The Action

2. The Action • At the Millennium Summit in September 2000, the largest gathering of world leaders in history adopted the Millennium Declaration, committing their nations to reduce poverty; improve health; and promote peace, human rights, and environmental sustainability. • The Millennium Development Goals were developed by in a process led by a UN Assistant Secretary General with follow-up place under the Inter-Agency and Expert Group (IAEG) of the UN Statistical Division. www.unmillenniumproject.org

3. 2005: The Breakthrough Year • There is still enough time to meet the MDGs – though barely. • With a systematic approach over the next decade, many countries now dismissed as too poor or too far off track could still achieve the Goals, but only if the world moves urgently with specific, scaled-up actions. • Most attention needs to be paid to Africa. www.unmillenniumproject.org

4. Resources needed for MDGs The cost of meeting the MDGs is less than what wealthy nations have already promised to contribute in development assistance. • At the Monterrey Financing for Development Conference in 2002, world leaders pledged “to make concrete efforts towards the target of 0.7%” of their GNP in international aid. In today’s dollars, that would amount to almost $200 billion. • The cost of supporting countries to meet the Goals would require donors to increase ODA to 0.44% of GNPby 2006 (or $135 billion) and to plan for a scale-up to 0.54% by 2015 (or $195 billion). • This means that of the combined rich world GNP of approximately $30 trillion dollars, only an average of $150 billion a year would be enough to get the world on track to ending extreme poverty throughout the world. www.unmillenniumproject.org

5. Initiatives for action Several worldwide initiatives are needed to translate the Goals from ambition to action: • Identify fast-track countries • Prepare MDG-based poverty reduction strategies • Launch a global human resource training effort • Launch the Quick Win initiatives • Engage middle-income countries in the challenge of meeting the MDGs www.unmillenniumproject.org

6. Quick wins Although far from comprehensive, with adequate resources some Quick Wins could bring vital gains in well-being to millions of people and start countries on the path to the Goals. Health quick wins include: • Training large numbers of village workers in health, farming, and infrastructure (in one-year programs) to ensure basic expertise and services in rural communities. • Distributing free, long-lasting, insecticide-treated bed-nets to all children in malaria-endemic zones to cut decisively the burden of malaria. • Eliminating user fees for basic health services in all developing countries, financed by increased domestic and donor resources for health. • Expanding access to sexual and reproductive health information and services, including family planning and contraceptive information and services, and closing existing funding gaps for supplies and logistics. • Expanding the use of proven effective drug combinations for AIDS, tuberculosis, and malaria. For AIDS, this includes successfully completing the 3 by 5 initiative to bring antiretrovirals to 3 million people by 2005. • Launching national campaigns to reduce violence against women. www.unmillenniumproject.org

7. SRH and the MDG Monitoring Framework Recommended SRH Target: Universal access to reproductive health services by 2015 through the primary health care system, ensuring the same rate of progress or faster amongst the poor and other marginalized groups Recommended SRH Indicators: Contraceptive prevalence rate (currently Goal 6, recommended to Goal 5) HIV prevalence among 15-24 year old women (Goal 6) Proportion of births attended by skilled birth attendants (Goal 5) Proportion of demand for family planning satisfied (Goals 3 and 5) Adolescent fertility rate (Goals 3 and 5) Availability of emergency obstetric care (Goal 5) These indicators are recommended for measuring together the systematic impact on women’s ability to bring into effect their stated fertility preferences and to have safe, voluntary and healthy sexual and reproductive lives and parenthood. Recommendations for an additional SRH-relevant target and indicatorsto be decided by the Inter-Agency and Expert Group (Recommended by the Task Forces on Maternal/Child Health and Gender Equality) www.unmillenniumproject.org

8. Inlarger freedom The SG includes Reproductive Health in his analysis: • 40. Empowered women can be some of the most effective drivers of development. Direct interventions to advance gender equality include increasing primary school completion and secondary school access for girls, ensuring secure tenure of property to women, ensuring access to sexual and reproductive health services, promoting equal access to labour markets, providing the opportunity for greater representation in government decision-making bodies and protecting women from violence. • 44. Strong health systems are required to ensure universal access to basic health services, including services to promote child and maternal health, to support reproductive health and to control killer diseases, such as AIDS, tuberculosis and malaria. This requires sufficient investments, large numbers of motivated and adequately paid health workers, scaled-up infrastructure and supplies, strong management systems and the elimination of user fees. www.unmillenniumproject.org

9. CPD compromise language “Emphasizes the importance of integrating the goal of universal access to reproductive health by 2015 set at the International Conference on Population and Development into strategies to attain the internationally agreed development goals, including those contained in the Millennium Declaration, in particular those related to improving maternal health, reducing infant and child mortality, promoting gender equality, combating HIV/AIDS, eradicating poverty and achieving universal access to primary education”. www.unmillenniumproject.org

