Overcoming verticality and integrating health approaches: The rationale for linking HIV and SRHR

The German Development Ministry (BMZ) posted a discussion paper in the post-2015 UN thematic consultation on health entitled, “Overcoming verticality and integrating health approaches: The rationale for linking HIV and SRHR” (see attached).

The paper:

  • References ICPD in Cairo and the 2004 Glion Call to Action,
  • Makes the case that comprehensive integrated services to SRHR and HIV are a prerequisite to achieve MDG 5 and 6, and should be included in the continuous development agenda,
  • Highlights the exclusion of these issues in the MDGs: “The consultation around the new Post 2015 development framework provides an opportunity to once more emphasize the need for comprehensive integrated SRH and HIV services, and take account of the fact that much of the miss-achievement in regards to these three MDG goals [4, 5 and 6] – apart from the also extremely positive advancements – has been caused by a little practical attention towards these interrelationships.”
  • Links SRH to women’s health and that of their children emphasizes the need for health services catered to youth: “‘Youth-friendly corners’ in health centers improve young people’s access to age-appropriate information about HIV, sexual and reproductive health services.”

 Government Ministers and UN, NGO Representatives from Asia, Africa, Europe, Latin America and Middle East Focus on Ending Violence Against Women and Girls and Fulfilling Sexual and Reproductive Health and Rights

(March 7, New York) At a roundtable meeting on March 5 hosted by the High-Level Task Force for the International Conference on Population Development (ICPD), Government Ministers, delegates to the 57thCommission on the Status of Women (CSW), and representatives from UN agencies and non-governmental organizations—164 individuals representing 36 countries in Asia, Africa, Europe, Latin America and the Middle East—shared recommendations for action around the event’s theme, Charting a Forward-Looking Agenda–Ending Violence Against Women and Girls and Fulfilling Sexual and Reproductive Health and Rights for All.

“At the very moment we are all gathered here, countless women and adolescent girls are being subjected to various of forms of violence in every country of the world–physical, emotional and sexual abuse. Every day, women and girls die from complications during pregnancy and childbirth, and from unsafe abortions. Every day, over 2,000 young people become infected with HIV.” This opening statement from Samuel Kissi of Ghana, the event’s facilitator and member of the Youth Coalition for Sexual and Reproductive Rights, underscores the severity and scope of these inter-related problems. “These are not separate issues. Violence against women and girls is a violation of sexual and reproductive health and rights. The denial of these rights is itself a form of violence, coercion and control over women’s basic freedoms and equality.” He pointed participants to the Bali Youth Declaration adopted in December 2012, encapsulating the demands of young people, policy-makers and other stakeholders from around the world on these issues.

“Fourteen women and 170 newborns die every day,” reflected Enrique Tayag, Philippines’ Assistant Secretary of the Ministry of Social Welfare on the situation of women and girls in his country. He referred to the historic adoption of the new Reproductive Health Law in 2012, which guarantees universal access to contraception, sexual education, and maternal care. He noted that in the Philippines, “men are standing up against violence against women…they are part of the solution.”Following on the theme of men’s roles, the UN Permanent Representative to the United Nations for Denmark, Carsten Staur, noted the various forms of sexual violence that women and girls face, calling for comprehensive sexuality education as a means to “make men understand that resorting to violence is not a solution.”

“I don’t think we’ll go much further in ending violence against women unless we fight the root causes,” stated Najat Vallaud-Belkacem, Minister of Women’s Affairs of France, reporting on her country’s commitments to ending violence against women. “We need to fight against those in the education system…We’re going to teach girls, and boys especially, the concept of equality. And we’re going to put in place sexuality education in high schools so that teenagers learn the respect and the right for the girl to say no.” She continued: “The ideal situation is to have an integrated approach in the area of reproductive and sexual rights,” with sexuality education linked to services as key to preventing unwanted pregnancy. “So for girls, contraceptive methods are fully reimbursed. Abortion is fully reimbursed because we believe that it’s never a comfortable choice for a woman and there’s no reason a woman should be subjected to a second burden, a financial one.” Vallaud-Belkacem concluded, “We realize that anything that can be done to guarantee that a woman is truly free to choose what she does with her body, is a lever of equality between the sexes. And also a factor and a lever to develop society.”

