Summary report, 8–12 February 1999
International Forum for the Operational Review and Appraisal of the Implementation of the ICPD Programme of Action (POA)
The International Forum for the Operational Review and Appraisal of the Implementation of the Programme of Action (POA) of the International Conference on Population and Development (ICPD) took place from 8-12 February 1999 in The Hague. The Hague Forum is an integral part of the five-year review of the implementation of the ICPD POA (ICPD+5), which will culminate in a Special Session of the UN General Assembly from 30 June-2 July 1999. The Forum, organized by the UN Population Fund (UNFPA) and hosted by the Dutch Government, was attended by approximately 2000 participants, including ministers and other high-level government officials, parliamentarians, representatives of UN specialized agencies, international and non-governmental organizations (NGOs), youth, and the media.
The goals of the Hague Forum were to: examine lessons learned, success stories, obstacles and constraints to enable further implementation of the POA; allow for exchange among countries facing similar experiences; bring together a wide variety of partners to refocus commitment on population and development; and provide technical inputs to the Special Session. The Forum assessed country-level operational and programme experience in POA implementation, focusing on five substantive themes:
- creating an enabling environment for the further implementation of the POA;
- gender equality, equity and empowerment of women;
- reproductive health, including family planning and sexual health and reproductive rights;
- strengthening partnerships; and
- resource flows and financing for POA implementation.
As a starting point for discussions, the Forum used a background paper prepared by UNFPA entitled “A Five-Year Review of Progress towards the Implementation of the ICPD POA,” which identifies further action required in the five thematic areas and synthesizes findings from roundtable and technical meetings, conclusions from consultations organized by the UN Regional Commissions, responses to a global field inquiry conducted by UNFPA in mid-1998, and progress reports on ICPD implementation by UN specialized agencies.
During the course of the week-long Forum, delegates met in parallel Plenary and Main Committee sessions. Statements from 134 ministers and other high-level government representatives, and 45 UN bodies, NGOs, youth and intergovernmental organizations were delivered in Plenary sessions during the first four days on the operational review and assessment of POA implementation at the country level. The Main Committee met during the first four days to consider the five substantive themes. US First Lady Hillary Rodham Clinton delivered the keynote address of the Forum.
The outcome of the Forum was a draft report that summarizes the findings and proposed actions of the Main Committee’s deliberations. The report will be submitted to the Commission on Population and Development (CPD) and will provide input into the upcoming Secretary-General’s Report, which will be the basis for negotiation at the Preparatory Committee (PrepCom) for the Special Session in March.
The Hague Forum was not about renegotiating the POA, although some may have anticipated or even hoped for this. Rather it contemplated country experiences to date, brought into focus some emerging and new concerns and, above all, underscored the length of the road ahead.
A BRIEF HISTORY OF THE ICPD+5 PROCESS
The ICPD was held in Cairo, Egypt, from 5-13 September 1994. An estimated 20,000 government delegates, UN representatives, NGOs and media representatives attended the conference, which adopted a 16-chapter POA on population and development. The POA, adopted by 179 countries, underscores the integral and mutually reinforcing linkages between population and development and endorses a new rights-based strategy focused on meeting the needs of individual women and men rather than on achieving demographic targets. One of the primary goals of the POA is to make family planning universally available by 2015 as part of a broadened approach to reproductive health (RH) and rights. It includes other time-bound population and development goals for 1995-2015, including the reduction of infant, child and maternal mortality and provision of universal access to education, especially for girls. The POA addresses issues relating to: population, the environment and consumption patterns; the family; internal and international migration; prevention and control of HIV/AIDS; technology, research and development; and partnership with the non-governmental sector. The POA provides estimates of the levels of national resources and international assistance required and calls on governments to make those resources available.
In Resolution 52/188 of 18 December 1997, the UN General Assembly decided to convene a Special Session from 30 June-2 July 1999 to review and appraise implementation of the ICPD POA. The General Assembly emphasized that existing agreements contained in the POA would not be renegotiated. The General Assembly designated the CPD as the preparatory body for the Special Session and the 32nd session of the CPD in March 1999 as the Preparatory Committee (PrepCom). The Population Division of the UN Department of Economic and Social Affairs (UNDESA)and UNFPA are collaborating and coordinating the ICPD review process leading up to the Special Session.
In preparation for The Hague Forum, UNFPA organized six roundtable and technical meetings in 1998 to provide input into ICPD+5, focusing on technical and operational assessments of progress made and constraints faced by countries in implementing the POA. The meetings addressed:
- Adolescent Sexual and Reproductive Health (14-17 April, New York);
- Reproductive Rights and Implementation of Reproductive Health Programmes, Women’s Empowerment, Male Involvement and Human Rights (22-25 June, Kampala, Uganda);
- Partnership with Civil Society in POA Implementation (27- 30 July, Dhaka, Bangladesh);
- International Migration and Development (29 June-3 July, The Hague);
- Population and Ageing (6-9 October, Brussels); and
- Reproductive Health Services in Crisis Situations (3-5 November, Rennes, France).
Five-year regional reviews on population and development were also conducted by the UN Regional Commissions to contribute to the ICPD+5 process.
REPORT OF THE HAGUE FORUM
UNFPA Executive Director Nafis Sadik opened The Hague Forum on Monday morning, 8 February 1999, by announcing the election of Amb. Nicolaas Biegman (the Netherlands) as President of the Forum.
A number of speakers then took the floor to deliver introductory remarks, including: Wim J. Deetman, Mayor of The Hague; Els Borst-Eilers, Deputy Prime Minister of the Netherlands; UN Deputy Secretary-General Louise Frechette; Nana Rawlings, First Lady of Ghana; Elizabeth Aguirre de Calderon Sol, First Lady of El Salvador; Eveline Herfkens, Dutch Minister for Development Cooperation; and Baron Vaea, Prime Minister of Tonga, on behalf of small Pacific Island States.
UNFPA Executive Director Nafis Sadik highlighted the commitment and work of the Dutch Government, NGOs and youth as an example for donor countries. She recalled efforts to achieve consensus in Cairo and the progress made since then, stating that the Forum would serve to appraise experiences, lessons and obstacles. She introduced the background document prepared by UNFPA, emphasizing that it was intended as a starting point for discussion and was not a draft to be renegotiated. She drew attention to the problems facing young people, such as teenage pregnancy and the increase in sexually transmitted diseases (STDs), including HIV/AIDS. Noting that all economic progress is built on a social foundation, she emphasized the need to summon the necessary commitment and resources to move from prescription to action and highlighted the importance of partnerships.
Forum President Biegman introduced the rules of procedure, provisional agenda and programme of work, which were adopted by the Plenary. Delegates elected to the Forum’s Bureau were: Aicha Belarbi (Morocco), El-Hadj Ibrahima Sall (Senegal), Gerald Sendaula (Uganda), Kiyotaka Akasaka (Japan), Datin Paduka hajah Zaleha binti Ismail (Malaysia), Elsa Berquo (Brazil), Rudolph Collins (Guyana), Rudolfo Tuiran (Mexico), Teodor Chernev (Bulgaria), Jerzy Holzer (Poland), Zoreslava Shkiryav-Nyzhnyk (Ukraine), Rosa-Anna Weiss (Austria) and Margaret Pollack (US). Anwarul Karim Chowdhury (Bangladesh) was elected as Chair of the Main Committee and Jyoti Singh (India) was designated as Secretary and ex-officio Bureau member. Elsa Berquo (Brazil) was later designated as the Forum’s Rapporteur. President Biegman noted that the Bureau would act as the drafting committee for the final document to emerge from the Forum.
Representatives from the Parliamentarians’, Youth and NGO Forums, held in The Hague in the days preceding the Forum, then presented reports of their deliberations.
