For Natalia Kanem, the executive director of the United Nations Population Fund since 2017, the last couple of years have been a wild ride.

In 2020, women the world over were getting ready to celebrate important anniversaries: 25 years since an international conference in Beijing pledged global action on women’s rights, including their reproductive choices; 20 years since the adoption of Security Council Resolution 1325 on women’s participation in security, peace and conflict; and a decade since the creation of UN Women.

UNFPA, as the fund is known by its founding initials, was a part of most landmark efforts. Then a pandemic of epic proportions disrupted the celebratory year, leaving anniversary events postponed or virtual. Out in the real world, the virus was taking a terrible toll.

“Covid-19 has been catastrophic for the health, rights, and safety of women and girls, setting back much of the progress made over the past 25 years,” Kanem said in an email interview with PassBlue. “The pandemic caused many overstretched health systems to scale back sexual and reproductive health services, which are often not deemed essential even though they can be life-saving and are a human right.

“UNFPA estimates that nearly 12 million women globally lost access to family planning services, leading to as many as 1.4 million unintended pregnancies,” Kanem said, drawing on data as of July 2021. “We also project that there will be 13 million child marriages and 2 million cases of female genital mutilation that could have been averted over the next decade due to disruptions to our programs.”

One positive note: under President Joe Biden, the United States has resumed $32.5 million in core contributions to UNFPA — which had been eliminated by the Trump administration — and proposes to raise that to $70 million in 2022. Donations to special appeals will increase that amount.

A Panamanian of African descent, Kanem, 66,  is the first Latin American to lead the Population Fund. In response to questions from PassBlue, she described how her background prepared her for these many recent months of improvisation. She is an all-rounder in her field, with degrees in history and science from Harvard; a doctor of medicine from Columbia University; certification in tropical medicine from Walter Reed Army Institute of Research; and a master of public health in epidemiology from the University of Washington.

This interview is the third of PassBlue’s new series, Women as Changemakers, focusing on individuals who are influencing global matters in profound ways. — BARBARA CROSSETTE

PassBlue: For years, the Population Fund was described as the world’s most extensive family planning organization. In recent decades that perception has changed, with more emphasis on the rights of women and gender rights and as an agency that places women at the center of development. What are the diverse needs and interests that UNFPA addresses now?

Natalia Kanem: UNFPA at its core is about helping people everywhere in the world reach their potential. Making voluntary family planning universally available is key to that vision, as is stopping child marriage, ending female genital mutilation in our lifetime, and ensuring women and girls can live free from harm.

When UNFPA was founded in 1969, there was a global panic about “overpopulation.” Unfortunately, that gave rise in some places to restrictive policies aimed at population control, including through forced sterilization or coercive family planning. From the very beginning, UNFPA stood out in understanding that the solution to sustainability lay in upholding the rights of women and couples to decide freely if, when and how many children to have. And at the International Conference on Population and Development in Cairo in 1994, the world resoundingly agreed. The groundbreaking Cairo consensus, adopted by 179 governments, heralded a shift in focus from human numbers to human rights. The focus went from “population” . . . to “people.” It is a vision that guides our work to this day, even as we adapt to meet evolving needs.

It underpins our current efforts to achieve “three zeros” by 2030: zero unmet need for family planning, zero preventable maternal deaths, and zero gender-based violence and harmful practices, including child marriage and female genital mutilation. To get to zero, we need to identify and reach those most in need. Quality population data and evidence help us do this, and UNFPA continues to innovate in the area of data collection and analysis through our work with national statistical offices.

It is the lack of bodily autonomy that underlies gender inequality. The reality is that women around the world are denied the fundamental right to make decisions over their bodies and futures. They are controlled by men, and this must change. Achieving the three zeros has countless positive knock-on effects that contribute to wider human and economic development. Countries flourish when all women are empowered to make their own informed decisions about their bodies and lives and have access to services to support their choices.

