A bold and comprehensive vision for sexual and reproductive health and rights
Next year will mark the 25th anniversary of the International Conference on Population and Development, when representatives from 179 countries collectively affirmed that the ability of all individuals to make autonomous and informed reproductive decisions is critical to sustainable development. Despite the progress made since that landmark agreement, the international community has taken a narrow view of sexual and reproductive health and rights. Persistent discrimination against women and girls and an unwillingness to openly address issues related to sexuality and rights continue to take a toll on communities worldwide.
To tackle the scope of this unfinished agenda, the Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights came together in early 2016 with 16 multidisciplinary experts from Africa, Asia, Europe, the Middle East, and North and South America. We released our findings and recommendations in Johannesburg in May, presenting a comprehensive and evidence-based vision for achieving universal sexual and reproductive health and rights.
The Commission proposes an integrated approach, affirming that we cannot achieve sexual and reproductive health without advancing sexual and reproductive rights.
At the heart of this vision is a package of essential sexual and reproductive health interventions. The package includes interventions that governments typically focus on, such as contraceptive provision, HIV prevention and treatment, and maternal and newborn health services. In addition, the Commission calls for attention to often neglected components of sexual and reproductive health, such as safe and legal abortion care; infertility treatment; appropriate and non-judgmental services for lesbian, gay, bisexual, transgender, queer and intersex people; prevention, detection and counseling for gender-based violence; and sexual and reproductive health information and services for adolescents.
The Guttmacher-Lancet Commission report offers a roadmap for addressing these issues comprehensively. It encourages health ministries and service providers to consider how best to integrate sexual and reproductive health interventions into other health care services, with the goal of bundling services to avoid missed opportunities. For example, routinely offering contraceptive counseling as part of postpartum and postabortion care enables women to easily obtain contraception and reduces the risk of unintended pregnancy.
The time is now to pursue this critical course of action. Each year in developing regions, more than 30 million women deliver their babies outside of a health facility. Each year worldwide, over 350 million people need treatment for one of the four curable STIs, more than 25 million unsafe abortions take place and approximately 266,000 women die from cervical cancer. And at some point in their lives, around one in three women experience gender-based violence.
Overcoming these stark realities is achievable.
In fact, the Guttmacher-Lancet Commission found that meeting the needs for modern contraception, safe abortion, and maternal and newborn health care in developing regions would cost just US$9 per person per year. This is an affordable investment, especially considering that half of this amount is already being spent to cover the cost of current levels of care.
The benefits to women and their families from this investment would be immense. Fully meeting the need for modern contraception in developing regions and ensuring that pregnant women and their newborns receive essential care would result in a 73% decline in maternal deaths from 2017 levels. Furthermore, newborn deaths would drop by 80% from a staggering 2.7 million to 538,000 each year.
Beyond the intrinsic value of fulfilling individual rights and improving health, investing in sexual and reproductive health and rights is beneficial to societies because it strengthens families, helps increase prosperity and bolsters gender equality. As the Guttmacher-Lancet Commission report affirms, marginalized communities with the least access to health care bear a disproportionate burden of poor sexual and reproductive health. Thus, a comprehensive approach—backed by evidence and grounded in human rights—is critical. We must address gaps in essential health interventions as well as the social, cultural and economic barriers that stand in the way of making sexual and reproductive health and rights a reality in people’s lives.