I would like
to congratulate Dr. Margaret Chan on assuming the strategic responsibility as
the Director General of the World Health Organization and I would like to thank
her for giving me the opportunity to address this honourable gathering. It is a
pleasure to say that Margaret and I have quickly gone beyond being just
colleagues to becoming friends, with the commitment to mutually support each
other in the complementary development agendas of our organizations and to work
together to deliver as one in support of national development.
I would also
like to pay tribute to His Excellency, the Prime Minister of Norway, Mr. Jens
Stoltenberg, for his leadership and vision and special emphasis on Millennium
Development Goals 4 and 5.
Though UNFPA
works in the areas of demographic analysis, censuses, data collection and gender
issues, we rely on the normative and technical guidance of WHO on issues related
to reproductive health and rights, which we support operationally. We work
together through joint programmes, an effort that both Dr. Chan and I are
committed to expand further.
It is only
through partnership that we can improve international health security.
In our
globalised world, international health security depends on the health security
of nations. It depends on the health of communities and families. And it depends
on the health and well-being of individuals, including women and young people,
who remain particularly vulnerable.
As the
Constitution of the World Health Organization rightly states, health is a
fundamental right of every human being.
And yet today,
good health is unevenly distributed, and new challenges and opportunities are
presented by urbanization, international migration, ageing populations and the
largest youth generation in human history.
Here in Europe
and other parts of the developed world, population growth is stagnant or
declining. But population continues to grow rapidly in the poorest countries
that are least able to meet growing needs.
Now, more than
ever, dealing with inequality—by achieving the Millennium Development
Goals—is central to economic stability and health security.
Honourable
Ministers,
UNFPA applauds
the stated priorities of the World Health Organization, under the leadership of
Dr. Chan, to focus on the health of women, the health of the people of Africa,
and the strengthening of health systems. These are essential to the achievement
of the Millennium Development Goals.
We look
forward to strengthened collaboration to guarantee universal access to
reproductive health by 2015, as set out at the 1994 International Conference on
Population and Development (ICPD) and reaffirmed by world leaders at the 2005
World Summit, and as a new target under MDG 5 on maternal health.
We will not
achieve the Millennium Development Goals, particularly those related to health
and gender equality, unless greater attention is paid to sexual and reproductive
health and reproductive rights.
No nation can
be developed when women are denied the right to health. And no nation can
progress when large numbers of women die while giving life.
Today, poor
sexual and reproductive health is a leading cause of death and disability in the
developing world.
As a result,
every minute, 10 people are newly infected with HIV, and every year, 3 million
people die of AIDS.
Every year,
more than half a million women die during childbirth, with more than 95 per cent
of these deaths occurring in Africa and Asia.
And yet we do
not see a headline in any newspaper or a news story on CNN’s ticker announcing
such tragedy that impacts their families and communities, and it does not
indicate it is worthy of our urgent attention. Their death passes quietly as a
silent tsunami, as the honourable Minister of Health of Afghanistan told me
recently when I met with him in Kabul.
Over the past
two decades, more than 10 million women have died from complications of
pregnancy and childbirth and some 300 million women have suffered complication
or long-term disabilities, such as obstetric fistula.
By any
measure, this situation is deplorable when we consider the fact that most of
these deaths and disabilities could be prevented if every woman had access to
reproductive healthcare. We all know that to reduce maternal mortality, every
woman needs skilled attendance at birth, emergency obstetric care and family
planning. This preventable mortality and morbidity of poor women is a true
violation of their right to life, to health, to well-being and to human dignity.
The nations
that have scaled up these services are reaping the benefits, saving the lives of
mothers and their children and ensuring their countries’ well-being.
Family
planning alone could save the lives of 150,000 women each year. Spacing births
by at least two years could each year save more than 1 million children under
five.
Family
planning also prevents recourse to abortion. Today, too many women are dying
from unsafe abortion—an estimated 186 women every single day. And we will not
meet goals to reduce maternal mortality unless unsafe abortion is addressed.
