Comment

www.thelancet.com Published online July 16, 2014 http://dx.doi.org/10.1016/S0140-6736(14)61190-9 1

Sexual and reproductive health and rights: a global
development, health, and human rights priority
In May, 2014, at the 67th Session of the World Health
Assembly, member states reviewed the progress made
in the implementation of resolution WHA57.12, the
WHO Reproductive Health Strategy.
1
The progress
report noted that although a range of regulations
and strategies to strengthen sexual and reproductive
health and related rights have been implemented,
certain areas required further attention, which include
unmet need for contraception, comprehensive sexual
and reproductive health services for adolescents and
young people, as well as prevention and management
of the consequences of unsafe abortion, gender
equality, violence against women and girls, and
cancers related to reproduction.
1
Importantly, in the
progress report WHO rearmed its commitment
to making sexual and reproductive health a priority
in the post-2015 development agenda.
1
This
rearmation underscores the importance of sexual
and reproductive health and rights and WHOs
commitment on these issues.
Sexual and reproductive health and rights are
fundamental to individuals, couples, and families,
and to the social and economic development of
communities and nations.
2
However, 20 years after
the International Conference on Population and
Development and the UN Fourth World Conference on
Women, universal access to sexual and reproductive
health remains an unnished agenda.
3
Much remains
to be done to achieve Millennium Development Goal
(MDG) 5 (reducing maternal deaths MDG 5a and
achieving universal access to reproductive health
MDG 5b).
4
Furthermore, as highlighted in the UN
Secretary-Generals report, inequalities between and
within countries, and persistent disparities between
women and men, and between social and ethnic
groups, continue to inhibit progress.
3
At the Rio+20 Summit governments rearmed the
need to achieve sustainable development.
5
To achieve
these objectives governments must create greater
health equity, ensure gender equality, and promote and
protect human rights. Promotion and protection of
sexual and reproductive health and rights lies at the very
core of this approach.
Sexual and reproductive health and rights encompass
eorts to eliminate preventable maternal and neonatal
mortality and morbidity, to ensure quality sexual and
reproductive health services, including contraceptive
services, and to address sexually transmitted
infections (STI) and cervical cancer, violence against
women and girls, and sexual and reproductive health
needs of adolescents. Universal access to sexual and
reproductive health is essential not only to achieve
sustainable development but also to ensure that this
new framework speaks to the needs and aspirations of
people around the world and leads to realisation of their
health and human rights.
Better control of womens fertility allows girls to
remain in education longer, accumulate more skills,
and eventually earn higher wages.
6
According to
the World Bank, female participation in the labour
force decreases with each additional child: by about
1015 percentage points among women aged
2539 years, and about 510 percentage points
among women aged 4049 years.
6
Universal access
to sexual and reproductive health is therefore not only
an essential human rights priority to ensure womens
empowerment and gender equality, it is also a key
international development priority.
Over the past 2 years, through the ICPD Beyond 2014
Global Review
3
and the post-2015 development agenda
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2 www.thelancet.com Published online July 16, 2014 http://dx.doi.org/10.1016/S0140-6736(14)61190-9
discussions, governments, UN agencies, development
partners, parliamentarians, academics, and non-
governmental organisations have argued through
debates, online forums, expert group meetings, and
other fora that sexual and reproductive health and
rights are critical dimensions of the international
development agenda and are a critical component of
health and wellbeing of individuals.
3,7
Based on evidence and knowledge and guidance
from member states, WHO has underscored the
need to achieve and exceed all health-related MDGs,
which includes ending preventable maternal deaths
and improving sexual and reproductive health, and
to ensure that the new development framework
highlights these priorities as part of nishing the
unnished work in health MDGs.
8
As underlined during
a recent discussion with the Open Working Group (a
member state body formed by UN General Assembly
to develop proposals for Sustainable Development
Goals), a universally relevant, transformative, high-
impact, and cost-eective post-2015 framework must
respect, protect and fulll the sexual and reproductive
health and rights of all individuals throughout the life-
cycle, including through universal access to quality,
integrated sexual and reproductive health information,
education and services.
9
It is imperative that the commitment from various
stakeholders to sexual and reproductive health and
rights must now be translated into clear and actionable
targets in the new international development agenda.
We must not allow history to repeat itself and wait for
another 7 years for the international community to
reach consensus on MDG 5b. Sexual and reproductive
health and rights is a global health, development, and
human rights priority. We must act now and ensure that
sexual and reproductive health and rights are given due
recognition in the Sustainable Development Goals.
Marleen Temmerman, *Rajat Khosla, Lale Say
Department of Reproductive Health and Research, World Health
Organization, CH-1211 Geneva 27, Switzerland
[email protected]
We declare no competing interests. The views expressed here are those of the
authors themselves and they do not necessarily represent the views of WHO.
2014. World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights
reserved.
1 WHO. Progress Reports by the Secretariat. A67/40. World Health Assembly
2014. Geneva: World Health Organization, 2014.
2 UN Population Division, Department of Economic and Social Aairs.
Report of the International Conference on Population and Development.
A/Conf.171/13. New York: United Nations, 1994.
3 UN. Framework of Actions for the follow-up to the Programme of Action of
the International Conference on Population and Development (ICPD)
Beyond 2014. Report of the Secretary-General. Jan 20, 2014. New York:
United Nations, 2014. http://icpdbeyond2014.org/uploads/browser/les/
sg_report_on_icpd_operational_review_nal.unedited.pdf (accessed
July 11, 2014).
4 UN. The Millennium Development Goals report 2014. New York: United
Nations, 2014.
5 UN. The future we want: Rio+20 outcome document. A/CONF.216/L.1.
Rio de Janeiro, Brazil. June 2022, 2012. http://www.uncsd2012.org/
content/documents/774futurewewant_english.pdf (accessed July 11, 2014).
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know and what we do: investing in reproductive health. New York: Women
Deliver, 2013.
7 UN High Level Panel on the post-2015 Development Agenda. A new global
partnership: eradicate poverty and transform economies through
sustainable development. New York: United Nations, 2013.
8 WHO. Health in the post-2015 development agenda. A67/A/CONF/4 Rev.2.
Geneva: World Health Organization, 2014.
9 Open Working Group session on Promoting Equality, including Social
Equity, Gender Equality and Womens Empowerment. Joint Statement to
the Open Working Group on the Sustainable Development Goals (SDGs).
Feb 37, 2014. http://sustainabledevelopment.un.org/content/
documents/6405argentina.pdf (accessed July 9, 2014).