Statement of Thoraya Ahmed Obaid, Executive Director, United Nations Population Fund UNFPA, Ministerial Meeting of Fifth Asian and Pacific Population Conference, 16 December 2002,Bangkok

Your Excellency, Mr. Thaksin Shinawatra, Prime Minister of Thailand; Mr. Kim Hak-Su, Executive Secretary, Economic and Social Commission for Asia and the Pacific; Mr. Steve Sinding, Director-General, International Planned Parenthood Federation; Your Excellencies, Ministers and Heads of Delegations; Colleagues and friends; It is with great pleasure that I visit the Economic and Social Commission for Asia and the Pacific for the first time, although I know and respect your work well. I am pleased to be here as your co-organizer of the Fifth Asian and Pacific Population Conference, especially that UNFPA and ESCAP have had a long and fruitful partnership.

The member States of ESCAP, through their own regional commission and in partnership with UNFPA since it became operational in 1969, have been leaders in making population a major development concern, as evidenced by the fact that we are here to participate in the fifth regional conference on the subject. Such vision and commitment, articulated in the Senior Officials Segment, 11 - 14 December 2002 leading to this Ministerial Conference, are strong reaffirmation of the consensus reached by 179 governments in 1994 on the principles and recommendations of the Programme of Action of the International Conference on Population and Development (ICPD). This commitment is well reflected in the great advances made by many countries in the region in the area of population in general and in reproductive health and reproductive rights in particular. And it is reflected in the action taken by other countries in the region, which had a slower beginning, to accelerate the implementation of its recommendations.

Such expression of commitment would not have been complete and advances would not have been achieved without a true and real partnership with other actors as well—namely, parliamentarians and non-governmental organisations (NGOs). It is rewarding to know that many of the governmental delegations include representatives of these voices of the people. It is also rewarding to replicate this partnership on the podium — the Government of Thailand, the United Nations represented by both ESCAP and UNFPA, and IPPF, a major NGO. With this kind of partnership, we can only move forward to continue to achieve what has been agreed upon in 1994 and what has been reaffirmed so solidly at the Senior Officials Segment last week. We look forward to a yet stronger reaffirmation of ICPD during this ministerial segment of the Conference. All delegations at this Conference have one main common aim. They want to create the enabling environment for people of the region to exercise a very essential and basic human right-to be free of want and free of fear, as the Declaration of Human Rights stated in 1948, and as world leaders endorsed at the Millennium Summit in 2000. The Programme of Action adopted at Cairo clearly states the link between poverty and population. Reinforcing the consensus and promoting its practical goals are the aims of this Fifth Asian and Pacific Population Conference.

Your Excellencies, sSince the Cairo Conference, we have collectively made progress in many areas, and we should feel proud of our accomplishments. Today, many countries have incorporated population, gender and reproductive health in their national development plans and policies. And their legislatures have been actively translating the commitments of Cairo into action programmes to transform the lives of their people, especially women. Not only were your governments part of the Cairo consensus, but also you have gone much further to internalize it in your programmes. In other words, each Asian country participating in this Conference has made the critical political decision to own the Programme of Action. Since Cairo, developing countries all over the world have moved to create an enabling environment to implement the Programme of Action.

Laws have been passed to ensure gender equality and punish the perpetrators of gender-based violence and trafficking in women. Police and judges have been trained to respect women's rights. Family planning programmes have been expanded to meet the needs of individuals. In many villages and cities, women are now moving forward with greater confidence and autonomy through better health, income-earning opportunities and legal rights. And men are joining in partnership for healthier and more equitable families and communities. The ICPD also focused attention on the rights of migrants, refugees and displaced persons, especially women and children, who are often the most marginalized population groups. And it drew our attention to two generations that are often forgotten— adolescents and the ageing, not only in terms of their demographic significance but also in terms of their roles and needs.

There has been strong support for the ICPD Programme of Action from all quarters, reaching across the political spectrum and across countries and communities and diverse cultures and religions. This support proves that the long and sometimes arduous negotiations that led to Cairo are bearing fruit, and I am confident that this conference will be another step forward and will bear similar fruits for a very worthy region. At the heart of the Cairo agreement are the concepts of gender equality, reproductive health and reproductive rights.