10. Outputs from other meetings Delhi Declaration on Maternal, Newborn and Child Health (April) Affirms that universal access to sexual and reproductive health is essential to meeting MDG 5 and will make significant contributions toward MDG 4 Key points for Delhi: Accepts a formulation recognizing reproductive, maternal, neonatal and child health as a coherent set of actions Accepts the target of universal access to reproductive health with appropriate indicators and inclusion of neonatal mortality rate Specifies an accelerated timetable with a methodology similar to that from the Millennium Project: ie a needs assessment for full MDG attainment, shorter term action planning, resource mobilization and political commitment "Take an integrated approach to reproductive, maternal, newborn and child health, ensuring a continuum of care from pregnancy through childhood, recognizing that maternal, newborn and child health are inseparable and interdependent, and that the achievement of their MDGs must be based on a strong commitment to the rights of women, children and adolescents” www.unmillenniumproject.org

11. Outputs from other meetings Stockholm Call to Action (April) Mobilize political commitment to advance reproductive health and rights, and their contributions to reducing poverty and achieving the MDGs, in national and global meetings, including the 2005 review of the UN Millennium Declaration, and in the implementation, at all level, of the commitments from the major international conferences. Stockholm conclusion • Recognized multiple implications of SRH for progress • Welcomed the "Investing in Development" report and called for the target of universal access to reproductive health by 2015 • Called for a broad-based range of action for women's empowerment and gender equality • Emphasized the role of strong health systems  to address RH, maternal and child health and action against HIV/AIDS, TB and malaria • Included human resources, management and commodities/supplies • Cited the WHO RH Strategy, Linked RH  and HIV/AIDS at level of delivery settings • Called for attention to young persons' health and development,  emphasizing SRH information and services as part of  "a comprehensive approach to develop their life skills and opportunities and support their rights" • Called for strong partnerships and the meeting of financial commitments www.unmillenniumproject.org

12. World Health Assembly 2005 Two resolutions were passed at WHA58: • Accelerating the achievement of the internationally agreed health-related development goals including those contained in the Millennium Declaration • Working towards universal coverage of maternal, newborn and child health interventions www.unmillenniumproject.org

13. UNDP/UNFPA/WHO /World BankSpecial Programme of Research, Development& Research Training in Human Reproduction PCC • ENCOURAGED HRP through WHO and the other co-sponsors to play a key role in the IAEG that will follow up on the September 2005 World summit to ensure that SRH are integrated in this process • URGED Member states to highlight SRH, including research in the September 2005 World Summit and its outcome as an issue essential to the attainment of the agreed health-related development goals including those contained in the Millennium Declaration www.unmillenniumproject.org

14. President’s Summary of High-Level Segment of Substantive Session of ECOSOC 2005 • Reproductive health services were considered an integral part of functioning health systems … Universal access to reproductive health, including family planning, is essential for making progress on MDG 5 and required sustainable and predictable financing. It was emphasized that without greater attention and resources to sexual and reproductive health and women’s empowerment and gender equality, the health MDGs will not be achieved. In this context, participants stressed the importance of full access to reproductive health by 2015 for achieving the MDGs. www.unmillenniumproject.org

15. UNAIDS Programme Coordinating Board27-29 June 2005 Policy position paper • Strong linkages between HIV and AIDS, and sexual and reproductive health programmes and services, and special efforts to reach those excluded from access to health and other services, will result in more relevant and cost-effective programmes of greater impact. • Broader focus on SRH, comprehensive and appropriate sexual education … • Preventing HIV infection among young women and girls, focusing on improved reproductive health care. www.unmillenniumproject.org

16. Outputs of other meetings • Pre-WHA Commonwealth Health Ministers Meeting • Wye River Meeting of 59 key leaders from 21 countries • Tokyo meeting of Health Ministers from Asian and Pacific countries • Up-coming: • Delhi Advocacy Conclave on RH and MDGs, 4 Aug • Indonesian Ministerial Meeting 3-5 (?) Aug www.unmillenniumproject.org

17. Where now … Key UN meetings July 27-28 Debate on latest draft of Outcome Document for 2005 World Summit Aug 5 Release of further draft of outcome document Sept 14-16 2005 World Summit www.unmillenniumproject.org

18. President’s draft -- 22 July Development -- HIV/AIDS and other health issues Para 34, bullet 6: • Achieving universal access to reproductive health by 2015 as set out at the ICPD, integrating this goal in strategies to attain the international development goals, including those contained in the Millennium Declaration aiming at improving maternal health, reducing child mortality, promoting gender equality and eradicating poverty; Para 35, bullet 3 • Ensuring access to reproductive health; www.unmillenniumproject.org

19. Efforts to and beyond September … • Heads of Government to include reproductive health when they speak at the 2005 World Summit to allow space for • The Interagency and Expert Group on MDG Indicators to adopt the new target and new indicators www.unmillenniumproject.org

20. Thank you www.unmillenniumproject.org