Cairo Dream Requires $264 Billion to Deliver Women’s Call for Justice and Bold Leadership

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NAIROBI, Kenya, Nov 12 2019 (IPS) – For each of the 830 women dying each day from pregnancy complications and childbirth, an estimated 20 others suffer serious injuries, infections or disabilities.

This is the reality that millions of women face, and informs the Nairobi Summit’s three critical commitments which are to bring preventable maternal deaths, gender-based violence and harmful practices, as well as unmet need for family planning, to zero. To achieve this objective money is needed.

Joyce Chimbi

Finding the money for commitments

Private sector organisations including the Ford Foundation, Johnson & Johnson, Philips and World Vision, announced that the world as envisioned in Cairo in 1994 will cost $264 billion to deliver.

“Building financial momentum and bridging existing resource gaps around these commitments will not be easy. While most countries have constitutionalised reproductive health and rights, mobilising domestic resources has not automatically followed,” says Nerima Were, programme manager of the Kenya Legal and Ethical Issues told IPS.

How much will it really cost to deal with family planning?

To bring maternal mortality to zero in the 120 countries that account for over 95 percent of maternal mortality will cost $115.5 billion in key maternal health interventions.

Ending the unmet need for family planning in the same number of priority countries will cost $68.5 billion. Ending gender-based violence will require investing 42 billion dollars in 132 priority countries.

Currently, only $42 billion in development assistance is expected to be spent on advancing these goals. It, therefore, means that an additional $222 billion in investments will be required over the next decade.

Who will really fund commitments?

Were says that envisioning and articulating what form and shape these investments will take, is critical. She argues that at the moment it is not clear whether these additional costs will be raised in foreign investments, domestic allocation or private spending.

“This discussion is not just about dollars and cents but values and choices. It is also about translating choices into practical ways of making decisions,” says Achim Steiner, of the United Nations Development Programme, UNDP.

Steiner says that financial decisions can be framed in different ways, and that analysing the cost and gaps in delivering the three commitments, is a way to advise the world on how to invest.

Making informed decisions

“It is about helping societies to be better informed and to make better choices. The issue is not what it will cost to bring them to zero, but the cost of not bringing them to zero,” he argues.

World Bank data has shown that family planning is the “best buy” for governments. For each additional dollar spent on contraceptive services in developing countries, the cost of maternal and newborn healthcare could be reduced by two dollars and twenty cents. Importantly, estimates also show that every dollar invested in family planning pays itself back $120 in saved costs.

Africa must and can find the money

Researchers at the African Population and Health Research Centre indicate that African countries will need to dig deeper.

Budget underspending in the health sector prevails across the continent. “Africa has the resources to achieve these three critical goals. The exponential growth of economies across the country is reflective of the continents financial muscle,” says Jackson Chekweko, executive director for Reproductive Health Uganda, the member association for International Planned Parenthood Federation (IPPF).

Chekweko argues that political will and commitments are more important, and that “there will always be resources for what the government, especially presidents, say is a priority. African presidents wield a lot of influence on resource allocation.”

He argues, for instance, that Uganda made a commitment at the recent London Summit “to allocate $5 million to family planning annually. This has been done because the president said so.”

Bold leadership from Kenya’s Uhuru Kenyatta

Chekweko adds that there’s also a new generation of leaders such as President Uhuru Kenyatta of Kenya who will not shy away from making ambitious commitments.

“President Kenyatta made several bold statements at the ICPD25 Summit. He has declared that East African countries will reduce FGM to zero by 2022 and confirmed gender-based violence will, without a doubt, be reduced to zero,” he says.

Chekweko says that a demonstrable political commitment will encourage partnerships to help meet existing resource gaps. “Once we agree that issues of sexual and reproductive health and rights are a priority, the money will follow this purpose. Even if it means raising taxes such as VAT(value-added taxes) and PAYE (pay as you earn) by just one percent, it will be done,” Chekweko says.

Were adds that within the context of limited domestic funding, a scale back by external donors, and ambitious health and health coverage targets and domestic resource mobilisation, has never been more critical.

