Sexual and Reproductive Health and Rights

(Topical issue)

Deputy Olivia Mitchell: Deputy Maureen O’Sullivan offers her apologies because she cannot be with us. I am grateful for the opportunity to raise this issue on behalf of the Oireachtas all-party interest group on sexual and reproductive health and rights. The Minister of State at the Department of Foreign Affairs and Trade, Deputy Costello, will be aware that, with the Rio+20 conference and the target date for realisation of the millennium development goals imminent, Ireland along with its international development partners will be evaluating the progress achieved, restating and renewing their commitments to achieving the unmet goals, setting new targets and, most important, establishing priorities. The all-party interest group is concerned to ensure Ireland prioritises gender issues and, specifically, sexual and reproductive health and rights in its input into these decisions, particularly while it exerts its influence while holding the EU Presidency.
Family planning is particularly important in this regard because it underpins the achievement of all the millennium development goals. The ability of women in poor countries to decide when to start having children and how to space them improves maternal and infant mortality, reduces miscarriages and abortions, particularly unsafe abortions which are unfortunately most prevalent in poorer countries, and impacts on the material well-being of the entire population because fewer children mean better fed and educated children.
In renewing the sustainable development targets in the Rio+20 conference, it is crucial that we do not ignore population issues. Sheer numbers are at least as damaging to the planet as excessive consumption and waste in rich countries. I ask our delegation to bring this message to the table in Rio.
I also wish to raise the issue of women’s family planning needs in conflict situations. Women are particularly vulnerable where there is war, natural disaster or mass migration. I welcome the Minister of State’s announcement that funds will be transferred from the Ghana depot to the starving people in West Africa. Normally in these situations the priority is food, shelter and medical supplies, while family planning and contraceptives are forgotten. However, it is precisely in situations where law and order breaks down that the latter are needed. If we are to prioritise maternal health, all aspects of aid must be proofed for its impact on this area.

Deputy Anne Ferris: Next year we will hold the Presidency of the EU, which gives the Government a great opportunity to put sexual and reproductive health and rights at the forefront of the UN development agenda. The framework for the millennium development goals expires in 2015 and it is vital these rights are prioritised for the next framework. I do not think the link between sexual and reproductive rights and poverty alleviation is being made sufficiently clear and the neglect of this issue is to the detriment of the millennium development goals. This is not a controversial issue, although some may attempt to undermine it by claiming otherwise.
Among these rights are the right to information on these matters and the right to gender equality. Access to adequate health facilities is also required. It is clear that women who gain access to greater educational and economic choice have a significantly greater chance of breaking intergenerational cycles of poverty.
End of Take

Ill-health from causes related to sexuality and reproduction remains a major cause of preventable death, disability and suffering among women, particularly in low and middle income countries.
A briefing report from the WHO on progress in this area stated that the decline in the maternal mortality ratio has been slow and remains uneven. Many countries in sub-Saharan Africa, east Asia, north Africa, southeast Asia, Latin America and the Caribbean have shown no incline and none of them have reached the target of 5.5% required to achieve the millennium development goal target.
Some 8 million of the estimated 210 million women who become pregnant each year experience life-threatening complications. Every year 536 women die during pregnancy and childbirth. Some 99% of these deaths occur in developing countries, making maternal mortality the health statistic with the greatest disparity between developed and developing countries. Ensuring universal access to skilled attendants at childbirth, emergency obstetric care, postpartum care, preventing unsafe abortions and widening contraceptive choices are some of the interventions shown to reduce maternal morbidity. I urge the Government to take the opportunity presented by the EU Presidency to ensure these items are firmly on the agenda.

