Population and Development: Responses to the Challenges of the 21st Century

Paris

Ministre Pierre-Andre Wiltzer, Ministre delegue a la Cooperation et a la Francophonie,

Madam Henriette Martinez, Presidente, Groupe d’Etudes Parlementaire Population et Development,

Madam Marie-Claude Tesson-Millet, Presidente, Equilibres et Populations

Ladies and gentlemen,

Good morning. It is a great pleasure to participate with you at this important and timely International Colloquium. It is especially gratifying to join you during the 10th anniversary year of the historic International Conference on Population and Development (ICPD). As you know, the 1994 Cairo Conference was a watershed event, and a great success.

It is also the 10th anniversary of our partner, Equilibres et Populations and we at UNFPA wish its leadership and staff success in the years to come.

The Cairo Conference was both visionary and comprehensive. It built on the commitment of governments to population-related policies and family planning programmes. It linked population issues with sustained economic growth and sustainable development. And it recognized that population trends and dynamics must be fully integrated into development planning and policy-making.

The Cairo Conference also focused on migration as an important part of economic transformation. It encouraged more cooperation and dialogue among countries of origin and countries of destination, both in terms of policies and in terms of human rights. And it focused on the right of migrant families and women, in particular, to reproductive health services.

While individual rights were emphasized, the Cairo agreement also stressed the family. It recognized that various forms of the family exist in different social, cultural, legal and political systems. And it reaffirmed that the family is the basic unit of society and, as such, is entitled to receive comprehensive protection and support.

Most importantly, the Cairo Conference placed the focus where it should be: on improving human lives. It put women where they should be: at the centre of efforts to reduce poverty and spur progress. And, it stated loud and clear that sexual and reproductive health is a basic human right.

My friends, we have come a long way in these past 10 years, and we have done it together. It is a pleasure for UNFPA to be partners with you, Equilibres et Populations. The work you do to advocate more efficient use of development aid is important, and very useful. Your focus on health and education is appreciated by UNFPA, and by countless others who believe in social investment and social justice. I thank you for always being a good partner and for ensuring that UNFPA is present at such a forum as today’s.

Friends, ladies and gentlemen,

Here in Paris, and around the world, we look to the scales of justice, hanging in balance, as a symbol of harmony. This is the very harmony that the Cairo Conference sought to establish. The Programme of Action is designed to create greater balance between population and a nation’s resources. It is designed to tip the scales in favour of people and the environment, and in favour of human rights, including the rights of women.

I will argue that it is only by addressing the issues of population, women’s rights and women’s health, that we will be able to achieve international development goals, specifically the Millennium Development Goals. It is only by addressing population issues, that we will achieve greater balance in our world and close some of the dangerous gaps that threaten us.

This is my first message for our collective work during the next 10 years of ICPD—to 2015. And I have five more messages to deliver.

If we look around, we see a world out of balance. Twenty per cent of the people in wealthy countries consume 80 per cent of the world’s resources. At the same time, over one billion people in poor countries live in poverty on less than $1 a day. Here in France and other wealthy countries, maternal death is extremely rare. Yet, in the developing world, complications of pregnancy and childbirth remain a leading cause of death for women, claiming one woman’s life every minute.

While wealth has increased tremendously during the past quarter century, the amount of money devoted to international development assistance has declined. The percentage of gross domestic product devoted to development assistance has dropped by half over the last 30 years, from 0.5 per cent to 0.23 per cent. And an alarmingly high level of money is being spent on military assistance and defence. In fact, the amount spent on development—to reduce poverty and improve human well-being—equals about 3 per cent of the amount that is devoted to global military spending.

I think we can all agree that this equation does not bode well for global peace and security. We need to tip the scales in favour of hope. We need to balance the scales in favour of social justice and development because we cannot have peace unless we eradicate poverty.

And to do that, we must invest in population, women and reproductive health, including international family planning, in order to provide greater input into poverty reduction. And that is my second message for the next 10 years.

Population Effect on Poverty

We now have solid evidence, based on new research, that work towards population goals helps reduce poverty in several ways.

At the national level, slower population growth encourages overall economic growth. Research shows that from 1960 to 1995, about a fifth of economic growth is attributable to reductions in mortality and about a fifth to reductions in fertility. This demographic shift, from large to smaller families and from high to low death rates, is happening in all countries to varying degrees, and it is partly the result of greater investments in education and health, including family planning.

Benefits of Family Planning

Today, women in large numbers in all parts of the world are choosing to have smaller families. This increases women’s social and economic opportunities, and it enables parents to invest more in each child, resulting in healthier, better-educated children and more prosperous families.

Because women are making their own choices and choosing to have fewer children, population growth is slowing. Today, 77 million people are being added to our planet every year, compared to 81 million a decade ago.