“To reach zero in all three areas, governments will need to carefully decide what their priorities are, anything that falls within that priority framework must be achieved,” she says.

 

Call to Action as Thousands Breathe New Life to the Cairo Promise at ICPD 25 Summit in Nairobi This Week

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Gender equality and women empowerment at the heart of ICPD25. Credit: Joyce Chimbi / IPS

NAIROBI, Kenya, Nov 11 2019 (IPS) – Every day 830 women die while giving life. At least 33,000 girls are forced into child marriage with 11,000 girls undergoing female genital mutilation. These are some of the cruel realities young women face every day. However, there is renewed hope that delegates expected to attend the International Conference on Population and Development (ICPD) in Nairobi this week will re-energise and breathe new life to the Cairo Promise.

“The Summit is a call to action to accelerate progress towards the world we imagined in 1994,” Arthur Erken, one of the three co-chairs of the International Steering Committee of the Nairobi Summit, tells IPS. He emphasises that the magic of the first ICPD conference is in the paradigm shift from “a numbers-driven approach to development to placing people, their needs and aspirations, at the heart of sustainable development”.

Erken says this summit is, therefore, a call to action to countries and partners to fulfil the Cairo Promise by making concrete commitments towards achieving the ICPD goals.

Unfulfilled promises and Re-energising the global community

Co-hosted by the governments of Kenya, Denmark and the United Nations Population Fund (UNFPA), the Nairobi Summit takes place on the 25th anniversary of the ground-breaking 1994 International Conference on Population and Development (ICPD).

Arthur Erken says that ICPD25 is a call for action to accelerate the Cairo promise. Credit: Joyce Chimbi / IPS

Unfortunately, says Erken, this promise has for millions of women and girls around the world not been fulfilled. “The world we imagined in Cairo is not a reality,” says Erken. He says the Cairo Promise was about ensuring that all people have access to sexual and reproductive healthcare, including safe pregnancy, childbirth and family planning services, and are free from all forms of violence and harmful practices.

Other experts such as Beatrice Okundi, assistant director of the National Council for Population and Development (NCPD), affirms that at the heart of the promise is gender equality, and the emphasis placed on equality and empowerment of women and girls.

Raising awareness

Okundi says that accelerating the Cairo Promise will require raising awareness on the relationship between population growth and sustainable development. “For Kenya to absorb an additional one million people every year as it has done for the past 10 years, our economy must grow at a double-digit figure up from the current 5.7 percent,” she tells IPS.

Five themes to a call for Action

Erken explains that the summit is focused around five themes: universal access to sexual and reproductive health and rights, financing the ICPD agenda, drawing on the demographic dividends, ending gender-based violence and harmful practices and upholding the right to sexual and reproductive healthcare, even in humanitarian and fragile contexts.

He says the summit is also about achieving three critical zeroes: zero unmet need for family planning, zero maternal deaths and zero violence and harmful practices against women and girls, including child marriages and female genital mutilation. “ICPD25 is also about assessing how much these three zeroes will cost governments as well as partners, and emphasises the need for innovative financial models,” Okundi adds.

She says that “ICPD sets in place a far-sighted plan that advances human well-being and their rights, well ahead of numerical numbers”.

Erken points out the Nairobi Statement “is not a negotiated document”. However, it is nonetheless the overall global framework formulated and based on wide consultations with diverse stakeholders, including governments and CSOs, among others. “This statement is an embodiment of areas that need prioritisings. It is a reflection of the state of implementation of the ICPD Programme of Action and the areas where concrete commitments are required in order to move the ICPD agenda forward.”

Finish what we started….

But not every expert or delegate is as hopeful, as expressed by Angela Nguku, the executive director of White Ribbon Alliance, an international coalition on safe motherhood. She argues there is no need for new promises or commitments.
“We need to finish what we started in Cairo by removing obstacles, especially corruption from our path,” she says. Nguku says that misappropriation of public funds continues to stand between populations and Cairo promise.

“On this continent, the ICPD agenda remains unfulfilled, not because of a resource gap, but a leadership and governance gap. We need to put the resources we have where they are needed,” she tells IPS.

