BERLIN: Katie Chau, a Canadian youth activist, was just 13 years old and in the throes of adolescence, experiencing her ‘first kiss’ in the September of 1994. But others like Sylvia Estrada Claudio, of the Women’s Global Network on Population and Development (WGNRR) saw that year as a ‘historic victory for women.’

The reference was to the International Conference on Population and Development (ICPD) held in Cairo in September 1994, where 179 nations had come together to agree on what is famously known as the Cairo Consensus.  For the first time, family planning – with its emphasis on achieving demographic targets and managing population growth – was supplanted by a concern for individuals’ sexual and reproductive health. The ICPD drafted a 20-year Programme of Action which privileged the necessary interconnectedness of reproductive health, sustainability and economic development. Rather than talking about birth control measures alone, the Cairo Consensus made plans for closing the gender gap in education, providing access to universal reproductive healthcare, and reducing maternal and infant mortality. As Claudio puts it, the Cairo moot ushered in a paradigm shift, reorienting sexual and reproductive health as a human rights issue.

Claudio, Chau and others were reminiscing about the Cairo Consensus at the opening of a ICPD forum on sexual and reproductive health and development in Berlin organised by the German government in collaboration with the United Nations Population Fund (UNFPA). More than 400 delegates arrived here for a three-day conference between September 2 and 4 to evaluate 15 years of work on sexual and reproductive issues since the ICPD announced its agenda in Cairo.

‘We were diverse, argumentative, boisterous and radical,’ Claudio recalled, adding, ‘for if we hadn’t been, we’d have been obliterated.’

For her part, Helen Clark, Under Secretary of the United Nations and administrator of the United Nations Development Programme pointed out that Cairo was a political moment in the United States. ‘NGOs were taken seriously,’ she said. 

But amidst excitement about the Cairo Consensus, many remembered the obstacles as well. ‘The impact of Cairo was huge, but it wasn’t all wonderful,’ explained Jacqueline Sharpe, president of the International Planned Parenthood Federation (IPPF), Trinidad and Tobago.  ‘There were 15 countries that had their reservations over signing the document,’ she recounted, in reference to concerns about the abortion issue.

Despite the hype, things began to fall apart soon after the Cairo Consensus was reached. In the United States, which was regarded as a leader on global reproductive health issues, assaults from Congress began in earnest as it was hostile to almost everything that was progressive, especially on many of the issues around sexual and reproductive health. In 2000, abstinence became the buzzword as the world sought a solution to HIV and other sexual health issues. 

But the atmosphere in Berlin on the fifteenth anniversary of the ICPD is optimistic. In a nod to Barack Obama’s administration, the UN’s Clark said, ‘We have friends in power now.’  She added, ‘change is slow and hard. Our expectations are high too. We want to kill abstinence once and for all.’

Clark’s positivity is shared by Thoraya Obaid, executive director of the UNFPA. ‘It’s not all gloom and doom. More girls going to school, more births attended by skilled birth attendants, more couples choosing to plan their families and rising awareness of violence against women,” she said speaking to media representatives. But, Obaid warned, the Cairo Consensus remained an ‘unfinished agenda.’

Gill Greer, the director general of the IPPF, who was at the Berlin conference as the chair of the steering group, used her time at the podium to point out how the goals of the Cairo Consensus remained unmet. According to Greer, a woman dies every minute due to pregnancy-related complications. Moreover, between 1994 and 2008, funding for reproductive health as a proportion of health aid has dropped from 30 to 12 per cent. Greer explained that the cost of this funding shortfall is extremely high worldwide as an additional dollar invested in voluntary family planning comes back at least four times in saved expenses.

‘We’re moving slowly,’ Obaid acknowledged, calling for more investment in women’s sexual and reproductive health, ‘which is wise and smart economics.’

One of the reasons why successes in the arena of sexual and reproductive health are slow coming is that few people comprehend what is at stake. Michelle Goldberg, author of The New York Times bestseller, ‘Kingdom Coming’ said it is perplexing  that there is ‘so little understanding’ of sexual and reproductive health and rights in her country, the United States of America. ‘Savvy, well-informed people look at me blankly when I tell them that there is a global battle going on over sexual and reproductive health, and yet our [US] policies have impact over global health.’ Part of the problem, in getting people to pay attention could be that it was not an easy issue to ‘summarise in quick sound bytes,’ added Goldberg. Moreover, she said, it was hard to get people excited when the results seem vague and amorphous but have real world impact.

Others, like Indian filmmaker, actor and activist Nandita Das, said that the global movement for reproductive rights had not coalesced well, and that many working on the same agenda as the ICPD had yet to be identified. She herself admitted that she had never heard of the Cairo Consensus before packing her bags to head to the Berlin forum.  ‘I don’t know if my work germinated from the ICPD or from other places, but I believe a lot of things happen simultaneously. To a large extent there are a lot of faceless, nameless people who are part of this movement and have made a difference,’ she said.  

With just six years left to achieve the eight Millennium Development Goals (five of which address the demands made in the Cairo plan of action), governments will have to make quantum leaps in order to fulfill their promises. The Berlin forum has thus chalked out what it is calling the ‘Berlin Clarion Call,’ appealing to governments, representatives of the United Nations, the World Bank, parliamentarians, NGOs, businesses, trade unions, and religious communities to listen hard and take the necessary steps to improve access to reproductive healthcare and education.

‘We call for an end to all forms of discrimination in connection with accessing and using health services, access to health services to be free of financial risks, universal access to sexual and reproductive health information, and services to be realized by 2015 at the latest, self-determination and the realisation of women’s human rights to be seen and promoted as being key to making sustainable progress on population development and health care.’ That’s a tall order for the immediate future. But without fulfilling it, the world will be forced to face a myriad of preventable human rights and resources-related crises.

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