Let us work
within the spirit and words of paragraph 8.25 of the ICPD Programme of Action.
In the agreement, you, Member States, asserted that abortion should never be a
form of family planning. You agreed that family planning services should be
expanded to reduce unwanted pregnancy and thus abortion. You also agreed that
the decision on abortion is a national matter and where it is not against the
law, it should be safe. And you agreed that women who suffer complications from
abortion should have ready access to life saving treatment and care.
We must also
do more to stop HIV and AIDS.
Investing in
sexual and reproductive health is strategic for curbing the HIV/AIDS pandemic.
With over 75
per cent of HIV cases due to sexual transmission, delivery and breastfeeding, it
makes sense to link HIV/AIDS efforts with reproductive health. This benefits
women and young people who bear a growing and disproportionate burden of the
pandemic.
Health systems
that deliver integrated services through primary health care at the community
level for reproductive health, child health and the prevention and treatment of
tuberculosis, malaria and HIV/AIDS, are cost-effective and have a greater
impact. We need to look again at how we can integrate such services so that
communities, especially women and young people, can have a “one stop” shop
for all their basic health needs.
Strengthened
health systems should also deliver a steady and reliable supply of reproductive
health commodities, including drugs for maternal health, contraceptives, HIV
test kits and condoms.
With no cure
in sight for AIDS, our first line of defense remains prevention.
Together, we
must intensify HIV prevention along with treatment, care and support.
Honourable
Ministers,
The benefits
of investing in reproductive health and rights are well-documented and
substantial and you as the experts are most knowledgeable about them.
The benefits
also extend beyond the health sector. The WHO Commission on Macroeconomics and
Health provided compelling evidence that better health for the world’s poor is
not only an important goal in its own right, but can act as a major catalyst for
economic development. Its report talked clearly about the burden of disease
associated with reproductive health and its costs on women, the health system ,
the family, as well as nationally and globally.
The
empowerment of women is vital to international health security. UNFPA welcomes
the draft strategy on integrating gender analysis and actions into the work of
the World Health Organization. And we look forward to our enhanced partnership
to take this important agenda forward.
Health
security also requires special attention to emergency situations and countries
affected by conflict. In countries affected by crisis, child and maternal
mortality rates are shamefully high and sexual violence is widespread; both
taking away the sense of security and dignity that woman try to preserve at time
of crises.
Honourable
Ministers,
Health
security depends on strengthened health systems staffed with skilled health
workers. And no one knows this better than you.
In my travels,
I am impressed by the dedicated and hard-working health workers I meet. Too many
toil in difficult conditions, faced with a crumbling health system and shortages
of basic supplies.
Others cross
borders in search of better opportunities and improved quality of life.
Nations need
to work together to address the health personnel crisis, as His Excellency the
Prime Minister has pointed out. Long-term solutions are required. But just as
important are short-term solutions to save people’s lives. We must explore and
support innovative ideas, such as the use of alternate and community health
workers to provide people with the health services they need.
UNFPA is proud
of its work with WHO to scale up the availability of midwives in communities to
save the lives of women and newborns.
To scale up
health services, massive investment is required in the training of health
personnel at all levels. Improvements are equally needed in their status, pay
and working conditions. Health workers need incentives to stay in their
countries and provide the health services that people so desperately need.
Honourable
Ministers,
It is urgent
that increased investment is achieved in reproductive health, as part of overall
efforts to strengthen health systems and ensure international health security.
We know what
needs to be done. We know what works.
What we need
is the political will and the sense of urgency to make greater investment in the
health sector so that reproductive health and rights become a reality.
Today, the
MDGs most closely related to reproductive health -- to improve maternal health
and prevent HIV infection -- show the least progress. The need for increased
resources and accelerated action is urgent.
Although
daunting challenges remain, I am encouraged by strong and growing commitment.
I see this
commitment when I visit national capitals and villages and United Nations
country teams.