Nonetheless, delegates expect that the new commitments made in the next three days will lead to completion of the unfinished business of ICPD.

Let’s not wait another 25 years

ICPD25 runs from November 12-14, bringing together more than 6,000 delegates from around the world, with at least 164 countries and delegates drawn from civil society organisations, grassroots organisations, young people, business and community leaders, faith-based organisations, indigenous peoples, international financial institutions, people with disabilities, academics and many others working towards the pursuit of sexual and reproductive health and rights.

“The summit is not a platform to prescribe solutions to convening countries and convening delegates. It is an opportunity for governments and other partners to make commitments, and own the process,” says Erken.

Experts acknowledge that tremendous progress has been made over the last 25 years, but emphasize that a lot more will need to be achieved in a shorter period of time, to fulfil the promise by 2030.

“We cannot have another 25 years of ICPD. This is hopefully the last ICPD conference,” Erken observes.

 

The Nairobi Summit Is about the Future of Humanity and Human Prosperity

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Kenyan President Uhuru Kenyatta hailed the strong partnership between his government and UNFPA during a meeting with UNFPA’s Executive Director, Dr. Natalia Kanem in March 2019, which will jointly convene the ICPD 25 from 12 to 14 November 2019 along with the Government of Denmark. Credit: PSCU

NAIROBI, Kenya, Nov 8 2019 (IPS) – As we count down the remaining days to the opening of the Nairobi Summit or the International Conference for Population and Development(ICPD), I am confounded by how much humanity has managed to simultaneously empower more women than at any other time in history, while at the same time failing to see that ‘women’s issues’ are actually ‘everyone’s issues’.

That countdown evokes memories of my own grandmother, who followed a common trend in India at the time, dropping out of school to get married and give birth to her first child at age 11. In many parts of the world, girls have over the years faced unthinkable obstacles while trying just to get an education, often jeopardizing their personal safety and risking being ostracized by their families and communities.

It wasn’t until a mere 25 years ago at the ICPD in Cairo that the world agreed that population and economic development issues must go hand in hand, and that women must be at the heart of our efforts for development.

Back then, governments, donors, civil society, and other partners made commitments to reduce infant and child mortality, reduce maternal mortality, ensure universal education, and increase access to sexual and reproductive health and rights, amongst many others. These commitments were a massive step forward for the rights of women and girls.

At the Conference in Nairobi, we all have an opportunity to repeat the message that women’s empowerment will move at snail-pace unless we bolster reproductive health and rights across the world. This is no longer a fleeting concern, but a 21st century socio-economic reality.

We can choose to take a range of actions, such as empowering women and girls by providing access to good health, education and job training. Or we can choose paths such as domestic abuse, female genital mutilation and child marriages, which, according to a 2016 Africa Human Development Report by UNDP, costs sub-Saharan Africa $95 billion per year on average due to gender inequality and lack of women’s empowerment.

Fortunately, the world has made real progress in the fight to take the right path. There is no lack of women trailblazers in all aspects of human endeavour. It has taken courage to make those choices, with current milestones being the result of decades of often frustrating work by unheralded people, politics and agencies.

Leaders like the indefatigable Dr. Natalia Kanem the Executive Director of UNFPA and her predecessors, supported especially by the Nordic countries, are pushing the global change of paradigm to ensure we demolish the silo of “women’s issues” and begin to see the linkages between reproductive rights and human prosperity.

Numerous studies have shown the multi-generation impact of the formative years of women. A woman’s reproductive years directly overlap with her time in school and the workforce, she must be able to prevent unintended pregnancy in order to complete her education, maintain employment, and achieve economic security.

Denial of reproductive health information and services places a women at risk of an unintended pregnancy, which in turn is one of the most likely routes for upending the financial security of a woman and her family.

A lot has been achieved since the years of my grandmother, when girls were expected to be demure and remain in the background. In many places the current teenage girl believes that every door is open to them; they can rise to any heights.

Yet in a lot of other countries, girls are up against a system that seems rigged against them for the long-term. These are countries where greater leadership and the right policies are sorely missing; where women and girls are robbed of the education they deserve and the jobs they need to lift themselves and their families out of poverty; where they are victims of sexual and physical abuse in their own homes or sold into child marriage.

