It is an honor for the United Nations Population Fund and for me personally to have this opportunity to speak to you at one of the most important conferences on Sexual and Reproductive Health and Rights -- not only in our region, but globally.
Sexual and Reproductive Health and Rights are of course central to the mission of UNFPA, but also to the mission of the United Nations as a whole, in all of the three pillars of our work: development, peace and security and human Rights. Sexual and reproductive health refers at one level to our physical and mental health -- which is on the one hand a fundamental human right, and on the other hand an essential part of the human capacity to contribute to social and economic development.
But is goes beyond that. At the core, sexual and reproductive health and rights are about how we love, with whom and how we share our bodies – and our hearts -- and whether and when and how many children we have. It is about being able to make good, happy and responsible decisions on these momentous questions that are also respectful and caring of our partners.
That means also having access to the services and information that empower us to make those decisions, in freedom and in safety. Guaranteeing this right to all people without exclusion and without discrimination is crucial for building inclusive, peaceful and democratic societies.
It’s especially significant that Myanmar is hosting this conference at such a historic moment for the country, a little more than a month before a new, democratically-elected government takes charge. There is great expectation – on the part of the people of Myanmar, but also the international community, that this new democracy will also achieve peace and an end to violent conflicts, greater prosperity and wellbeing -- including sexual and reproductive health and rights -- and a unity that embraces the wonderful diversity of this country, bringing an end to exclusions based on ethnicity, religion or any other differences.
We very much hope that this conference can contribute useful and constructive ideas and proposals toward the achievement of those objectives.
This conference also comes at an auspicious moment globally, not long after the adoption of the 2030 Agenda for Sustainable Development in the United Nations. The 2030 Agenda, seeks to advance development processes that bring together all spheres of life -- the economic, social, environmental, and also how we are governed, and how we live together as societies. It seeks the universal fulfillment of human rights, calling on nations to overcome inequalities and ‘leave no one behind.’
Among the goals and targets included in the 2030 Agenda are reducing maternal deaths, universal access to sexual and reproductive health and universal exercise of reproductive rights.
Where are we now in our progress toward these goals? In recent decades, we have achieved major advances. Between 1990 and 2015, maternal mortality – the number of women who die from causes related to pregnancy and child birth -- dropped by approximately half globally, but by more than 60 percent in South-East Asia and Myanmar in particular. Access to basic health services has increased significantly in our region, including the number of pregnant women receiving pre-natal care and the number of births attended by skilled health staff.
But there are still far too many women in our region who die in pregnancy -- an estimated 85-thousand lives are lost each year. Access to modern methods of contraception has greatly increased, but in many countries -- including Indonesia, Pakistan, the Philippines and Viet Nam -- we are seeing an increasing number of adolescent girls becoming pregnant. And, not surprisingly, it’s the poorest populations where unwanted pregnancies are the highest. Across Asia and the Pacific, the higher income groups have 40 percent higher rates of contraceptive use, 45 percent lower unmet need for contraception and a 65 percent lower percentage of adolescent mothers, as compared to the lowest income groups.
How do we overcome these injustices and exclusions and correct these violations of human rights? The first step is to recognize these numbers as such -- as manifestations of injustices, exclusions and violations of rights. I say this to highlight the fact that these are not natural occurrences like cyclones or earthquakes. They are a product of political and policy decisions that benefit certain groups and exclude others.
The second step is to make the political commitment to overcome these gaps and to progressively advance toward the universal exercise of rights, prioritizing the allocation of the resources – financial and human -- available for this purpose. One key step is to allocate greater budgetary resources for health in general and sexual and reproductive health in particular. Evidence suggests that even a modest increase of 25 percent in basic measures such as skilled birth attendance and making contraceptives readily available could reduce the maternal mortality ratio in Asia-Pacific by more than 30 percent. That means almost 30,000 fewer women dying each year.
But public spending on health remains far too low in Asia and the Pacific -- an average of less than 3% of GDP as compared to 6% in the world as a whole. So we need to substantially increase public investment in health, including in sexual and reproductive health.
These resources must then be invested effectively toward extending sexual and reproductive health services to all people. On the one hand this has to do with expanding the coverage of services. But it is also about ensuring high quality services that truly offer good options and choice of family planning methods to people – especially women; skilled birth attendants that ensure the safety of mothers when they are giving birth; health workers that treat all people with kindness and respect; that inspire the confidence and trust of young people that their private information will not be divulged to parents or school authorities.
Young people also have to be empowered through comprehensive sexuality education that not only teaches them about anatomy and biology but encourages them to talk openly about sex, both as a physical act and also as an act of two people connecting emotionally. Young people also need to be mindful of the importance of making that connection with love and respect and care, in safety and in freedom, especially for women and girls.
And we can’t be content with only addressing services and information directly to do with sexual and reproductive health. Because if women and girls are to truly benefit from these measures, we need to push for gender equality and the empowerment of women and girls in all spheres of life, through laws and in policy, but also in practice. Political, social, religious and community leaders need to inspire change by example -- combatting violence against women and girls, fighting harmful practices like the forced marriage of children and adolescents, teaching girls to value themselves and their abilities and encouraging them to pursue their dreams, guaranteeing women equal access to decent employment.
And to accomplish all of this in a region where nearly a third of the population is between 10 and 24 years of age, the active participation of young people is crucial, not only in demanding that governments do the right thing, but in building societies that are committed to ensuring health and safety and freedom in this very intimate part of our lives that is so central to our dignity. These conditions must be assured for all people –regardless of ethnicity, culture, beliefs, sexuality, gender or any other kind of differences and especially for those who have traditionally been excluded and marginalized.
This sounds nice – but ensuring universal access to sexual and reproductive health, and universal guarantee of sexual and reproductive rights is not going to be an easy thing to accomplish. We only have to remember the number of women still dying each year in this region from causes related to pregnancy and child birth, or the violent conflicts that still rage over the kinds of differences that I just mentioned.
So it isn’t enough that young people dream of and demand a better world. You have to work really hard, generating and using scientific evidence to find the right solutions, not only in the big policies but the nitty-gritty details of how you get services and information to people. You have to persevere and not give up in the face of many, many obstacles and setbacks. As a woman political leader we met yesterday told us, you have to learn to ‘endure.’ It doesn’t sound glamorous – but if you want to change the world for the better – it’s what it takes. And enduring and persevering does produce fruit. For example, halving the number of maternal deaths over 15 years -- that is a huge accomplishment.
And as I said in my remarks to you yesterday, we at UNFPA are ready and eager to accompany and support you on that difficult but worthy journey.
