Produced by Women Deliver April 8, 2018 Women Deliver & Deliver for Good

SRHR- the bedrock of gender equality: A Q&A with Dr. Natalia Kanem & Dr. Alvaro Bermejo

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Sexual and reproductive health and rights are the bedrock of gender equality.  When a woman can control her own body and fertility it powers progress for all.

Research shows that investing in sexual and reproductive health – including access to modern contraception and safe abortion services – is cost effective and critical to boosting economic growth and advancing the health, rights, and wellbeing of girls and women, their families, and their communities.

As the Deliver for Good campaign explores the investment case for sexual health and rights, there is no one more qualified to share their expertise on this topic than our guests for this month’s Q&A – Dr. Natalia Kanem, Executive Director of the United Nations Population Fund (UNFPA) and Dr. Alvaro Bermejo, Director General of the International Planned Parenthood Federation (IPPF). Both new to their positions, Women Deliver President and CEO Katja Iversen had the opportunity to speak with these leaders on the bold steps needed to respect, protect, and fulfill the sexual and reproductive health and rights of girls and women everywhere.


1. Katja Iversen: You recently stepped into a new position leading one of the most respected organizations working to change the world for girls and women. What drew you to this new role, this mandate, and what items are at the top of your agenda for the first year?

Dr. Alvaro Bermejo: At IPPF we fight for everyone to exercise their right to make choices about their reproductive health and sexual rights. But there are too many women who are being imprisoned for decades for having a miscarriage or an abortion. This cannot continue. Progressive legislation and better access is needed to reduce the number of women who are forced into pregnancy or to use unsafe abortion methods. This is a priority for IPPF, especially when we are seeing the rollback on women’s rights like with the global gag rule.

Let’s not forget that the world has the largest youth generation ever. We must act quickly to remove the barriers that compromise the health, well-being and development of young people is essential. Only when young people are healthy and empowered can they contribute to building strong communities and vibrant nations.

I am joining IPPF at a time of great opportunity but also at a time when we must defend hard-won gains. The world is changing and fast. That means we need to accelerate the pace of change so women and girls are able to decide for themselves, freely, about their lives, wherever they are.

My priorities are to increase the quality of our services on the ground, to expand our partnerships and influence to ensure global commitments produce change at the national level, and to support youth and women’s grassroots movements.

Dr. Natalia Kanem: My agenda is the universal agenda that UNFPA represents, which is sexual and reproductive health and rights for every women and young person on the planet.

As to my priorities: I want UNFPA and our partners to succeed in achieving three bold, transformative results by 2030 – to end preventable maternal deaths, end unmet need for family planning, and end gender-based violence and harmful practices against women and girls. And a foundation of quality population data will help us ensure that everyone is accounted for and no one is left behind.

These are ambitious aims. We can’t do this alone. So we at UNFPA are mobilizing more partners and resources. We are gathering the evidence necessary to target and reach the unreached, particularly adolescent girls who are often the most vulnerable and left furthest behind. We are strengthening our communication and advocacy, and fostering a culture of innovation – innovative thinking, leadership and action to maximize our impact and reach.

I’ve been active in the field of women’s health and rights for as long as I can remember. As a student, I developed a concern for different people’s access to medicine and health care, which became a feature throughout my career as a public health doctor. As an undergraduate student at Harvard, in 1975, I heard about the first World Conference on Women. I took a bus and a train to Mexico City to see and be a part of what the world’s women were formulating back then. It was a mission that captured me and has strongly influenced my life’s trajectory. Many years later, I attended the International Conference on Population and Development (ICPD) in Cairo in 1994, followed by the World Conference on Women in Beijing in 1995.

So, as I look back now, it's an honour and a huge privilege to be heading one of the bodies of the United Nations that is leading the global standard-setting and response to these issues. And I still have that same hunger to serve the poorest and most vulnerable women and girls in the world. Of course, I never would have expected when I attended the ICPD that some 25 years later I would be asked to lead UNFPA, the organization that serves as the custodian of the groundbreaking ICPD agenda that considers individual rights, capabilities and dignity as the foundation of sustainable development.

Next year we mark two anniversaries – the ICPD@25 and UNFPA@50!  This is an incredible opportunity to mobilize the world to recommit to the vision of Cairo, celebrate our achievements, and focus on reaching those still left behind.

2. Katja Iversen: While we are seeing progress, we’re also witnessing conservative political winds blowing around the world - what new political dynamics make it more difficult to do your job now than if you were in this position 20 years ago? And what are some specific ways you will confront these challenges?