Minister of State at the Department of Foreign Affairs and Trade (Deputy Joe Costello): I thank Deputies Mitchell and Anne Ferris for raising this matter. It is accepted internationally, and the Government agrees, that the provision of reproductive health services to women is essential in tackling the continuing high rates of maternal mortality in the developing world. These include pre-natal and postnatal care, emergency obstetric services and access to family planning services. The position Ireland takes in international policy discussions on sexual and reproductive health is based on a firm commitment to the programme of action agreed at the international conference on population and development, ICPD, in Cairo 1994. The ICPD set out a number of clear principles of reproductive health. These include the importance of gender equality and the empowerment of women in reducing poverty and vulnerability, the right of all women to the information and means to make autonomous decisions about their fertility, and the link between women’s control over their fertility and the wider empowerment of women in the economic, social and political life.
The agreement on the ICPD programme of action was the first time the international community committed to the goal of universal access to reproductive health care by 2015, a target later integrated into the millennium development goals, MDG. The fifth MDG is to improve maternal health. Ireland is fully committed to helping to achieve the goal. Through our aid programme, we provide funding for programmes that aim to improve maternal health, reduce maternal mortality and provide family planning and reproductive health services to women in the developing world. Unfortunately, less progress has been made on the targets set out under the fifth MDG than on any other development targets. For instance, there is still a massive unmet need for family planning globally, especially in the poorest countries and communities. We need broad international consensus on sexual and reproductive health issues if serious progress is to be made on meeting these targets.
Ireland’s main partners for our support of reproductive health and maternal health programmes include the United Nations Population Fund, UNFPA, and Irish and international NGOs. Ireland has provided almost €30 million in funding to UNFPA since 2005. We also support reproductive and maternal health programmes as integral elements in our assistance in many of Irish Aid’s priority countries, including Ethiopia and Mozambique.
One of Ireland’s development priorities for our Presidency of the Council of the EU in 2013 will be agreeing a common EU position for UN General Assembly high level meeting in September 2013 on the millennium development goals and developing a position on the framework for international development after 2015, the target date for the MDGs. Ireland’s consistent position has been to draw particular attention to the targets and the countries where least progress has been made, notably in sub-Saharan Africa. We will continue to emphasise the need for a renewed commitment to reducing maternal mortality and to achieving universal access to reproductive health care.
The European Commission has started the process for preparing a Commission communication on the MDG review and post-2015 development framework and will formally launch a public consultation in the next few weeks. The consultation will last some 12 weeks. We expect the Commission communication will be available in early 2013. Ireland will work closely with the Commission throughout the process and we look forward to having Council conclusions adopted by the Foreign Affairs Council on this important issue during Ireland’s Presidency.

Deputy Olivia Mitchell: I am pleased this issue will be to the fore in our Presidency. The good news is that, since 1994, there has been a 50% drop in maternal mortality in the developing world. There are still unmet goals and 1,000 women a day die in childbirth, which is unacceptable. Over 200 million women have no access to family planning. This is partly because AIDS resulted in diverting funds away from family planning and towards solving AIDS. The inverse relationship between maternal mortality and the availability of contraception means it is essential that funds are redirected to family planning. It is more than just a case of funding – political will is at least as important from the donor and recipient countries. I recognise the Minister of State has that political will. I ask the Minister of State to use every opportunity during the Presidency and in his interaction with recipient countries to ensure they prioritise policies and practices that put maternal health to the fore and prioritise millennium development goals Nos. 4 and 5.
Deputy Anne Ferris: I thank the Minister of State for his positive report and I am heartened to hear the Government is committed to having this at the forefront during the European Presidency. Less progress has been made on the targets set in the fifth millennium development goals than in any other development issue. This must be grasped. As Deputy Mitchell said, there must be cross-party political support and political will. We must show ourselves to be leaders and it is not good enough that the target has been left behind. Women are dying every day in less developed countries and something must be done. I welcome the report of the Minister of State. Deputies Mitchell and Maureen O’Sullivan and I will be keeping an eye on matters.

Deputy Joe Costello: I thank the Deputies for their remarks. These are issues of life and death for mothers and children. Maternal, child care and gender issues have always been central to the Irish Aid programme and will continue to be so while I am Minister of State. We have a key role in preparing for the post-2015 millennium development goals. The review will start during our Presidency and the first summit meeting will take place in New York in September 2015. We are charged with developing a common European Union negotiating position. It will be done during our Presidency and agreed at the Council meetings during the Presidency. This will be the basis for the negotiations to begin in September 2013, which will continue until September 2015. The post-millennium development goals will be the second stage. We are in a position to play a key role in that respect and we note that the fifth millennium development goal, concerning reproductive health and maternal child care, is the one that has been least developed to a successful degree. It is an area to which we will pay particular attention.