At Cairo, 179 conscientious and committed governments hammered out these concepts in an international spirit of mutual trust and co-operation, building on principles that are coherent and in harmony with national priorities and laws. They were also respectful of religious beliefs and cultural values, within the context of internationally adopted human rights principles. The ICPD Programme of Action and the Key Actions of ICPD's five-year review are beautifully balanced documents, giving space to everything from voluntary abstinence to meeting unmet needs for family planning, and including carefully crafted language on abortion and adolescents, which articulates the common agreement among the participants in all their diverse cultures, religions, values and practices.

Excellencies: The language of the ICPD Programme of Action is extremely clear. There is no hidden agenda, nor any secret codes. The ICPD Programme of Action states, and I quote: "In no case should abortion be promoted as a method of family planning. All Governments and relevant intergovernmental and non-governmental organizations are urged to strengthen their commitment to women's health, to deal with the health impact of unsafe abortion as a major public health concern and to reduce the recourse to abortion through expanded and improved family planning services. Prevention of unwanted pregnancies must always be given the highest priority and every attempt should be made to eliminate the need for abortion— Any measures or changes related to abortion within the health system can only be determined at the national or local level according to national legislative process." Unquote (para.8.25).

This paragraph means exactly what it says, no more, no less. Let me also state once more, since it has been called into question: the meaning of the phrases "reproductive health" and "reproductive rights" are not in doubt. The components of reproductive health are safe motherhood; voluntary family planning; protection from and treatment of sexually transmitted infections, including HIV/AIDS, and protection from gender-based violence. As the ICPD Programme of Action points out "Reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents. These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes the right of all to make decisions concerning reproduction free of discrimination, coercion and violence as expressed in human rights documents." (para. 7.3) The phrase "reproductive health services" is not code for the promotion or support for "abortion services".

Nothing in the proceedings at Cairo, or the five-year review, justifies describing them as such. Countries have the sovereign right to make laws regarding all aspects of reproductive health, including abortion: nothing in the Programme of Action, or any international consensus document, infringes on this sovereign right. Indeed, national sovereignty, together with internationally-agreed standards of human rights, are the pillars on which the ICPD consensus stands. The Cairo goals—to provide universal access to reproductive health and primary education for girls, reduce maternal mortality and morbidity and HIV/AIDS, and advance gender equality- are absolutely key to the achievement of seven of the eight Millennium Development Goals. And we only have 12 years left to fulfil ICPD's vision by 2015.

We will not be able to reduce poverty by half unless we empower half the population by actively confronting gender discrimination and gender-based violence. We will not be able to cut poverty unless we expand opportunities, choices and freedoms for all people, not just a fortunate few. And we will not be able to have healthy, educated and productive people to bring about economic growth if maternal and infant and child mortality continue, if girls are denied the right to education and if young people of working age die from HIV/AIDS. To ensure greater progress and to meet the Millennium Development Goals, all efforts must directly target the poor, the very people we all know in our hearts are too frequently left behind. This is our collective moral obligation globally, regionally and nationally. Excellencies: We have come a long way since Cairo, but we have a long way to go.

Today, well over one billion people live in extreme poverty on less than $1 a day, and more than 800 million people go to bed hungry every night. The widespread poverty that we see today is exacerbated by environmental degradation, lack of arable land and water scarcity, unplanned urbanization and migration, wars and military conflicts. Poverty is worsened by economic and social exclusion and marginalization, and fueled by a lack of access to basic social services. Today, 350 million couples lack access to safe and affordable family planning. Today, 48 per cent of all births in the developing world take place without skilled medical assistance. Today, HIV prevention efforts reach just one in five of those at risk. Every minute one woman dies needlessly from the complications of pregnancy and birth. Every minute, 10 people are newly infected with the deadly virus HIV and half of these new infections occur in young people, especially young women. Promoting reproductive health and rights is indispensable for economic growth and poverty reduction. This was clearly shown in our State of World Population report this year- People, Poverty and Possibilities. The report shows that developing countries that invested in health and education, including family planning, like our host country, have achieved smaller families and slower population growth. They have also registered higher productivity, more savings and more productive investment.

Asia and the Pacific region

Over the last decade, the Asia and Pacific region has achieved significant progress. But widespread poverty and illiteracy, gender discrimination, growing demands in urban areas, environmental degradation and the spread of HIV/AIDS require greater political commitment and financial support than ever before. Unless these issues and the challenges presented by a large youth population and growing numbers of older persons are tackled with leadership and vision, there is danger that the gains achieved so far may well be reversed. Of the 1.2 billion people who live in extreme poverty worldwide on less than $1 a day, over 60 per cent, or 750 million, live here in Asia.