As the UN Resident Coordinator to Kenya, I am privileged to serve in a country, which is hosting this very important conference. It has shown leadership to advance the cause of women’s right-from criminalizing female genital mutilation to stepping up the fight to end child marriage and pushing hard on improving reproductive, maternal and child health.

When the ICPD opens in Nairobi on 12 November 2019, I wonder how my grandmother’s life might have been different if she had been able to learn how to read and write and achieve her full human potential, but also appealing to all Governments to work towards giving half the world population the final and absolute control over their own bodies.

Siddharth Chatterjee is the United Nations resident coordinator to Kenya.

 

Austerity, the “New Normal”

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Isabel Ortiz is Director of the Global Social Justice Program at Joseph Stiglitz’s Initiative for Policy Dialogue at Columbia University, former Director at the International Labour Organization (ILO) and UNICEF, and senior official at the UN and at the Asian Development Bank.
 
Matthew Cummins is senior economist who has worked at UNDP, UNICEF and the World Bank.

WASHINGTON DC, Oct 11 2019 (IPS) – While this week Ministers of Finance and economists meet in Washington to confront global economic challenges at the IMF and World Bank Annual Meetings, the majority of the world population lives with austerity cuts and see their living standards deteriorating. World leaders must reverse this trend.

Isabel Ortiz

Since 2010, most governments in both high income and developing counties have been implementing austerity policies, cutting public expenditures. Surprisingly, this trend is expected to continue at least until 2024, according to a global study just published by the Initiative for Policy Dialogue at Columbia University, global trade unions and civil society organizations. Austerity has become “the new normal.”

Based on IMF fiscal projections, the study finds that a new fiscal adjustment shock will start in 2020. By 2021, government expenditures as a share of GDP will be declining in 130 countries, nearly three-fourths of which are in the developing world. The reach of austerity is staggering: nearly 6 billion persons will be affected by 2021.

How are governments cutting their budgets and implementing austerity reforms? In practice, the most commonly considered adjustment measures in 2018-19 include: pension and social security reforms (in 86 countries); cutting or capping the public sector wage bill, including the number and salaries of teachers, health workers and civil servants delivering public services (in 80 countries); labor flexibilization reforms (in 79 countries); reducing or eliminating subsidies (in 78 countries); rationalizing and/or further targeting social assistance or safety nets (in 77 countries); increasing regressive consumption taxes, such as sales and value added taxes (in 73 countries); strengthening public-private partnerships (PPPs) (in 60 countries); privatizing public assets/services (in 59 countries); and healthcare reforms (in 33 countries).

All of these measures have negative social impacts. As a result, in many countries older persons have lower pensions; there are not sufficient teachers, medical and care staff, and the quality of public services suffers; there are less jobs, and people work under more precarious conditions; prices increase while wages are stagnant; and the low and middle classes are squeezed and under pressure.

Matthew Cummins

In perspective, the macroeconomic and fiscal choices made by governments over the last decade are alarming. The G20 alone committed US$10 trillion to support the financial sector in response to the global financial crisis, and then passed the costs of adjustment to populations, with millions of people being pushed into poverty and lower living standards.

The worldwide drive toward austerity or fiscal consolidation can be expected to aggravate the growth and employment crisis and diminish public support at a time of high development needs, soaring inequalities and social discontent.

Austerity is also being used as a trojan horse to induce “Washington Consensus” policies to cut back on public policies and the welfare state. Once budgets are contracting, governments must look at policies that minimize the public sector and expand private sector delivery, including PPPs. There are clear winners and losers from this renewed Washington Consensus, and governments must effectively assess and question these policies.

Austerity and budget cuts do not need to be “the new normal.” There are alternatives, even in the poorest countries. Governments can find additional fiscal space to fund public services and development policies through at least eight options, which range from increasing progressive tax revenues, cracking down on illicit financial flows, improving debt management and using fiscal and foreign exchange reserves, to adopting more accommodative macroeconomic frameworks, reprioritizing public expenditures and -for lower income countries- lobbying for greater aid. All these options are endorsed by the United Nations and the international financial institutions.

