1999 WGNRR Position Paper for the Cairo +5 Process

Counterpoint: Position Paper on Women, Population and Development

In this position paper, while we acknowledge the usefulness of the ICPD 1994 Programme of Action in some contexts, we want to highlight several aspects of current international and national developments that are a cause of deep concern to us.

1. "Reproductive Health" as Population Control
2. Abortion
3. Health for All
4. Physical, Mental and Social Well-being
5. Migration
6. Consumption Patterns
7. Military Expenditure  

The International Conference on Population and Development, ICPD, in 1994 has been a vital and much needed event for womens organisations in many parts of the world. Thanks to the influence of womens groups over the years, the agenda of the ICPD was much more progressive and human centred than those of previous years. The Cairo Programme of Action emphasised reproductive rights and reproductive health, and de-emphasised narrow population control approaches of the past.

Many womens organisations have used the Programme of Action as a tool for negotiating for a change in their own countrys policies. For instance, womens groups in Brazil are using the Programme of Action to demand a far stronger participation for the groups in the decision making process, specifically in the area of health care. In Kenya, womens organisations used the Programme of Action to push for changes in property and other civil laws in favour of women. Womens organisations in the Philippines worked on different levels to bring about a change to a totally inadequate general and reproductive health situation. The Programme of Action was used, therefore, as a tool, to advocate for a human-centred health and development approach.  

1. "Reproductive Health" as Population Control
Whilst the rhetoric has shifted, through the Cairo process, from a demographic, target-driven orientation in family planning programmes to one concerned with reproductive health, the drive to reduce the fertility of women in poor countries continues to be the focus of health and population policies. Reproductive health and reproductive rights have become a "means to an end" instead of being "an end in themselves" i.e., instead of acknowledging womens rights to health care as a basic human right. For instance, in Peru, the government set up a quota system for the number of sterilisations that they wanted to achieve. As part of this programme, over 280 000 indigenous and poor slum women were sterilised between 1996 and 1998.  

2. Abortion
The Programme of Action emphasises womens reproductive rights. The right to safe and legal abortion is one of the most important demands of womens self-determination, however, this has yet to be guaranteed to women in most parts of the world. On the contrary, abortion continues to be criminalised in most countries with severe penalties for women and service providers. In Chile, women do not have any access to legal abortion even if the life of the pregnant women is endangered. The restrictive law on abortion violates womens reproductive rights, including their right to health and their right to life itself.

Even when services are available, women have difficulties getting access to them. For example, the Catholic Church and Christian fundamentalists in Poland have played a crucial role, as in many other countries, in socially stigmatising and restricting womens access to abortion services. In the USA, the anti-abortion movement is becoming increasingly violent with service centres and doctors who perform abortions becoming targets of this violence.  

3. Health for All
We believe that Health for All is a basic human right for every person in every country. The Programme of Action stated that reproductive health services should be an integral part of basic health care. However, what is happening is that there is an overall reduction in government expenditure for health services. At the same time, health services are often narrowed down to delivering contraceptive services in the name of reproductive health. In India, for example, there have been severe cuts in health sector investment. The budget for the family planning" programme has risen from 30% to 40% of the total health budget whilst there have been severe cuts in the programmes for the control of communicable diseases such as TB and malaria. This has resulted in a significant rise in incidence and deaths due to communicable diseases.  

4. Physical, Mental and Social Well-being
We believe that a state of physical, mental and social well-being can only exist in a context where the basic needs of people such as food, shelter, land, education, work and participation in mainstream society are also met. Whereas development (which aims at meeting these needs) was supposed to be on the ICPD agenda, there have been insufficient attempts by governments and international donor agencies to promote a more just and equitable distribution of resources. On the contrary, the effects of Structural Adjustment Programmes and the subsequent cuts in public expenditure have had severe consequences for the poor and marginalised sections of populations everywhere. In fact, macro institutions like the International Monetary Fund (IMF), World Trade Organisation (WTO), World Bank and bilateral institutions like, for example US Agency for International Development (USAID), are undermining the very spirit of the Programme of Action. Industrialised countries must take responsibility for the impacts of unfair trade practices, economic re-structuring programmes and export-oriented growth that they have promoted in the developing world, as well as for the impact of cuts to social spending in their own countries, which are undermining the health of their own people.