I see this
commitment among world leaders at the World Summit committing themselves to
ensuring universal access to reproductive health by 2015 and asking that it be
linked to the various relevant MDGs, including poverty reduction.
I see this
commitment in the Political Declaration on HIV/AIDS adopted by the General
Assembly.
I see this
commitment in the groundbreaking Maputo Plan of Action on Sexual and
Reproductive Health adopted by African Health Ministers last year to expand such
health services across the African continent.
I see this
commitment in the maternal and newborn health roadmaps that are paving the way
for scaled up efforts and thus further progress.
Yes, I am
optimistic, but I am also realistic because I am aware of the highly politicized
nature of the reproductive health and rights agenda. It is the agenda where
human rights and culture seem to conflict. Yet if we facilitate dialogue and
understanding among communities and development actors, culture and its positive
values can be facilitators for human rights, especially the right to health.
Therefore, it
is important to stress that if we are to make greater progress, we have to
strengthen our alliances and support national efforts to move ahead. Building
alliances means reaching out to every institution that provides services to
communities-- national institutions, non-governmental, civil society, religious
and faith-based organizations.
Honourable
Ministers,
Together, we
must now ensure that reproductive health is fully integrated into development
plans, sector policies and budgets, these very critical national processes.
Our challenge
is to deliver an essential package of reproductive health information, services
and supplies.
At UNFPA, we
are encouraged by the recent call to action by the Prime Minister of Tanzania
for leaders to increase health spending to 15 per cent of national budgets, as
he spoke at the first Partner’s Forum of The Partnership for Maternal, Newborn
& Child Health.
UNFPA is a
committed and active member of the Partnership. And we welcome the Global
Business Plan put forward by His Excellency the Norwegian Prime Minister to
accelerate action towards the achievement of MDGs 4 and 5.
For UNFPA,
maternal health is a top priority. As champions of reproductive health and
rights, we are committed to saving women’s lives.
To be more
effective, we are working with United Nations partners at the country level to
deliver as one.
To this end,
Dr. Chan and I are discussing how WHO and UNFPA can intensify our work, together
with other partners in the United Nations system, to strengthen our coordination
in countries and provide one United Nations voice.
The goal is to
provide better United Nations support to countries to develop national capacity
and scale up maternal, newborn and child health services at the community and
country levels. The partnership will build on the comparative advantages of WHO
and UNFPA and other UN partners in achieving MDGs 4 and 5.
Honourable
Ministers,
I always
communicate to my colleagues that, “The best way to bring out the best in
people is by being the best ourselves”. UNFPA is committed to a more effective
and cohesive United Nations system. There is no doubt that as a United Nations
country team, we need to support national priorities and build national capacity
to achieve stronger results and we need to depend on national human resources.
And we need to
engage civil society and religious institutions that deliver much of the health
and education services at the community level, to join us in being part of the
solution, because working together brings greater results.
There are no
stronger champions of women’s health than women themselves. Young people, too,
know what they need. And people living with HIV and AIDS help build an effective
response to the AIDS pandemic. We need to engage them in the efforts to serve
them and to empower them to claim their rights to quality healthcare for
themselves and their families.
But there is
also another strong champion for women and their health—that is the men in
their lives, whether they are fathers, brothers, husbands, partners, teachers,
doctors, leaders of churches, mosques and temples and most of all, you,
Ministers of Health, and many of you are men. Men need to feel morally compelled
to be engaged and supportive because they are also part of the solution.
Honourable
Ministers,
You are well
placed to advocate for greater investments in health and well-being.
If we join
forces, results will be concrete and clearly measured: in the lives of the
mothers, newborns and children you save; the young people who are able to
prevent HIV infection; the girls who escape child marriage and female genital
mutilation, the couples who can plan their families, and the women who receive
treatment and justice for violence inflicted against them.
Together and
as individuals, we share the power, responsibilities, and possibilities to make
the world a better home for people living with dignity, so that they can claim
their rights, especially their rights to life, health, education, and safety.
I thank you.
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