Family planning also has another benefit—it saves lives. Over the years, it has saved the lives of millions of mothers, babies and children. This is because having babies too close together, or too early or late in life, poses serious health risks. A woman’s ability to plan and space her births gives her a better chance of surviving pregnancy and having a healthy baby.

A recent study in Africa shows that family planning could reduce maternal deaths by 20 per cent, and spacing births by three years or more could reduce infant deaths by half.

Overall, the story of population is a success and it will continue to be a success if we stay focused and committed to population and reproductive health and if we provide the necessary institutional support and financial resources for these programmes.

We can take heart in the fact that all over the world, the Cairo agenda is guiding policy-making and legislation to secure better health, respect for human rights, and gender equality.

Last year, UNFPA conducted a field survey to determine progress in implementing the Cairo Programme of Action. Of the 187 countries we contacted, 92 per cent responded. This high percentage of response is by itself a sign of change and of progress. It is a sign that countries are taking the issues of population and reproductive health seriously and that they are taking the request from UNFPA as responsibly as possible.

We are in the process of finalizing the analysis of the survey. It shows that much progress is being made and that countries in all regions are incorporating the Cairo recommendations into their national plans, laws and policies. 

• About 96 per cent of countries that responded report action to integrate population concerns into development strategies.
• Close to 87 per cent of countries have taken actions to integrate family planning, safe motherhood, HIV/AIDS and other sexually transmitted infections into reproductive health programmes.
• Almost all of the countries in the field survey have reported taking some action on reproductive rights and gender equality.
• Over 90 per cent of countries are taking action to address the reproductive health and rights of adolescents.
• Over 90 per cent of the countries have established comprehensive national HIV/AIDS strategies.
• And nearly half of the countries in the field survey identified HIV/AIDS as the top emerging issue in their countries, emphasizing prevention.

There is broad consensus in all regions that the Cairo Programme of Action paves the way for the achievement of the Millennium Development Goals. We will not be able to reduce poverty, gender discrimination, hunger and disease, especially HIV/AIDS, unless greater efforts are made for women’s rights and greater investments are made in education and health, including reproductive health. These actions must be speedy, effective and scaled-up.

And this is the third message for next 10 years.

All over the world, better understanding of these issues has brought real change. Millions of people now have wider choices, and can make key decisions about their own lives. Across the globe, increasing numbers of women, and men, are standing up against female genital cutting, rape, gender violence, and other human rights violations.

Since the Cairo Conference in 1994, the percentage of couples in the developing world that are able to choose and use contraception has jumped from 55 to 60 per cent. Infant mortality rates have dropped from 71 to 61 out of every 1,000 babies born. Life expectancy in the developing world has jumped from 61 years to 63. Today in many countries, fewer women now die in childbirth, but this is an area where much more needs to be done. There are three things that save women’s lives and these are family planning, skilled attendance at birth, and access to emergency obstetric care.

It is now time to scale up efforts and ensure that these life-saving services reach all women. This is an urgent priority because more than half a million women die each year from complications of pregnancy and childbirth. And just over half of the women in poor countries give birth with the assistance of a skilled medical worker.

One of the results of this neglect is obstetric fistula. This little-known condition disappeared in the rich countries over a century ago, but it continues to afflict tens of thousands of poor girls and women in poor countries. It is a horrible condition caused by prolonged labour and lack of health services. The baby always dies and the mother is left ruptured and damaged, and often shunned by her family, left to suffer in silence and shame.

Fistula can be prevented and it can be treated. One of the pioneers, who has taught us the way forward, is Catherine Hamlin. Thirty years ago, she and her husband founded the Addis Ababa Fistula Hospital. If any of you travel to Ethiopia, you must visit the hospital with some European Parliamentarians. For all of us, it was a very moving experience and it deserves all attention and support.

Based in part on Dr. Hamlin’s success, UNFPA last year started the first global campaign to end fistula. We are working to expand services to many countries in Africa and Asia. Surgery is 90 per cent effective and costs about $300. Today, 2 million girls and women are awaiting treatment.

I have mentioned several reasons why we should increase investments in family planning and other reproductive health services. But one of the most important reasons is to stop the spread of HIV/AIDS.

Today, AIDS is taking a brutal toll everywhere it strikes, particularly in southern Africa—and increasingly in parts of Asia, the Caribbean and Eastern Europe. With no cure in near sight to stop AIDS, our first line of defence remains prevention, but we must also give greater attention to care and treatment.

UNFPA is taking part in the initiative led by the World Health Organization, called "three-by-five", to provide three million people with anti-retroviral treatment by 2005. One entry point for providing treatment is through existing family planning and maternal health care facilities. The link between reproductive health and HIV infection should not be overlooked, since HIV is a reproductive health matter. As we scale up treatment, we must also scale up HIV prevention. This is my fourth message for our work for the next 10 years.

