The 2010 Millennium Development Goals Review Summit
Written Evidence submitted by the International Planned Parenthood Federation (IPPF)
1
The International Planned Parenthood Federation (IPPF) welcomes the opportunity to submit written evidence to the International Development Committee Inquiry into the 2010 Millennium Development Goal Review Summit. IPPF is a global service provider and a leading advocate for sexual and reproductive health and rights (SRHR). Through national organizations, we work in over 170 countries. T
he evidence in this submission will focus in particular on issues related to SRHR within the context of all the MDGs.
2
IPPF was an active participant at the MDG Summit (and one of very few civil society participants). IPPF’s Director-General participated in Roundtable 2 on Health and Education
Key outcomes from the Summit
3
The two key outcomes of the 2010 High-Level Review Summit on the MDGs were the High Level Plenary Meeting Outcome Document and the Secretary-General’s Global Strategy on Women’s and Children’s Health. IPPF welcomes the fact that the MDG Summit Outcome Document recognizes the importance of MDG 5, the most off-track of all MDGs, for achieving the MDGs. MDG5b – universal access to reproductive health - agreed to at the 2005 Review Summit is also critical to the attainment of the MDGs overall. IPPF welcomes the 2010 Outcome Document as more progressive than that agreed in 2005, largely due to the strong political consensus that prevailed on issues such as reproductive health at this year’s Summit.
4
MDG 5b recognizes that the health and well-being of women and their children is influenced significantly by the health, knowledge and choices available to women and men while they are adolescents and during times that they may be in a sexual relationship, but are not and do not wish to become pregnant. We welcome the link recognised between MDG5b and other development goals especially including r
educing
maternal mortality and morbidity.
5
From a civil society perspective, IPPF is disappointed that civil society did not have a more significant role – access or voice – in the MDG Summit itself, or in the negotiations of the Outcome Document.
6
Overall IPPF is disappointed with the content of the Outcome Document in providing a bold and progressive agenda for change. We believe that this will hinder, not help, Member States achieve the MDGs. The Outcome Document fails to recognise the significance of unsafe abortion and lack of access to safe legal abortion services as key causes in the deaths of over 70,000 women annually. Almost 20 million unsafe abortions take place every year and worldwide 8 million women experience complications from abortion, but only 5 million receive the necessary care
.
7
The Outcome Document fails to give sufficient weight to the human rights of women and girls and specifically their sexual and reproductive rights. This is especially disappointing in light of existing commitments made by Member States at the Commission on the Status of Women (CSW) and elsewhere. It is important that the UK/EC take a lead role in championing rights in the future.
8
The Outcome Document gives minimal recognition to young people and girls. This reflects the lack of visibility in the MDGs of young people, who we all recognise as essential for sustainable development. There are at present 1.8 billion young people representing the largest generation of young people ever. If their needs and priorities are neglected then it will be impossible to make meaningful and lasting progress towards the attainment of the MDGs. One-third of the total disease burden in adults can be attributed to behaviours or events from adolescence, including smoking, exposure to violence, mental illness and unsafe sex Adolescent girls account for just over one-tenth of births worldwide and they experience a disproportionate burden of disease due to pregnancy related conditions (23 per cent). In addition close to 40 per cent of all new HIV infections are among young people. Complications from pregnancy and childbirth are the leading cause of death in young women aged 15 to 19 in developing countries. The Outcome Document on MDG 5 takes a very narrow focus on methods of family planning without recognizing that a considerable proportion of maternal mortalities occur in adolescent girls. This is compounded by a lack of reference and understanding in the Outcome Document to the impact of violence against women and the lack of gender equity.
9
The Outcome Document falls short in regard to previously agreed UN consensus adopted in Cairo (International Conference on Population and Development 1994) and reinforced at the UN’s Commission for Population and Development in 2009 in recognising the importance of safe abortion, comprehensive sexuality education and the protection of human rights. The MDG Outcome Document may inadvertently serve to undermine its own vision and goals.
10
The second key outcome from the Summit was the Secretary-General’s Global Strategy on Women’s and Children’s Health. This is a plan to fast track progress on MDGs 4 and 5. IPPF welcomes the Global Strategy on Women’s and Children’s Health as a bold attempt to address the off track targets for MDGs 4 and 5, and in supporting SRHR. The Global Strategy on Women’s and Children’s Health has successfully mobilized donors, national governments, the private sector and civil society to make a range of commitments which will accelerate progress towards improving women and children’s health. IPPF welcomes this as a strategy to ensure that MDG5 is adequately financed. It is vital that these are monitored and those making major commitments are held to account by a strong and independent mechanism.
11
IPPF is delighted by the positive commitments to funding maternal health in this Global Strategy. However, it is unclear how much of this funding is actually new.
12
Given the role of civil society in contributing to and providing health services in many countries, it is important that civil society is involved in the implementation of the GSWACH. Plans for implementation need to recognise the plurality of service provision and the service delivery and advocacy role of civil society groups.
13
IPPF supports the Global Strategy and has pledged, amongst other commitments offered, to contribute to meeting the needs of the 215 million women with unmet need for contraception by increasing the number of new users of IPPF contraceptive services by at least 50
per cent
by 2015, and at least doubling the number of unintended pregnancies averted
. Full details of IPPF’s pledges to help reach the goal of the Global Strategy can be forwarded on request.