The International Parliamentarians Forum resolved to further promote RH and rights and advance women’s empowerment. They noted advances in areas including laws to ban violence against women but highlighted continuing challenges. They called on governments to increase the flow of ODA to reach the 0.7% target and devote 4.5-5% to population issues.
The NGO Forum highlighted the need to: achieve consensus on policy formulation that includes NGOs as partners; establish permanent mechanisms for POA implementation; mobilize additional financial resources for sexual and reproductive health (SRH) initiatives; ensure that health sector reform includes RH; mobilize funds for women and youth activities; and prevent the spread of HIV/AIDS.
The Youth Forum highlighted the central role that youth play in development of policies and programmes for POA implementation. The Forum formulated recommendations on access to education, informed choice and access to RH, elimination of violence against youth and children and HIV/AIDS prevention for youth. They also called for: inclusion of RH and rights, family life education, safe motherhood and gender equity and equality in school curricula; a new UN agency for youth; effective incorporation of youth issues into development programmes; development of national education programmes designed for and by youth; and governmental promotion of youth entrepreneurship.
PANEL ON FOLLOW-UP TO THE ICPD POA
Following the opening Plenary, heads of UN organizations participated in a panel on follow-up to the POA. WHO Director- General Gro Harlem Brundtland noted that since Cairo, more open debate has occurred on previously taboo topics related to SRH. She stressed that failure to address RH needs is a matter of human rights and social justice. She noted that global resources for public health interventions have not kept up with increasing demand. Looking ahead, she highlighted maternal health and adolescent SRH as issues demanding particular attention. She expressed the WHO’s commitment to putting health at the center of the development agenda.
UNICEF Executive Director Carol Bellamy underscored that adolescents should enjoy the rights of access to education, health and other services, and said parents and teachers must be active in adolescents’ education. She stressed the need for investment in girls’ education, expanded approaches to safe motherhood and women’s RH, and political will.
UNAIDS Executive Director Peter Piot stated that the AIDS epidemic has worsened since Cairo, particularly for youth. He said AIDS is undermining hard-won gains in development, although some countries have succeeded in reversing the trend with education campaigns. He emphasized the need for political commitment, greater investment and technological breakthroughs.
UNFPA Executive Director Nafis Sadik said the global conferences of the 1990s demonstrated that social investment is fundamental to progress. She highlighted the need for a new development paradigm where macroeconomic policies look at micro-level needs and stressed the need to incorporate communication with economic leaders into advocacy for population issues. She called for: a more integrated approach to RH; involvement and education of men; improved data and knowledge; and maximization of resources to the social sector.
US First Lady Hillary Rodham Clinton delivered the keynote address of the Forum on Tuesday. She recalled that the world had agreed in Cairo that choice, not coercion or control, creates smaller families and slower population growth, and that respect for women’s rights must be part of efforts to improve the quality of life. She reaffirmed the US Government’s commitment to implementing the ICPD goals and announced President Clinton’s proposal to commit US$25 million as a voluntary contribution to UNFPA next year. She stressed the need to make abortion safe, legal and rare, and to reduce teenage pregnancy. She said women’s childbearing decisions should be made freely and responsibly without government coercion. She underscored the need to invest in human resources and give equal access to RH services to all women. She called for sustained commitment from all partners, especially from youth, who will bear the responsibility in the next century.
In Plenary sessions from Monday evening to Thursday evening, 179 delegates from 134 governments, 12 UN agencies, 23 NGOs, seven international organizations and three youth organizations delivered statements on the operational review and assessment at the country level of the POA. Several statements highlighted the need for a multi-sectoral approach to population issues, noted financial constraints that have hampered developing country capacity to implement the POA, and called on donor countries and organizations to increase their level of support. Delegates addressed the importance of: RH services; awareness creation among adolescents; women’s empowerment; STDs, including the HIV/AIDS epidemic; migration; partnerships; resource constraints caused by debt servicing and economic crises; and creation of enabling environments through application of holistic approaches, appropriate policies and legislative frameworks. A number of speakers noted adoption and implementation of national population policies and establishment of population commissions as well as safe motherhood programmes. Legal reforms to protect women’s rights, eradicate violence against women and children and outlaw female genital mutilation were also highlighted. Several representatives observed a marked increase in the number of women in decision-making positions. They stressed that the ability to effectively implement the POA depends on overcoming social, political and cultural barriers, enhancing human and institutional capacities and making resources available.
Representatives of international organizations highlighted their activities in cooperation with governments, local communities and civil societies and reiterated their commitment to the ICPD goals. Civil society representatives stressed: elimination of legislative barriers; eradication of corruption; transparency; improvement of maternal health care; development of proper curricula in education; effective involvement of youth, NGOs, women and other groups in decision-making; and prioritization in the provision of education and health services.
CREATING AN ENABLING ENVIRONMENT FOR FURTHER IMPLEMENTATION OF THE POA: The Main Committee considered this substantive theme on Monday afternoon. Joseph Chamie, Director of the Population Division of UNDESA, introduced the issue.
Discussions highlighted the need for institutional capacity- building, enhancement of partnerships, data and indicators for monitoring progress, strategies to increase awareness, and consideration of the impacts of structural adjustment programmes (SAPs) on the creation of enabling environments for POA implementation. Several delegates stressed community mobilization, creation of partnerships, prioritization of high- risk groups and consideration of population in the wider context of global problems. They emphasized the need for tools to integrate population into planning and for partnerships that bring direct benefits to the poor. Governments were urged to create or strengthen structures that coordinate civil society collaboration and facilitate early private sector inclusion in POA implementation. A number of participants supported strengthening and consolidating viable institutions, clearly articulating training policies and improving support mechanisms to address women and poverty. They emphasized private sector participation, SRH and access to education and employment. Regarding SAPs, some delegates noted that they undermined institutional capacity and hindered POA implementation. Debt servicing and unsustainable resource use were highlighted as weakening governments’ ability to address poverty. Several delegates called for debt cancellation for the poorest countries and stressed the need for clear rules on capital flows and a sound macroeconomic environment as preconditions for POA implementation. IMF involvement in design and planning of new programmes and in the population and development dialogue was proposed. Given the increasing flows of migrants and the impacts of migration, delegates called for increased attention to economic and social transformation, as well as factors underlying involuntary migration. The need for social indicators that cover a diversity of socio-cultural norms to monitor progress on POA implementation was raised.
GENDER EQUALITY, EQUITY AND EMPOWERMENT OF WOMEN: The Main Committee addressed this theme on Tuesday morning. Maria Isabel Plata, Executive Director of PROFAMILIA, introduced the topic. A number of speakers emphasized the importance of incorporating a gender perspective into the development of policies. Delegates emphasized the need for: policies and actions aimed at empowering women and girls; indicators to monitor progress in gender mainstreaming; and gender-disaggregated data. The importance of changing negative attitudes and stereotypes towards women was emphasized.
Several speakers stressed the need to eliminate discrimination and violence against women. CANADA said eradicating violence against women is central to achieving equality and requires integrated, holistic and multi-disciplinary approaches, legal, social and economic reforms and involvement of institutions, NGOs and civil society. FRANCE emphasized the need to ensure that increasing privatization does not cause poor women to be excluded from health care. A number of delegates called for increased attention to the needs of aged women. Delegates also emphasized: constant attention to mainstreaming of gender concerns; consultation with women in programme design; agenda prioritization of gender equity; training of special staff on gender perspectives; changes to customs and traditions that prohibit women from exercising their rights; legislative reforms to deter sexual abuse of girls; steps to raise women’s awareness of their rights; an increase in female literacy; and closure of the gender gap in education. The need to increase the number of women in decision-making positions, particularly at the highest political levels was highlighted. UNIFEM supported capacity- building in policy-making bodies and the need for gender mainstreaming in all areas, not just in those with gender implications. Several delegates stressed the need for a human rights-based approach to POA implementation and the importance of drawing on other commitments, such as the Beijing Platform of Action, to strengthen ICPD implementation. Numerous interventions underscored the protection of the girl child. GREECE advocated prioritization of education, vocational training and sexual education for girls. Reducing sex trafficking and FGM and increasing male responsibility and partnership were also emphasized.
