Universal access to sexual and reproductive

health is needed more than ever!!

Nearly 350 million couples worldwide are still in need of effective family planning methods so they can space their children or limit the size of their families. This number is expected to grow by 40 per cent in the next 15 years.

At least 120 million women want to use family planning methods, but lack access to information and services or the support of their husbands and communities.

At least 330 million people are infected with a sexually transmitted infection that could have been avoided with correct and consistent use of condoms.

In Africa only 27 % of the married women and women in consensual union aged 15-49 use any method of contraception.

In Sub-Saharan Africa one out of 16 women dies during pregnancy or delivery. For women in developed countries only 1 out of 2.800 women die.

Despite the grim figures that express the incredible needs for increased access to sexual and reproductive health information and services there continues to be a lack of political commitment and will to want to save lives. On the contrary the opposition against sexual and reproductive health and rights is growing in the US and Europe. The promotion of sexual abstinence among unmarried young people has serious consequences for the supply of sexual education, prevention of sexually transmitted infections, including HIV, and unwanted pregnancies. Young people have limited knowledge about, access to and use of condoms and other forms of contraception. This is particularly problematic, as most young people are sexually active prior to marriage. At the same time this agenda threatens many of the principles and goals behind the UN International Conference on Population and Development held in Cairo in 1994 and the UN International Women’s conference held in Beijing in 1995.

The abstinence only message is promoted in various connections – through sexual education in schools, through the attitude to contraception and in the attitude towards the fight against sexually transmitted infections including HIV. The heart of the message is that the only morally acceptable and rational behaviour is to abstain from sex until marriage and for young people to delay their sexual debut until marriage.

Sexual abstinence is promoted by conservative religious forces

The opposition against sexual and reproductive rights in Europe and the US can be found at many levels in society but are often rooted in religion.

The Roman Catholic Church

The Roman Catholic Church for example plays a decisive role in the promotion of sexual abstinence. The Vatican has been against contraception for a long time, as contraception is a crime against the sacred life. All over the world the Catholic Church administers hospitals and organisations that help treat AIDS patients and inform about HIV prevention. The Catholic Churches however promote HIV prevention messages, which are based on ‘abstinence only’ and to ‘be faithful’ during marriage. The Vatican is therefore against any use of contraception, as condom promotion, according to the Vatican, encourages an amoral and hedonist lifestyle. For this reason condom use is not an acceptable strategy to prevent that a person living with HIV infects its wedded partner. However, in recent years there are several cardinals that have stated that condoms are the lesser evil if the alternative is to become HIV infected.

PEPFAR

The Bush-administration is an important ally in the promotion of sexual abstinence. In 2004 PEPFAR (The President's Emergency Plan for AIDS Relief) was established, which is the American government’s strategy in the fight against the HIV/AIDS epidemic. PEPFAR indicates a number of priorities in terms of HIV/AIDS related prevention, treatment and care and the financing of this. Within prevention the promotion of ’abstinence only and behaviour change among young people’ has been prioritized and condoms have only been provided to so-called high-risk groups. In other words the emphasis on use of condoms in the ABC-approach (Abstain, Be faithful, use Condoms) for HIV prevention has been strongly reduced and instead the key prevention message has been to abstain from sex before marriage.

The Global Gag Rule

The American opposition against sexual and reproductive health and rights already became evident when George W. Bush in 2001 reinstated the Mexico City Policy also called the Global Gag Rule. The Global Gag Rule prohibits US development aid to be given to organizations that, carry out, inform about or refer to abortion or in any other way promote abortion. This has had direct consequences for countless men, women and young people’s sexual health as the organizations that carry out abortion related work also often are the ones that provide condoms, sexual education and provide other sexual and reproductive health services. Many of these organizations’ clinics have been forced to shut down as a consequence of loosing American funding.

Education about sexual abstinence does not reduce young people’s sexual activity

The evaluations of ’abstinence until marriage’ – programmes in the US show that:

• These programmes do not prevent young people from having sex. Rather, these programmes mean that young people are not provided the necessary skills to ensure that they are able to negotiate with a potential sexual partner about whether they would like to have sex and whether they should protect themselves. Ironically this can have the result that those that actually wish to maintain the principle about abstinence until marriage might not be able to this.

• Young people lack the knowledge and skills to protect themselves with contraceptives and thereby increase their risk to become infected with a sexually transmitted infection or become unintentionally pregnant.

• Sexual education that exclusively focuses on sexual abstinence is less effective in delaying sexual debut compared to education that focuses more broadly on young people’s sexual health
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Reasons why sexual abstinence in itself is not an effective strategy for the prevention of sexually transmitted infections including HIV and unwanted pregnancies

§ Sexual abstinence is an inefficient strategy in a male dominated society where women do not have full control over their bodies and sexuality, and where men are expected to express masculinity by being sexually active.

§ Programmes that promote sexual abstinence are potentially dangerous as they seek to limit the accessibility and use of condoms and encourage young people not to use contraception.

§ Abstinence only does not work as an HIV prevention strategy for young people as many young people already are sexually active and because there is a gap between the average age for young peoples sexual debut and the average age of marriage for young people

§ Marriage does not protect women against HIV infection as it has become evident that married, monogamous women have a very high risk of becoming infected. Most HIV infected women are infected within marriage.

§ Fear, shame and moral condemnation are used to control young people’s sexual behaviour. This further strengthens the taboos surrounding the issue of sexuality, and it becomes more difficult to access information and health services which are needed in order to limit the spread of HIV and other sexually transmitted infections as well as unwanted pregnancies.

WHAT WE PROMISED:

In 1979:

CEDAW (Convention on the Elimination of All Forms of Discrimination against Women):

By accepting the Convention, States commit themselves to undertake a series of measures to end discrimination against women in all forms, including:

• To incorporate the principle of equality of men and women in their legal system, abolish all discriminatory laws and adopt appropriate ones prohibiting discrimination against women;

• To establish tribunals and other public institutions to ensure the effective protection of women against discrimination; and

• To ensure elimination of all acts of discrimination against women by persons, organizations or enterprises.

In 1994:

The International Conference on Population and Development (ICPD) was held in Cairo. It was the largest intergovernmental conference on population and development ever held..

From the programme of action:

• Reduction of Infant and Child Mortality

• Reduction of Maternal Mortality

• Access to Reproductive and Sexual Health Services Including Family Planning

In 1995:

Beijing Declaration:

Governments participating in the Fourth World Conference on Women,

Were convinced that:

§ The explicit recognition and reaffirmation of the right of all women to control all aspects of their health, in particular their own fertility, is basic to their empowerment;

And were determined to:

§ Promote people-centred sustainable development, including sustained economic growth, through the provision of basic education, life-long education, literacy and training, and primary health care for girls and women;

§ Ensure equal access to and equal treatment of women and men in education and health care and enhance women's sexual and reproductive health as well as education;

§ Promote and protect all human rights of women and girls;

In 2000:

The Millennium Development Goals:

The Millennium Development Goals consist of 8 goals agreed to by all the world’s countries and all the world’s leading development institutions.

Among others:

§ Eliminate gender disparity in primary and secondary education;

§ Reduce by two thirds the mortality rate among children under five;

§ Reduce by three quarters the maternal mortality ratio;

§ Have halted HIV/AIDS by 2015 and begun to reverse the spread of HIV/AIDS.

Hold your government accountable to all the promises made

and help save lives of women, men and young people!!