DFID's role in delivering agreed strategies
14
The UK, through DFID, has set out a bold pledge to double the number of women and children’s lives saved. To achieve this, the UK will provide an annual average of UK£740 million (US$1.1 billion) for Maternal, Newborn and Child Health from 2010 to 2015. This means that the UK will spend an additional UK£2.1bn on Maternal, Newborn and Child Health during this period. IPPF strongly welcomes this commitment which adds an additional UK£1.6bn to the commitment of UK£490m made by the UK for 2010 and 2011 at the Muskoka Summit held in Canada earlier this year.
15
IPPF warmly welcomes DFID’s new commitment to maternal, newborn and child health but would emphasise the importance of making clear the mechanisms by which the UK additional funding pledge will be delivered, and whether it will form part of amounts directed to the Global Fund on AIDS, Tuberculosis and Malaria.
16
IPPF applauds the UK government for stating at the Summit that it is "proud to be boosting our contribution to the international drive on maternal and infant health. Our new commitments will save the lives of 50,000 mothers and quarter of a million babies by 2015."
17
IPPF looks forward to DFID maintaining a leadership role as a global champion on SRHR at all levels to ensure the agreed strategies for prioritising MDGs 4 and 5 are implemented. DFID is well placed to help ensure other governments prioritise and meet their commitments to health.
18
As
Rt.
Hon
Andrew Mitchell MP, Secretary of State for International Development
,
stated at the Annual Ministerial Review of the ECOSOC in July 2010, the place of women and girls in development is impossible to overstate. He stated that the MDGs can only be achieved if there is a renewed focus on gender equality and women’s empowerment and that there was a need to shine a spotlight on women’s health and equality. He added that "improving reproductive health is the lynch pin of poverty eradication". IPPF strongly concurs with and supports this view.
19
IPPF looks
to the
UK
to ensure continuing progression of global policy norms that have relevance to public health outcomes and women’s rights. An early opportunity will be the
2011
UN
C
ommission on
P
opulation and
D
evelopment,
which has as its priority theme ‘Fertility, reproductive health and development’. DFID must also play a key role in any post-Summit accountability framework to ensure that commitments and pledges to deliver Summit outcomes by member states, UN agencies, civil society organizations and the private sector are implemented and monitored rigorously. One such arena for this could be the Annual Ministerial Review of the ECOSOC which in recent years has reviewed progress on the health MDGs (2009) and gender equality and the empowerment of women (2010).
The role of the UN, the World Bank, the European Commission and NGOs in securing and delivering Summit outcomes, and how these organisations will be held accountable for achieving them
20
Civil society was not allowed to contribute to the outcomes of the MDGs in any meaningful or effective way. An event entitled the "Informal Interactive Hearings of the General Assembly with Non-governmental organizations, Civil Society Organizations and the Private Sector" was held at the UN in June 2010. This gave a voice to civil society, though mainly to those from the North as the prohibitive costs of travelling to the UN in New York is often beyond that of southern based NGOs. Unfortunately, the lack of importance attached to the voice of civil society by member states was reflected in the small number of senior government delegates present at the hearings. The Outcome Document of these hearings was an official General Assembly document and was distributed to member states by the President of the General Assembly who asked that member states take its findings into consideration throughout the negotiation process. However, it is clear that it had very little weight or influence on the negotiation process - despite the recognition that civil society has a key role in delivering the programmes and services required to achieve the MDGs. In addition, it should be noted that the Outcome Document was drafted by UN entities without any consultation from the constituencies represented at the CSO Hearings.
21
It should be noted that one of the key roles of civil society is to hold governments to account. However this is difficult if civil society is unable to participate meaningfully in the relevant forums. There was very little space for civil society to participate at the MDG Summit. Only 25 Observer passes were made available to ECOSOC accredited NGOs (of which there are in excess of 3,000) and civil society only had four spaces on each of the 6 roundtables, each of which included 50 member state representatives. The importance of civil society seemed to be further relegated at the Roundtables as often CSOs were called at the end of these sessions and the time given to address participants was reduced from three minutes to one due to lack of time. To compound this lack of civil society representation further, the UK unlike a number of countries, offered no space for civil society to participate on its official delegation to the Summit. However, the NGO coordinating body BOND did facilitate two meetings between the Secretary of State and NGOs, and the Deputy Prime Minister, the Secretary of State and BOND Members. We were very grateful that these opportunities were made available by the government, and also appreciate the meeting with DFID to discuss the role of the UK at the Summit prior to the UN meeting itself.
22
DFID has stated that it will compile a list of all commitments made at the Summit by member states, foundations, civil society and the private sector. This list will help DFID hold governments and other bodies to account for the commitments they have made. We welcome this. There is a current lack of data on the mechanisms used by member states to report on their achievements for attaining the MDGs. This process needs clarifying.
23
The UN in conjunction with developing countries must provide the policy advice and data required to ensure the MDGs are met. Data, and especially appropriately disaggregated data is essential if policies and plans of action can focus using evidence on reaching the targets and goals in the MDGs. The World Bank too must ensure that its policy advice and funding is focused on prioritising the achievement of the MDGs, along with European Commission, the largest global development donor of all.
The role of developing countries in securing and delivering Summit outcomes
34.
Developing countries must be encouraged to work within the MDG framework and ensure that national health and poverty reduction strategies reflect the need to make progress towards achieving the goals by the 2015 deadline. While recognizing that donors cannot impose conditionalities and ensure that aid is untied, is harmonized and predictable and in line with the Paris declaration, they may need to remind partner governments of the many promises that have already been made – for example, at the UNGASS, Beijing, Cairo and the Millennium Summit. And partner governments need to ensure expenditure on areas such as reproductive health is available when the funding is provided expressly for this.
Looking ahead to after the MDG deadline of 2015
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