REPRODUCTIVE HEALTH, INCLUDING FAMILY PLANNING AND SEXUAL HEALTH, AND REPRODUCTIVE RIGHTS: The Main Committee considered this substantive theme on Tuesday afternoon and Wednesday morning. Dr. Mahmoud Fathalla, Rockefeller Foundation Senior Advisor, and Dr. Raj Adul Karim, Director-General of the National Population and Family Development Board, introduced the key issues.
Several delegates emphasized the need for integration of RH into primary health services, universal access to RH and comprehensive services. Delegates stressed the importance of improving legal frameworks to protect the rights of women and girls and ensure equal access to RH and health care. The CENTER FOR REPRODUCTIVE LAW AND POLICY said the rights to RH care and reproductive self-determination are fundamental and enshrine human rights protected under international law.
The need for international assistance to developing countries to improve quality of RH services was underscored. Several delegates proposed training of health workers in counseling and reproductive rights and emphasized protection of privacy, informed and free consent and confidentiality. Delegates stressed women’s right to free and informed choice from all available and safe contraceptive methods. They proposed development of standards for quality and costs of services and indicators to monitor access. Several speakers advocated extending networks of RH services to under-supplied groups, including poor people, those in rural areas, people with disabilities, men and older women. GERMANY stressed the role of the private sector in ensuring wider coverage by distributing subsidized contraceptives through social marketing programmes.
The YOUTH FORUM called for allocation of 20% of public health spending to programmes geared toward adolescents including comprehensive sex education in schools. A number of speakers supported including sex education in school curricula and efforts to ensure access to RH services appropriate to young people’s needs.
On unsafe abortion, several speakers reaffirmed POA paragraph 8.25, which states that abortion should be safe where it is legal and calls for access to treatment of complications from abortion. The International Planned Parenthood Federation (IPPF) suggested that ICPD+5 endorse the Beijing recommendation urging review of laws containing punitive measures against women to accelerate implementation of paragraph 8.25. Delegates called for renewed commitment to minimizing maternal mortality and morbidity from unsafe abortion and expressed concern about the lack of quality emergency obstetric care. The UK proposed developing intermediate milestones for 2005, 2010 and 2015 for maternal mortality.
MEXICO said abortion is a public health problem that should be reduced by improving quality of family planning services and counseling. She proposed providing information on emergency contraception, which is intended to prevent induced abortion. ARGENTINA rejected the inclusion of abortion within RH, stating that voluntary interruption of pregnancy or abortion is an attack on the right to life of the unborn. The INTERNATIONAL RIGHT TO LIFE FEDERATION said legalizing abortion in developing countries would increase rather than decrease maternal mortality. The HOLY SEE proposed reaffirming that in no case should abortion be promoted as a family planning method. He said “emergency contraception” cannot be considered an application of family planning nor the exercise of an alleged reproductive right.
On HIV/AIDS, delegates highlighted the need for greater emphasis on prevention and treatment, counseling for those infected, awareness campaigns, and further research. UNAIDS stressed the need to integrate prevention into general health programmes. The UK recommended establishing a global goal and intermediate targets for HIV/AIDS reduction. FRANCE endorsed the adoption of an HIV/AIDS indicator. GHANA called for affordable access to testing and life-prolonging drugs in developing countries. Several delegates supported HIV prevention in school curricula and AIDS programmes that promote condom use and responsible sexual behavior, with special emphasis on male involvement. The need for provision of RH services to refugee women, including emergency contraceptives, was underscored by numerous delegates.
STRENGTHENING PARTNERSHIPS: Participants addressed this substantive theme on Wednesday afternoon. Florence Manguyu of the Medical Women’s International Association introduced the topic.
Discussion highlighted advances in cooperation and collaboration between governments, civil society and the international community, although delegates felt there was still considerable scope to develop partnerships further. A number of delegates talked about creating an enabling environment for collaborative policy formulation and programme implementation and monitoring. Closer and more formalized links were advocated at local, national and international levels.
Regarding partnerships between civil society and governments, the need for transparency, accountability and inclusiveness was articulated. Participants also emphasized the importance of NGOs, stressing the need to build human resource and institutional capacities. Closer relations between NGOs and international organizations were advocated. The importance of developing private sector involvement in POA implementation was stressed by several delegates. They emphasized the involvement of religious and women’s groups and highlighted the unique role of parliamentarians. Delegates underscored the need for closer collaboration among the various UN agencies and organizations and partnership between intergovernmental groups. A number of delegates reflected on the need for closer cooperation with youth.
RESOURCE FLOWS AND FINANCING FOR FURTHER IMPLEMENTATION OF THE POA: Delegates addressed this substantive theme on Thursday morning. Dr. Steve Sinding, Director of Population Science at the Rockefeller Foundation, introduced the topic. Many delegates underscored the need for more funding and resources from donor countries in order to meet ICPD goals. CYPRUS said donors have a moral obligation to increase assistance, as agreed in Cairo. Many speakers stressed the need for political will.
The NETHERLANDS identified the possible need to update the Cairo cost projection for POA implementation and highlighted the need to observe priorities, the 0.7% of ODA target and, with others, the 20/20 Initiative. DENMARK stressed an integrated approach rather than a vertical “numbers game” approach. BELGIUM urged donors to earmark funds for basic services. On behalf of youth participants, the NGO DUTCH COUNCIL ON YOUTH AND POPULATION called for funding from donors for SRH projects to be conditional on allocation of at least 20% to initiatives for adolescents.
The need for efficient and effective use of resources was emphasized. Several speakers highlighted the need to develop innovative financial mechanisms, such as a tax on financial transactions, and to improve coordination between agencies. Several delegates underscored the benefits of South-South cooperation and called for its support. A number of delegates supported domestic mobilization of resources. UGANDA called for government accountability and innovative means to mobilize local private sector funds. The GAMBIA emphasized improvement of enabling environments to encourage fulfillment of commitments. JAMAICA supported debt forgiveness for implementing the 20/20 Initiative and “debt for programme swaps.” A number of participants recommended tracking and monitoring resource flows. It was suggested that financial institutions make their mandates more flexible and simplify their procedures for support.
Another constraint mentioned was the lack of resources for NGOs. Participants underscored the increasingly important role of the private sector. PERU emphasized private sector mobilization for RH and family planning at international and local levels. Concerning resources for the broader ICPD goals, NORWAY said the Cairo agenda must not be viewed in isolation from the other global conferences of the 1990s, noting that poverty, the right to development and social investment apply to all these agendas and that the percentage of funding to the population sector is less important than that channeled to development.
Eveline Herfkens, Netherlands Minister for Development Cooperation, observed that a central message came through at the Forum: ICPD works. She said it has succeeded in giving people more choices, especially women. She highlighted an increased awareness of the need for information and services, especially for youth, and welcomed their involvement in the Forum. Stressing the importance of resources, she called on donors to “put your money where your mouth is.” She also called for establishment of national priorities, noting that investment in health, including RH, is a condition for economic growth and stressing the need to get priorities right, implement legislation and dedicate resources.
