Select Committee on International Development Appendices to the Minutes of Evidence


Memorandum submitted by Marie Stopes International

  In view of the forthcoming inquiry by the International Development Committee on the effectiveness of EC Development Assistance, please find following the contribution by Marie Stopes International (MSI) on the role of the EC in supporting reproductive health care and HIV/AIDS prevention policies and programmes.

  MSI has worked with the principal EU institutions, namely the Council of Ministers, the European Commission and the European Parliament, for over ten years.

  Since 1991, MSI has provided secretariat services to the Working Group on Population, Sustainable Development and Reproductive Health in the European Parliament. The Group provides members of the European Parliament with a forum for dialogue and action on the related issues of population growth, reproductive health, sustainable development and gender equality. In accordance with the ICPD Programme of Action, it advocates the support of sexual and reproductive health and rights and women's empowerment as the basis for social and human development. Since its creation, the Group has played a key role in influencing EU policy on reproductive health.

  As well as working closely with the European Parliament, MSI has worked in partnership with the European Commission for many years, and has gained considerable expertise in European community policy and funding for reproductive health programmes.


Reproductive health and HIV/AIDS prevention for poverty eradication

  While welcoming poverty reduction as the over-arching objective of the Commission's development policy statement, and the importance given to social and human development and, in particular, to health and education, it is vital that the commitment to increasing and improving access to reproductive health care services and information be upheld as a priority area. This is especially important given the increasing feminisation of poverty and the dramatic increase of HIV infection among women.

  The Commission's central tenet that the integration of developing countries into the world economy is key to achieving poverty reduction must take into account the growing spread of disease and ill-health in the developing world and their economic and social impact. HIV/AIDS in particular has reversed development gains in some of the world's poorest countries.

  In order to contribute to the attainment of international development targets, and to fulfil its commitments made at the major UN conferences, the Community's new development policy should provide a stronger rights-based framework for sustainable development. Special attention should be given to gender equality in striving to achieve women's empowerment. Human rights and gender equality should be integrated into the EC's political dialogue with its partners.


  The EC has become an increasingly important player in health, HIV/AIDS and population (HAP) activities, with assistance to these sectors having grown significantly from barely 1 per cent of total EC aid in 1986 to over 8 per cent of total aid today (compared to an OECD average of approximately 5.5 per cent in 1998).

  Total EC commitments to health, AIDS and population amounted to almost 700 million euro in 1999, making it the largest donor after the World Bank, supporting health-related programmes in over 70 countries[1].


  In welcoming the priority given by the EC to health-related interventions and in particular to the fight against HIV/AIDS, it is important to note the role of special budget line B7-6212, Aid for Population and Reproductive Health, including HIV/AIDS, in Developing Countries. This small but significant budget line is of great importance as it is intended to fund innovative pilot interventions to test new ideas and approaches which can then be incorporated into the EC's larger-scale strategies. As such, it is intended to complement the EC's main financial and technical cooperation instruments by supporting policy and strategy development, in order to improve the effectiveness of the EC's action in these areas.

  Despite the EC's renewed commitment to the ICPD +5 process during 1999, in its Preliminary Draft Budget for 2000, the Commission proposed to delete budget line B7-631 (aid for population and reproductive health policies and programmes) and proposed over a 60 per cent cut to budget line B7-6211 (the fight against HIV/AIDS in developing countries). The inconsistency between the Commission's stated commitments and its proposed cuts to budgetary allocations was due to a lack of sufficient human resources and resulting difficulties in managing small budget lines. Following concerted action by European Parliament members of the Development Committee, and, in particular, members of the Working Group on Population, Sustainable Development and Reproductive Health, the two lines were merged into a single line (B7-6212) and funding allocations, amounting to 20 million euro, were restored. This example highlights the need to ensure that allocations to small, but strategically important funding instruments, is not threatened in the future and that the Commission's staffing problems are properly addressed in the current reform process.

  The further rationalisation of the different financial instruments for development cooperation, as outlined in the Commission's policy statement, is welcome. However, regrouping thematic budget lines under common denominators such as "social development" should take into account the EC's added value and experience in health-related interventions and the priority given to reproductive health. Access by civil society organisations to these budget lines should also be maintained and improved through improved management of EC aid. Furthermore, rationalisation of budget lines should be accompanied by an increase in funding allocations and the visibility of specific interventions in areas such as reproductive health, HIV/AIDS and gender should be maintained.


Human resources and management

  The growth in volume of EC aid in recent years has not been matched by a corresponding increase in human resources to manage funds. This, coupled with complex administrative procedures, has meant considerable discrepancies between aid commitments and disbursements, leading to the under-spend which has characterised EC aid in the 1990s. An increased number of officials with expertise in social and human development, in particular reproductive health, HIV/AIDS and gender issues should be employed by DG Development. This is essential in order to ensure effective and efficient management EC aid in these sectors, and to ensure that they are real priority areas for poverty eradication.

Capacity building in-country

  Following an audit of the Commission's delegations carried out by Marie Stopes International in 1999, although the majority stated that the EC funded at least one reproductive health programme in their country, most of the delegations said they lacked any related expertise and had never undergone training in population and reproductive health issues. Knowledge and expertise within the Commission's delegations in-country need to be strengthened, in order for EC delegations to effectively manage projects and programmes in-country. This is especially important in view of the foreseen increased devolution of project management to the Commission's overseas delegations, as outlined in the Commission's development policy paper.


  Appropriate monitoring and evaluation mechanisms are necessary in order to assess the effectiveness of EC aid and to ensure transparency and accountability. This is particularly important for improved communication and exchange of information between the European Parliament and the Commission.

  Reproductive health indicators and health impact assessments should be used systematically in order to gauge the effectiveness and qualitative impact of EC aid and to ensure systematic feedback into policy dialogue and programme formulation.


  The new ACP-EU Partnership Agreement represents an innovative framework for development cooperation, with poverty eradication at its heart. The new agreement gives unprecedented importance to social and human development and makes specific reference to the need to integrate "population issues into development strategies in order to improve reproductive health, primary health care, family planning; and prevention of female genital mutilation" (Article 25).

  It also explicitly states that cooperation will include the fight against HIV/AIDS. The new policy framework provides great scope for reducing poverty through an integrated approach based on economic, social and human development and regional integration. This approach should be taken as a positive example in finalising the new EC development policy. The new EC policy statement and the reform process must facilitate the implementation of social sector programmes within the new cooperation agreement.

Marie Stopes International

June 2000

1   European Community Development Cooperation Fact Sheet on Health, AIDS and Population (HAP), May 2000. Back

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