In the global annals of women’s rights defenders over the last half century, Nafis Sadik’s name will always rank high, though little may be known about her among the broad American public, focused as it usually is on Western feminists with Western issues. As head of the United Nations Population Fund in 1994, Sadik marshaled a disparate, fractious assembly of governments and nongovernmental organizations gathered in Cairo to adopt a revolutionary new international consensus on the rights of women, in particular control over their own bodies and personal lives.

Sadik, a Pakistani doctor and a Muslim, remains in the fight, notably in the developing world, where advances on women’s rights have met with official disdain or lethargy. Now 83, she flew to Kuala Lumpur at the end of May to speak at a Women Deliver conference, and some of her comments were blunt, even acid. She might have wondered, looking at the meeting’s final draft, why she bothered to make the trip. Old, now hollow, promises are still being trotted out almost two decades after Cairo was supposed to have ended the conversation on a high note.

Here’s the ho-hum closing communiqué of the Kuala Lumpur meeting about future challenges: “We must achieve universal access to sexual and reproductive health and rights for everyone — if women cannot plan their fertility, they cannot plan their lives.” Sadik has been saying that since the 1970s.

A backlash against women’s rights has taken so great a toll that advocates for women do not want a 2014 commemoration of Cairo at the UN, fearing more setbacks. In the years since Cairo’s International Conference on Population and Development, conservative Catholic and Protestant groups have organized to undermine the life-changing declarations that progressives thought had been irrevocably endorsed by a large majority of UN member nations. And little more than six years after Cairo, the George W. Bush administration declared war on the Population Fund and cut off American donations, drawing on the now-familiar concoctions of misinformation and downright fabrications about its role in abortions in China. A decade later, popular revolutions in Arab nations have opened the way for misogynist Islamist movements.

In a long conversation just before Sadik left her home in New York for the Women Deliver conference, she described the strategy of using guile, arm-twisting and steamroller tactics she devised to corral imams, priests and government leaders in Cairo in 1994. She also talked more expansively about the insidious pressures on women and antifeminist biases among UN member nations that often made her job as the first woman to head a large UN program a constant battle.

One of her ploys in Cairo, where the Vatican was actively seeking Islamic support in stemming women’s reproductive rights, was to invite female leaders from Muslim-majority countries. “I was going to have Tansu Ciller from Turkey, the prime minister, Khaleda Zia from Bangladesh and Benazir Bhutto,” she said. “I thought to have three Muslim women, heads of government, would be a powerful message. Then Zia backed out and Ciller backed out. With Benazir, I think I spent several hours on the phone talking to the [Pakistani] foreign secretary, to mullahs.” Bhutto, the prime minister, said she had been told, Don’t go. She went anyway “and brought every provincial-level health minister and the central government minister with her,” Sadik said. “They were all terrified.”

In Cairo, Sadik said, she had to negotiate behind the scenes to ensure that Fred Sai of Ghana, a towering figure in family planning and women’s rights in Africa — and a political foe of the Ghanaian president at the time, Jerry Rawlings — would represent the African region on the conference’s critical steering committee. “But on the first day, the Africans elected Senegal as committee rep for the region,” she said. “I said to them: You can’t select Senegal. We will select who we want.  Fred was so wonderful. He could stand up to the church, he could stand up to us.”

Sadik is the subject of a new biography, “Champion of Choice,“ by Cathleen Miller, an overlong, disjointed and somewhat breathless narrative that nonetheless tells the story of Sadik’s life in copious detail. Born in August 1929 in colonial north India, she and her family fled to the new nation of Pakistan after Partition in 1947. She obtained her medical education at Dow Medical College in Karachi, the City Hospital in Baltimore and Johns Hopkins, then began working as an obstetrician/gynecologist in Pakistan at a uniquely upbeat moment in the country’s history.

Absorbing firsthand the agonies suffered by many Pakistani women gave Sadik a lifelong commitment to reproductive health. In 1970, she was named director general of Pakistan’s national family planning council, where her headstrong advocacy for women in a region where their status was and still is low, drew the attention of the new UN Fund for Population Activities, now the Population Fund (known as UNFPA). She became the agency’s executive director in 1987, a position she held until 2000.

“I decided that if I have a pulpit I should just use it,” she told reporters at the time. “I don’t want to annoy governments, but I want to be quite direct and want to tell them what the situation in their own country is.” A data wonk, she said she always went into government meetings armed with statistics that could not be denied. In Nicaragua, where abortion is still banned after a deal was cut by Daniel Ortega, the president, with the conservative Catholic hierarchy to gain the church’s support in a national election, she recalls being given a warning kick under the table when she tried to raise the subject with a government minister.

“They were telling me that in our country the women don’t have abortions, don’t want them,” she said. “The reality was quite different. The data shows that they have the largest number of teenage mothers [in the region] and there’s quite a high incidence of unsafe abortion. I just rattled off all this. At the end of my presentation, all the women in the room clapped.”

The boys’ club atmosphere pervades the United Nations, she said. “Governments are men, and they control issues affecting women. In every conference since Cairo, health and rights have been an issue that’s always in brackets: Not agreed. I used to keep asking all these delegates, How come you always put women’s issues in these brackets? Oh, they said, because Western countries are very interested. So I said, And you are not interested in the lives and health of your women? Yes, yes, of course, they said, but it’s a good bargaining tool.”

