Denis Fitzgerald

The future global development agenda must include a standalone goal for gender equality, and United Nations member states, who will have the final say on the successor to the Millennium Development Goals, should not use culture or ideology as an excuse for failing to include sexual and reproductive rights of women and girls among the post-2015 goals. That is the advice of Dr. Nafis Sadik, the first woman to ever head a UN agency. She spoke with other experts during the Commission on the Status of Women, an annual UN conference that is convened this week and next to assess the conditions of women globally. Dr. Sadik, now a UN envoy on HIV/AIDS in Asia and the Pacific region, is a trained medical doctor who ran Pakistan's family planning council before leading the UN Population Fund. She has never minced words on the rights of women to gain access to sound reproductive health care, sexual education and contraceptives. When she led the Population Fund, Dr. Sadik persuaded 177 leaders, mostly men, who were attending the International Conference of Population and Development (ICPD) in Cairo in 1994, to agree on a groundbreaking rights program to empower women worldwide. She didn't hold back once again as a panelist at a March 11 event that addressed the "unfulfilled promise" toward gender equality and how to ensure its primary role in the post-2015 MDG agenda. The discussion was organized by the Danish and Uruguayan governments as well as the task force on the ICPD, which was established in 2012 to push for gender equality, particularly sexual and reproductive health rights, for women. Joining Dr. Sadik were Michel Sidibé, the executive director of UNAIDS; Crown Princess Mary of Denmark, a philanthropist; Beatriz Ramirez Abella, director of the National Institute for Women in Uruguay; and Amina Doherty, a Nigerian and board member of the Global Fund for Women. Lynne Featherstone, a member of Britain's Parliament, was the moderator, ensuring the debate followed a frank, lively format. Most of the Millennium Development Goals, which went into motion in 2000, came from the Cairo conference, Dr. Sadik said. "But the most important goal of the ICPD, sexual and reproductive health for all, was dropped," she added. "If we had included that on our agenda, I think we would have a different world today." The MDGs include a goal, No. 3, to empower women, but it solely targets parity in primary and secondary education, ignoring many other major rights. Dr. Sadik set the tone by asking tough questions as she spoke: "What is it that prevents policymakers from allowing women to make their own policy choices and their own decisions in this most important area of their life, and why should that decision be made somewhere else? Girls always seem to be left out of sexuality education, with the belief in many societies, maybe nearly all societies, that what girls don’t know won’t hurt them. "But in fact we know it's the opposite. What girls don't know frequently hurts and ends sometimes in death, and many other terrible things happen too to them," she said. The MDGs also aim to reduce maternal mortality, and though the number of women who die giving birth has almost halved since 1990, the baseline year, nearly 300,000 deaths occur annually, mostly in sub-Saharan Africa. "Maternal health has not improved to the extent that it could, and certainly maternal morbidity has not declined as much, and a large part due to the fact that adolescent sexuality is not being addressed," Dr. Sadik said. "Unsafe abortion and deaths from unsafe abortion has not moved at all. It still stands at 70,000 a year more or less." Crown Princess Mary of Denmark, the former Mary Donaldson of Australia, who married Crown Prince Frederick in 2004, said that her involvement with the maternal mortality issue began years ago, when she met a doctor from Chad who told her that in her country, "when a woman gets pregnant she has one foot in the grave." Princess Mary called it a tragedy that 800 women still die every day from pregnancy and childbirth, given the inexpensive, quick solutions that are available in many regions of the world. (Denmark is a top donor to the UN Population Fund.) "For 16 million adolescent girls in low- and middle-income countries, maternal mortality is also a leading cause of death," she said. "Many of these girls not only risk their lives, they are often robbed of their education, health and the chance to fulfill their full potential. And we also don't know how many become pregnant due to the silent epidemic of rape. Roughly one-third of girls report that their first sexual encounter was forced." Sidibé of UNAIDS and a Malian, said that the link between HIV and gender equality must also be featured in the next MDGs. "We cannot deal with HIV any more in isolation," he said, noting that in Botswana, almost 60 percent of maternal deaths are related to HIV and that in South Africa, 1 percent of male youths between 15 to 24 years old are living with HIV. But the comparable figure for female youths in the same age bracket is a whopping 16 percent. Dr. Sadik and the other panelists also noted that the world's 1.8 billion youths must be moved to the center of the post-2015 goals. Adolescent sexuality is getting short shrift, "and if we want to really eradicate these preventable deaths, women and girls need to be able to make choices and decisions for themselves," Dr. Sadik said. She said that an accountability mechanism must be part of the new goals to move political will in the right direction. "Any program that has achieved anything has a measure of accountability, and without that you really won't make progress." Governments need to make sure what they agree at the international level is actually what they will do at the national level because there's often a huge gap between the two, Dr. Sadik said. Her message for the 193 UN member states who will convene in September 2015 to sign off on the next set of development goals? Put people and their rights at the forefront of the agenda. "You need to get consensus at the maximum level and based on scientific evidence, not on ideology or some mythical belief of culture or values," she said. "There's nothing more important than human life, and that must be the central focus of all our discussions. We know what we need to do. We know what works. Without doing it we will fail. Ideology and false value systems should not stand in the way."

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Denis Fitzgerald

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