The financial crisis in Asia and in Brazil, which are the result of the insecurity and volatility of international financial markets, have similar devastating impact on the well-being of people in general and women in particular. The effects of all these policies and practices can be seen on sensitive health indices like infant and maternal mortality rates. In Nigeria, one of the consequences of cuts in the health sector budget, has been a rise in maternal mortality figures, being among the worst in Africa - approximately 1500 per 100 000 live births in 1997 - and expected to rise to 2000 per 100 000 live births in the year 2000.  

5. Migration
The Cairo Programme of Action links population and migration, and emphasises an increase in the stay options for potential migrants in their home countries, as well as protecting the rights of foreign migrants in host countries. In recent years migration, both voluntary and forced, has become a highly complex phenomena. Governments nationally and internationally are responding with increasingly repressive mechanisms to the presence of migrants. In Australia, Germany, The Netherlands and the USA, for instance, migrants from southern countries are made scapegoats for problems such as criminality and unemployment and are the targets of racist violence. At the same time, migrants are the ones who have the least rights, especially migrant women who find themselves at the lowest rang of the hierarchy. Migration from southern countries has begun to be seen as a national security threat by the governments of rich countries leading to the reaffirmation and support to population control programmes in countries of the South.  

6. Consumption Patterns
There have been few and limited attempts by governments in the North to control or reduce the levels of consumption in their countries. Global inequalities in resource consumption have risen. The North has 20% of the worlds population while consuming 86% of all goods and services - 45% of all meat and fish, 58% of all energy and 84% of all paper in the world. By contrast, the poorest one fifth of the worlds population consume 1.3% of the same. The problems that such inequality in resource consumption creates, including the depletion of non-renewable resources, must be addressed as part of the ICPD Programme of Action and in international fora.

7. Military Expenditure
The rise in military expenditure by governments also has consequences for other sections of public spending. Military spending undermines the security of human life and affects the well-being of women and children around the world by using up precious resources that could be spent on meeting basic human needs. For the fiscal year 1995, the USA spent 257 billion dollars on military expenditure whereas education, housing, environmental protection, job training and economic development added up to only 71,4 billion dollars. The Clinton government has recently recommended a huge increase to the military budget for the year 1999, while cutting budgets for welfare programmes which have a direct effect on the lives of women and the poor. The ecologically-destructive practices of military and corporate institutions must also be addressed. The U.S. Pentagon generates one ton of toxic waste per minute through the production of weapons.

Voicing our Concern
We want to voice our concern that population control and neo-Malthusian thinking continues to wield great influence in the international arena. It is important for us to state once again that the number of children women have, in whichever part of the world, cannot at any time be blamed for poverty, inequality or environmental degradation.

Although womens rights are beginning to be recognised as basic human rights, this is a long way from becoming a reality. The above mentioned processes have adversely affected womens lives and health. We believe that the achievement of reproductive rights for women cannot be ensured without the fulfilment of basic needs such as food, water, shelter, land, work and education - conditions essential for our physical and mental well-being.

* We call on

• The International Monetary Fund, the World Bank and the World Trade Organisation
• All multilateral, bilateral donor agencies and NGOs
• All national governments,

to take the issue of womens rights to a healthy life, free of oppression, poverty and violence as their starting point in their policy making. Womens autonomy and empowerment encompasses more than reproductive health and family planning.

* We call on national governments and international organisations to cancel all national debts of poor countries and develop means to restrict speculation on international financial markets and to control the volatility of finance capital.

* We call on the members of the Womens Global Network for Reproductive Rights and its supporters to critically assess the shortcomings in the implementation of the ICPD Programme of Action and continue working for human development and social justice.

Signatories of this position paper are:

Asamblea Feminista de Madrid, Spain
Boston Womens Health Book Collective, USA
CHETNA, India
Committee for Women, Population and Environment (CWPE), USA
Coordination Office of the Womens Global Network for Reproductive Rights, The Netherlands
EMPARC, Nigeria
Inter Pares, Canada
ISIS - Uganda, Uganda
Likhaan, Philippines
Sister Namibia, Namibia
SOS Corpo, Brazil
The Corner House, UK
Womens Health Interaction, Canada
Loes Keysers, Staff, Institute of Social Studies, The Netherlands
Ulrike Schaz, FINRRAGE, Germany