Thank you very much.
(Applause.) Thank you all. Thank you. Thank you all very much. My goodness,
thank you. Wow, this is a wonderful occasion. Several of us were quite
nervous when we saw the snow start last night, so I’m delighted the sun is
out and shining on all of you here as we gather for this commemoration of
the 15th anniversary of the groundbreaking gathering and agreement in Cairo.
When I think about that and
the thousands of people who were part of it who came together to declare
with one voice that reproductive healthcare is critical to the health of
women, and that women’s health is essential to the prosperity and
opportunity of all, to the stability of families and communities, and the
sustainability and development of nations, it makes me nostalgic for
conferences that are held that actually produce results – (laughter) –
and give us a framework for moving forward. There is no doubt in my mind
that the work that was done and the commitments that were made in Cairo are
still really the bulwark of what we intend to be doing and are expected to
do on behalf of women and girls.
The year 2015 is the target
year. Part of the reason we wanted to have this commemoration is not only to
look backwards, but to look forward. What is it we will do between now and
2015? Remember what was expected of us. All governments will make access to
reproductive healthcare and family planning services a basic right. We will
dramatically reduce infant, child, and maternal mortality. We will open the
doors of education to all citizens, but especially to girls and women.
| It is somewhat hard to believe
in retrospect that Cairo was the first ever global forum that recognized the
connection between women’s health, the quality of women’s lives, and
human progress on a broader scale.
So I am delighted to join you in marking
this landmark event, but more importantly, to asking you to join with us in
rededicating ourselves to the goals that we embraced 15 years ago.
They
remain critical and they remain unfilled.
I’ve had the honor and
privilege as I look around this audience of knowing many of you, some of you
for a very long time.
And I know how committed many of you have been and
continue to be. We have made measurable progress since 1994 in improving the
health and the lives of women and children, especially girls.
For example,
the use of modern contraceptives worldwide has increased from under 10
percent in the 1960s to 43 percent in 2008.
We have greater access to
neo-natal care, including medicines that prevent the spread of HIV from
mother to child. We’ve significantly increased child survival rates.
|
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|
The
number of girls enrolled in schools around the world has gone up. And
we’ve come closer to a less measurable but still critical goal: The
integration of gender into a range of global programs, including our efforts
through the United Nations to bring an end to sexual and gender-based
violence in places of conflict.
However, vast inequities
remain. Too often, still today in 2010, women and girls bear the burdens of
regional and global crises, whether it’s an economic downturn or climate
change or political instability. They still are the majority of the
world’s poor, unschooled, unhealthy, and underfed. They are rarely the
cause of violent consequences, but increasingly – of violent conflicts,
but increasingly they bear the consequences of such conflicts. We’ve seen
that from the Congo to Bosnia to Burma. And 15 years after the Cairo
conference, far too many women still have little or no access to
reproductive health services, including family planning and maternal
healthcare.
| When we look at this deficit
in healthcare for women, we can see what it means in terms of lost
productivity, lost resources, and lost lives.
Nearly half the women in the
developing world deliver their babies without a nurse, a midwife, a doctor,
or access to crucial medical care.
Global rates of maternal mortality remain
perilously high; one woman dies every minute of every day in pregnancy or
childbirth, and for every woman who dies, another 20 suffer from injury,
infection, or disease every minute.
|
|
More than 215 million women
worldwide lack access to the modern forms of contraception, and this
contributes to the nearly 20 million unsafe abortions that take place very
year. Sexually transmitted diseases, of course including, but not limited
to, HIV and AIDS, claim millions of lives annually among women. Fistula
destroys the lives of millions, and it is often the result of pregnancies
that occur when a girl is too young. An estimated 70 million – that is 70
million women and girls worldwide – have been subjected to female genital
cutting, a procedure that is not only painful and traumatic but is also the
source of infections and increased risks of injury during childbirth.
Now, as those of us gathered
in the Ben Franklin Room on the eight floor of the State Department know
very well, the topic of reproductive health is subject to a great deal of
debate. But I think we should all agree that these numbers are not only
grim, but after 15 years, they are intolerable. For if we believe that human
rights are women’s rights and women’s rights are human rights, then we
cannot accept the ongoing marginalization of half the world’s population.
We cannot accept it morally, politically, socially, or economically.
(Applause)
So we’re here today to
examine the distance that remains to be traveled before the world fully
realizes the ICPD goals. This is a journey that the Obama Administration and
the United States Government will travel with you. But we need to travel
quickly, because we only have five years to meet our original goals.
For the health statistics that
I just mentioned point to a broader impact. There’s a direct connection
between a woman’s ability to plan her family, space her pregnancies, and
give birth safely, and her ability to get an education, work outside the
home, support her family, and participate fully in the life of her
community.