One point you and others often make is that men and boys are an integral part of advancing the lives of women. But recent reports emerging during the Covid pandemic show rising domestic violence and the trafficking of girls. UN Secretary-General António Guterres said in a speech in 2020 that “persistent patriarchy” (which he called “stupid”) was to blame. “Just as slavery and colonialism were a stain on previous centuries, women’s inequality should shame us all in the twenty-first,” he said. “There is a strong and relentless pushback against women’s rights.”  Do you agree?

Kanem: There is no doubt that patriarchy is entrenched in many societies. To tackle it, we must engage men and boys and make them part of the solution. Many of UNFPA’s programs aim to foster behavior change at the community level, from our “husband” schools across Africa’s Sahel region, which help increase men’s understanding of women and girls’ health needs and rights, to the life skills education we offer to young boys — and girls — around the world, teaching them about positive gender relations and how to dismantle toxic masculinity.

Even before the pandemic, gender-based violence was a problem of epidemic proportions, with one in three women worldwide experiencing physical or sexual abuse in her lifetime. This is a statistic that we need to change. Since the time of Methuselah, women have been victimized in their homes. Women want that to change, men want that to change, young people are leading this change. This is going to be hard to do, but UNFPA is willing to lead to make it happen. We are fortunate at the UN to be led by a true feminist, Secretary-General Guterres.

As we saw at the [UNFPA] Nairobi Summit in 2019, which galvanized concrete voluntary commitments in support of sexual and reproductive health and gender equality, and more recently at the Generation Equality Forum, the push forward by the global community is stronger than the pushback. We are seeing wonderful solidarity and mobilization across society — women and young people marching in the streets, making their voices heard, demanding their rights. We are also seeing more men and boys joining the movement and speaking out against gender-based violence and systemic gender inequality.

Let us also not forget that racism and discrimination have long been part of that equation. UNFPA is proudly partnering with the Office of the United Nations High Commissioner for Human Rights on the International Decade of People of African Descent (2015-2024) under its theme of recognition, justice and development.

Tell us about your life from childhood in Panama and later in the US and how it all led you to the top of one of the UN’s most important agencies?

Kanem: Looking back on my life, I can trace many of my professional passions and interests to my childhood and upbringing. I was born in Panama and lived in a diverse suburb of Panama City. As an Afro-Panamanian, I grew up proud of the diversity of Latin America. My father was the first dentist of African descent to qualify for practice in Panama, and he devoted much of his time to helping families who could not afford dental care. That instinct to care for those less fortunate than myself was imprinted upon me at an early age. My mother was — and still is — a very strong role model. She raised her four children as a single parent after her husband died, and got her college degree in her 50s. She recently celebrated her 100th birthday. I was seven when my father died, and I moved to the USA to live with my aunt and uncle in Middletown, New York, where I had a wonderful public school education.

My quest to be a doctor shaped what I studied. I first became interested in women’s reproductive health when I was an undergraduate at Harvard. As a student, I attended the first UN World Conference on Women in Mexico City in 1975. At Columbia University, my first mentors, the great O.O. Ransome Kuti and Allan Rosenfield, piqued my interest in tropical medicine, public health, and the fate of the African child.

All of these influences drove my work, first in medicine as a pediatrician and HIV researcher, then in philanthropy for 20 years. During that time, I attended historic UN conferences, including the ICPD in Cairo in 1994, the Beijing Women’s Conference in 1995, and the Durban World Conference against Racism in 2001. All of these meetings showed me the powerful influence of the United Nations. I joined UNFPA, initially as head of the Tanzania Country Office, then served as deputy executive director for programs, and now as Executive Director. It has been a very rewarding journey.

Because UNFPA has a strong global footprint, you as its executive director must travel widely and often. How useful are these trips and the impressions they make on you regarding your planning or even rethinking the fund’s priorities?

