25 years after Cairo, how far have we come?

A quarter-century ago, a seismic shift took place in Cairo

A quarter-century ago, a seismic shift in global development took place in Cairo. Gathered at the International Conference on Population and Development (ICPD), 179 governments – including Japan -- recognized that the world’s population was not a balance sheet but a rich tapestry of people’s lives. The ICPD adopted a landmark Programme of Action that placed individual dignity and the right to plan one’s family at the very heart of development.

I was there when it happened. I joined the many government delegates, public health leaders, women’s rights activists, researchers and youth advocates who assembled in Cairo in 1994 with a sense of mission and purpose. What inspired us, and millions around the world, was the simple conviction that population is not about numbers, but about people. We were united in the belief that women and girls must be placed squarely at the centre of the development agenda; that all human beings have the right to decide freely whether, when and with whom to have children; and that everyone must have the means to exercise this basic human right.

It is that simple. So simple, in fact, that many may take it for granted. Yet 25 years ago, in many parts of the world, that dream seemed far out of reach. And even today, this fundamental right is still not a reality for all.

An exhilarating feeling

In 1994, at the time of the Cairo conference, I was the Ford Foundation’s representative in West Africa, working to ensure reproductive health and rights for women, helping them lead dignified and empowered lives free of harmful practices like female genital mutilation. It was a pivotal year for Africa: just months before the ICPD, we celebrated the end of apartheid and the election of President Nelson Mandela in South Africa.

Change was in the air, and the agreement reached in Cairo was the big pivot women's rights advocates had long been hoping for. There can be few feelings more exhilarating than to suddenly have the backing of the international community for your mission in life. And it wasn’t just any agreement – the ICPD Programme of Action was the most comprehensive and forward-looking international document that had ever been signed on the critical issues for which we had fought so hard.

It’s time to re-energize the movement

In Cairo, we were filled with hope for the big changes that lay ahead. Now, 25 years later, I have mixed emotions.

More than a billion people have climbed out of poverty, and hundreds of millions have gained access to family planning. Maternal mortality has declined by 40 per cent, and we have made great progress in rooting out harmful practices such as child marriage and female genital mutilation. The proportion of women married as children has dropped from one in four to one in five since 1994.

Yet for many, the promise of Cairo remains far from complete. Over 300,000 women still die each year from complications in pregnancy and childbirth; more than 200 million women who want to plan their pregnancies cannot access contraception; and millions of girls are married off against their will or subjected to genital mutilation. All of these women and girls are robbed of their reproductive rights, the same rights their leaders promised to protect a quarter-century ago.

The framework adopted in 1994 is as relevant as ever, so much so that it was woven into the Sustainable Development Goals. Yet, despite this, sexual and reproductive health and rights have rarely made it into the mainstream discourse among world leaders since Cairo. On the ICPD’s 25th anniversary, it’s time to re-energize the movement and make sexual and reproductive rights a priority for a new generation whose rights are at stake.

Nairobi Summit to be held in November

As we recommit to the promise of Cairo and accelerate our collective efforts to achieve a world of rights and choices for all, we must also look at some of the incredible advances in reproductive technology that have helped millions of women conceive, and the demographic shifts – such as ageing populations – that are shaping many societies, including Japan’s.

Today, in a world buffeted by discrimination, political turbulence and climate change, the progress made since 1994 is under threat. Against this backdrop, it is more urgent than ever to champion the vision of Cairo and redouble our efforts to complete the unfinished business. This is the message I will be bringing to Yokohama in August when the global community gathers for the Seventh Tokyo International Conference on African Development.

And it is why in November, UNFPA and the governments of the Republic of Kenya and Denmark will convene world leaders, civil society and many other stakeholders at the Nairobi Summit on ICPD25 to discuss, agree on and commit to the path ahead to fully implement the Programme of Action adopted in 1994. We owe it to those still left behind – to the poorest women and girls, to those caught up in humanitarian crises, and to all who face stigma, discrimination and violence.

The best way to care for children is to take good care of mothers

Starting out as a young pediatrician over thirty years ago, it didn’t take me long to realize that the best way to care for children is to take good care of their mother, from a healthy pregnancy onward. These days, when I visit a refugee camp and speak with a new mom who delivered her newborn child safely thanks to UNFPA support, and see her smile, it brings such joy to my heart. Then, the importance of promoting women’s health and rights is very clear.
The support of the Government of Japan and other partners helps make this life-saving work possible. We have long-standing partnerships in Japan with Hellosmile for the prevention of cervical cancer and more recently teamed up with Kao Corporation to support menstrual hygiene and empower girls in Uganda. We are exploring new initiatives with other private sector partners like Sanrio who are promoting and contributing to the Sustainable Development Goals.

It is time to be bold

We have seen significant progress since the Cairo conference; however, unfinished business awaits. For the sake of the world’s women and girls, and for our collective prosperity, it is time to be bold. I would like women and men in Japan, and in every country, to speak up for what we know is right: a world where everyone has rights and choices, with no exceptions. It is high time for the world to act upon our promises and to realize the dream of good health and dignity for every woman and girl, everywhere.