Sadik’s exasperation at the slow pace of change for millions of the world’s women surfaced at the recent conference staged by Women Deliver, a global advocacy organization. While acknowledging the advances in women’s rights and reproductive health care in many places, Sadik added in a speech: “But in my travels and discussions, I still find policy makers and even national leaders who somehow regard these essential services for girls and women as a matter of charity, or social welfare. They apparently think of pregnancy and childbirth as part of the natural order of things, something that just happens. Presumably, in their minds, women’s death and disability ‘just happens,’ too, to the tune of 320,000 maternal deaths a year, and many times that number of infections and injuries.”

“These policy makers are reluctant to extend information and services to young people,” said Sadik, who was appointed  the UN secretary-general’s special envoy on HIV-AIDS in Asia at the end of her UNFPA term and held the position until last summer. “Of course, they have it exactly backwards — what girls don’t know hurts them every day,” she told delegates.

Millions of girls are forced into child marriages or become the brides of rapists to save the family honor. “In this world of denial, marriage is seen as a safe haven for young girls,” she said. “Wrong on all counts. . . . Every year, 70,000 adolescent girls die in pregnancy or childbirth, most of them in South Asia and sub-Saharan Africa. In these countries, maternal death is the most common cause of death for girls between 15 and 19 years old. Yet families still believe that girls are safer in marriage than in school — and their leaders allow the belief to persist.”

Sadik said that when policy makers and well-meaning outsiders say women in developing societies contend that they don’t want family planning, “I tell them go to a village, say you are a doctor, and talk to them. I bet you they will ask you, Do you know something that can help us prevent the next pregnancy that I can hide from my husband, that I don’t have to take every day? That’s their main preoccupation. All over India, all over Pakistan, all over African villages, I said, Go to villages and do the survey.”

“It’s all to do with control over women,” she said.

In her three decades at UNFPA, Sadik faced many attempts to silence her in and around the UN when she spoke with candor about sex education or contraception or the practice of female genital mutilation (FGM), which she campaigned against vigorously. In Cairo, she promoted a film made by a CNN crew about the brutality of genital cutting and its prevalence in Egypt, which her hosts had tried to deny. “The facts are facts,” she said.

On numerous occasions in the UN, she was accused of meddling in politics and being culturally insensitive. “They said I should be aware of sensitivities. The sensitivities of whom? What about the women who are dying? They said, You know what we mean, dwelling on FGM. Africans used to say to me: We are Africans and you are an Asian. Why are you doing this? I said, Well I’m working at the UN and I feel very strongly about it. They said, You should let us deal with it. And I said, So deal with it.” Much has since been done by African nongovernmental organizations and some governments to end the practice.

At the UN in the 1990s, Sadik was part of the largest group of women to head agencies in the organization’s history, among them Carol Bellamy at Unicef, Catherine Bertini at the World Food Program, Sadako Ogata as high commissioner for refugees, Mary Robinson as high commissioner for human rights and Gro Harlem Brundtland as director-general of the World Health Organization. The first UN deputy secretary-general was Louise Fréchette. But Sadik was the only woman among them from the developing world — and the only Muslim.

Little was known then and is still not known now about how enthusiastically Muslim-majority nations had embraced family planning and women’s reproductive rights. “Muslim countries were way ahead. There was a huge conference in Morocco on family planning and Islam in 1969, and it came to an agreement that abortion was allowed up to the end of three months,” she said. “Tunisia had such a good family planning program. Algeria was coming along. Iran was quite progressive.”

Egypt, which acted as host to the 1994 conference in the face of Islamic opposition, has been a particular disappointment, post-revolution. Combating the rise of Islamic attempts to impose restrictions on women or condone violence against them is complicated by the central role in promoting women’s rights that was played by Suzanne Mubarak, the wife of the deposed president, Hosni Mubarak.

“She did so many good things,” Sadik said. “The schools she established, the health centers, the rights of women, the commission on women, work on HIV-AIDS also. Whenever I get an opportunity, I always say [to Egyptians] whatever you might think of her, she has done a lot of very good things, and those should be retained. But now even the ones who helped her are turning against their own programs.”

Related articles

Women’s Right to Contraception: The Movement Grows

Ban Ki-moon Backs Emergency Steps for Women Raped in Conflict

Barbara Crossette

Barbara Crossette is the senior consulting editor and writer for PassBlue and the United Nations correspondent for The Nation. She is also a member of the Council on Foreign Relations. She has also contributed to the Oxford Handbook on the United Nations.

Previously, Crossette was the UN bureau chief for The New York Times from 1994 to 2001 and previously its chief correspondent in Southeast Asia and South Asia. She is the author of “So Close to Heaven: The Vanishing Buddhist Kingdoms of the Himalayas,” “The Great Hill Stations of Asia” and a Foreign Policy Association study, “India Changes Course,” in the Foreign Policy Association’s “Great Decisions 2015.”

Crossette won the George Polk award for her coverage in India of the assassination of Rajiv Gandhi in 1991 and the 2010 Shorenstein Prize for her writing on Asia.