Messages from the UN Millennium Project Reports June 2005 Population, Reproductive Health and the Millennium Development Goals Population, Reproductive Health and the Millennium Development Goals Messages from the UN Millennium Project Reports June 2005 Report produced under the direction of Stan Bernstein Copyright © 2005 by the United Nations Development Programme All rights reserved Photos: Front cover, top to bottom and left to right, Christopher Dowswell/UNDP, Giacomo Pirozzi/Panos Pictures, Liba Taylor/Panos Pictures, Jørgen Schytte/UNDP. This book was edited, designed, and produced by Communications Development Inc., Washington, D.C. The UN Millennium Project was commissioned by the UN Secretary-General and sup- ported by the UN Development Group, which is chaired by the Administrator of the United Nations Development Programme. The report is an independent publication. This pub- lication does not necessarily reflect the views of the United Nations, the United Nations Development Programme, or their Member States. http://www.unmillenniumproject.org Population, Reproductive Health and the Millennium Development Goals iii Table of contents Foreword    iv Introduction    vi Part One  Millennium Development Goals 1 Part Two  Sexual and Reproductive Health and Investing in Development: A Practical Plan to Achieve the Millennium Development Goals 3 Part Three  Sexual and Reproductive Health and the UN Millennium Project Task Force Reports 8 Part Four  Two-page spread in Chapter 5 of Investing in Development, “Sexual and reproductive health—essential for reaching the Goals” 14 Part Five  Proposed SRH Targets and Indicators for Monitoring the MDGs 19 Part Six  A Guide to the Key SRH References in the UN Millennium Project Documents 21 iv Population, Reproductive Health and the Millennium Development Goals The world has an unprecedented opportunity to improve the lives of billions of people by meeting the Millennium Development Goals (MDGs), the interna- tional community’s time-bound and quantified targets for addressing extreme poverty in its many forms. At the request of UN Secretary-General Kofi Annan, the UN Millennium Project has identified practical strategies to meet the MDGs, emphasizing the scaled up investments required in human capital and infra- structure and environmental sustainability, alongside efforts to promote gender equality. The UN Millennium Project, an independent advisory body to the Secretary- General, has been a unique undertaking. Its 10 Task Forces have brought together a broad array of participants from academia, government, UN agencies, inter- national financial institutions, nongovernmental organizations, donor agencies, and the private sector, creating a worldwide network of development practitioners across a wide range of disciplines. It is therefore particularly striking that diverse groups of experts from differ- ent sectors clearly and consistently recognized that expanded access to sexual and reproductive health services and protection of reproductive rights are essential to the achievement of the MDGs. The health-related goals (reducing child mortal- ity; improving maternal health; reversing HIV/AIDS, tuberculosis and malaria) are most clearly and directly affected. But access also has important impacts on poverty and hunger, on gender equality and the empowerment of women, on educational attainment, on environmental sustainability, and on the quality of life of slum dwellers. Dramatic disparities in access to comprehensive reproductive health infor- mation and services are both a symptom of and a contributor to poverty and gender inequality. Until the poor and marginalized—including youth and rural Foreword Population, Reproductive Health and the Millennium Development Goals v populations—gain access to voluntary family planning, safe motherhood services, and protection from sexually transmitted diseases, gender violence and harmful traditional practices, and until all women reap the benefits of participation and equality, progress against poverty will be handicapped. The required interventions for sexual and reproductive health are clear, as detailed in the UN Millennium Project’s reports, and they need to be urgently implemented. They need to be sensitive to local cultural realities while following the experience collected from population and reproductive health programs over the past 40 years. Monitoring progress and achieving universal access to sexual and reproductive health services is essential to the attainment of the MDGs. Jeffrey D. Sachs Director UN Millennium Project vi Population, Reproductive Health and the Millennium Development Goals Introduction The UN Millennium Project is the independent advisory body commissioned by the UN Secretary-General to propose the best strategies for meeting the Mil- lennium Development Goals (MDGs). The MDGs are the world’s targets for reducing extreme poverty in its many dimensions by 2015—including income poverty, hunger, disease, exclusion, lack of infrastructure and shelter—while pro- moting gender equality, education, health and environmental sustainability. The Project’s analytical work has been carried out by ten thematic task forces com- prising more than 250 experts from around the world, including development practitioners, national and international policymakers, as well as civil society and private sector representatives. Although there is no formal MDG outlining targets for sexual and repro- ductive health (SRH), the MDGs cannot be achieved in low-income countries without attention to population issues and access to SRH services. By placing such emphasis on SRH issues in its recommendations, the UN Millennium Proj- ect hopes these issues will become properly entrenched in programs to achieve the MDGs. Indeed, strong SRH-relevant messages and recommendations appear throughout key UN Millennium Project documents—including the Millennium Project Task Force reports, the report on the UN Millennium Project’s main findings and recommendations, entitled Investing in Development: A Practical Plan to Achieve the Millennium Development Goals, and its summary Overview document. These reports were launched on 17 January 2005 and can be down- loaded at http://www.unmillenniumproject.org. This document outlines how the UN Millennium Project reports incor- porate and promote sexual and reproductive health issues. This document also provides a guide to finding the relevant SRH text in these reports. Population, Reproductive Health and the Millennium Development Goals 1 Goal 1 Eradicate extreme poverty and hunger Target 1   Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day. Target 2   Halve, between 1990 and 2015, the proportion of people who suffer from hunger. Goal 2 Achieve universal primary education Target 3   Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling. Goal 