Main Committee Chair Chowdury introduced the draft report of the Forum, as contained in FPA/HAGUE/FC/1, explaining that it was referred to as a draft report because it would undergo minor editing by the UNFPA Secretariat prior to its submission to the CPD. The report would be taken into account, along with UNFPA’s background document on the five-year review and appraisal of ICPD implementation and the reports of the regional reviews, in the preparation of the Secretary-General’s Report, which will serve as the basis for negotiation at the PrepCom. Chowdury introduced the findings and proposed actions contained in the draft report, explaining that he had summarized the central points of the Main Committee deliberations on the five substantive themes and submitted these to the Bureau, which acted as the drafting committee.
President Biegman explained that the Bureau engaged in “soft drafting” of the report, which was not a negotiated text and therefore did not bind delegations, but would provide important input to the negotiations in New York. The Plenary then adopted the draft report and the floor was opened for closing remarks.
IRAN voiced its support for providing information and educating youth on human rights and SRH, but stressed that cultural and religious values should be observed. He said he did not support including sexual education at all levels, as called for in the draft report. GERMANY, on behalf of the EU, stated that while the draft report was not a negotiated document, it provided a useful summary of the issues. She expressed hope that the Secretary-General’s Report would be as concise and action- oriented as possible. GUATEMALA, ARGENTINA, EL SALVADOR and SYRIA said the report did not fully reflect their views, was not a negotiated paper and was therefore not binding. ARGENTINA stressed the need to adapt the report’s language with that adopted in Cairo, and said the term “sexual rights,” which is not Cairo language, should not be included. President Biegman said the term would be removed and replaced with Beijing language that addresses the same issue.
The US stated that while financial commitments lag behind political commitments, the Cairo approach has moved from commitment to action. She welcomed the high level of participation by young people and NGOs and progress made in the review effort. Highlighting a need for the draft report to include the religious dimension as a principle, MOROCCO warned against redrafting Cairo language without a mandate. SUDAN called for consideration of different ages and abilities as well as differing national values and norms when educating adolescents on RH. COLOMBIA stressed strengthening links with NGOs, including women’s and human rights groups, and supported investment for social justice programmes.
On the proposed actions for adolescents’ RH, MOROCCO cautioned against the inclusion of contradictory language and stressed the role of parental guidance in educating and shaping adolescents’ attitudes. The NGO AND YOUTH FORA called for their involvement in global policy-making and looked forward to participating in the continuing dialogue in New York.
In her closing statement, UNFPA Executive Director Nafis Sadik stated that the Forum had succeeded in engaging participants in an exchange of ideas on POA implementation, resulting in a common understanding of the ICPD goals. She said the most important achievement had been to demonstrate that the POA is more than a piece of paper by highlighting the progress made in its implementation. She referred to ICPD as a watershed that changed approaches to population and development. She stated that POA implementation strengthens the human rights framework, improves lives and saves women’s lives, protects the family and offers choices beyond the family, liberates the mind, energizes the spirit and is based on ethical and moral principles. She said the Forum resulted in a better understanding of the concept of a rights-based approach. It also placed adolescent RH and rights issues, including those of people in emergency situations, as well as gender-based violence, on the public agenda. She underscored that several challenges and obstacles remain and reiterated the call for sustained commitment and political will to overcome these in a productive way. She stressed the need to identify new ways to cooperate with the private sector, lauded donor countries that have proposed increasing contributions to UNFPA, and thanked the private foundations that have committed resources to population and health activities. She paid tribute to the parliamentarians, NGOs and youth that participated in the Forum and called on religious leaders to participate in further dialogues. She thanked participants for their efforts and expressed hope that they would continue to work with reinforced determination and be inspired to fight “the battle of everyday” with renewed commitment and partnership.
In his closing statement, Forum President Biegman said the Cairo consensus has taken root and the approach based on the rights of the individual is being applied worldwide. He said delegates know what must be done and how to do it, which explained the absence of controversy at the Forum. He noted that population and RH have to compete for funding with many other sectors and stressed that the lack of resources currently poses the major constraint to POA implementation. He expressed hope that the Forum, apart from taking stock and reaffirming commitment, had helped to generate the interest and attention of decision-makers outside the population community. He stated that youth have a direct interest in ICPD issues and play an important role in implementation, and said he valued their active and sizeable participation in the Forum. He called on delegates to “go out into the world and spread the word,” and drew the Forum to a close at 5:30 pm.
DRAFT REPORT OF THE FORUM
The draft report of The Hague Forum contains four introductory chapters that provide background, list countries and organizations that attended, note the election of the Bureau members and other procedural matters, and describe the functioning of the Forum (the number and subject matter of Plenary and Main Committee sessions). The fifth chapter provides background, outlines progress to date, identifies issues and constraints and recommends proposed actions for each of the five substantive themes. It is preceded by an introduction. This substantive part of the draft report is summarized below.
The introduction notes that the purpose of the Forum was to conduct an operational review of POA implementation. It highlights considerable progress in policy and programme design, increased partnership and collaboration toward implementation. The review of progress on the scope of collaborative efforts with civil society provides a basis for optimism, as do the devolution of public responsibilities, decentralization of public administrations and other institutional changes. However, since 1994 the world has faced a series of adverse occurrences with impacts on POA implementation, including financial crises, natural disasters, a steep drop in prices of oil and other commodities, social instability, and civil and subregional conflicts.
Global population has doubled since 1960 and 97% of future population growth will occur in developing countries. As people have been given greater choice of contraception, population growth rates have continued to decline but the population continues to grow by 77 million people a year. There are over one billion young people between 15-24, the largest cohort ever, and their SRH needs are not yet being adequately addressed. The number and proportion of older persons is increasing due to recent mortality and fertility reductions, yet policies to provide the services they need are lacking. Mortality decline has been uneven, with declines in life expectancy in countries with economies in transition due to social stress, poor nutrition and deteriorating health services, and in countries most affected by HIV/AIDS, such as sub-Saharan Africa. Maternal mortality also requires attention and action.
As the demand for smaller families has increased and access to safe and accessible contraception has improved, fertility levels have declined. Nevertheless, over 150 million couples still have an unmet need. Recourse to abortion has declined dramatically in countries where contraceptive access and acceptance have increased, but it remains a serious problem. International migration and its social impacts have increased in importance, prompting governments to undertake action, such as assistance to refugee women and children, promotion of integration of migrants and sanctions to combat illegal migration. The challenge is to understand the root causes of migration.
The introduction also underscores that the contexts for implementation of population and development programmes vary, and the POA recognizes the need to consider the economic, social, cultural and environmental diversity of different countries and people’s shared but differentiated responsibilities to forge a better common future.
It notes that The Hague Forum reaffirmed the POA in critical areas. A human rights-based approach has received growing acceptance and has served to enhance the quality and accessibility of RH services. The international human rights treaty bodies, national human rights offices and NGOs have increasingly taken note of RH in recommendations and decisions. Policy changes in many countries demonstrate a commitment to move from vertical family planning programmes to a comprehensive SRH approach emphasizing quality of care. The ICPD and the subsequent Fourth World Conference on Women enhanced national attention to the centrality of gender equity, equality and women’s empowerment in sustainable development, and governments have made strides to implement conventions such as CEDAW and enact gender action plans and legislation on gender-based violence.
There has been an increase in the number and variety of partnerships over the past five years, particularly in which NGOs share responsibility with government institutions for POA implementation. National coordination mechanisms have been established, with increasing recognition of the importance of transparency and good governance. Where communities have been involved, dramatic progress has been made in furthering implementation. There has been increasing involvement by parliamentarian groups and a growing recognition of the need for full involvement of youth.
