Mr. President, it is my great honor to be here today to commemorate the fifteenth anniversary of the Program of Action of the International Conference on Population and Development (ICPD) – the Cairo Program. We appreciate the thoughtful remarks of other delegations today, and would like to recognize the other governments and organizations represented here and others around the world for their support of the ICPD Program of Action over the last 15years. The United States strongly supports the goals and ideals of the ICPD, and under President Obama’s leadership has renewed our commitment to work with the international community to implement the ICPD Program of Action.
The ICPD represented a turning point in the world’s perspective on population and development. The international community recognized the importance of the voluntary decisions made by individuals and couples about the number, timing, and spacing of their children, and the importance of ensuring that information and services were available to make and implement informed decisions. It also clearly recognized the importance of population and development objectives critical to achieving the goals of sustained economic growth in the context of sustainable development; education, especially for girls; gender equity and equality; infant, child and maternal mortality, and the provision of universal access to reproductive health services.
We stand here today, fifteen years on, with many accomplishments, but with daunting challenges still ahead. I want to highlight some of the accomplishments, note some of the continuing obstacles, and describe some of what the United States plans to do moving forward.
The international community has made significant progress towards fulfilling the Cairo Program of Action in the last 15 years. According to a report published by UNFPA, more births are now attended by skilled health personnel. In East Asia, the percentage of infants delivered with the assistance of skilled personnel has risen from 71 percent in 1990 to 98 percent in 2006 – a tremendous accomplishment. In Latin America and the Caribbean, the increase over the same period was from 68 percent to 86 percent, and in North Africa, from 45 percent to 79 percent. More women and couples are choosing to plan the size of their families, space their pregnancies, and choose the number of their children. The use of modern contraception has increased worldwide, from about 47 percent of women of reproductive age in 1990, to 56 percent in 2007.
Infants and children are also healthier. Infant mortality has declined in every region. In South and Central Asia, there were 80 deaths per 1,000 live births in the period from 1990-1995. UNFPA projects that this rate declined to 56 deaths per 1.000 live births for the period 2005-2010. In Sub-Saharan Africa, the decline was from 109 to 89 deaths per 1.000 live births over the same period.
The United States was heartened that so many delegations took a strong interest and actively participated in the 42nd Session of the Commission on Population and Development last March that focused on the ICPD and produced a highly substantive outcome document. That document reaffirmed the commitment of member states to the ICPD Program of Action without qualification, and provided clarity to important commitments. The resolution included an unprecedented emphasis on human rights and a new commitment to “comprehensive education on sexuality and gender equality,” a call for access to reproductive health commodities and services for adolescents, an assertion of the importance of integrating programs that address HIV with sexual and reproductive health, and a strong multilateral statement that the ICPD Program of Action is integrally related to the achievement of the Millennium Development Goals. We look forward to working toward implementation of these commitments.
The United States was particularly pleased by the Commission’s outcome document’s strong focus on youth education and services. Many developing countries, including those struggling to meet their Millennium Development Goals commitments, are grappling with unprecedented surges in their youth populations. This is putting tremendous new strains on health and education infrastructure, including those related to family planning and maternal and child health and survival.
Much work remains to be done to realize the promise of Cairo. It is also clear that much more progress needs to take place in fulfilling Millennium Development Goal 5, which calls for a two-third reduction in maternal mortality by 2015.
Every minute of every day, a woman dies from conditions related to pregnancy or childbirth. This amounts to 530,000 deaths annually. Women, girls, and their babies still die every day as a result of too-early pregnancy, a lack of skilled medical personnel, inadequate spacing of births, or insufficient post-natal care. For every death, 20 or more women suffer from injury, infection, and disease. The dire problem of maternal mortality is particularly grave in certain regions, where, according to UNIFEM, as many as one in 10 women die from pregnancy-related causes. As noted above, infant mortality in sub-Saharan Africa remains at an unacceptably high rate of 89 deaths per 1000 live births.
UNFPA data shows that pregnancy is the leading cause of death in teenage girls in developing countries. Girls ages 15 to 19 are twice as likely to die from pregnancy related complications as women in their 20s, while girls under 15 are five times more likely to die.
These deaths of mothers occur even though the means for preventing maternal mortality are cost-effective and well-known, including skilled birth attendance, birth spacing, and pre-natal care and nutrition. The world needs to take additional action to provide this life-saving care.
President Obama, Secretary Clinton and Ambassador Rice have all underscored the strong support of the United States for human rights, women’s rights and reproductive rights as well as universal access to reproductive health and family planning.
The United States has a strong history of supporting family planning as part of its foreign assistance programs. Through the U.S. Agency for International Development (USAID), the United States provided family planning assistance to over 50 countries in 2009, including 35 to 40 percent of donor-supplied contraceptives to the developing world. USAID also supports the Demographic and Health Surveys (DHS) that provide essential information about family planning and health dynamics in many countries. United States’ government programs have trained more than half a million medical professionals, including clinic supervisors and administrators, physicians, and community-based workers so that the advances in reproductive health will belong to, and remain, in the host country. Modern contraceptive prevalence rates increased from 24 to 38 percent on average in 36 countries receiving U.S. assistance. From 1990 to 2000, the percentage of contraceptive users increased in every region. The United States is also funding UNFPA and strongly supports its life-saving work.
In May of this year, the President announced the United States’ Global Health Initiative – a six-year, $63 billion effort that emphasizes global health as an essential element of U.S. foreign policy. In his announcement, he said, “We cannot fix every problem. But, we have a responsibility to protect the health of our people, while saving lives, reducing suffering, and supporting the health and dignity of people everywhere.” Reproductive health and family planning are essential aspects of this effort.
Mr. President, as the United States moves forward on this initiative, we are pleased to join with the international community in commemorating the fifteenth anniversary of the ICPD and to re-endorse its Program of Action.
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