3 Promote gender equality and empower women Target 4   Eliminate gender disparity in primary and secondary education, pref- erably by 2005, and in all levels of education no later than 2015. Goal 4 Reduce child mortality Target 5   Reduce by two-thirds, between 1990 and 2015, the under-five mortal- ity rate. Goal 5 Improve maternal health Target 6   Reduce by three-quarters, between 1990 and 2015, the maternal mor- tality ratio. Goal 6 Combat HIV/AIDS, malaria and other diseases Target 7   Have halted by 2015 and begun to reverse the spread of HIV/AIDS. Target 8   Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases. Part One Millennium Development Goals 2 Population, Reproductive Health and the Millennium Development Goals Goal 7 Ensure environmental sustainability Target 9   Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources. Target 10   Halve by 2015 the proportion of people without sustainable access to safe drinking water and basic sanitation. Target 11   Have achieved by 2020 a significant improvement in the lives of at least 100 million slum dwellers. Goal 8 Develop a global partnership for development Target 12   Develop further an open, rule-based, predictable, non-discrimina- tory trading and financial system (includes a commitment to good governance, development and poverty reduction—both nationally and internationally). Target 13   Address the special needs of the Least Developed Countries (includes tariff- and quota-free access for Least Developed Countries’ exports, enhanced programme of debt relief for HIPCs and cancellation of official bilateral debt and more generous ODA for countries commit- ted to poverty reduction). Target 14   Address the special needs of landlocked countries and small island developing states (through the Programme of Action for the Sustain- able Development of Small Island Developing States and the twenty- second General Assembly provisions). Target 15   Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term. Target 16   In cooperation with developing countries, develop and implement strategies for decent and productive work for youth. Target 17   In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries. Target 18   In cooperation with the private sector, make available the benefits of new technologies, especially information and communication technologies. Note: See Part Five for Task Force comments on Target 6. [...]... mutilation and other harmful traditional practices, expanding access to safe abortion (where permitted by law) and reviewing of such legislation to protect women’s health Population, Reproductive Health and the Millennium Development Goals  Part Three Sexual and Reproductive Health and the UN Millennium Project Task Force Reports Below are the key findings and recommendations on population and sexual and reproductive. .. information and services in the achievement of the MDGs Population, Reproductive Health and the Millennium Development Goals  Chapter 5—Box 5.5 (“Sexual and reproductive health essential for reaching the Goals ) is a two-page spread that highlights the key reasons why ensuring universal access to sexual and reproductive health information and services is necessary for achieving the MDGs The current... Two Sexual and Reproductive Health and Investing in Development: A Practical Plan to Achieve the Millennium Development Goals Below are six key findings and recommendations on population and sexual and reproductive health (SRH) in the UN Millennium Project’s report on its main findings and recommendations, Investing in Development: A Practical Plan to Achieve the Millennium Development Goals, and its... Reproductive Health and the Millennium Development Goals 13 Part Four Two-page spread in Chapter 5 of Investing in Development, “Sexual and reproductive health essential for reaching the Goals Sexual and reproductive health is essential for reaching the Goals It entails healthy, voluntary and safe sexual and reproductive choices—voluntary choices of individuals and couples about family size and family... and the Millennium Development Goals Part Six A Guide to the Key SRH References in the UN Millennium Project Documents Below is a guide to the key population and reproductive health references in the UN Millennium Project documents—Investing in Development: A Practical Plan to Achieve the Millennium Development Goals, its summary Overview document, and the UN Millennium Project Task Force Reports The. .. monitoring and evaluation capacities can lead to faster increases in quality and coverage 18 Population, Reproductive Health and the Millennium Development Goals Part Five Proposed SRH Targets and Indicators for Monitoring the MDGs The Task Force on Child Health and Maternal Health and the Task Force on Education and Gender Equality have recommended the following additional SRH-relevant target and indicators... devastating the neglect of sexual and reproductive health can be The differences in reproductive health between the rich and the poor and within and between countries—are larger than in many other areas of healthcare…Sexual and reproductive health services should be integrated into a strengthened health system.” Recommendations The Overview contains Ten Key Recommendations, which includes the bullet... Population, Reproductive Health and the Millennium Development Goals 11 an integral part of their AIDS responses In addition, there should be greater integration of HIV and other reproductive health services, including pMTCT, VCT, family planning, and safe motherhood.” Note that the Glion and New York declarations are cited Recommendation Strengthened links between family planning and HIV/AIDS programs and. .. communities and cultural leaders, strengthen health delivery systems at multiple levels, create effective referral systems and improve logistics and management There are numerous channels to integrate sexual and reproductive health services in a strengthened health system For example, maternal and child health 16 Population, Reproductive Health and the Millennium Development Goals services can provide an opportunity... delivery to men (and their families) in the military and police forces has also been important in scaling up Population, Reproductive Health and the Millennium Development Goals 17 many national reproductive health programs Additional programs addressed to men and boys are needed to encourage them to be responsible in their behaviors and to end violence against women Civil society and nongovernmental . women’s health. 8 Population, Reproductive Health and the Millennium Development Goals Part Three Sexual and Reproductive Health and the UN Millennium. from the UN Millennium Project Reports June 2005 Population, Reproductive Health and the Millennium Development Goals Population, Reproductive Health and