CREATING AN ENABLING ENVIRONMENT FOR FURTHER IMPLEMENTATION OF THE POA
The draft report provides background on the thematic area of creating an enabling environment for further implementation of the POA. Good governance, transparency, accountability and the promotion of democracy are listed as essential to achieving sustainable development. It stresses the need to recognize and address interrelationships between population, resources, environment and development and to bring patterns of production and consumption into balance.
PROGRESS TO DATE: The report notes: strong political commitment; efforts to articulate and/or implement broad-based population policies grounded in human rights work; enactment or reform of legislation protecting the human rights of women and outlawing gender-based violence, including harmful traditional practices; and the increasing recognition of civil society groups as effective entities for further POA implementation.
The draft report identifies global economic trends, environmental degradation, national conflicts and crises, migration, resource limitations and changes in population structure as constraints. Global economic trends with adverse effects on the pace of POA implementation include unrestricted flows of capital and SAPs, falling GDP, rapid inflation, and burdensome debt service. The need to respond to economic crises distracts governments from addressing environmental concerns. Unbalanced production and consumption patterns, unregulated movement of toxic materials, inadequate integration of population issues into environmental policy and planning and insufficient analysis of environment, population and poverty linkages are highlighted. Natural disasters, instability and armed conflict result in a breakdown of governance, inadequate infrastructure and competing priorities. Internal and international migration and the vulnerability of displaced persons to exploitation and human rights abuses are highlighted. It underscores inadequate attention given to the economic, social and health needs of the increasing numbers of youth and the rising number of elderly people. It also notes the need to mobilize financial resources to support the POA.
PROPOSED ACTIONS: The draft report contains actions to overcome constraints to creating an enabling environment. On global economic trends, it calls for:
- promotion of a supportive economic environment to enable developing countries to achieve sustained economic growth;
- establishment of mechanisms for the management and regulation of capital flows;
- promotion of an open, equitable international trading system by stimulating direct investment, reducing debt burdens and ensuring that SAPs are responsive to social and environmental concerns;
- integration of gender equity, equality and empowerment of women in sustainable development policy initiatives;
- reformation of health sectors and sector-wide approaches to prioritize gender-sensitive RH services and ensure universal access; and
- training of planners and decision-makers at national and local levels to understand population, environment and macro- economic linkages.
Proposed actions on the environment emphasize the need to:
- initiate legislative and administrative measures to promote balanced patterns of consumption and production;
- integrate demographic factors into planning processes;
- develop better frameworks to analyze population, environment and poverty linkages; and
- conduct additional research on the impact of environmental degradation on health, especially women’s RH.
Special attention to the needs of countries emerging from conflicts and crises to strengthen their capacity to deal with population and development issues is proposed.
On migration, the draft report stresses the need to:
- address the root causes of migration;
- promote dialogue between sending, transient and receiving countries to protect the human rights of refugees and migrants and provide access to social services; and
- ensure the fair treatment and rights of migrants, refugees and displaced persons, including providing for their RH needs.
The report also calls on States to become parties to the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families.
Concerning the population age structure, governments are urged to invest in education and skills training for young people, provide funds for programmes to meet their SRH needs and ensure the economic and social security of older persons, particularly ageing women. It emphasizes intergenerational solidarity through better communication and mutual support.
GENDER EQUALITY, EQUITY AND EMPOWERMENT OF WOMEN
The draft report reaffirms the fundamental role played by the POA in transforming population and development programmes and particularly in changing the quality of women’s lives.
PROGRESS TO DATE: There is progress to date in the following areas: establishment or reinforcement of initiatives promoting integration of a gender perspective into polices and programmes; removal of laws discriminating against women and girls and enactment of laws protecting them; initiatives to promote participation of women at policy- and decision-making levels; implementation of measures for institutional strengthening that incorporate gender equality, including capacity-building for staff and laws, legal awareness creation and advocacy to eradicate violence against women; advocacy for protection of the girl child and promotion of her well-being; and gains in ensuring that men take equal responsibility for their own and their partner’s SRH.
CONSTRAINTS AND ISSUES: The draft report identifies constraints and issues in the area of gender equity, equality and women’s empowerment, including: lack of understanding of how to interpret gender concepts in differing social and cultural contexts; legal provisions preventing women from exercising their rights; lack of legal protection for women exercising their human and particularly sexual rights; violence at all stages of women’s life cycle in private and public life; gross under-representation of women in positions of power and decision-making due to poverty, illiteracy, access to education, inadequate financial resources, patriarchal mentality, gender hostility and the dual burden of domestic and occupational obligations; inequitable remuneration of women for work of equal value and negative impacts on women’s training and promotion opportunities; susceptibility of vulnerable groups of women to marginalization in policy and programme efforts and lack of consultation to develop strategies that meet their needs; negative impacts on the SRH of the girl child caused by prevalence of cultural attitudes promoting the low value of girls; harmful traditional practices such as FGM, use of sex- selection technologies and sexual servitude; lack of gender- disaggregated data; lack of human technical capacity to undertake gender analysis and design and implement and monitor programmes from a gender perspective; and social and cultural attitudes constraining men from sharing in family responsibilities and lack of male engagement in the discourse on gender equality and empowerment of women.
PROPOSED ACTIONS: The draft report proposes the following actions to incorporate a gender perspective into policies, programmes and activities:
- further developing and strengthening the ICPD reproductive rights approach to population and development policies and programmes;
- forging operational linkages between the POA, the Beijing Platform for Action and other international instruments in order to promote gender equality systematically and comprehensively;
- formulating actions to eliminate negative traditional, religious and cultural attitudes and practices that subjugate women and reinforce gender inequalities;
- adopting a gender perspective in all policy formulation and implementation processes and the delivery of services;
- having all data and information systems ensure availability of gender-disaggregated data;
- addressing the health and well-being of the increased proportion of ageing women through special programmes, services and institutional mechanisms and monitoring and addressing the needs of other vulnerable groups; and
- removing all gender gaps and inequalities pertaining to women’s participation in the labor market, with implementation of policies or legislation to establish equal pay for work of equal value.
Actions proposed to promote gender equality include:
- strengthening institutional capacity and technical expertise of staff in government, NGOs and civil society to promote gender mainstreaming;
- promoting gender awareness education of children to eliminate discrimination against women;
- ensuring future empowerment of women by enforcing enrollment of girls in school;
- accelerating women’s participation in political and all policy and decision-making levels;
- developing strategies to promote gender equality at family level;
- ratifying CEDAW with removal of existing reservations;
- establishing laws to protect women’s human rights and advocacy to enable women to claim their rights; and
- encouraging media and parliamentarians to help improve attitudes about the value placed by society on women.
Actions proposed to address violence include:
- zero-tolerance for all forms of violence against women and children through an integrated, holistic and multi-disciplinary approach from a life-cycle perspective;
- protection of the girl child, particularly from harmful traditional practices, and promotion of her access to health, education and life opportunities;
- action to promote a positive self-image and self-esteem among girls and women through information, education and communication strategies; and
- removal of gender stereotypes from educational curricula.
The draft report proposes the following actions to promote male responsibility and partnership with women:
- involving men in defining positive male role models to encourage a more proactive role in supporting and safeguarding women’s RH and rights and facilitate gender-sensitization of boys;
- addressing men’s SRH and supporting men to take responsibility for their sexual behavior;
- developing capacity-building strategies enabling men and all stakeholders to understand gender-related concepts; and
- promoting advocacy by all leaders, especially influential men, in support of gender equality, empowerment of women and protection of the girl child.
REPRODUCTIVE HEALTH, INCLUDING FAMILY PLANNING AND SEXUAL HEALTH, AND REPRODUCTIVE RIGHTS
The draft report notes as background that the ICPD endorsed the principle that all couples and individuals should be enabled to make voluntary reproductive choices free of coercion, and ensured this ability was recognized as a basic right. It notes that RH, including family planning and sexual health, includes the full range of components pertaining to the SRH of women and men from adolescence through the life cycle.