It is time for world leaders to abandon the myopic scope of macroeconomic and fiscal policy decisions that benefit few and, instead, look for new fiscal space and financing opportunities to foster a robust global recovery and the achievement of long-term global prosperity for all.

 

Translating Ambition to Action: High Hopes for United Nations Action Week

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Cameron Diver is Deputy Director-General, the Pacific Community (SPC)

New Caledonia, Sep 13 2019 (IPS) – In less than 10 days, countries from around the planet will come together in New York for the United Nations Secretary General’s Climate Action Summit. I look forward to representing the Pacific Community (SPC) at this important event, and throughout “Action Week” during the upcoming UN General Assembly.

Cameron Diver

The interconnections and synergies between major issues of global concern and the key role multilateralism and international cooperation can play in helping tackle these challenges are illustrated by the agenda of the week from 23 to 27 September. Underpinned by the Sustainable Development Goals, each of the high-level summits will focus on commitments to accelerate action across climate change, enhance efforts to secure healthy, peaceful and prosperous lives for all, mobilise sufficient financing to realise the 2030 Agenda and address the specific issues and vulnerabilities of small island developing states.

The week of summits kicks off with a focus on climate action. And this is, in my mind, highly appropriate. The multiplier effect of climate change undermines our efforts to achieve the sustainable development goals, it increases the challenges of biodiversity conservation and sustainable use, it intensifies competition and the potential for conflict around natural resources and it poses the single greatest existential threat to the lives and livelihoods of millions of people around the globe. From where I stand, the science on climate change is clear. To take only these examples, the IPCC Special Reports on the impacts of global warming of 1.5° above pre-industrial levels and climate change, desertification, land degradation, sustainable land management, food security and greenhouse gas fluxes in terrestrial ecosystems provide us with the most robust, high quality evidence base to understand the significant negative impact climate change is already having on our natural environment, on the wellbeing of people, ecosystems, flora and fauna and the massive and potentially irreversible consequences of inaction. As regards our ocean, the upcoming Special Report on the Ocean and Cryosphere in a Changing Climate is likely to confirm what the islands of the Blue Pacific continent, and others whose cultures, traditions and livelihoods are deeply attached to the ocean, have already sensed: the climate crisis is a real and present threat to ocean and coastal ecosystems and the human communities that depend on them.

The stakes are high, but where there is a threat there is also an opportunity. If we act now, there is still have time effectively to tackle the climate crisis! To put it simply: ambition without action is insufficient and simply not an option. SPC is committed to working with our Member States, international and regional partners to translate climate ambition into tangible climate action, for both mitigation and adaptation. The benefits could be huge, with the Global Commission on Adaptation estimating that investing $1.8 trillion in climate adaptation globally in just five areas from 2020 to 2030 could generate $7.1 trillion in total net benefits. We are also convinced that we must collectively harness the synergies between, for example, climate and the ocean, biodiversity, health, security, economic development, food systems, land use, gender and many other development areas to fully exploit the potential of the SDGs and ensure that future pathways to sustainable development are integrated, inclusive, nature-friendly, climate-informed and resilient. SPC is already implementing this approach with its Members and partners. One illustration is our EU funded PROTEGE project, whose intended outcomes include a transition to sustainable integrated agriculture and sound forestry resource management; sustainable fisheries and aquaculture management that is integrated in and adapted to island economies; sustainable integrated water resource management; and invasive alien species control, all against a backdrop of climate-change hazards that require ecosystem and biodiversity protection, resilience and restoration.

