Opinion-Editorial by Dr Natalia Kanem, UNFPA Executive Director and Bjorn Andersson, UNFPA Asia-Pacific Regional Director

COVID-19 continues to take an enormous toll on women and girls around the world, including in Asia and the Pacific, as a direct consequence of national lockdowns and the sidelining of sexual and reproductive health services by health systems struggling to respond to the pandemic.

As the crisis rages on, the number of women unable to access family planning, facing unintended pregnancies, gender-based violence and other harmful practices could skyrocket in the months ahead.

A recent study commissioned by UNFPA, the United Nations sexual and reproductive health agency, highlighted that if mobility restrictions continue for at least 6 months with major disruptions to health services, 47 million women in low- and middle-income countries may be deprived of modern contraceptives, resulting in 7 million unintended pregnancies.

The disruption of UNFPA’s programmes on the ground could result in 2 million cases of female genital mutilation and 13 million child marriages – including in South Asia - that could have been averted by 2030.

We can also expect up to 31 million additional cases of gender-based violence for every 6 months of movement restriction measures. Many women are trapped with abusers at a time of heightened household tensions and reduced prevention and protection efforts, social services and care. In many countries across Asia, reports of domestic violence, for instance, have jumped since the pandemic started, with helplines reporting an increased volume of calls for assistance.

This is just the current snapshot; the future of what we call the “shadow pandemic” could be much worse. UNFPA projects that COVID-19 will slash by at least one-third global progress towards ending preventable maternal deaths, unmet need for family planning and gender-based violence and harmful practices against women and girls in this decade.

In Asia-Pacific, we’ve analysed 14 countries that are particularly vulnerable on three key sexual and reproductive health services: births supported by skilled providers, births occurring in health facilities and access to contraception. Even before the pandemic, these countries had high maternal mortality ratios – more than 100 deaths per 100,000 live births, linked to lower access to, or use of, essential services.

The best-case scenario, according to our estimates, is a 20% decline in use of the three key services. That would result in a 17% increase in the maternal mortality ratio, equivalent to almost 25,500 additional deaths this year alone. The worst-case scenario is a 50% drop in use of services leading to a 43% increase in maternal mortality, or almost 68,500 additional deaths. Of these additional numbers of women who could die during childbirth, a significant proportion would be those who became pregnant because of reduced access to contraceptive services.

While the spread of the coronavirus has slowed significantly in some countries, such as Thailand and Viet Nam, it is rapidly increasing in other countries – including in places where national health systems were already overstretched before the pandemic, and those experiencing protracted humanitarian crises.

UNFPA and its partners around the world are working around the clock to ensure access to sexual and reproductive health services and to protect essential workers such as midwives.

We are also doing our part to lobby for inclusion of essential services to address gender-based violence in preparedness and response plans for COVID-19, and to make modern contraceptives widely available to avoid unintended pregnancies.

We cannot do this alone. UNFPA calls on governments and partners to prioritize the sexual and reproductive health of women and girls and respond urgently to their needs, especially in humanitarian situations.

In this, the first year of the Decade of Action to achieve the Sustainable Development Goals by 2030, we must not allow the coronavirus to further worsen inequalities, including gender inequality.

Assisting people affected by public health and humanitarian crises is not only the right thing to do; it is the smart thing to do.

Failure to respond, or indulging in a false sense of complacency, may result in countless lives lost and lead to a future resurgence of COVID-19 – not only in fragile and conflict-affected countries, but even in countries that have robust health systems and infrastructure. The harms seen now could have an impact for years to come.

Pregnancy doesn't stop during a pandemic. Neither does childbirth. And neither do human rights. On World Population Day, and beyond, it’s time to reaffirm and act on our collective resolve to secure sexual and reproductive health and rights for all.

For more on UNFPA's response to the COVID-19 pandemic, visit https://www.unfpa.org/COVID19 and https://asiapacific.unfpa.org