PROGRESS TO DATE: Progress since 1994 includes momentum in policy and programme development in RH and rights, better understanding of a human rights-based approach to RH, including family planning and sexual health, movement away from vertical service provision, demographic targets and quotas, and promotion of adolescent RH. Specifically, it notes progress in, inter alia: developing specific policies and/or legislative or institutional changes in RH and rights; integrating RH services into health delivery systems; providing high quality, client- responsive services ensuring free and informed consent; promoting male involvement in SRH; making available a wider range of contraceptive choices; recognizing the risks of maternal mortality and morbidity; acknowledging unsafe abortion as a serious public health concern and establishing services where abortion is legal; and demonstrating that efforts to prevent STDs, including HIV/AIDS, are cost-effective.
ISSUES AND CONSTRAINTS: The draft report identifies issues and constraints regarding reproductive rights, including inconsistent reflection of human rights approaches in policies, insufficient political will, and reservations to Article 12 of CEDAW (discrimination of women in health) by 54 countries.There is insufficient understanding of how best to implement the RH approach, a need to implement measures to safeguard RH when reforming health sectors, and a tendency to shape RH policies primarily by the health sector, excluding other important sectors. Other issues and constraints include: lack of service providers trained in RH care; increased risk of unwanted pregnancy and STDs including HIV/AIDS due to lack of information and increasing unprotected sex among adolescents; exacerbation of RH needs of women and adolescents in refugee or emergency situations; limited progress in male involvement and responsibility in SRH; lack of access to family planning information and services for some 150 million women; unacceptable risk of maternal mortality and morbidity for women in developing countries and countries with economies in transition; unsafe abortion as a major public health concern and cause of maternal mortality; and continued spread of STDs and HIV/AIDS, particularly among adolescents.
PROPOSED ACTIONS: The draft report contains a number of proposed actions related to RH. On reproductive rights, it recommends:
- enacting and implementing policies to meet Cairo commitments that ensure reproductive rights, gender equity and equality;
- ensuring that policies and RH programme implementation are based on human rights and cover the life cycle;
- strengthening knowledge and confidence of women, men and adolescents to enable them to claim their reproductive rights and promote their RH;
- ensuring women’s human rights include their right to have control over and decide freely and responsibly on matters related to their sexuality free of coercion, discrimination and violence;
- withdrawing government reservations to CEDAW; and
- developing within the UN system methodologies and indicators to promote and monitor women’s rights, particularly in SRH.
Regarding development and implementation of RH programmes, it recommends:
- ensuring health sector reform and sector-wide approaches maintain high priority for SRH, and ensuring equity of access to information and services;
- ensuring governments facilitate participatory policy development processes;
- engaging all relevant sectors;
- promoting decentralization of health planning and implementation;
- establishing long-term strategic partnerships between governments and all civil society partners;
- strengthening integration of services where it will result in increased acceptability, utilization and cost-effectiveness;
- increasing and monitoring investment in standards of service provision;
- increasing investment in RH training;
- developing quantitative and qualitative indicators to monitor progress;
- strengthening community-based services and social and subsidized marketing and exploring new partnerships with the private sector;
- allocating resources to meet growing demand for access to information, counseling, services and follow-up on the full range of safe and effective contraceptive methods;
- recognizing and promoting safe motherhood as a human rights issue;
- training and deploying more primary health care workers with life-saving skills;
- developing effective referral systems;
- ensuring availability of skilled workers to provide quality services, particularly emergency obstetric care;
- establishing intermediate benchmarks for maternal mortality;
- promoting men’s understanding of their roles and responsibilities;
- recognizing and addressing unsafe abortion as a public health problem;
- reducing unsafe abortions by diminishing unwanted pregnancy through provision of family planning information and services, including emergency contraception, and investment in training and equipping of medical service personnel to manage complications;
- reviewing laws containing punitive measures against women who have undergone illegal abortions;
- affirming commitment to POA paragraph 8.25; and
- developing a system for monitoring implementation.
Regarding STDs and HIV/AIDS, the draft report recommends:
- ensuring governments commit to action to prevent HIV transmission and improve care for those infected;
- providing resources to UNAIDS;
- initiating intensive and urgent action against the epidemic;
- ensuring prevention of HIV/AIDS as an integral part of RH;
- securing access to available technologies, such as the female and male condom;
- ensuring service and communication campaigns include sexuality and gender power;
- ensuring men do not threaten women’s human rights through practices and behavior that put women at risk;
- investing in STD prevention and treatment programmes;
- developing goals and benchmarks to monitor progress in prevention;
- including HIV/AIDS modules in adolescent sex education curricula;
- ensuring an environment free of discrimination for people infected with HIV/AIDS and making available in developing countries the drugs they require; and
- supporting research and development.
On adolescents, the draft report proposes that:
- ensuring SRH programmes for adolescents encompass sex education and provision of contraceptives, basic health care, STD prevention and treatment, effective referral services and counseling;
- developing innovative strategies that provide adolescents with SRH information that promotes gender equality, responsible sexual behavior and unwanted pregnancy prevention;
- developing and implementing national plans for investment in youth with full involvement of adolescents;
- educating and involving parents in providing SRH information to adolescents;
- ensuring health care providers’ attitudes do not restrict adolescents’ access to services and information;
- including sexual education in school curricula at all levels and ensuring teachers receive adequate training;
- providing sexual health services for all adolescents who demand them;
- ensuring fathers fulfill their responsibility to be positive role models; and
- reaffirming POA paragraph 5.9 (on family-sensitive housing, work, health, social security and education policies).
The draft report also recommends that refugee women and others in emergency situations receive appropriate health care, including RH care, as well as greater protection from sexual violence, and all health relief workers be given basic training in RH information and services.
The section of the draft report on strengthening partnerships recognizes the importance of a broad-based and interactive collaboration among governments, the international community and civil society in implementing the goals of the POA.
PROGRESS TO DATE: The draft report reflects the virtual consensus at the Forum that significant advances in strengthening partnerships have been made since Cairo. It identifies a conceptual shift among stakeholders towards human- centered development and the life-cycle concept of SRH. It notes that many governments have adopted significant measures to involve civil society in the policy- and decision-making process, highlighting particular achievements in countries with economies in transition. It points out that some countries have taken steps to strengthen civil society by providing funding and removing legal impediments. It reports that UN inter-agency coordination has been enhanced and notes in particular the formation in 1995 of the Basic Social Services for All Task Force by 18 UN organizations and agencies, including the Bretton Woods institutions. It underscores increased involvement of women’s and youth groups, religious communities, the private sector and advocacy organizations, and praises the success of parliamentarians who have secured more government funding and adopted legislation on RH and gender-based violence, including FGM.
CONSTRAINTS AND ISSUES: On policy formulation and programme implementation, one constraint relevant to strengthening partnerships is the frequent absence of clear legal frameworks, regulations and guidelines to facilitate partnerships with NGOs. The draft report also notes limited progress in strengthening the human resource, institutional and financial capacities of civil society organizations, as well as their weaknesses in transparency, accountability and networking.
Other constraints and issues identified in the draft report include: constraints on government resources available to support NGOs; problems in strategic planning for NGOs dependent on external funding; a lack of mechanisms for coordinating and funding partnerships at the national level; the frequent absence of multi-sectoral frameworks for identifying key issues for joint action and indicators for assessing the contribution of civil society groups; the need to increase private sector and youth involvement; and the importance of a positive and stable political environment.
