Global Health, Population Change and Economic Development

Good evening.

I am delighted to be here tonight as your guest speaker. I would like to thank the Chairman of the Health Advisory Board, Edward Ludwig, for inviting me to participate. My gratitude also goes to the US Committee for UNFPA, and its President, Peter Purdy, for the kind introduction.

I would like to commend the Johns Hopkins Bloomberg School of Public Health and its many efforts, including the Center for Communication Programs. At UNFPA, we consider the Bloomberg School of Public Health to be a true partner and friend, and I would like to thank you for your hard work, collaboration and dedication to our common causes over the years.

Ladies and gentlemen,

We are living today in a world of paradox. On the one hand, we are greatly connected through trade, travel and communications. On the other, we are deeply divided. We are divided between rich and poor, between powerful and powerless. We are also divided by perceptions.

What does globalization mean to the half of humanity that has never talked on a telephone, let alone hooked up to the Internet? What does globalization mean to a young man who has just watched helplessly as his wife died during childbirth? And what does globalization mean to a young HIV-positive woman in Africa who cannot get antibiotics, let alone the combination drug therapies that prolong lives in wealthy countries?

In my travels around the world, I have seen firsthand the tremendous needs of people. And I have also seen the hope and determination that people retain in the most difficult circumstances -- hope and determination that truly provide inspiration to us all.

I have heard a woman in Oman tell me that before literacy classes, the women were like animals in the dark because they could not read and write, but now there was light. I have heard a young girl in India reply, when asked what she would want if she could have anything, that she wants to be a boy so she can go to school and not get married too early.

I have heard presidents and prime ministers tell me that population growth is a major concern for their countries as they face shortages of water, food and jobs. And I have come to one conclusion: That the world must do more, much more, to support the world's women and girls and to support population and health, particularly reproductive health, to ensure safe motherhood and to slow the spread of AIDS.

If there is one thing we have learned over the past decade, it is that investments in women produce immediate results, results that extend far beyond the individual--to the family, the community, the nation and our world at large.

Let me give you one example: family planning.

Over the past 50 years, contraceptive use in the developing world has increased from 10 per cent to 65 per cent. This is a tremendous achievement that was attained with relatively small resources. And yet, it constitutes a victory for women and the exercise of their basic rights that has literally changed the world.

Because women are planning their families, birthrates have dropped by half in the less developed parts of the world. And this has caused population growth to slow.

Because population growth is slowing, there are smaller families that are better able to provide health care and education to each child. There are nations that are better able to pursue a course of sustainable development, and register higher savings and faster economic growth. We have seen this most clearly in East Asia.

UNFPA, the organization I head, is committed to the empowerment of women and to universal access to reproductive health services by the year 2015. These services include voluntary family planning, care during pregnancy and birth, and prevention of sexually transmitted infections, including HIV/AIDS.

These basic services are in high demand in the developing world and UNFPA is committed to working with governments and partners to bring these services to people, especially the poorest of the poor.

We are also working to reach young people. Youth have traditionally had the least access to reproductive health information and services. Yet today, they face unprecedented risks. They need services to protect themselves from unwanted pregnancy and unsafe sexual relations. This is especially critical with the AIDS crisis.

I was gratified to learn that the Bloomberg School of Public Health's Center for Communication Programs is part of a consortium of community and faith-based organizations that will receive funding from the United States Agency for International Development to fight AIDS. It is only by working together and scaling up our responses that we will be able to slow the spread of HIV/AIDS and make a real difference.

UNFPA is fully committed to ensuring that reproductive health services include services for HIV prevention.

Today, half of all HIV infections occur in young people aged 15 to 24. Yet, they know very little about how the virus is transmitted and oftentimes what they do know is often nothing more than myth. We are working with a wide range of partners to scale up youth-friendly information and services.

We are also focusing on pregnant women because most of the world's pregnant women are HIV-negative and they should remain so. Pregnancy is known to be one of the few occasions where women go to health clinics and hospitals. Therefore, it is a natural entry point and opportunity to provide information on HIV prevention. It is also an opportunity to provide HIV-positive women with the required support and care they need to ensure a better chance of a safe pregnancy and birth.

Our strategies for HIV prevention also include condom programming. When used correctly and consistently, condoms are a proven and effective means for preventing HIV infection. That is why we support the ABC approach that includes abstinence, being faithful, and condom use. Taken together as a whole, these three messages form an effective, comprehensive approach that meets real people's real needs.

UNFPA is the world's largest multilateral provider of condoms to developing countries. We are able to buy them in bulk at highly reduced prices. But, donor funding in this area falls far short of global needs. And we estimate that demand for contraceptives and condoms will increase by a further 40 per cent by the year 2015.

Countries worldwide have missed the goals for spending on population and reproductive health that were set in 1994 at the International Conference on Population and Development, in Cairo.

Countries agreed at that conference to spend $17 billion annually on population and reproductive health by 2000, but only $11.2 billion was spent that year, and in 2001, the figure fell to $9.4 billion. So, there is a real need for greater advocacy in this area, and UNFPA is working very hard to increase funding. I am happy to report that we have been able to increase the number of contributing countries to 136, up from 69 four years ago.

However, there is one nation that we, unfortunately, cannot count among our contributors, and that is the United States. Last year, the United States Administration decided to withdraw $34 million in Congress-appropriated funds for UNFPA. We very much hope the United States will come back on board and supply leadership as it did when it helped create UNFPA more than 34 years ago.

But I would like to emphasize that, while the current United States Administration has not been consistently generous to UNFPA, the American people have been. Last year, two American women, Lois Abraham of New Mexico and Jane Roberts of California, started a grass-roots campaign to raise the missing funds. The 34 Million Friends Campaign is now in full swing.

What started out as a trickle of support has turned into a steady stream. We now receive envelopes containing about $7,000 dollars every day, and will soon reach the $1-million-dollar mark. Just as encouraging as the contributions that arrive each day are the notes of support. One person wrote: "As a 77-year-old retiree, I have little income to spare, but I want to help in my small way." Another woman wrote: "My husband and I both lost our jobs in the past year. Still, we would like to contribute.... Promoting family planning and safe pregnancies for women around the world is a worthwhile and important cause." Another person wrote: " I am sending three [dollars], one for my mom, my sister and myself. Thank you for your efforts." And another person said: "This dollar is a financial contribution. It is also a statement: that we the people of the world are one family, and that Americans know and support this."

In closing, I would like to stress that we, the people of the world, are indeed one family--one family living on one small and interdependent globe. What happens on the other side of the world can easily have ramifications at home. As I speak tonight, there is a war raging in the Persian Gulf. Regretfully, despite all efforts to find a peaceful solution, we are now faced with the reality of war in Iraq and increased suffering.

During the past 12 years of the sanctions, as documented by the United Nations Children's Fund, the health situation of Iraqi children, mothers and families has suffered. With war, the situation will only get worse. The United Nations is working hard to provide support. All these efforts are important to save lives and reduce suffering. But there is one ingredient that is so very essential - and that is peace. Without just and lasting peace, the human rights of all people cannot be protected and enjoyed. Without peace, the most basic right - that is the right to life - will invariably be denied.

Thank you.