Maternal Mortality and Morbidity

Today, more than 600 Asian women die each day from complications of pregnancy and childbirth—even though we know what needs to be done to reduce maternal deaths. Yet, today only 48 per cent of women in Asia go through delivery with a trained attendant and the consequences are tragic. The lifetime risk of maternal death in Asia is 18 times greater than in Europe. Fortunately, we know that progress can be achieved from success stories of countries in the region.

HIV/AIDS

Another challenge that we must confront is HIV/AIDS. Though HIV/AIDS came later to Asia, its spread has been swift, especially in the most populous countries of the world. Unless serious measures are taken to stem the epidemic in its early stages, the consequences could be ravaging. With no cure in near sight to stop AIDS, our first line of defence remains prevention. Large-scale prevention efforts have halted or reversed the spread of the epidemic in a growing number of countries, including Cambodia and Thailand. We must build on these successes and expand effective interventions. Efforts must be scaled up nationwide so that information, education, counselling, as well as care and treatment, spread faster than the virus itself. We must break the silence, stigma and discrimination that fuel the AIDS pandemic. The commitment of top political leaders is crucial to an effective response. The 2001 United Nations General Assembly Special Session on HIV/AIDS rightly adopted the ABC approach to prevention: abstinence, being faithful and condom use. In line with the consensus reached, all countries, supported by UNFPA, have wisely adopted this three-pronged method of HIV/AIDS prevention.

Changing Demographics

Adolescents comprise more than 20 per cent of the total Asian population. Most are married before the age of 20 and, sadly, many girls are married as young as 13 or 14. These marriages are often forced, which is a fundamental violation of their human rights. Early pregnancy and childbearing pose a grave health risk to adolescent girls. Action to promote later marriage and to sensitize parents and communities to the dangers of early marriages, and to ensure the right to decide who to marry is therefore an urgent priority. Furthermore, the Programme of Action recognizes clearly the reproductive health needs of adolescents and stipulates that they should be provided with information "that helps them attain a level of maturity required to make responsible decisions" (para. 7.41).

It further states: "Recognizing the rights, duties and responsibilities of parents and other persons legally responsible for adolescents to provide, in a manner consistent with the evolving capacities of the adolescents, appropriate direction and guidance in sexual and reproductive matters, countries must ensure that the programmes — do not restrict the access of adolescents to appropriate services and the information they need, including on sexually transmitted diseases and sexual abuse." (para. 7.45) . This is the first youth generation to grow up with the threat of HIV/AIDS and the looming ghost of death as part of their everyday lives. We must therefore join forces to ensure that this young generation has a fighting chance, not only to survive, but also to a quality of life and to an active contribution to the well being of their families and their societies.

Young people need education, information, counselling and reproductive health services to protect them from unwanted pregnancy, HIV/AIDS and other sexually transmitted infections. The United Nations Population Fund is making young people a priority focus.

Conclusion

Since 1994, the Cairo agreement has galvanized action to offer lifesaving treatment for millions of mothers and their babies, prevented millions of unwanted pregnancies, helped slow the spread of AIDS and helped nudge nations toward prosperity. In an age of coalitions, the Cairo consensus is one of the most critical coalition because it saves people's lives. It is a coalition of 179 countries for the human rights of women and men, old and young. As such, it is our collective duty not only to safeguard it but also to move its implementation forward.

The ICPD Programme of Action and the Key Actions remain feasible, affordable and effective. The agreements represent a balanced and pragmatic approach to population and development issues—an approach centred on human rights and sustainable development. Together these agreements address the rights of all stakeholders in all diversities. As Ministers and senior officials, you are uniquely placed to offer leadership in all the matters I have mentioned. You can set priorities and budgets, build partnerships and strengthen efforts to empower people to help themselves. Your governments participated in the consensus reached in ICPD and the ICPD+5. And only you know how best to implement the ICPD effectively within the context of your national laws, communities and culture. We stand by you every step of the way in your efforts to achieve the goals of the Programme of Action.

To each and every Member States of ESCAP, we, at UNFPA salute you. To every delegation that is working so hard in this conference to ensure its success, we are grateful. And to the Executive Secretary of ESCAP and his staff, in particular the Chief and the staff of the Population and Rural and Urban Development Division, we thank you. Let us all go forward and never forget those for whom we work. Let us try to support and assist all of these people of the world as if they were members of our family; because they truly are. Thank you.

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