At the 1994 International Conference on Population and Development (ICPD) in Cairo, the international community agreed to allocate an annual sum of $18.5 billion by 2005, $20.5 billion by 2010 and $21.7 billion by 2015 for population and reproductive health programmes in developing countries. Two thirds of the target would come from developing countries themselves and the remaining one third would come from external donor funding.
Both donors and developing countries made promising starts, achieving their 2005 targets as set out in the ICPD. However, in 2009 the UN’s Commission on Population and Development updated and increased the costed population package included in the ICPD. This revision was necessary as the costs and needs to ensure the achievement of the ICPD had changed during the first 15 years of its existence, and by 2009 it was apparent that the current levels of funding were insufficient for the international community to be able to reach MDG 5 (a decline in the maternal mortality ratio in developing countries by 75%).
In 2012, as the deadline for the original Programme of Action approaches, serious gaps in the population funding that is required to meet the criteria above remain, which make it difficult for countries to provide the information, services and commodities needed to meet the ICPD goals by 2015.
Over the past decade funding for reproductive health, especially family planning, has not been accorded the importance it deserves by the international community. Spending on reproductive health services has been steadily increasing, but nowhere near as fast as funding for STIs and HIV/AIDS. And spending on family planning is no higher now than it was when ICPD began. As a result of this, funds for reproductive health and family planning are nowhere near sufficient for keeping up with the needs of an increasing number of couples of reproductive age in developing countries. It has been calculated that there are over 215 million women who are not able to access the modern forms of contraception that they want.
In response to these challenges 2010 saw two major moves from the international community.
The UN launched a ‘Global Strategy for Women’s and Children’s Health.’ This took place at the time of the UN Leaders’ Summit for the Millennium Development Goals (MDGs) in 2010, and approximately US $40 billion was pledged towards women’s and children’s health and the achievement of MDGs 4 & 5 (to reduce child mortality and improve maternal health).
In the same year the Muskoka Initiative on Maternal, Newborn and Child Health was announced at the 36th G8 summit, which commits member nations to collectively spend an additional US $5 billion between 2010 and 2015 to accelerate progress towards the achievement of Millennium Development Goals 4 and 5.
Whilst clearly being steps in the right direction, parliamentary scrutiny is now required more than ever to ensure that the world’s leaders’ actions match their words. Moreover, while developing countries as a whole are making progress in providing domestic resources for their population programmes, the poorest countries continue to depend entirely on external assistance. They will not be able to meet the needs of their populations unless donors increase their support.
But it is not only financial assistance that developing countries require. Another important challenge for advancing the ICPD agenda is need to the create and nurture an enabling environment in the domestic context for SRHR issues. This can be realized by adopting and improving relevant laws, policies and programmes on population and development. Significant progress has been made in this area in the past decade.
For example, 96% of the 151 countries that responded to UNFPA’s global survey in 2004 reported action to integrate population concerns into development policies and strategies.
The partial omission of SRHR from the original MDGs, and its instatement in 2005 under MDG 5b also indicate both the importance that the issue has achieved among the international community, and the challenges that the issue faces from conservative forces.
Yet, many of the laws and policies, while improved, are still not where they should be. And the implementation of existing laws and policies remains a challenge in many countries. Over half a million women die every year from treatable complications of pregnancy and delivery. Population growth in developing countries is also still contributing, along with high resource consumption by affluent populations, to increasing stress on the global environment. It is obvious that much more needs to be done in the next five years in order to meet all of the ICPD goals.
Whether or not we can fill the gaps in laws, policies and funding, and whether or not we can achieve the ICPD and the Millennium Development Goals by 2015, depends on the political will of governments in both developed and developing countries. Strong support of parliamentarians is critical to building this political will. The IPCI will serve as a crucial event for keeping the issue alive and within mainstream parliamentary discourse across the world, both now and in the future.