Kanem: The minute I was vaccinated, I prioritized going on mission to humanitarian settings. Like so many others, I was grounded in 2020 due to the coronavirus pandemic. I missed not being able to see firsthand the impact of UNFPA’s work on the ground and speak to the communities we serve. I am proud of the way UNFPA staff around the world adapted so quickly and rose to the challenge. They continue to show up for the women and girls we serve in the more than 150 locations where we operate.

My first missions post-“lockdown” were to Sudan, Yemen, Tanzania, and the Democratic Republic of the Congo, via Ethiopia. These visits were part of my strong commitment to support women and girls in my role as the Inter-Agency Standing Committee’s champion on protection from sexual exploitation and abuse.

My experience in Yemen will stay with me forever. I’ve been in many maternity wards, and they are usually places of joy. But in Yemen, I witnessed the devastation of malnutrition and hunger, with newborn babies on feeding tubes and mothers weakened by fear and exhaustion. It was heartbreaking to see fellow members of the human family in such dire conditions.

UNFPA is a longstanding partner in Yemen, where we provide essential, lifesaving medicines and services to support women’s health, ensure safe deliveries, and prevent and respond to gender-based violence. That unrivalled field presence is part of what makes UNFPA unique. Our heart lies in the field, in maternity wards, in women’s safe spaces and on boats, motorbikes and in the backpacks of our roving service providers who take our lifesaving supplies to those who need them most.

In the Democratic Republic of the Congo in May, I listened as woman after woman recounted stories of the horrible, heavy price they pay with their rights, their bodies and their lives. These women are not passive victims. They were emboldened to call for change and a greater voice in decision-making related to their safety and protection. They wrote their recommendations on the spot as we sat outdoors in a circle. I immediately shared their demands for action with the network of colleagues devoted to protection from sexual exploitation and abuse. Feedback mechanisms are essential to protect women’s rights and deliver justice.

I conferred with changemakers such as Nobel laureate Dr. Denis Mukwege, a key ally in global efforts to protect and defend women, whose Panzi Hospital in Congo provides survivors of sexual and gender-based violence medical and psychological treatment, job skills and other support. I was also fortunate to be the first UN official to greet the first woman to be president of Tanzania, Her Excellency Samia Suluhu Hassan.

These missions allow me to learn from inspirational colleagues, listen to the needs of communities, and see the impact and challenges of UNFPA’s work. It is my duty to apply the knowledge that I have gained and to share these stories with the world and with you.

Under your leadership, the 2021 State of the World Population report takes on some controversial topics such as “sex work” and surrogate motherhood, free of accusations or moral judgments. Have there been any negative reactions from activists or governments to this bold move to advance dialogue?

Kanem: I have a strong belief that we must open the dialogue on reproductive rights and choices. Bodily autonomy is neither anti-conservative nor anti-liberal. It is also, by the way, fully coherent with religious guidance and feminist values. Bodily autonomy is a universal value; it is not just about the body, but also about the whole self, the whole person, and it is about individual empowerment. There were a few objections, but those tended to misinterpret or misread the report. One, for example, claimed it promoted immoral sexual practices, but those objectors were bringing their own assumptions to the term “bodily autonomy.”

More women are being elected to higher political positions globally, many of them young with new ideas. Do you see better days ahead?

Kanem: Absolutely. Because I have faith in young people to transform the situation that we have handed to them. I have repeatedly declared my trust in young people, including young women, who have succeeded in galvanizing action during the pandemic. We see women leading at all levels today, from heads of state to CEOs to our youth advocates on the ground. Throughout the pandemic, I have been constantly inspired by women sustaining health systems as the majority of front-line workers, while often juggling extra care-giving responsibilities at home. Despite evidence that shows that women’s leadership changes the world for the better — even peace is more durable when women are involved in conflict resolution — no country has yet attained complete gender parity in leadership. But I believe that we will get there, by dismantling the obstacles that still block women’s paths.