Five years after Cairo we are getting together with a three-fold purpose:

• To maintain momentum where we have made progress
• To recreate momentum where we are lagging behind
• And to inspire each other to make an extra effort in the quest for the right of women, men and adolescents to lead a healthy reproductive life.

Let us thank the Government of the Netherlands, for giving us the opportunity to come together to review progress since that historic meeting in Cairo. And let us pay tribute to Dr Nafis Sadik, who has kept the vision of Cairo alive during these five years.

In Cairo we sent a new message: it is possible to achieve the stabilization of the world population while at the same time attending to people's health needs and respecting their rights in reproduction. We called for a shift in population policies and programmes. We went from an emphasis on demographic targets for reduced population growth to a focus on improving reproductive health. We advocated for measures that would enable people to make choices in a context of equity, human rights, mutual responsibilities and shared respect.

We sent a new message - an optimistic message. Progress and development can be reached by empowering people, especially women who for too long have been denied their fair access to political, social and economic decision-shaping and decision-making.

As Prime Minister of Norway, a country with a long interest in international health and development, I addressed the Cairo meeting. I emphasized then that visions are needed to bring about change. But I stressed that we must let visions and commitments materialize through allocation of resources. It was clear to me that the really hard work would begin when the ICPD was over.

Today, as Director-General of the World Health Organization, I see even more clearly the truth of what I chose to say five years ago.

Let us be clear about it. The Cairo commitments have not always been followed by the resources needed for commitments to be translated into improvements in people's lives. Many developing countries are responding to the challenge and allocate more resources to reproductive health - often with WHO's support and assistance. However, with some laudable exceptions, such as our host country, developed countries are not fulfilling their commitments.

In 1996, donor assistance represented no more than 35% of what was promised in Cairo. We have obligations to fulfill. Needless suffering and death are sufficient cause for action themselves but there are also significant social and economic considerations. Reproductive ill-health affects the young, people with family responsibilities, women and men at a period in their lives when they have the potential to be most productive for communities and societies.

In area after area of reproductive health we know what to do to change the course. And in most cases it is not costly. Not at all.

On this important occasion, I pledge WHO's commitment to the issues of population, development and reproductive health, a commitment that will be strengthened in the new organizational structure of the Organization. WHO will be more effective, more accountable, more transparent and more receptive to a changing world. We will establish stronger partnerships with Member States and we will be reaching out to the whole UN family, the international financial institutions, nongovernmental organizations and the private sector.

I would like to take this opportunity here at the Hague - as we start our preparations for the General Assembly in July - to focus on one specific issue that lies at the very heart of the Cairo consensus. I am talking about the tragedy of maternal mortality.

At the end of the twentieth century, it is unacceptable that women continue to suffer and die as a result of complications related to pregnancy and childbirth. The enormous disparities in levels of maternal mortality and morbidity between rich and poor are a continuing affront to all of us.

We have evidence of what works and what does not work to reduce maternal mortality. Women must have access to skilled assistance during pregnancy and childbirth; they must be able to reach a functioning health care facility when complications arise. We are not asking for the impossible; the interventions needed are well known. They are simple and cost-effective. We have no excuses for failing to act. As Director-General of WHO, I pledge maximum efforts to address maternal mortality.

Distinguished participants,

It is essential to maintain a long-term perspective regarding the implementation of the ICPD agenda. But we also need to be impatient. Despite many encouraging signs, we know that only limited progress has been made in actually implementing the Cairo Programme of Action. This should not surprise us. Despite the enormous conceptual advances that Cairo represented, much remains to be done about reproductive health. There are many barriers - political and cultural barriers - to its attainment. It takes time to turn institutions and thinking around, and even longer to be able to measure the impact of those changes.

We all need to mobilize to make a difference. WHO as the lead agency in health is ready to make a real contribution. Let us be impatient and enthusiastic. We can make a difference for the lives of millions.