls and women were dying annually from unsafe abortions. Unsafe or botched abortions, along with other factors, help explain the persistence of high maternal death rates among both women and teenage girls. “This represents about 13 percent of all pregnancy-related deaths,” the report said. “Almost all unsafe abortions take place in developing countries, and this is where 98 percent of abortion-related deaths occur.”
In August 2015, the Guttmacher Institute called attention to a newer, specialist medical survey published in BJOG: An International Journal of Obstetrics and Gynecology, which found that in 2012 an estimated 6.9 million women in developing countries had been treated for complications from unsafe abortions. Based on available data in 26 countries, it was estimated that 7 of every 1,000 women and girls between 15 and 44 years old in developing regions had suffered from unsafe abortions.
“Because many women who experience complications do not receive medical care for them, the actual number of women injured by unsafe procedures is likely far greater,” Guttmacher report said.
Promoting the rights of women, many UN officials and independent development experts repeatedly say, is crucial to the development of communities and nations as well as to the success of the SDGs. Girls and women with no control over their personal lives, who are married off without their consent and denied education will add little to economic growth. The price a country pays for such denial of rights is a potential loss of skills and involvement in development of half of its population.
The Guttmacher-Lancet Commission will be led by two co-chairs, Ann Starrs, president of the Guttmacher Institute, and Dr. Alex Ezeh, executive director of the African Population Health Research Center in Nairobi.
The 14 commissioners are Dr. Gary Barker, international director and founder of Promundo, a gender-justice organization that advocates the involvement of men and boys as partners with women in preventing violence; Dr. Robert Blum, William H. Gates professor and chairman of the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health; Dr. Willard Cates, president emeritus of FHI 360, a nongovernment organization that promotes locally driven development; Anand Grover, director of the HIV/AIDS unit at the Lawyers Collective of India and adjunct professor at Georgetown University Law Center; Dr. Ilona Kickbusch, director of the global health program and adjunct professor at the Graduate Institute of International and Development Studies in Geneva; Dr. Laura Laski, chief of the sexual and reproductive health branch in the United Nations Population Fund’s technical division; Mónica Roa, vice president of strategy at Women’s Link Worldwide; Dr. Zeba Sathar, director of the Population Council of Pakistan; Dr. Lale Say, coordinator of the adolescents and at-risk populations team at the World Health Organization; Dr. Awa Marie Coll Seck, Senegal’s minister of health; Dr. Gamal Serour, director of the International Islamic Center for Population Studies and Research (IICPSR) at Al Azhar University, Cairo; Dr. Susheela Singh, vice president for Research at the Guttmacher Institute; Karin Stenberg, health economist for the World Health Organization; and Dr. Marleen Temmerman, director of the Women’s Health and Research Network in East Africa at the Aga Khan University in Nairobi.
In announcing the new commission, Starrs said: “The level and range of expertise of the commissioners will ensure that the work of the Guttmacher-Lancet Commission will be of the highest caliber. It will provide a roadmap for truly addressing essential sexual and reproductive health and rights issues that are fundamental to achieving overall developmental goals.”
A final commission report is expected in 2017; findings will be analyzed continuously over the next few years.