distinguished guests, friends and colleagues,
Ladies and Gentlemen,
- Almost a month ago, I was in The Hague at the 5-year review of the Cairo Conference by
governments, NGOs and United Nations Agencies - I was in The Hague to reaffirm the
commitment of WHO to reproductive health - as a health priority.
- Cairo was a visionary conference - it changed the way we viewed populations. We became
concerned with the well-being of human beings - rather than human numbers. Population
became a key development issue. New partnerships developed and the voices of NGOs and
women's health advocates became a driving force on empowerment of women to become
full and equal members of society. A human rights-based approach to reproductive health
issues became an important principle. The need to involve men, the need to give
information and services to young people - one billion of them (between the ages of
15-24), the largest group of young people that the world has ever known - were accepted in
the ICPD Programme of Action, and approved by consensus by 179 countries.
- The experience of countries and actions taken by them is for review at the Special
Session of the General Assembly this June. The Secretary-General will present a report
which will contain proposals for key actions for further implementation.
- As we reviewed our own work 5 years after Cairo, and as we listened to countries'
experiences last month, we noted with satisfaction that in most countries the Cairo agenda
had made a good start, especially at the policy level. Issues that were debated till the
early hours of the morning, day after day in Cairo, now had a life of their own and took
many different national flavours and were presented to people in a form, in an approach,
that was acceptable to them. However, there was still a need to continue to reiterate the
commitment at the highest political levels that reproductive health is a priority and to
allocate enough resources to it. Financial, institutional and human resources.
My second observation was that even though infant-child mortality had come down and was
expected to continue this downward trend, maternal mortality remained unacceptably high
especially in sub-Saharan Africa and parts of Asia. The tragedy of death in childbirth
shows that we still need to reiterate that the three core components of reproductive
health must receive priority action, for they are interlinked and they will provide gains
in terms of human development.
These 3 core elements are
- access to quality family planning services
- reduction in maternal mortality
- preventing and treating HIV/AIDS and sexually transmitted
My third observation is that Cairo commitments have not always been followed by the
resources needed to be translated into improvements in people's lives. As you
remember, in Cairo it was agreed that two-thirds of the projected cost of implementing
reproductive health programmes would come from domestic sources and one-third from the
international donor community. An analysis of resource flows shows that while many
developing countries are responding to the challenge and allocating more resources to
reproductive health, developed countries are not fulfilling their commitments. Official
development assistance has taken a downward trend. We need to work with governments and
the international community to recommit and make every effort to mobilize financial
resources as agreed in Cairo. If we are to see substantial change, the international donor
community should fulfil its promise to reach the 0.7% of the GNP for official development
assistance and devote 4% of it to reproductive health programmes.
What has WHO done post-Cairo?
- Dr Olive Shisana, Executive Director, Health Systems and Community Health, will present
to you WHO's contribution to sexual and reproductive health since Cairo.
- Since July 1998, WHO has reorganized itself to have one reproductive health programme,
rather than two separate programmes, comprising of action and research closely bound to
each other. HIV/AIDS activities have been brought to the forefront of the Cluster on
Health Systems and Community Health. We shall continue to work closely with UNAIDS and our
Member States in combating HIV/AIDS. Normative and technical cooperation functions of WHO
have been strengthened to provide assistance to countries in sexual and reproductive
- I will be meeting with Dr Nafis Sadik on 8 April to review carefully our mandate, work
plans and what each agency can do separately and together in order to advance the work on
reproductive health in countries, avoid duplication and save scarce resources. The broad
reproductive health agenda is too big and complex for any single agency. We can be more
effective when we link with others, agree on a division of labour and create real
partnerships to achieve real outcomes.
- After a careful review of the global sexual and reproductive health needs of countries,
WHO's contribution as a specialized agency in health will be further defined in view
of our extensive partnership with other agencies, collaborating centres, NGOs, and
- WHO will continue to assist countries with tools that have evidence-base, value-base and
- WHO is committed to putting health at the core of the development agenda. This is where
it belongs. Reproductive health is part and parcel of that commitment.