Today, it is globally recognized that fulfilling the rights of women and girls is central to development. But if one were to trace the origins of this realization, many threads would lead back to Cairo in 1994.
There, at the International Conference on Population and Development, diverse views on human rights, population, sexual and reproductive health, gender equality and sustainable development merged into a remarkable global consensus that placed individual dignity and human rights, including the right to plan one’s family, at the very heart of development.
Three decades later, the world has seen remarkable progress. But with multifaceted crises threatening to erode hard-won gains on the ICPD agenda and the Sustainable Development Goals – the historic set of goals adopted by world leaders in 2015 to eliminate poverty, achieve gender equality and secure the health and well-being of all people – we are at a critical inflection point. Urgent action must be taken to make the vision for humanity expressed by the ICPD a reality.
The 30th anniversary of the ICPD in 2024 is a moment to remind the world of the critical importance of its agenda, which champions people-centred development, rights and choices for all, and the pursuit of common objectives such as peace and prosperity. The world is undergoing unprecedented changes – economically, socially, geopolitically, demographically and environmentally – and how we deal with them will define our common future.
In fact, our collective future depends on how we think about and respond to the ties between population and development. The choices we make will either pave the way for a brighter, more resilient world or lead us towards unprecedented costs and irreversible consequences at individual and collective levels.
That is why we must make concerted efforts to go beyond business as usual and collaborate to ignite changes that deliver on the promise of Cairo. The costs of inaction are simply too great. By doing nothing, we risk perpetuating existing inequalities and failing to achieve sustainable development goals. The economic, social and environmental costs of not prioritizing people-centred development are staggering, and will be disproportionately borne by the poorest and most marginalized communities.
A race to the finish line: Progress is too slow
Maternal mortality is a global crisis. Every day, around 800 women die from preventable causes related to pregnancy and childbirth. This means that more than 290,000 women die every year, leaving behind families and communities devastated by loss.
The impact of maternal mortality goes beyond individual lives. It also has significant economic and social consequences, affecting the health and well-being of entire societies. When mothers die, families lose caregivers, breadwinners and role models, which can lead to poverty, malnutrition and poor health outcomes for their children.
Violence against women is also pervasive and an urgent issue that affects nearly 1 in 3 women worldwide and that can no longer be tolerated. The consequences of this violence can be devastating, with serious physical, emotional and psychological impacts on women, their families, communities and societies.
We need urgent action to meet the vision set out by the ICPD 30 years ago, to stop the needless violence, harm and death and to ensure a brighter, more resilient future for all.
Despite pushback, there is more that unites us than divides us
Population-centred development starts with people – with their dignity and human rights. This concept rests at the foundation of both the ICPD Programme of Action and the Sustainable Development Goals in the 2030 Agenda for Sustainable Development.
It is in the interest of every nation to pursue population-centred development because it creates the conditions for healthy, empowered individuals and societies. But amid recent complex crises and escalating polarization, uniting the world in pursuit of this practice has never been a more urgent priority. It will take more solidarity than ever before to tackle inward-looking nationalistic agendas that peddle simplistic fixes and conspiracy theories and destroy shared truths and understandings.
Where people continue to lack rights, resources and choices to manage their lives, they will lag on every measure of development and remain less likely to be resilient to shocks. Further, societies do not flourish until all people are guaranteed full rights, and not just a privileged few.
A woman’s right to exert agency over her own sexual and reproductive health is fundamental to gender equality, human rights and well-being. However, only 56 per cent of women around the world are able to make such decisions, leaving nearly half of women globally to be denied this basic right. The costs of such violations extend across lifetimes and generations. They erode development prospects for whole populations and multiply across societies, undercutting trust, social connectivity and productivity, and spill over borders in a highly interconnected world.
8 billion opportunities for change
Our expanded human family of 8 billion people in the world is one to celebrate. Major achievements in human health and well-being have brought us here. But with shifts in the global population come anxieties over how demographics are changing with high population growth in some countries and ageing and low fertility in others. Two thirds of the world’s population is living in countries with below replacement level fertility.
Concerns about our demographic futures – about too many people, or too few – lead to responses that risk undermining women’s reproductive rights.