At the United Nations Population Fund, HIV prevention is a top priority. We are focusing on three strategic interventions: ensuring that information and services reach and involve young people, especially adolescent girls; ensuring that pregnant women and their children can remain HIV-free; as well as ensuring that condoms are accessible, and used correctly and consistently.

Ladies and gentlemen,

Policy makers have massively underestimated the positive effects that reproductive health and family planning can have on economic and social development. A more correct understanding should lead to increased investment.

Now, I will tell you another reason why we must pay greater attention to population—and that is because the demographic trends that we are now witnessing demand a policy response.

Demographic Trends/Population Dynamics

First of all, the population of the least developed countries is expected to triple in the next 50 years. This is a serious issue since these countries have difficulty now providing basic education, health and housing to their populations.

In the next half century, the developing world as a whole will gain another 2.5 (two-and-a-half) billion people, while the total population of the developed countries is expected to remain the same. In other words, the population of more developed regions will remain at about 1.2 billion people, while the population of less developed regions will grow from 5.2 billion people today to 7.7 billion by 2050, representing an increase of nearly 50 per cent. These figures have taken into account the decrease in population projections resulting from HIV and AIDS.

Secondly, there are the great challenges posed by an ageing population as well as the largest youth generation in human history. Greater investments must be made for both segments of the population. And that is the fifth message for our work during the next 10 years.

While Europe focuses on the issues of an ageing population, in much of the developing world today, the issue is youth, and with good reason. There are 1 billion young people on our planet today between the ages of 15 and 24—and the conditions in which many of them are living do not bode well either for their future or ours. Too many are growing up in poverty, in conflict, or in environments where there is little opportunity or hope for a better life.

This young generation sees a better life, not around the corner but through a television screen, which raises their expectations. Unfortunately, these expectations are not matched by opportunities.

The point I want to stress is that the current bulge in the youth population presents an unprecedented opportunity for growth and transformation if there is a concerted, massive investment in education, health care, including reproductive health, and employment.

As we look ahead to the future, we must stay focused on the Programme of Action that was adopted by 179 governments at the International Conference on Population and Development. We must remain committed to the goals of universal access to education and reproductive health services, and gender equality. Whether we greatly increase commitment and investment to population, reproductive health and women's empowerment over the next decade will largely influence whether we do or do not meet the Millennium Development Goals.

With greater resources effectively focused on reproductive health, we can save millions of lives, reduce the spread of HIV/AIDS, increase gender equity and reduce widespread poverty.

But we cannot move ahead without stronger partnerships—partnerships with governments, non-profit organizations, the private sector, parliamentarians and the media. It is also about partnership between North and South and South and South. And this is the sixth message for the next 10 years.

In 2002, parliamentarians from all regions met in Ottawa. They pledged to attain 5 to 10 per cent of national development budgets for population and reproductive health programmes. It is time to make that pledge real. I call on the Government of France to show global leadership and increase its funding for population and reproductive health programmes.

Today, donor countries provide half the amount they promised in Cairo. They agreed to provide an annual amount of $6.1 billion by 2005. Today, they contribute $3.1 billion. There is a $3 billion dollar shortfall in funding, and this shortfall is one of the reasons why we are not making greater progress.

In many developing countries, there is a severe shortage of condoms and contraceptives. This is a serious concern, since demand for contraceptives alone is expected to increase by a further 40 per cent in the next 11 years. As we mobilize women, men and young people to be aware of their reproductive rights, we are failing them when they realize there are no services to make these rights a reality.

Other challenges noted by governments include lack of trained staff, insufficient institutional capacity, lack of data, insufficient coordination among institutions and ministries, negative social and cultural attitudes, and in some situations, religious opposition.

Ladies and gentlemen,

We cannot place a price on what a woman feels when she is free to chart her own life, free of unwanted pregnancy and the fear of death during childbirth. And we cannot put a price on the prevention of HIV/AIDS.

But we can say for certain that the benefits of these investments are enormous. Last month, I launched a report in London, with The Alan Guttmacher Institute, entitled Adding it Up. The report points out that current programmes providing contraceptives to 500 million women in developing countries already prevent each year: 

• 187 million unintended pregnancies
• 105 million abortions
• 2.7 million infant deaths
• 215,000 maternal deaths, and
• 685,000 children losing their mothers.

Imagine what we could accomplish if these life-saving services reached all in need. Today, more than 200 million women would be using family planning if they had access to these services.

In closing, I would like to stress that we are on the right track and we must stay the course. UNFPA is honoured to be associated with all of you. Let us make the right investments to bring our world into greater balance. Let us tip the scales in favour of health and education and human development.

Together, we have come a long way, and together we will continue to move forward. I would like to wish a happy 10th anniversary to our partner, Equilibres & Populations. UNFPA thanks you for your support and looks forward to many years of continued collaboration in the future.

Thank you.