When a girl becomes a mother
before she becomes literate, when a woman gives birth alone and is left with
a permanent disability, when a mother toils daily to feed her large family
but cannot convince her husband to agree to contraception, these struggles
represent suffering that can and should be avoided. They represent potential
that goes unfulfilled. And they also represent an opportunity to extend
critical help to women worldwide and the children who depend on them.
Investing in the health of
women, adolescents, and girls is not only the right thing to do; it is also
the smart thing to do. That is why we are integrating women’s issues as
key elements of our foreign policy agenda and in, especially, our Global
Health Initiative and our Global Food Security Initiative. That is why we
saw the first appointment of an ambassador for global women issues, and it
didn’t take me long to decide who should fill that position. It is why we
are launching women’s entrepreneurial efforts through Pathways to
Prosperity in Latin America, to ensure that prosperity is spread more
broadly, including to women. It is why we are working with religious leaders
in Afghanistan and Pakistan to increase access to information about family
planning and preventive healthcare.
We are doing all of these
things because we have seen that when women and girls have the tools to stay
healthy and the opportunity to contribute to their families’ well-being,
they flourish and so do the people around them.
Consider this one story from
Uganda, where USAID works with the International Planned Parenthood
Federation to provide reproductive health services, education, and skills
training to low-income women. Among their clients are a group of teenage
girls who call themselves the “Moonlight Stars.” Their parents are dead,
leaving them the sole providers for their younger brothers and sisters,
without any other options, they were working as prostitutes. Through this
USAID-funded program, they gained access to condoms and comprehensive sex
education to protect themselves from disease and pregnancy. They also began
taking classes in sewing and knitting and other kinds of skills that could
be used to help support their siblings without endangering their physical or
emotional well-being. And thanks to this job training and the support that
accompanied it, many of the Moonlight Stars have left prostitution behind
and embarked on a new path of opportunity for themselves and their families.
While investing in women lifts
many lives, the inverse is also true. In societies where women’s rights
and roles are denied, girls are forbidden from attending school or they pay
a very heavy price to try to do so. Few have the right to decide whether or
when to get married or become mothers. Poverty, political oppression, and
even violent extremism often follow.
Maternal and child health are
particularly important indicators of broader progress. In recent years,
we’ve learned more about the conditions that accompany political unrest.
It turns out that one of the most constant predictors for political upheaval
is the rate of infant mortality. In places where the rate of infant
mortality is high, the quality of life is low because investment in and
access to healthcare are often out of reach. And that breeds the kind of
frustration, hopelessness, and anger that we’ve seen. We also know that
child mortality is closely connected with maternal mortality. When a mother
dies, her children are at much greater risk of dying as well.
These struggles can’t be
separated, and neither can their solutions. In the Obama Administration, we
are convinced of the value of investing in women and girls, and we
understand there is a direct line between a woman’s reproductive health
and her ability to lead a productive, fulfilling life. And therefore, we
believe investing in the potential of women and girls is the smartest
investment we can make. It is connected to every problem on anyone’s mind
around the world today. (Applause.)
So we are rededicating
ourselves to the global efforts to improve reproductive health for women and
girls. Under the leadership of this Administration, we are committed to
meeting the Cairo goals. We’re committed to working in partnership with
all of you. One of President Obama’s first actions in office was to
overturn the Mexico City policy, which greatly limited our ability to fund
family planning programs. (Applause.)
We have pledged new funding,
new programs, and a renewed commitment to achieve Millennium Development
Goal Five, namely a [three-fourths] reduction in global maternal mortality,
and universal access to reproductive healthcare. This goal is, again,
critical to and interconnected with every other millennium development goal.
But the world has made less progress toward fulfilling that goal than any
other.
This year, the United States
renewed funding of reproductive healthcare through the United Nations
Population Fund, and more funding is on the way. (Applause.) The U.S.
Congress recently appropriated more than $648 million in foreign assistance
to family planning and reproductive health programs worldwide. That’s the
largest allocation in more than a decade – since we last had a Democratic
president, I might add. (Applause.)
In addition to new funding,
we’ve launched a new program that will be the centerpiece of our foreign
policy, the Global Health Initiative, which commits us to spending $63
billion over six years to improve global health by investing in efforts to
reduce maternal and child mortality, prevent millions of unintended
pregnancies, and avert millions of new HIV infections, among other goals.
This initiative will employ a new approach to fighting disease and promoting
health. It will address interrelated health challenges together, for
example, by integrating family planning, maternal health services, and
HIV/AIDS screening and treatment, so that women receiving reproductive care
will also receive HIV counseling, and will be referred to an HIV clinic if
they need one.
