International action: Cairo and beyond

Four essential points emerged from the ICPD process.

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• It was agreed first that population and development problems are not simply a relationship between numbers and development needs such as school places, health care and natural resources - but also between numbers and consumption patterns. The Programme of Action recognises that excessive consumption in the wealthier Northern countries and rapid population growth in the poorer South, both contribute to global environmental and development problems.
  
• Secondly, it acknowledged that tackling poverty must be an essential part of efforts to reduce family size and human numbers. Agreement on these two points helped to defuse some of the North-South conflicts, which were apparent at the two previous world population conferences.
  
• Thirdly, it accepted that population problems cannot be tackled through a macro numbers approach: solutions must be found at the micro level. So much of what needs to be done turns on a proper understanding of people as individuals and communities, on the status of women, their education and the provision of proper health and particularly appropriate, good quality reproductive health care.
  
• Fourthly, population and development are issues of concern to many sectors of society. They should therefore be shared among all those concerned, severally and in coalitions.
  

Key targets
The 20-year programme approved at Cairo also agreed to:

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• Ensure universal access to quality and affordable reproductive health services, including family planning and sexual health. Reproductive health services, including family planning, can save the lives and improve the health of women and children. These services are also a key component of efforts to slow population growth.
  
• Enable couples to make real choices about family size through social investments.
  
• Improve rates of child survival. No country in the developing world has experienced a sustained reduction in family size without first reducing infant and child mortality. Couples must feel confident that their children will survive before they are willing to have fewer children.
  
• Expand educational opportunities, close the "gender gap" in education, and provide universal access to primary education. Educated women tend to want smaller families, and are better at looking after those children they do have. Educated parents rely less on children for income and support, particularly in old age.
  
• Invest in women's development. When women can exercise their full legal and social rights, they often have both the desire and the ability to choose smaller families. Where women are valued as full human beings, there is less societal preference for sons. Efforts to increase women's self-determination have been shown to improve the health and well being of women and their children, and to slow the pace of population growth.
  
• Expand opportunities for young women. In the year 2000, some 400 million adolescent girls stand on the brink of adulthood. If many choose to delay childbearing, even for a few years, they will enhance their health, education and employment prospects. In the year 2100, the developing countries' population will be smaller by 1.2 billion if the average age at bearing the first child is delayed by five years.
  

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• The right of couples and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to do so;
  
• The right to attain the highest standard of sexual and reproductive health; and
  
• The right to make decisions free of discrimination, coercion or violence. (ICPD 7.3)
  

Measuring results
What progress has been made since the Cairo Conference?

A 1999 review of progress since the Cairo Conference ("ICPD+5") provided growing evidence that the ICPD agenda is practical and realistic, and that despite all obstacles, it is being put into practice. The review included reports on national implementation efforts, global expert meetings and an international forum at The Hague, organized by UNFPA; it culminated in a special session of the United Nations General Assembly which identified key actions needed for further implementation of the ICPD Programme of Action and new benchmarks for measuring progress towards ICPD goals.

But resources for sexual and reproductive health are falling far short of the targets agreed upon in Cairo. Donor countries in the developed world committed less than half the $5 billion target set by ICPD for the year 2000. Developing countries, in contrast, have spent increasing amounts towards the goal of $19 billion from all sources.

Nevertheless, it is clear that in most regions of the world, ideas and realities are changing in support of sexual and reproductive health, as many of the case examples on this website demonstrate.

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• Laws and policies are being reformed and new partnerships formed at international, national, district, and local levels.
  
• Gender equality and equity are being addressed through both policy and programme initiatives, and there are increasing signs of men's involvement in sexual and reproductive health.
  
• A wider range of reproductive health needs is being met through an increased focus on service quality, integration, referral, and other service delivery mechanisms, as well as greater acknowledgement of existing public health risks such as gender- based violence and unsafe abortion.
  
• And the rights and needs of adolescents to and for sexual and reproductive health information and services are beginning to be addressed.
  

Link:
UNFPA: ICPD pages.

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