As was recently remarked to me at the Green Climate Fund Global Programming Conference in Korea: “we already know what we must do. We need to stop talking and start doing”. It is my sincere hope that “Action Week” in New York will indeed be a turning point for “doing”; a catalyst for firm, measurable commitments to tangible actions that match the level of ambition already expressed to address the climate crisis and the multiple development challenges that remain as we approach the final decade of the 2030 Agenda. If we do not translate ambition into action, we will fail ourselves, we will fail future generations and we will fail our planet. If, however, we take up the challenge and take sustained, coordinated and integrated action, we can win the battle against climate change, create new and innovative opportunities for development, deliver on the promise of the Global Goals and trace a positive pathway to new era of resilient and sustainable development. High hopes indeed…

 

Calls for Reform, Research and Reorganisation in Leprosy Healthcare

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The 20th International Leprosy Congress (ILC) is being held Sept. 10 to 13 in Manila, Philippines. The conference is hosted every three years and was last held in China in 2016. Credit: Stella Paul/IPS

MANILA, Sep 12 2019 (IPS) – Rachna Kumari of Munger in Eastern India’s Bihar state is not yet 30. But she’s already been married at 18, abandoned by her husband after she was diagnosed with leprosy and become an award-winning advocate of the disease. She has traversed a long road. And this week she undertook another step in her journey to fly to Manila, Philippines, as a delegate at the 20th International Leprosy Congress (ILC).

The grassroots leader, who is employed by the International Leprosy Elimination Partnership (ILEP), has also previously traveled to Ethiopia and China to share stories about her life and her work.

Prior to attending the ILC yesterday Sept. 12, she participated in the Global Forum of People’s Organisations on Hansen’s Disease, an event co-organised by Japan’s  The Nippon Foundation (TNF) and Sasakawa Health Foundation (SHF). The global forum gave her valuable insights into the universal challenges of leprosy-affected and leprosy advocates such as stigma and lack of financial sustainability, Kumari said.

She said she also gained technical education and management skills, which she feels are crucial for success in advocacy.

She added that when she carries out her work in communities across Munger, she has no official identification to show many of the Hansen’s disease-affected persons she comes across, many of whom are weary of strangers as they continue to face discrimination and stigma.

This simple form of accreditation, Kumari said, played a huge role in advocacy against the disease.

“[In] my community, I have nothing to prove that I am an advocate, a knowledge builder. So, people doubt me, they don’t know if they [can] trust me. A simple document of identification can be a big step to build trust between a community worker and her community,” Kumari told IPS.

Maya Ranavare, who works as a treasurer in Association of People Affected by Leprosy (APAL), in western India’s Maharashtra state, says that partnerships among organisations must not remain in closed rooms but should instead result in collective action that reaches communities.

“There is a sense of competition among  people’s organisations. Instead, we must act collectively. Also, if it is a partnership, then there should not be duplicity. Tasks should be distributed evenly. If one organisation is doing mobilisation, other should work on technical education. This will increase everyone’s skill and ability,” Ranavare told IPS.

According to Dr Arturo Cunanan, the Chief Medical Officer of the Culion Sanitarium and General Hospital in the Philippines, there needs to be programmatic changes in the government public health system. Budgetary allocation, innovation, new research and sensitisation of healthcare workers are all needs of the hour.

“Leprosy elimination is now like a car that has run out of fuel. We need that fuel right now. The fuel is innovation. Take vaccination for example. Why is that even after centuries, we still don’t have a vaccination for universal application?

“Also, we need innovative, easier ways to diagnose leprosy. If you look at Tuberculosis, there are several ways to do a quick test and find out if a person has it. But for leprosy, we still have only clinical test. We need new tools, quicker ways and for all of that we need new investments in innovation, research,“ Cunanan told IPS.

The ILC started runs Sep 10 to 13. The congress will identify the priorities for a future course of action to end leprosy. Currently there are 200,000 new leprosy cases reported every year across the world, with 60 percent of those new cases originating in India.

According to the organisers, the congress will identify the priorities for the future course of action for achieving zero leprosy. The congress also emphasised the importance of partnerships and a new future partnership among the leprosy-affected people’s organisations has already started between HANDA – a Chinese NGO– and PERMATA, an NGO based in Indonesia.

HANDA, which has recently been recognised by the government of China for their skills in project management, finance management and organisational re-structuring, is set to share these crucial skills with PERMATA. 

“We will soon host a delegation from PERMATA in our Guanzhou office. They have a special interest in finance management and we are ready to share our expertise and experience in that area with them,” Sally Qi of HANDA told IPS.

SHF was instrumental in building this partnership and encouraged  both HANDA and PERMATA to start a dialogue on skill sharing, Qi added.