We’re now seeing the rise of
the largest youth generation in the history of the world. They need and
deserve to know how to stay healthy, and through this initiative, we will be
providing critical information to them. The Global Health Initiative will
also focus on helping countries strengthen their own health systems. We want
to build sustainable health systems in countries. And it will ensure that
all of our global health programs, including nutrition, malaria, TB,
HIV/AIDS are designed to meet the needs of women and girls, including by
taking into account the many social and economic factors that have an impact
on their health from sexual coercion to domestic violence to pervasive
gender inequities.
You know that HIV/AIDS is now
morphing into a women’s disease, and increasingly younger and younger
women in many, many poor countries are infected. We know that expanding
access to contraception helps only if women are empowered to use it, that
protecting oneself from HIV is harder when one’s life depends on staying
in a man’s good favor, and that all the prenatal care in the world won’t
protect a mother and child from an abusive home. Promoting women’s health
and children’s health means improving the quality of their lives on many
levels, and it also means reaching out to men and boys to encourage them to
become advocates and allies.
So we have our work cut out
for us, but we have an excellent roadmap in the Cairo program of action and
a worthy target in the Millennium Development Goal Number Five. And we’re
going to need your help. In everything that we’re doing in the Department
and at USAID, we are injecting the needs and the roles of women and girls.
We’re asking for how women and girls can play more of a role in their
societies, be more involved in peacemaking and peacekeeping, assist in
mitigating against and preventing climate change. Just across the board, we
are making it clear that there has to be special attention paid to the needs
of women and girls. It’s in America’s national security interests to do
so.
I want to close with the story
of one woman whose life was transformed by the work that the people in this
room do every single day. Caroline Ditina is a young woman from the
Democratic Republic of Congo who for years endured the shame and ostracism
caused by obstetric fistula. Eventually, she found her way to a clinic
supported by the UN Population Fund, and she finally received the surgery,
care, and emotional support she needed to heal. Then she started speaking
out about her experience to fight the stigma and to let other women know
that even in isolated places, treatment is possible.
Her message has traveled the
world. Two years ago, she came to Washington and urged members of Congress
to support maternal health programs worldwide. And today, the United States
is proud once again to support the work of the UN Population Fund. But one
advocate, even one with such passion and commitment, can only do so much.
Every woman everywhere deserves high-quality care not only at her most
vulnerable hour, but at every single stage of life. That’s our goal and
that’s our responsibility.
It is also a matter of simple
equity and fairness. I’ve been in many places in many parts of the world
where the rich, the educated, the well off, the connected, the powerful, the
elite had access to every single form of healthcare. And yet it was denied
– denied by law, denied by culture, denied by taboo, denied by regulation,
denied by resources to the vast majority of women in the same societies.
That is unacceptable.
So part of what we need to do
is not only provide services to those who need them, but to change the minds
and attitudes of those who can be responsible for delivering those services
in countries around the world. I have said in many different settings on, I
guess, every continent except Antarctica that the rights that women who have
a position in society are able to command cannot, therefore, be denied to
the women who live down the street or care for their children or clean their
homes or plant their crops, and that we have to do a better job of making
the equity argument on behalf of girls and women, and particularly on behalf
of the Cairo agenda.
I’m very optimistic and very
committed that we can do this together, and I am very grateful for what so
many of you have done for so many years. You have ridden the ups and you
have survived the downs. You have worked in favorable political environments
and unfavorable ones. You have seen the Mexico City policy come and go, and
you have stayed true. You’ve stayed true to your commitment, your passion,
your belief that every single child in this country – boy or girl –
deserves a chance to live up to his or her God-given potential.
I just want to urge that we do
not grow weary. I don’t about you, but sometimes it can seem a little bit
hard to take. It is also self-evident; it seems so obvious to the rest of us
that this needs to be done, and we keep encountering obstacles of every
shape and size. But please, stay with us and let’s try to create
institutional and structural change that does not get wiped away when the
political winds blow. Let’s try to create markets for these goods and ways
of funding them and educational and instructional programs along with our
commitment to serve that will give women everywhere a chance to take their
own lives and their own futures into their own hands.
It is now my great pleasure
– you’ve met two of my wonderful team members. I want to introduce two
more whom I see. One is Raj Shah, Dr. Raj Shah, our new superb Administrator
of USAID. (Applause.) Raj, come here. Come here, Raj. (Applause.)
We want you to get to meet him
if you don’t know him. We want you to support him as he makes the changes
that are necessary to put USAID back in the forefront of world development
agencies.
And now it’s my honor to
introduce our Under Secretary Maria Otero. And maybe, Maria, you and Raj
could say a few words to close out the program. (Applause.)