Dr. Alvaro Bermejo:  There’s always been opposition from those who would control and coerce women. However now, unlike 20 years ago, opposition is very well funded and coordinated and has the political support of populist leaders, already causing tragic impact at the national and international levels. SRHR is under attack every day.

I am convinced that we can tackle regressive forces by showing the human impact of our work. Sexual and reproductive healthcare does not discriminate. Everybody needs these services and that means access for all. Being united as an SRHR community is essential to achieve this. Solidarity is the way forward. We must harness the momentum and mobilise to increase both political and financial support by opening our doors to other movements and causes. Standing together and strong.

Dr. Natalia Kanem: I would say that any opposition we may be seeing today feels heightened because we are viewing it against the backdrop of the tremendous strides the international community has made over the past 20 years.

That said, it’s true that we are seeing pushback, especially with respect to key issues like sexual and reproductive rights, abortion, comprehensive sexuality education, the place of parents, culture and religion, and sexual orientation and gender identity. It is more important than ever that we debunk misconceptions with facts and evidence, and we count on like-minded partners – like Women Deliver! – to continue helping us make these arguments.

On the upside, we are also seeing enormous solidarity and mobilization. We see women and young people marching in the streets, making their voices heard, demanding their rights. We see more men and boys speaking out for women’s rights. The sexual and reproductive health and rights community is united and resilient. We are not going to give up or give in. Momentum is on our side.

Since 1990 maternal deaths have fallen by 44 percent and more women than ever before are using modern contraceptives of their choice.  Our greatest challenge now is to reach women and girls still being left behind – the more than 800 women and girls who still die giving birth each day; the more than 200 million women who lack modern family planning, and the tens of thousands of girls forced into marriage each day. It’s time to ensure reproductive rights for all. Everyone. Everywhere.

3. Katja Iversen: People have heard me say many times that a woman’s ability to control her own fertility is the bedrock of gender equality – and progress for all. What is the link you see between gender equality, women’s control over their own bodies, and the achievement of the sustainable development goals? Please provide examples.

Dr. Alvaro Bermejo: A woman controlling her body is a woman controlling her life and building her future. This starts with fertility but goes far beyond it. A woman with the right to have access to information and healthcare means she can choose. Every woman should be able to decide and have the skills and confidence to say no to things they think are not right for them. To thrive in life, women must have the same opportunities as men, girls the same opportunities as boys.

It is important also to remember that to achieve gender equality and for women to have control over their bodies- there are many other essentials. The SDGs holistically encompass most of these aspects, like education, so we should ensure that political commitments are monitored at the national level and advancement in all aspects, to make the vital improvements for women’s and girls’ lives positively on the ground. From going to school, accessing healthcare, being able to work and live free from harm or fear.

Dr. Natalia Kanem: Gender equality is a human right. A woman’s right to decide over her own body is at the heart of this right. When a woman can plan her family, she can plan the rest of her life. Protecting and promoting her reproductive rights – including the right to decide the number and spacing of her children – is essential to ensuring her freedom to participate more fully and equitably in society and the economy.

In countries with the youngest populations, creating equality between girls and boys can help end poverty – Sustainable Development Goal 1. When a teenage girl can avoid child marriage and unplanned pregnancies and stay in school, when she has the skills she needs to find decent work and participate fully in all spheres of life – she becomes a greater asset for her country’s economy.

At UNFPA, our research has found that investing just under four dollars per person annually in programmes to reduce child marriage will generate economic benefits of almost six times the total investment by 2030. The poorer the country is, the greater the impact will be.

A 2015 McKinsey report found that if women participated in the economy identically to men, it would add 28 trillion dollars to global GDP by 2025 – an increase of 26 percent.

Simply put, enabling girls to grow up educated and empowered is one of the most effective ways to lift a country out of poverty.

4. Katja Iversen: In this current political climate, why is it important to not back away from the full range of SRHR services, including access to safe abortion, and how will you remain steadfast in making sure all of these issues stay on the agenda?

Dr. Alvaro Bermejo: As an international community we have great aspirations but we must recognise that we are far from our goals and the need is still enormous. It impacts women every day. Access to safe abortion is a fundamental bedrock of sexual rights. You cannot chip away at it without undermining the foundation of all sexual rights. Opposition to safe abortion is entirely ideologically driven, to the extent that women could go to jail even for a miscarriage in five countries. Seven million women in developing countries will go to hospital or are at risk of death or disability as a result of complications following unsafe abortion.

Access to legal and safe abortion saves lives. There is hard and incontestable evidence. IPPF is, and always will be, a champion of access to safe abortion, providing high quality, non-judgmental services for women.

