NGO Contribution
to the Deliberations of the European Population Forum
Geneva, Switzerland
12-14 January 2004

The European Population Forum is meeting at a significant time, as the global community seeks to assess ten years of progress since the 1994 International Conference on Population and Development (ICPD). This anniversary provides European nations with an opportunity to review their own programmes and priorities in this field, both within and across the deeply varied countries that form part of the Economic Commission for Europe and in the wider world, as leading members of the International development donor community.

European non-governmental organizations have worked in partnership with governments on sexual and reproductive health and rights issues for many years, often being among the first to tackle sensitive issues, such as adolescent sexuality and unplanned pregnancy, that governments sometimes find difficult to address directly. Seizing this opportunity to contribute to your work, we would urge you to prioritize three tasks, within which we have summarized our priority concerns at this time. These are as follows:

1. Uphold the Cairo Programme of Action;

2. Maintain commitment to a consistent, rights-based approach to sexual and reproductive health, both within Europe, in the context of European priorities, such as migration and HIV/AIDS, and beyond, in responding to global issues, such as the links between women's empowerment, sexual and reproductive health and the elimination of poverty;

3. Assert leadership among global development donors to keep promises to fund programmes that deliver the Cairo agenda bearing in mind the critical contribution they can make to achieving the Millennium Development Goals (MDGs).

Upholding Cairo

The ICPD Programme of Action agreed by 179 countries in Cairo in 1994 broke new ground in recognizing the importance of sexual and reproductive health and rights,
the rights of young people to information, education and services concerning their sexual and reproductive health, the public health impact of unsafe abortion and the need to address it effectively, the importance of increasing access to contraceptive services especially for migrant's, refugees and other marginalized groups, and the emerging global threat to development itself represented by the HIV/AIDS epidemic.

For and within Europe, these issues are still pressing concerns. To take just one - HIV/AIDS - the complexities exemplify the differences within and between European countries, as well as the important role European countries can play as leading international development donors.

While the number of HIV/AIDS cases in Central and Eastern Europe and Central Asia is a relatively small percentage of the global cases, the region has the highest growth rate of newly infected cases in the world. In Western Europe, HIV/AIDS related mortality has decreased, largely due to widespread access to anti-retroviral treatment. However, Western European and North American countries have seen a resurgence of other sexually transmitted infections, which demonstrates a clear need for more effective prevention strategies and services to address high-risk sexual behaviour that can lead to increases in the incidence of HIV infection. The issues of HIV/AIDS and sexual and reproductive health are closely linked and each is a prerequisite for the other.

The global epidemic shows no sign of abating; one in five adults across southern Africa is now living with HIV/AIDS, and two countries have infection rates of 40%. The responsibilities of donor nations to live up to promises they have made in respect of funding HIV/AIDS prevention and treatment programmes have never been clearer, nor the consequences of not doing so more devastating.

Consistency Promoting a Rights-Based Approach

Europe has consistently been in the forefront of efforts to advance global understanding of and respect for basic human rights. We now stand at an important crossroads, with significantly different contexts for sexual and reproductive health and rights within and beyond its borders which challenge European governments to demonstrate a clear commitment to human rights whether addressing migration or asylum issues within Europe, or efforts to reduce poverty beyond its borders in Africa, Asia and Latin America.

Within Europe, migration and the integration of migrant communities are key issues which feature high on the agenda of this Forum; others include childbearing and parenting in low fertility countries, pensions, health, and other factors associated with aging populations. To take just migration, it is essential that a human rights-based approach, which focuses on the needs and entitlements of migrants, is adopted to manage this issue. We know, for example, that sexual trafficking in women is increasing in Europe. We also know that all young people throughout our continent do not have access to the education, information and services they need to protect themselves from sexually transmitted infections and unwanted pregnancies. Placing a priority on addressing these issues can act as an important stimulus to ensure that minority groups within host communities have access to these services and is consistent with commitments European governments have made to fulfill the Cairo agenda for all of their citizens.

Within Europe, women, particularly single mothers, still face several problems. These range from maternity insurance to living in poverty, and include lack of recognition and compensation for their many roles as mothers, income generating professionals and care-givers, especially in relation to the elderly. There is a lack of statistical data for many of these issues but they continue to constitute unfinished business related to the Cairo and Beijing agendas to which European governments committed themselves ten years ago.

