Behind the Numbers: The PRB blog on population, health, and the environment

by Charlotte Feldman-Jacobs, program director, Gender 

Secretary of State Hillary Clinton’s speech on Friday, Jan. 8 commemorated the 15th anniversary of the International Conference on Population and Development (ICPD) in Cairo but could reasonably be called the “No Woman Left Behind” speech.

The Secretary extolled the Cairo Conference as a milestone in proclaiming that “women’s health is essential to the prosperity and opportunity of all, to the stability of families and communities, and the sustainability and development of nations.”  She reminded us that the 1994 Conference set specific targets to be met by 2015—to provide evidence of improvement in women’s health care; reductions in infant, child, and maternal mortality; of education for all, but especially for girls and women. These improvements will lead to sustainable development and economic growth — all the while contributing to gender equality, equity, and the empowerment of women. It’s a short time frame with a tall order, especially given the lack of progress in reducing maternal mortality in the last 15 years.

Secretary Clinton listed some of the great achievements that have been made towards these 2015 targets in the increased use of contraceptives, in reducing the spread of HIV/AIDS from mother to child, in improving neonatal and child health, in the number of girls in school, and in the widespread realization that gender needs to be mainstreamed into the entire range of global programs.

However, she rightly pointed out, “vast inequities remain:” Women and girls are the majority of the world’s poor – too many unschooled, unhealthy, underfed, and bearing the brunt of gender-based domestic abuse as well as brutally violent national and regional conflicts.

The statistics Clinton threw down to illustrate that woman are the downtrodden of the earth are very familiar to many of us: one woman dies every minute of every day in pregnancy or childbirth, and “for every woman who dies, another 20 suffer from injury, infection, or disease every minute;”  215 million women lack access to modern contraceptives to prevent unplanned and unwanted pregnancies, a contributing factor in “the nearly 20 million unsafe abortions that take place very year.”  And she noted that millions of women and girls suffer the pain and indignity of such crippling conditions as obstetric fistula and of sexually transmitted infections which they have neither the power nor the information to prevent. Calling specific attention to Female Genital Mutilation (by its “gentler” term Female Genital Cutting), Clinton noted the resulting serious infections and injuries during child birth, but she might have added that it also robs women of their sexual pleasure and indeed  has been outlawed in many countries where it occurs. But, Madame Secretary, far more than 70 million girls and women have been subjected to this cruel tradition. The latest figures show that 100-140 million girls and women worldwide have undergone FGM/C and more than 3 million girls are at risk for cutting each year on the African continent alone.

Moving from the problems to the solutions, Secretary Clinton emphasized “Investing in the health of women, adolescents, and girls is not only the right thing to do; it is also the smart thing to do.” She said the Administration’s commitment and actions will be guided by Cairo’s excellent “roadmap” through:

• New funding to achieve Millennium Development Goal Five (improving maternal health and achieving universal access to contraception)
• The re-funding of UNFPA
• Working with the Congress to appropriate nearly $650 million to family planning and reproductive health programs worldwide
• The Global Health Initiative (GHI), the crown jewel in this administration’s “women-centered approach.”

While the exact strategy of the GHI has not been revealed, $63 billion will be committed over the next six years to prevent millions of new HIV infections; reduce maternal and child mortality; avert millions of unintended pregnancies; eliminate some neglected tropical diseases, and integrate women and girls into all health programs.

If this blogger were to change just one thing about this important speech, it would be to elevate the one sentence that came near the end about the importance of engaging men and boys in the societal changes that will need to take place to achieve better health and equity for women and the world.  “Men are presented as the abusers and HIV vectors,” the Secretary said, adding that we need to reach out to men and boys to encourage them to be active partners in working toward better reproductive health and equality.  This important point deserves to have been made more than once; lack of progress over the last decade in achieving gender equity shows it needs to be raised early and often if our work is to be successful.

Nevertheless, even though I was watching the speech on a TV monitor, I wanted to stand up and cheer her statements that:

• It is a national security issue to pay attention to women and girls.
• It is a matter of equity and fairness.
• It is not just the elite women in societies but also “ the women who live down the street or care for their children or clean their homes or plant their crops” that need our attention.”  Rights must be protected for women everywhere.

Secretary Clinton exhorted the leaders in the august Ben Franklin Room of the State Department (and maybe even those watching on the ICPD2015 simulcast), “Do Not Grow Weary.” She might have borrowed a line from Robert Frost:  For we have promises to keep, and miles to go before we sleep.”?

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