PROPOSED ACTIONS: The draft report proposes a number of actions that would operate on several levels. Regarding establishing an enabling environment for effective partnerships, it says multi- sectoral collaboration should be based on negotiation, agreed intentions and explicit outcomes. It also recommends that partnerships enhance the activity of governments rather than substitute for it. It calls on governments to:
- ensure a legal framework that gives legitimacy and autonomy to NGOs;
- adopt policies and remove legal and bureaucratic obstacles to involving civil society in achieving the POA objectives;
- build partnerships with civil society groups from a broad spectrum of society; and
- work with civil society to clearly define each partner’s role.
Governments and civil society should develop operational guidelines so all programmes are either complementary or conducted jointly. Systems should be transparent in order to promote accountability, instruments to help assess and monitor the interaction between the two sectors should exist, and youth should participate at all levels of the policy and decision- making process. Parliamentarians need to continue to establish national and international networks, mobilize political support, push for sufficient budgetary allocations, and work with the health community on necessary legislative reform.
On strengthening the human resources and institutional capacities of civil society, the draft report calls for innovative financial and technical assistance from governments and international groups, as well as a broader scope for assistance, which could include direct funding for NGOs and other non-state actors. NGOs should strengthen their capacities and work at coalition-building and networking. South-South cooperation should receive multi-sectoral support.
The draft report recommends strengthening and intensifying social mobilization efforts by working more closely with the media and the private sector and encouraging women in the private sector to be workplace advocates for the POA. To promote access to high quality RH and family planning services, it urges cooperation with the private sector and medical professional associations.
To strengthen collaboration among UN and intergovernmental organizations, the draft report calls for improved inter-agency coordination at all levels on selected population and development themes and inclusion of the development banks in partnership activities. UNFPA should continue to focus on including civil society in partnerships and should support government efforts in this regard. It should strengthen the NGO advisory committee to UNFPA at the international level and establish committees at regional and national levels, develop guidelines for partnership-building and strengthen relations with countries with economies in transition.
RESOURCE FLOWS AND FINANCING FOR FURTHER IMPLEMENTATION OF THE POA
The section of the draft report on resource flows and financing for further implementation of the POA stresses the need for governments to commit themselves at the highest political level to achieving the goals of the ICPD. The report highlights the POA estimates and projections on necessary financial resources and takes special note of The Hague Parliamentarians’, Youth and NGO Forums’ calls for the mobilization of adequate resources for population and development activities.
PROGRESS TO DATE: The draft report identifies progress to date: international assistance for population activities increased from US$1.3 billion in 1993 to US$1.9-2.0 billion in 1995-97 with a small decrease in the last year; the percentage of ODA earmarked for population assistance is at its highest level and preliminary figures for 1997 show that donor countries contributed 3.09% of their total ODA to population assistance; developing countries are mobilizing domestic resources for population activities and estimates provide a crude global figure of almost US$8 billion for domestic financial resources for population activities in 1997; and the private sector, including private foundations and NGOs, is playing an increasing role in the mobilization of resource flows.
ISSUES AND CONSTRAINTS: The draft report identifies a number of issues and constraints. Funding for population activities has not increased at a rate that would ensure mobilizing the required US$17 billion by 2000. Preliminary data for 1997 indicates a funding decrease to just under US$1.9 billion and external sources have met 33% of their ICPD commitment; total ODA is decreasing, having declined from $56.5 billion in 1993 to $47.6 billion in 1997; most domestic resource flows originate in only a few large countries and developing countries are generally unable to generate the necessary resources from domestic sources to fund national population programmes; economic and political difficulties are impeding efforts in a number of countries to mobilize domestic resources required to implement national policies and programmes; shortfalls in resource mobilization require heightened attention to improvements in the efficiency and effectiveness of resource utilization; the HIV/AIDS epidemic has progressed faster than forecasted, requiring additional resources; and youth needs for SRH remain inadequately addressed.
PROPOSED ACTIONS: To mobilize resources, the draft report calls for countries to:
- fulfill their financial commitments and strive to reach the nominal 0.7% of GDP allocation to ODA and in this context, at a minimum, reach the nominal commitment of 4% of ODA to population activities with consideration of increasing the minimum to 5%;
- increase levels of funding to UNFPA;
- make special efforts to meeting, at a minimum, all US$1.3 billion for HIV/AIDS prevention in the year 2000, as called for in the POA, targeting young populations in particular;
- mobilizing additional resources for broader population and social sector objectives in areas not costed in the POA, with further consideration of the 20/20 Initiative for resource mobilization;
- redoubling advocacy efforts between and within countries to mobilize the necessary additional resources, including specific efforts by parliamentarians to increase support for population and RH programmes;
- giving population and RH concerns the necessary allocations in integrated and sector-wide programmes;
- ensuring an increased role for the private sector, including private foundations and NGOs, in the mobilizing resource flows;
- ensuring donor funding to support the activities to implement the POA and build capacity;
- mobilizing special support from external donor sources for countries least able to generate domestic resources for population and RH programmes, especially for initiation of integrated RH programmes;
- increasing resource flows directed to meeting adolescent and RH needs, with at least 20% of donor allocations to RH programmes being earmarked to meet the information and service needs of adolescents, and involving youth in programme design, execution and monitoring; and
- using qualitative and quantitative performance indicators in donor allocation decisions that take full account of the POA recommendations.
For efficiency and effectiveness in the use of resources, the draft report proposes:
- improving use of available funds through actions including implementing strategic planning approaches, minimizing financial and human resource waste arising from duplication in national programmes, and exploring the use of management systems linking programme resource decisions to outcomes;
- directing government and donor resources to promote access to information and services for poor populations;
- increasing accountability through technical and managerial capacity-building and more transparent information systems on resource allocations and expenditures;
- coordinating, harmonizing and increasing the flexibility of donor financing policies and initiatives; and
- strengthening mechanisms to coordinate national RH programmes in developing countries.
The report also recommends actions concerning new mechanisms to generate additional resources to meet ICPD goals:
- exploring selective use of user fees, social marketing and other forms of cost recovery, along with innovative financing approaches;
- promoting and supporting expanding South-South cooperation and information exchange on cost-effective programme strategies and best practices;
- strengthening partnerships to mobilize resources;
- utilizing more efficient mechanisms to reduce external debt in order to encourage allocations to population and RH programmes, including debt cancellation and debt swaps for basic social service investments; and
- advocating increased funding for population and RH from international financial institutions.
The draft report also proposes the following actions:
- supporting methodological research, including operational research to improve monitoring of resource flows for the costed integrated population and RH package;
- monitoring by levels of poverty and gender;
- monitoring financial flows to the non-costed portions of the POA, especially those addressing gender concerns and population and environment interactions; and
- assigning higher priority to technical discussions evaluating the POA cost projections, with special attention to the area of safe motherhood.
A BRIEF ANALYSIS OF THE FORUM
The gale force winds that heralded the start of the Forum died down after a week characterized by optimism and a renewed will to “continue the battle of the everyday.” Although the Forum has ended, the discourse for further POA implementation has just begun. In the final hours of the Forum, many participants were expressing sentiments of satisfaction with the process and the outcome, observing that the Forum had re-energized the spirit of cooperation and re-focused efforts on the far-reaching goals established in Cairo. Delegates will barely have time to catch their breath before setting off to New York to roll up their sleeves and begin actual negotiations to set the course for further implementation, but there seemed to be general agreement that the Forum provided a solid basis for the more difficult steps ahead.