We have reached a perilous crossroads at which global crises are threatening to undermine achievements made under the Sustainable Development Goals and the health of our environmental systems. Due to the escalation in the number and frequency of crises threatening the globe, such as pandemics and conflicts, and the repercussions of climate change, human development has retreated for the first time in decades. We are pushing against planetary boundaries and exhausting the natural resources humanity needs to survive, and billions of people are still unable to realize rights inherent to all human beings.
It is time to act with trust and solidarity and plan for a future in which each person has autonomy and access to rights and opportunities – enabling all people to thrive. With 8 billion opportunities to create a sustainable, inclusive world, the possibilities are infinite.
Investing in population for the future
Bodily autonomy is a major tenet of population-centred development because people who can make choices about their bodies often have more and better options throughout their lives.
The so-called three zeros that underpinned the 2019 Nairobi Summit on ICPD25 – to end the unmet need for family planning, preventable maternal deaths and gender-based violence and harmful practices – connects to fundamental elements of bodily autonomy. There is no development if we allow our aim to stray.
All three transformative results are important as a matter of human rights – and as accelerators of development, which moves forward based on the many benefits they deliver, including decreased health-care costs, education gains and workforce productivity increases. In a fragile world, these advances are needed more than ever.
Between 2022 and 2030, spending an additional $79 billion on ending the unmet need for family planning and ending preventable maternal deaths would avert 400 million unplanned pregnancies, save 1 million women’s lives and generate $660 billion in economic benefits.
Ending child marriage, at a cost of around $152 billion between 2022 and 2030, would stop 230 million cases of this harmful practice, ensure 386 million girls complete school and generate $5.1 trillion in economic benefits.
By contrast, if we do not make these investments, we effectively save $231 billion today, only to lose $5.7 trillion tomorrow.
But the price of inaction is not only monetary. It is also measured in the loss of human life, dignity and rights. Recent figures confirm that rates of reduction in maternal mortality, once promising, have now stalled and even reversed in some places. Hundreds of thousands of women are dying preventable deaths due to pregnancy, childbirth or its aftermath.
At the current rate of progress, losses to development and human well-being will compound.
Buffeted by COVID-19, economic distress, debt burdens and multiple other crises, spending on health care could contract by 20 per cent in low- and lower-middle income countries in coming years. Sexual and reproductive health care are among the services most at risk of budget cuts.
Demographic shifts could further exacerbate these shortfalls.
We cannot afford to wait any longer to achieve a global maternal mortality ratio below 70 by 2030. This is a challenging goal that requires an annual rate of reduction of 11.6 per cent, a rate that has rarely been achieved at the national level. But it is critical for reducing maternal deaths and improving women’s health and well-being. We must take immediate and bold action to ensure that every woman has access to the care and services she needs to survive pregnancy and childbirth.
An agenda for everyone: Building alliances
Population-centred development as envisioned in the Programme of Action provides a perspective on the range of choices and investments that delivers benefits not just to some people, but to entire populations and all groups within them. It reveals how progress in one area can trigger gains in others. It guides the sequencing of investments to deliver the greatest returns for the largest numbers of people and for those most left behind.
Perhaps most importantly, population-centred development opens doors to expanded alliances with actors intent on igniting transformational change, especially through bringing the Programme of Action from the global to the local level so it becomes a reality in human lives.
It is urgent that we accelerate opportunities to engage with the many voices calling for the rights of women, adolescents and youth that are increasingly emerging through an array of movements for social justice, climate action and equality. They stand up for development that delivers lasting benefits for all in line with the needs of communities and diverse population groups all over the world.
Powerful alliances can spur effective responses to the complex issues impacting population and development. Successful responses to urbanization, for instance, will come from close collaboration with and among local governments and non-governmental organizations wrestling with an array of daily challenges, such as access to services, infrastructure, technology and transportation. And preventing the toxic spread of digital misinformation on the ICPD agenda and online violence against women and girls requires the combined efforts of tech companies, human rights groups, local and national leaders and others.
Harnessing the potential of demographic diversity also depends on mobilizing new actors, calling policymakers, businesses, social movements and more to build social consensus around investing in people’s well-being even when budgets are tight.
Let’s build on the vision set by the Programme of Action and make the right choices today for a better tomorrow.
Updated 12 July 2023