Sexual and Reproductive Health for All: twenty Years of The Global Strategy

Thirty years ago, the International Conference on Population and Development (ICPD), held in Cairo, Egypt, underscored the right of all individuals to attain the highest requirement of sexual and reproductive health and rights (SRHR). In 2004, WHO released a strategy – ratified by 191 Member States at the Fifty-seventh World Health Assembly – that reinforced the midpoint of SRHR to societies and economies (Resolution WHA57.12). These frameworks are grounded in gender equality and recognize the unchanging importance of sexual health in attaining health for all.

WHO scientists worked with Member States, civil society and communities throughout all regions to operationalize a Global Strategy to cover the five key pillars for improving SRHR:

– enhancing antenatal, perinatal, postpartum and newborn care

– offering family planning services

– getting rid of hazardous abortion

– fighting sexually sent infections (STIs).

– promoting sexual health.

Resolution WHA57.12 further notified SRHR policies and directing documents in a number of areas and Member States. For example, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Strategy from 2016 (building upon the initial 2006 strategy) both include language and concepts enhancing and maintaining SRHR.

” The international method is the fundamental policy file that centres WHO’s mandate for sexual and reproductive health to date,” stated Dr Pascale Allotey, Director of the UN Special Programme on Human Reproduction (HRP) and WHO’s Department of Sexual and Reproductive Health. “The text stays essential in adding to guiding research priorities and working with nations to establish helpful resources to make sure detailed SRHR across the life course.”

Significant progress has been made over the last twenty years within each of the five pillars, consisting of these examples.

– The Global technique happened as the world was reeling from the HIV and AIDS epidemic. Today, the number of people acquiring HIV has fallen by 38% since 2010 alone, due in part to the Strategy’s focus on getting rid of STIs consisting of HIV.

– Since March 2022, 60% of WHO Member States have actually included the human papillomavirus vaccine (HPV) in their routine immunization schedules, significantly advancing efforts to remove cervical cancer as a public health threat.

– Prioritizing family planning services and contraception access led to WHO’s Family planning: an international handbook for suppliers referral guide, which has actually been distributed over a million times. Accordingly, the proportion of women using modern-day contraceptive techniques increased from 467 million in 1990 to 874 million in 2022, while a wider series of contraceptive alternatives is now available.

A 2020 study found that there has been a worldwide decline in unintentional pregnancy. Furthermore, evidence-based medical abortion routines have actually enhanced worldwide access to abortion, and over 60 countries have actually liberalized abortion laws in the previous thirty years in line with evidence on the importance of such efforts to make sure the health of ladies and adolescent girls.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for helping produce crucial scientific evidence on SRHR that has added to some of these shifts. “Some of the fantastic advances that we have actually seen – including the method civil society has taken up the cause to argue for access to safe and legal abortion – are because of the Strategy and the organized generation of proof over these previous 2 decades,” she stated.

Despite early gains, nevertheless, current years have seen signs of stagnation. From 2000 to 2020, the maternal death rate visited 34% around the world – but a 2023 report discovered that progress has actually mostly stalled because. The uneasy pattern was shown during a recent occasion showcasing international datasets on the advancement of SRHR given that ICPD. High maternal death rates continue a few nations and sexual health issues, such as endometriosis, infertility and sexual erectile dysfunction, are frequently overlooked or stabilized.

Dr Allotey and Dr Manjulaa Narasimhan, scientist at WHO and HRP, noted in a recent commentary in the WHO Bulletin that the SRHR agenda stays incomplete and in some instances has actually regressed due to geopolitical stress, economic declines, the international food crisis, environment change, humanitarian crises and COVID-19.

There are emerging opportunities to catalyse progress – for example, by boosting human rights-based approaches in SRHR and embedding principles like non-discrimination, consisting of in crisis circumstances. Improving health systems with a primary health-care method can boost equity and expand access to detailed SRHR services. New innovations and alternative service shipment techniques can enhance SRHR by broadening gain access to, choice and autonomy.

Other future-looking focus locations within SRHR include research study on the transformative role of synthetic intelligence and ingenious contraception methods, more deal with strengthening health systems, and the sustaining prioritization of positive pregnancy and giving birth experiences.

At a wider level, Dr Allotey called for an ongoing focus on the foundational value of SRHR. “Sexual and reproductive health must never ever be relegated to the margins of healthcare, but recognized as critical for the general well-being of people and the communities in which they live,” she said.