The Hague Forum was not about renegotiating Cairo, although some may have anticipated or even hoped for this. Rather it contemplated country experiences to date, brought into focus some emerging concerns and, above all, underscored the length of the road ahead. Prior to the Forum the stage was set the previous week when NGOs, parliamentarians and youth convened to assess their own achievements and challenges in implementing the POA and formulate recommendations that provided valuable input to the Forum. Their impact on the Forum was considerable, with youth taking center stage in the debates on reproductive health, partnerships and resource allocations. Their proposal that at least 20% of donor allocations for reproductive health programmes be earmarked for initiatives to meet the information and service needs of adolescents was supported by a number of delegations and found its way into the Forum report’s proposed actions. This proposal was considered by many to be one of the Forum’s major accomplishments. This was due to the fact that issues relating to adolescent sexual and reproductive health, especially the significant increase in HIV/AIDS among young people, have come to the fore in the five years since Cairo. The enthusiastic and energetic participation of youth was highlighted by many as one of the most significant features of the Forum and a reflection that Cairo’s call for increased partnerships and civil society involvement was becoming a reality.
Hillary Clinton’s keynote address provided significant impetus to discussions in The Hague. Her appearance not once but twice, the second time following her attendance at the funeral of King Hussein of Jordan, was seen by many as a true demonstration of her commitment to championing population and development issues, particularly reproductive health and women’s rights. Her presence also served to rally significant media attention to the Forum, and provided considerable inspiration to Forum delegates.
Another accomplishment that garnered particular attention was the advancement of women’s empowerment and reproductive health and rights over the past five years. To no one’s surprise, these emerged as high-profile issues during the Forum, and the abortion issue again generated a contentious debate, with no apparent change of stance from either camp since Cairo (with the notable exception of the legalization of abortion in South Africa in 1996). There were a few areas where the Forum report was seen as pushing the envelope beyond Cairo, however, including its highlighting of the recent availability of emergency contraception (the “morning after” pill) as a means to reduce unsafe abortion. Calls to incorporate concepts and language from the Beijing Platform for Action, which was an important milestone in advancing women’s issues since Cairo, were considered by many as a significant output of the Forum and an effort to move the agenda forward. This was a point of contention, however, because some of the more conservative delegations who objected to elements of the Platform, such as recommendations relating to sexual rights, were opposed to including Beijing language in the Forum report. They attempted to block its inclusion by reiterating that the Forum was not mandated to reopen Cairo. Significantly, however, the draft report does include a proposal from NGOs to review laws containing punitive measures against women who have undergone illegal abortions, which is based on a Beijing recommendation.
When it came to strengthening partnerships, Florence Manguyu’s introductory remarks in the Main Committee, “united we stand, divided we fail,” epitomized the spirit of cooperation necessary for successful POA implementation. Most delegates agreed that involvement of civil society in implementing the POA has been one of the areas where real progress has been made and which has greatly contributed to progress made in other areas. The spirit of partnership was embodied in the degree and diversity of civil society participation in the Forum and in the willingness expressed by governments to cooperate with other stakeholders nationally and internationally. The Forum’s recognition that civil society groups need assistance in strengthening their human resources and institutional capacities is an indication that their involvement and valuable contributions to advancing the Cairo agenda will only be strengthened in the future.
Throughout the week, the need for resource mobilization was repeatedly highlighted as being pivotal to implementation of the POA. The failure of many donors to fulfill their financial commitments was identified as the single most significant constraint to implementing the POA. The silver lining on the cloud came in the inspirational form of Hillary Clinton’s announcement of US President Bill Clinton’s proposal to contribute US$25 million to UNFPA next year. This gave delegates renewed optimism that the ambitious programmes they had been discussing would be funded and implemented. In spite of the galvanizing potential of this announcement, the size of the shortfall remains ominous. The solution was put most neatly by Dutch Minister for Development Cooperation Eveline Herfkens when she threw down the gauntlet for all recalcitrant donors by stating “put your money where your mouth is.”
The Forum’s significant accomplishments in light of its modest aims leave little to be said about its shortcomings. A few delegates felt it could have been more productive if there had been more time to formulate concrete measures. They concluded that the non-binding nature of the Forum’s report and its lack of specifics in some areas means that this meeting will play only a limited role in determining the outcome of the all- important PrepCom in March and UN Special Session in late June. Although some also criticized the meeting and some donor governments for expounding rhetoric that has yet to be backed up by action, no one can deny that the Forum has served to inspire, renew commitment and strengthen the determination to advance Cairo’s ambitious goals. It is this renewed energy that could be just what it is needed to push delegates to achieve further progress in the coming months. As one delegate aptly stated, “The wind toward success is blowing. We cannot change the direction of the wind, so let us adjust our sails.”
THINGS TO LOOK FOR BEFORE THE UNGASS
COMMISSION ON SUSTAINABLE DEVELOPMENT: The CSD Ad hoc Working Group on Consumption and Production Patterns and Tourism and Sustainable Development will meet in New York on 22-26 February 1999. The Ad hoc Working Group on Oceans and Seas and the Review of the Programme of Action for the Sustainable Development of Small Island Developing States will meet in New York from 1-5 March 1999. The CSD will hold its 7th session from 19-30 April 1999. For information contact: Andrey Vasilyev, Division for Sustainable Development; tel: +1 (212) 963-5949; fax: +1 (212) 963-4260; e-mail: [email protected]; Internet: http://www.un.org/esa/sustdev/.
COMMISSION ON THE STATUS OF WOMEN: The 43rd session of the CSW meets from 1-19 March 1999 in New York. From 1-12 March there will be an in-session Working Group on the Elaboration of a Draft Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). The last week will serve as the PrepCom for Beijing+5. For information contact: the UN Division for the Advancement of Women, United Nations, Room DC2-1204, New York, NY 10017 USA; e-mail: [email protected]; Internet: http://www.un.org/womenwatch.
COMMISSION ON POPULATION AND DEVELOPMENT: The 32nd session of the CPD will convene from 24-31 March 1999 in New York and will act as the PrepCom for the Special Session of the General Assembly to review and appraise implementation of the ICPD POA. For more information contact: United Nations Population Fund, 220 East 42nd St, New York, NY 10017 USA; fax: +1 (212) 557- 6416; e-mail: [email protected]; Internet: http://www.undp.org/popin/icpd5.htm.
MINISTERIAL MEETING ON REGIONAL COOPERATION ON IRREGULAR MIGRATION: This meeting will be hosted by the Government of Thailand from 21-23 April 1999 in Bangkok. Invitations to attend this meeting have been sent out at ministerial level. For more information contact: Peter Schatzer, International Organization for Migration; tel: +41-22-717-9278, fax: +41-22-798-6150, e- mail: [email protected].
COMMISSION ON HUMAN SETTLEMENTS: The 17th session of the Commission on Human Settlements will meet from 5-14 May 1999 in Nairobi, Kenya. For more information contact: Information and External Relations, UN Centre for Human Settlements, UNCHS (Habitat); tel: +254-2-623067; fax: +254-2-624060; Internet: http://www.unhabitat.org/.
COPENHAGEN+5: The Preparatory Committee for the Special Session of the General Assembly on the Implementation of the Outcome of the World Summit for Social Development (WSSD) and Further Initiatives will hold its first substantive session in New York from 17-28 May 1999. The second session will be held in April 2000, with the Special Session to take place later in 2000. For more information contact: Secretariat, UN Commission for Social Development; tel: +1 (212) 963-6763; fax: +1 (212) 963-3062; e- mail: [email protected]; Internet: http://www.un.org/esa/socdev/wssdcal1.htm.
SPECIAL SESSION OF THE GENERAL ASSEMBLY ON ICPD+5: The Special Session of the UN General Assembly will meet from 30 June-2 July 1999 in New York to review and appraise implementation of the POA five years after the ICPD. For more information contact: United Nations Population Fund, 220 East 42nd St, New York, NY 10017 USA; fax: +1 (212) 557-6416; e-mail: [email protected]; Internet: http://www.undp.org/popin/icpd5.htm.