SADC: Winding road towards Nairobi ICPD25

By Sifisosami Dube

Johannesburg: The Programme of Action agreed by 179 governments in 1994 was a huge milestone towards realising population, development and well-being. Twenty-five years down the line there are strides that have been made worldwide in achieving Sexual Reproductive Health and Rights (SRHR). These include the Sustainable Development Goals (SDGs) principle of ‘leaving no one behind’, implementation of the Maputo and SADC Protocol on Gender and Development, the SADC SRHR Strategy (2018) and the Common Africa Position on population.

However, in 2019, women are still dying whilst giving birth, choice of termination of pregnancy is still criminalised, gender based violence has reached pandemic proportions and youth are largely excluded in accessing SRHR. Many champions of gender and SRHR have been profiled yet; there is little change on the ground in inclusive access to SRHR. These and other aspects will be deliberated upon in Nairobi from 12 to 14 November 2019. It is critical to note that this conference is not a once off event but a process set to save many lives through political commitment on SRHR.

Southern Africa’s demographic transformation has prompted attention towards youth and adolescents in terms of realising SRHR. The constant outcry from the youth has been a need to be meaningfully involved in regional and national policymaking. This is particularly important as the world prepares for the 25^th anniversary of the International Conference on Population and Development.   The big question is how youth, adolescents and women in particular benefit from the outcomes of this global conference.

The road to Nairobi is really a winding one with each government defining its own package for Universal Health Coverage. The World Health Definition of UHC is that “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship”. Evidence on the ground shows that the region is far from achieving UHC due to the high cost of primary health care. Furthermore, the UHC package in most countries does not include all elements of SRHR.

Another finer road to ICPD25 is this year’s United Nations General Assembly that will include a high-level meeting on UHC. The meeting’s theme of ‘Moving Together to Build a Healthier World’ is clearly an utopian vision since UHC packages will be defined by each member state. For example, eleven years before 2030, three in four abortions are unsafe. Key populations are still side lined in the distribution of health care resources. It is clear that the road towards Nairobi is bumpy due to the non-inclusive silhouette curtain of national sovereignty.

The many speed traps towards ICPD25 are worsened by lack of information to civil society partners who have been advocating for SRHR and its full inclusion in the UHC. Whilst civil society organisations are working hard as watchdogs to monitor instruments such as the SADC SRHR strategy, Gender Protocol and many other related instruments, they are often left at the mercy of governments to include them in delegations for such important platforms as the ICPD25. Rumours are already high that side events for civil society organisations will not be held at the main conference venue of the ICPD25. This however, must not deter activism towards advocating for SRHR. The road towards achieving SRHR goes beyond ICPD25.

There is heavy luggage to be taken to Nairobi. This includes questions such as who will deliver UHC, who will pay for UHC, who will be accountable for UHC delivery and how will UHC be achieved. There is ground work that needs to done which includes eradicating corruption that is blocking health care finance, including civil society in defining a national’s UHC package and advocating for autonomous adolescent access to SRHR. Training of health care workers on SRHR is critical in achieving UHC.

It is commendable to see the UN family coming together to ensure realisation of SRHR. UNFPA in particular will be at the helm of ICPD25 and there is need for civil society to create effective linkages ahead of the conference. The 2gether4SRHR Programme, a joint United Nations effort that brings together the combined efforts of UNAIDS, UNFPA, UNICEF and WHO and the UNESCO Our Rights, Our Lives, Our Future Programme has consciously involved civil society in consultations ahead of Nairobi.

Governments, development partners, civil society and health institutions clearly need to work together to achieve SRHR as part of UHC. This unity needs to be demonstrated in Nairobi, particularly highlighting the SRHR gaps that exist in Africa. The tagline of #VoiceandChoice must accompany all discussions and outcome documents in Nairobi. The time for collective action is now.

Sifisosami Dube is the Head of Governance and Sexual Reproductive Health and Rights at Gender Links. This article is part of the GL News and Blogs .