This article is reprinted with permission from The Lancet, and was co-authored by Katie Chau, Youth Coalition, Ottawa, Canada; Catherina Hinz, German Foundation for World Population (Die Deutsche Stiftung Weltbevölkerung), Hannover, Germany; and Sivananthi Thanentiran, The Asian-Pacific Resource and Research Centre for Women, Kuala Lumpur, Malaysia.

Sex happens: 125 million times each and every
day. So how is it that in the 21st century this precious element of
human existence is still taboo? We are used to seeing sexualised
images, yet the reality of sex and reproduction seems as secret as
ever.

In the political and religious skirmish over sex and morality, we
often lose sight of the critical contribution that a realistic approach
to sexual and reproductive health makes to our lives.  Against
this backdrop, we recently marked the 15th anniversary of the world’s most
comprehensive blueprint for sexual and reproductive health.

The 1994
International Conference on Population and Development (ICPD) in Cairo
was a defining moment that resulted in a visionary plan that placed
individual human rights at the heart of global development.
ICPD saw a consensus around population and development among 179
governments along with unprecedented and diverse participation by civil
society.

ICPD was groundbreaking, with
the potential to be revolutionary if fully implemented. It upset
prevailing orthodoxies and attracted much criticism from religious and
political opponents—mainly over reproductive rights. Nevertheless, ICPD
brought about a seismic change in thinking about population and
development, moving from demographics to sexual and reproductive health
and wellbeing with a new emphasis on individual rights and gender
equality. ICPD recognised that comprehensive sexual and reproductive
health, including voluntary family planning, is essential for
individual and national development, as well as being one of the most
cost-effective routes for alleviating poverty. More recently, the ICPD
goal of “universal access to reproductive health” has been incorporated
into Millennium Development Goal (MDG) 5B and its contribution to all
of the MDGs has been belatedly acknowledged.

The
Programme of Action that emerged from ICPD offered a roadmap for the
next 20 years. But 15 years on can we honestly say we have followed
that roadmap? This was the question addressed by
non-governmental organisations (NGOs) at a Global NGO Forum on
Sexual and Reproductive Health and Development held Sept 2—4 in Berlin,
Germany, and hosted by the German Government and the United Nations
Population Fund (UNFPA).

Although there
has been progress, this has been selective and uneven.
The right to the
highest attainable standard of health, particularly sexual and
reproductive health, continues to elude millions of people, especially
the poor and marginalised.

Statistics speak for themselves. Over 200
million women currently lack access to modern contraceptives, and
demand for contraception is expected to increase by 40% by 2050.
There are more than 1.5 billion people aged between 10 and 25 years—the
largest generation of young people in history—and they will need sexual
and reproductive health services.  Globally there are about 33 million people living with HIV, with 2.7 million new infections in 2007, most of which are sexually
transmitted infections. Every year, more than half a million women die
in pregnancy or childbirth, including 67,000 women from unsafe abortion.
Millions more suffer injury, illness, or disability.

While
ICPD offered a visionary plan, political leadership and financial
commitment have been lacking; between 1994 and 2008, funding for
reproductive health as a proportion of health aid dropped from 30 percent to
12 percent.
Led by the conservative US administration of George W Bush and the
Vatican, political opposition to ICPD resurfaced and programmes for
sexual and reproductive health came under sustained attack at the UN
and around the world.
At the same time a global HIV epidemic devastated communities, and in
the response linkages to sexual and reproductive health and rights were
not always fully understood or implemented.

Today, these linkages are
understood, potentially strengthening the response to both HIV and
sexual and reproductive health.
The
challenges today are perhaps greater than those faced in 1994. The
global financial crisis, the impact of climate change, increasing
religious fundamentalism, and fragmented health systems are some of the
challenges. That is why this anniversary is so important. By holding
governments to their promises of 15 years ago, NGOs can remind them
that sexual and reproductive health is a more important long-term
investment than arms—a third of countries spend more on the military
than they do on health and nearly half of countries with the highest
defence spending rank among the lowest in human development.

The
Global NGO Forum on Sexual and Reproductive Health and Development must act as a clarion call to reinvigorate the ICPD Programme of Action to
make it a reality for all women, men, and young people. We have clear
evidence that sexual and reproductive health saves lives and makes a
critical contribution to poverty reduction and development.
Strengthening sexual and reproductive health and rights is a pressing
global need, one on which the future of humankind may well depend.

References used in this article: