The Road from Cairo - Statement at the European Population Forum

We meet in Europe at a pivotal moment.

Europe is both a continent of great diversity and a continent engaged in unprecedented integration and unification. With this process comes increased opportunities, and increased responsibility, to ensure that human rights are respected, and human lives are improved. Integration and unification hinge on social solidarity, equity and protection of the vulnerable—both within national borders and beyond.

Today, the economic and social challenges facing Europe, and the range of solutions aimed to address them, vary widely.

The issues of low fertility, ageing, and migration figure high in public and policy debates. As we all know, there are no well-tested policy recipes to follow, and there are competing claims on resources. That is why discussing these issues and sharing experiences and insights, as we will do over the next few days, is so important. Such dialogue is vital for effective policy-making, and essential to good governance.

Also essential is respect for human rights. We know that sexual and reproductive health is an essential part of those rights.

These issues lie at the heart of the agreement that was reached nearly 10 years ago in Cairo at the International Conference on Population and Development.

The Cairo Programme of Action helped governments to move away from a narrow focus on family planning to a new concept of sexual and reproductive health throughout the life cycle. The Cairo agenda changed the international debate about population from human numbers to human beings.

It put the focus squarely where it should be—on improving human lives. Investing in individuals, broadening their opportunities and enabling them to realize their potential as human beings, is the key to sustained economic growth and sustainable human development. It also put the focus on women, and emphasized the need for gender equality and the support of men for the empowerment of women. It recognized that women’s rights are critical to global progress.

At its essence, the Cairo agreement aims to fully integrate population concerns into development strategies and resource allocations, with the overarching goal to meet the needs and improve the quality of life of present and future generations.

In many ways, the Cairo agreement anticipated the Millennium Development Goals (MDGs) adopted six years later by the largest gathering of the world’s leaders. Enabling people to choose their family size will slow the rapid population growth that undermines poverty reduction efforts in the world’s poorest countries. Better reproductive health information and services are critical to reducing maternal and child mortality and halting HIV/AIDS. Preventing unwanted pregnancies helps keep girls in school, advancing women’s empowerment. MDGs are pertinent to Europe in one way or another, and success in implementing them depends critically on strong partnerships.

I am delighted that we are gathering in this tenth anniversary year of the historic Cairo Conference. The occasion gives us a chance to take stock.

All States now understand that if they are to provide adequate social services for their citizens, for their education and health, for their housing and employment and retirement, they need to incorporate population policies and demographic trends into their development strategies.

Let us first examine some issues of particular concern to European nations. The process of transition in Eastern Europe has presented new challenges and consequences. As I see it, there are three issues, in particular, that deserve our attention.

One is the rise in gender inequality. In the wake of reform, people have faced increasing unemployment as well as crumbling health care, pension and education systems. This has contributed to poverty, widening gaps between rich and poor, and increased gender inequalities. One of the most dramatic developments is the reduction in opportunities for women’s participation in economic, social and political life. In some countries, the burden of transformation has fallen disproportionately on men, particularly in the Russia Federation, Ukraine and Belarus, where life expectancy has fallen.

A second effect of transition is the rise in human trafficking, especially of women. This growing crime requires increased cooperation among countries in the area of law enforcement, as well as in addressing the root causes of trafficking and meeting the needs of the victims. Greater international cooperation is needed to bring traffickers to justice and to protect the human rights, including sexual and reproductive health and rights, of the women and girls who are trafficked.

A third consequence of the transition is the rapid spread of HIV/AIDS. Unless urgent action is taken now, the AIDS epidemic in Eastern Europe and Central Asia could easily spiral out of control. Together, we must confront this threat head on. We must not allow this region to become home to the next wave of the global AIDS crisis.

Intensified efforts must be made now to provide information, prevention, treatment and care to young people, sex workers and drug users, who remain highly vulnerable, and largely neglected.

Let me now turn to the issue of low fertility and declining populations, an issue of growing concern to many European nations.

Throughout the region, women and men are choosing to have fewer children for different reasons. In large part, they are responding to their economic and social circumstances.

The concern over low birth rates and shrinking populations should in no way deprive individuals of needed family planning, which is a basic human right and could have potentially serious public health consequences. Access to quality sexual and reproductive health services is needed in all countries to prevent HIV and other sexually transmitted infections, to reduce the incidence of maternal and infant mortality, and to lower rates of unplanned pregnancies and unwanted or orphaned children. I would also like to stress that ready access to modern contraception reduces recourse to abortion and the infertility that may follow repeated abortions.