European governments have, in the main, continued to champion sexual and reproductive health and rights on the international agenda, and their leadership has been particularly significant since the Bush Administration re-imposed the Global Gag Rule in 2001 creating what European Commissioner Poul Neilson has called the "Decency Gap". However, recognition of sexual and reproductive health and rights as domestic priorities within Europe has been more patchy. Europe is characterized by a relative lack of national policies on these issues, with several governments considering them to relate solely or mainly to international development work.

Funding the Cairo Agenda as a Core Contribution to the MDGs

European countries have historically been significant donors to international sexual and reproductive health care programmes. This leadership becomes particularly important during times such as these, when the US government is hostile to the holistic approach to sexual and reproductive health and rights enshrined In the Cairo Programme of Action. Looking back, Cairo seems to have been the high water-mark, in terms of international consensus support for sexual and reproductive health and rights as global development priorities, but donor government funding commitments to support the Cairo agenda have not been fulfilled1. According to research by Population Action International, in real terms - meaning constant 1993 dollars, those used in the ICPD Programme of Action - donor funding in 2001 was just 36 percent of what it should have been in the year 2000, or $2.057 billion out of the $5.7 billion goal.

Furthermore, sexual and reproductive health programs worldwide confront a growing crisis as a result of the lack of availability of supplies needed for HIV/AIDS prevention, contraception and other vital services. Already under-funded reproductive health programs risk continued supply shortfalls due to waning donor commitment, insufficient coordination mechanisms at the global and national levels, and inadequate logistics capacity in developing countries.

In addition to these critical funding shortfalls, the international community has since adopted the Millennium Development Goals, which now guide development assistance funding allocations. Although the achievement of sexual and reproductive health and rights is crucial if the MDGs are to be reached, the issues, with the exception of HIV/AIDS and maternal health, are not visible as specific goals or targets. The MDG on improving maternal health includes the promotion of skilled attendance at birth, which is key to ensuring safe motherhood. However, the goal of reducing maternal mortality by 2015 cannot be achieved without also reducing unsafe abortion and high-risk pregnancies. While there is increased recognition of the urgent need to fight HIV/AIDS with both prevention and treatment programmes - a development that is to be welcomed - this is increasingly resulting is less funding being made available for the more comprehensive sexual and reproductive health and rights agenda endorsed in the Cairo agenda. If HIV/AIDS is the over-riding priority, it is not self-evident that, for example, it is important to address gender-based violence, or reduce the public health impact of unsafe abortion. In reality, these issues are inextricably linked, as gender-based violence increases women's vulnerability to the virus; advocacy on the links between these issues is badly needed if they are to be more widely recognized. In fact, there are direct links between achieving the Cairo agenda and most of the MDGs; it is simply not possible for the world to eliminate poverty, achieve universal education, promote gender equality and empower women, reduce child mortality, or, indeed, get very far with any of the MDGs, unless serious efforts are made to fund programmes that will contribute to achieving the Cairo agenda. European governments have an important role to play in ensuring that the Cairo agenda is not forgotten but is fulfilled - not only because of its leadership in defining the priorities within the ICPD Programme of Action, nor yet the breach of faith that not fulfilling promises made in Cairo to fund such programmes represents, but also because of the critical role that achieving the Cairo objectives will play in reaching the Millennium Development Goals.

Similarly, there are clear links between sexual and reproductive health and rights and the overarching development goal of poverty elimination. These links are clear to those of us who came into this work because we have seen how a couple's or individual's inability to choose the number and spacing of their children limits their social and economic options. They are less self-evident within today's development agenda, and less attractive in a climate where the world's largest development donor country remains implacably opposed to increasing access to comprehensive sexual and reproductive health and rights programmes which include effective sex education, access to as wide as possible a range of contraceptive methods, and, where contraception has failed, access to safe abortion services.

The need for European leadership on sexual and reproductive health and rights has never been greater. It resonates among population groups within Europe, as well as beyond. At the 10th anniversary of the Cairo Conference, European governments are well-placed to uphold the Cairo agenda in its entirety. As European NGOs in the forefront of the fight to advance sexual and reproductive health and rights within Europe and beyond, we urge you to champion the ICPD Programme of Action and to advocate the consistent development of inclusive rights-based programmes within national, as well as international programmes. We further call upon European governments to take on global and steadfast leadership in advocating the values that underpin the Cairo agenda, and in funding the programmes that must be created and maintained if the Millennium Development Goals are to be realized both within and throughout Europe, and across the globe.