5. Katja Iversen: There are currently 1.8 billion young people globally, the greatest number of youth that the world has ever had. So, let’s talk about the sexual and reproductive health of young people. Why is this an issue that can’t be ignored?

Dr. Alvaro Bermejo: The facts are clear. Among young people there is a higher incidence of sexually transmitted infections and unplanned pregnancies, principally due to the lack of access to modern contraception and good, impartial advice. In some countries, SRHR services are denied to young people because of their age, marital status or stigma.

With comprehensive sexuality education, young people are empowered with good information that helps them make decisions about key issues in their lives. We seek to build a dynamic new world, approaching sexuality education from a frame of respect and pleasure rather than violence, fear or abstinence.

It’s clear that access to good education and knowledge helps to protect young people. It gives them the confidence to say “no” to people who would try to force them into things they do not want to do but may not have the skills and knowledge to resist without help. We don’t believe than denying education and protection to young people can be right.

Dr. Natalia Kanem: Today's generation of young people is absolutely massive. How well they navigate the transition from adolescence to adulthood will determine not only the course of their own lives, but that of the world as well.

Most of the 1.8 billion young people you’re referring to live in developing countries, often comprising a huge proportion of the population. Yet, young people are systematically hampered in their ability to grow up safely and to be empowered. In developing countries, one in every four girls is married before age

18. One in nine is married before 15. Every day in developing countries, 20,000 girls under the age of 18 give birth. And, it is estimated that 200 million girls and women alive today have undergone some form of female genital mutilation.

These abuses rob girls of their rights, their dignity and their chance to pursue a future of their choosing. They also rob societies and economies. By denying half the population their opportunity to succeed, a country denies itself the chance to develop faster.

Ensuring that young people know about and can exercise their rights is at the heart of our mandate at UNFPA. We work with governments, civil society and youth-led organizations to extend access to sexual and reproductive health information, counselling and services, including voluntary contraception, to all young people. We also advocate for the integration of comprehensive sexuality education into school curricula. This is life-changing – often life-saving – information, as it provides young people the tools to know their bodies, to lead healthy lives and to build healthy relationships. UNFPA also supports programmes promoting gender equality, especially those reaching vulnerable adolescents and those that support young mothers.

6. Katja Iversen: There has recently been increased momentum and a growing dialogue around sexual abuse, power dynamics and gender equality. As a leader in this field – I have to ask, what is UNFPA doing about it, and what in your mind should come after #MeToo and TimesUp?

Dr. Natalia Kanem: It has been an incredible year for women’s rights, and we have seen the impact that motivated and mobilized people can have in pushing for meaningful progress. I wholeheartedly welcome that, and I am so pleased to see that the issues we are advocating for at the UN have gone mainstream around the world. I would also like to note that one of our Goodwill Ambassadors, Ashley Judd, was a leading figure in this movement and among the first celebrities to speak out publicly about the sexual harassment she’d endured as a Hollywood star. That broke the dam of silence.

Sexual abuse and harassment pervade every area of society, the economy and public life. It is an absolute necessity that these injustices be identified and rectified, and the perpetrators be held to account. The UN itself must be part of that process.

As one of the lead UN agencies working to end gender-based violence and to empower women and protect their rights, UNFPA must hold itself to the highest standard possible. UNFPA has zero tolerance for sexual exploitation and abuse. We take this very seriously. I want everyone at UNFPA to feel empowered to break the silence and to speak up. We have recently also strengthened and made mandatory related training for all staff. We take every claim of sexual harassment, exploitation or abuse seriously. Every claim is investigated, and we punish those found to have engaged in misconduct.

There is also a UNFPA Policy for Harassment, Sexual Harassment and Abuse of Authority, which provides detailed guidance for personnel who believe that they have suffered sexual harassment.

On the global stage, I hope that #MeToo and #TimesUp can continue to cross geographical, cultural, economic and linguistic boundaries to ensure that women, girls and other people facing oppression can harness this momentum and create meaningful, lasting change.

7.  Katja Iversen: What inspired you to work in this field, and what keeps you motivated to remain committed to these issues?

Dr. Alvaro Bermejo: It inspires me to see the determination of activists and organisations to make sure that access to SRHR is available. Fundamentally, it is about how we care for our fellow humans. I have spent many years in these areas but it’s when I visit peer educators, member associations and community based staff I really am energised by their passion and commitment to improving people’s lives. I am committed to progressing the movement and ensuring that IPPF continues to be an influential agent of change at national, regional and global stages. We are dedicated to meeting the healthcare needs of all people, wherever they are, for as long as they want it.

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