While migration is a matter for national decision, its impact is global. We at UNFPA welcome the recent formation of the Global Commission on Migration and look forward to its report in 2005 as well as the high-level dialogue on migration to take place in the United Nations General Assembly in 2006. The approach that is taken to migration is an important test of our commitment to universal values and international human rights. It is an important test of our response to globalization.

It is most unfortunate that in some countries the debates on migration have generated feelings of fear and even hate.

As United Nations Secretary-General Kofi Annan has wisely stated, there is a need to address legitimate concerns about migration, “rationally, creatively, compassionately, and cooperatively”. There is a case to be made for a win-win situation with positive impacts flowing to both sending and receiving countries. Here in Europe, migrant labour is increasingly seen as a way to compensate for shrinking labour forces. The remittances that migrants send home to their families and the contribution they make to their host country offer concrete benefits to all. International migration also has the potential of facilitating the transfer of skills and contributing to cultural enrichment.

Cultural diversity can be a source of strength when mutual respect and dialogue are actively cultivated.

UNFPA is currently strengthening its programming with a focus on cultural sensitivity so that we can be more effective in promoting universal human rights. We hope that this effort will contribute to international development.

Ladies and gentlemen,

We must be careful not to harken back to some ideal notion of the family. In all times, there are some families that are filled with respect and support and love, while others are characterized by dysfunction, and even violence and abuse.

The good news is that women, and more and more men, are speaking out about gender-based violence and discrimination, and demanding its end. Policies and laws are being put in place and the agreement reached in Cairo has played a pivotal role. So has the work of countless organizations that advocate for women’s health and women’s rights.

Policies that promote gender equity, women’s rights and male responsibility are pro-family, and they build social cohesion.

Also critical to social cohesion is care for the elderly.

The greying of the planet represents one of the most significant population shifts in history. Although the trend is more advanced here in Europe and in Japan, it is truly a global phenomenon.

Today, the elderly are the world's fastest growing population group, and among the poorest. The next few decades will test our ability to address health care, retirement and pension benefits, and other issues that affect senior citizens. The Conference on Ageing held in Madrid rightly emphasizes the promotion of solidarity among generations and mutual support.

Today, support is needed for all generations, including the world’s largest youth generation. The decisions they take today will shape our world for decades to come. Because there are so many young people in the developing world, global population continues to grow by 77 million people every year. The fastest growth is occurring in the poorest countries that are the least able to provide for more people.

We estimate that demand for family planning commodities alone will increase by 40 per cent by the year 2015. Yet, we cannot even meet demands for such services today. There is a current shortfall of over $100 million dollars to purchase needed condoms, contraceptives and other supplies in the developing world. And there is a $3 billion dollar shortfall in donor funding for the Cairo agenda.

I can assure you that the consequences of these shortfalls play themselves out in the lives of people everywhere.

Every day, some 14,000 people become newly infected with HIV/AIDS.

Every day, 1,450 women die of complications of pregnancy and childbirth.

We can take heart in the fact that all over the world, the Cairo agenda is guiding policy-making and legislation to secure sexual and reproductive health, and to secure a sustainable balance between population and development, within a framework of human rights. There is broad consensus in all regions that the Cairo Programme of Action paves the way to the achievement of the Millennium Development Goals.

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.

And in many countries, fewer women now die in childbirth, but this is an area where much more needs to be done. Right here, close to Europe, a woman in Central Asia faces 28 times greater risk of dying from pregnancy and childbirth than a woman in Western Europe.

The health disparities that exist here in Europe and around the world require urgent attention and increased investment.

Over a year ago, parliamentarians from all regions met in Ottawa. They pledged to attain the allocation of 5 to 10 per cent of national development budgets for population and reproductive health programmes. It is time to make real on that pledge.

Today, donor countries provide less than half the amount they promised in Cairo. I thank all of the ECE member nations that contribute to population and reproductive health and encourage you to do more so that we can meet the goal of universal access to primary education and reproductive health services by the year 2015. And we can further reduce maternal and infant mortality and reverse the spread of HIV/AIDS.

As we head towards the tenth anniversary of the Cairo Conference, we must build stronger partnerships for action and mobilization. We must stay on track. Together we have come a long way, and together we will continue to move forward. I welcome all of you who have joined us at this meeting, and I look forward to a stimulating Forum that facilitates a rich exchange of views.