The International Foundation for Population and Development (IFPD), based in Lausanne (Switzerland), initiated the elaboration and dissemination of the present document with a view to clearly formulating and asserting the joint position of the NGO Community within the context of the European Population Forum, hosted by IFPD's home country.

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1 ICPD costs package: $17 .0 billion in 2000, $18.5 billion in 2005, S20.5 billion in 2010 and $21.7 billion in 2015
Donor share: $5.7 in 2000; $6.1 billion in 2005; $6.8 billion in 2010 and $7.2 billion in 2015.

Following organisations endorse the document entitled "NGO
Contribution to the Deliberations of the European Population Forum":

o Action Canada for Population and Development (ACPD)
o AIDOS, The Italian Association for Women in Development
o AMANITARE (African Partnership for the Sexual and Reproductive
o Health and Rights of Women and Girls)
o APF, Associaçao para o Planeamento da Familia, Portugal
o Association HERA XXI, Georgia
o ASTRA - Central and Eastern European Women's network
o Bulgarian Family Planning and Sexual Health Association
o CARE Raks Thai Foundation, Thailand
o Catholics for a Free Choice, USA
o Center for Development and Population Activities (CEDPA), Washington, DC, USA
o Center for Reproductive Rights, Christina Zampas and Katherine Hall-
o Martinez, USA
o Center for Women Policy Studies, USA
o CHOICE (formerly known as Dutch Council on Youth and Population), The Netherlands
o Czech Family Planning Association
o DAWN, Development Alternatives with Women for a New Era, Fiji
o Deutsche Stlftung Weltbevolkerung (DSW) - German Foundation for World Population
o Engender Health, USA
o Equilibres et Populations, France
o Family Care International, USA
o Family Planning Association of Iceland (FKB)
o Family Planning and Sexual Health Association of Lithuania
o Family Planning Association of New Zealand
o Foreningen Sex &. Samfund, the Danish Family Planning Association
o "For Family and Health" Armenian Association
o fpa (Family Planning Association), United Kingdom
o ICCO Interchurch Organisation for Development Cooperation, Margot Klute, President Gender Group ICCO, The Netherlands
o Interact Worldwide (formerly Population Concern), United Kingdom
o Inter-American Parliamentary Group on Population and Development (IAPG)
o International Family Health, United Kingdom
o International Foundation for Population and Development, Switzerland
o International Planned Parenthood Federation
o International Women's Health Coalition, USA
o Ipas, USA
o Irish Family Planning Association (IFPA)
o Israel Family Planning Association
o Japanese Organization for International Cooperation in Family Planning (JOICFP)
o Latin American and Caribbean Women's Health Network (LACWHN)
o Marie Stopes International (MSI), UK
o McCafferty, Christine, MP and Chair of the All Party Parliamentary
o Group on Population, Development and Reproductive Health (APPG on PD & RH), UK
o Mouvement Francais pour le Planning Familial
o Norwegian Association for Sexual and Reproductive Health and Rights
o Oesterreichische Gesellschaft für Familienplanung, Family Planning
o Association of Austria
o PPAT (The Planned Parenthood Association of Thailand)
o PLANeS, FPA Switzerland, IPPF Member
o Planned Parenthood Federation of America
o Population Action International, USA
o Pro Familia - Deutsche Gesellschaft für Familienplanung, Sexualpädagogik und Sexualberatung (IPPF member in Germany)
o Pro Familia Hungarian Scientific Association
o RAINBO (Research, Action and Information Network for the Bodily Integrity of Women), UK
o Regional Public Organization "Novgorod Gender Centre", Veliky Novgorod, Russia
o RFSU - The Swedish Association for Sexuality Education
o Russian Family Planning Association
o Sensoa, Belgium
o Slovak Family Planning Association
o UICEMP, Family Planning Association, Italy
o Väestöliitto, the Family Federation of Finland
o Women's Global Network for Reproductive Rights (WGNRR), The Netherlands
o World Population Foundation (WPF), The Netherlands
o YouAct (Temporary Steering Committee of European Youth Network on SRR), The Netherlands
o Youth Coalition