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Cairo at 15 - Much Remains to be Done

Fifteen years ago after the International Conference on Population and Development (ICPD) held in Cairo, Egypt, the ICPD's 20-year Programme of Action is far from fulfilled. While many governments have embraced reproductive health as an essential component of poverty reduction, access to family planning information and services is far from universal and maternal mortality remains stubbornly high.

Despite the pledges made in 1994, UNFPA estimates that between 120 and 150 million women in developing countries still have an unmet need for family planning. A "woman with unmet need" is a married woman of reproductive age at risk of pregnancy who would like to postpone or stop childbearing now or prior to her last birth, but is not using a method of contraception. In sub-Saharan Africa, one in every four married women has an unmet need for family planning.

Globally, the estimated number of maternal deaths is unchanged since 1990. Maternal mortality has fallen by less than 1% annually between 1990 and 2005, far below the 5.5% annual decline necessary for achieving Millennium Development Goal (MDG) 5. In Sub-Saharan Africa, where help is most needed, the annual decline has been approximately 0.1%. It's estimated that improved access to family planning could reduce maternal mortality by one-third and child mortality by 10%.

Despite the pledges that were made at the ICPD 15 years ago, most developing countries have experienced a major reduction in donor funding for reproductive health. Per capita donor assistance for family planning has declined by more than 50% in many parts of Latin America, Africa, and South Asia. While the U.S. and Europe have recently boosted their support, much remains to be done.

Speaking at an October ICPD conference held in Addis Ababa, Ethiopia, Thoraya Ahmed Obaid, Executive Director of the United Nations Population Fund (UNFPA) told more than 400 parliamentarians that they must "hold governments accountable" for the promises that were made at Cairo.

In response to Obaid's plea, the parliamentarians approved a statement, which said, in part, "We must act with a sense of urgency. Time is short.  Access to sexual and reproductive health and reproductive rights and family planning for all women is a top priority.  Investing in the health and rights of women and girls is smart economics for families, communities and nations."

Bill Ryerson, who represented the Population Institute and the Population Media Center at the conference in Addis Ababa, warned that in many developing countries a lack of access to contraceptives is not the only barrier to family planning. "Many women believe that fate, not contraception, determines how many children they will bear. Many more do not use contraceptives because of male or religious opposition. And, tragically, some believe that condoms spread, rather than prevent, the transmission of HIV/AIDs."

[As part of its coverage of "Cairo at 15," Popline inviteded reflections from Friends of UNFPA, JSI Research and Training Institute, and Population Action International. Their comments follow.]