Karina Ruiz, Uruguay’s Director of the Division for Prevention and Elimination of Violence Against Women of the National Institute for Women, affirmed that her country is “on the road to putting in practice the commitments that were made in the international arena on human rights,” as she explained recent laws adopted in 2008 recognizing and protecting sexual and reproductive rights as human rights, and the new law of 2012 on voluntary pregnancy termination. “This is part of our contribution to the norms and tools for full enjoyment of sexual and reproductive health and rights, without any forms of discrimination.”

Fatma Sahin, Minister of Family and Social Policy in Turkey, also shared legal progress in her country to end impunity: “Violence against women, not only physical violence, but economic and psychological violence as well, has been redefined in a new version of the Turkish criminal code. We changed it in 2002 for the first time in 35 years…the main goal was to change penalties with regard to violence against women.” Sanctions were increased for the crime of honor killings as “such offenses had been considered a qualified manslaughter and previously were penalized with only two to five years in prison. Those penalties are now 25-30 years.”

As first discussant responding to the ministerial panel, Leymah Gbowee, Nobel Peace Laureate and Member of the High-Level Task Force for ICPD from Liberia shared the Task Force’s positions, echoing sentiments expressed by the government representatives and panel speakers. She reinforced that it is “essential to reaffirm and protect sexual and reproductive rights as human rights in laws and policies.” This includes revoking “laws that pervert justice,” such as those that set rapists free when they marry their victims, or that let abusive husbands simply “go back home” only to repeat vicious cycles of abuse. Given how “horrific rape” is often used a tactic of war, she noted the Task Force is calling for sexual violence to be eliminated from amnesty provisions when peace plans are negotiated.

“The time has come,” Gbowee continued, “All women and girls subjected to violence must have prompt access to critical services and supports for their safety, health, housing, legal and other needs and rights…and here sexual and reproductive health programmes and services have an especially strategic role to play in supporting women and girls subjected to violence–including to address especially neglected forms of violence, such as abuse during pregnancy.” Such services must provide “access to quality post-rape care that includes emergency contraception, post-exposure prophylactic to prevent HIV, access to safe abortion for all survivors of rape and incest and diagnosis and treatment of sexually transmitted infections.” Turning to the rights and empowerment of young people, in addition to the importance of comprehensive sexuality education, she highlighted the violence and risks girls face, including harmful practices and appealed for efforts to “eliminate early and forced marriage and female genital mutilation within a generation.”

Gbowee concluded by saying, “We must work to end the accountability deficit. We can create laws and policies, but if they are not enforced, implemented, adequately resourced and monitored for effectiveness, we will have failed.”

Rashida Manjoo, Special Rapporteur for Violence against Women and its causes and consequences, reinforced the important role of the State, saying, “Violation of sexual and reproductive health and rights is often a result of direct state action—coercive population control, coerced sterilization of women and girls, especially in marginalized communities and women with disabilities, and criminal sanctions against all forms of abortion and contraception.” But she emphasized that state inaction also contributes to the violation of these rights by “failing to address structural systemic oppression of women and girls.”

As the final discussant, Dr. Michelle Bachelet, Executive Director of UN Women focused on ongoing CSW negotiations: “What the CSW can include in their agreed conclusions, so we can ensure that when we are dealing with this awful issue of ending violence against women, we really include also the sexual and reproductive health and rights, and the access of women for all sexual and reproductive health services.” She noted that, “the international community recognizes that there can be no peace, no progress, no equality without women’s full and equal rights and participation,” and went on to say, “What amazes me is that we are discussing an issue that 20 years ago we defined as an international community…In Cairo we discussed the linkages between sexual and reproductive health, empowerment of women and sustainable development. Here we are again 20 years later, trying to get agreement on these issues.”

Echoing panelist Paavo Arhinmäki, Minister for Gender Equality Affairs of Finland, who had stated, “We believe that sexual and reproductive health and rights issues must be kept high on the international development agenda, including in discussions leading up to post 2015,” Dr. Bachelet said in her conclusion, “Women’s rights to sexual and reproductive health and ending violence against women are the missing MDGs for the post-2015 development agenda.”

Co-hosts for the event were the Governments of Argentina, Denmark, Finland, France, Turkey and the Global Leaders Council for Reproductive Health.

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The High-Level Task Force for the International Conference on Population and Development (ICPD) was established in September 2012 as an independent body to provide a bold, progressive voice for advancing sexual and reproductive health and rights for all, especially for those living in poverty and otherwise marginalized, and to advance gender equality and the empowerment of women and young people. For more information, see http://www.icpdtaskforce.org.

Source: www.icpdtaskforce.org 

Overcoming verticality and integrating health approaches: the rationale for linking HIV and SRHR