While the ICPD Plan of Action  in 1994 emphasized women’s rights, a continuous point of contention has been sexual rights. Following up on ICPD at the Beijing Women’s Conference in 1995, women’s rights were specified to include their decision on own sexuality. Interestingly the term ‘Sexual and Reproductive Health and Rights (SRHR)’ did not appear in the adopted consensus texts prepared in Beijing, although several delegations, especially from the Nordic countries, were – and have continued to be – strong advocates.

In the development of the MDGs in 2000 we don’t see the inclusion of Reproductive Health. It was only in 2008 that international consensus on the idea that access to family planning must be part of the MDGs was reached and acted upon by including MDG 5b. This consensus is very significant, but also very recent, and it is not yet known what will happen in the post 2015 deliberations.

But is this at all important? Is it not only words in high level documents? What does it mean in real life?

UNFPA, the global agency charged with promoting sexual rights, refers to sexual and reproductive health and reproductive rights! WHO usually (but not consistently) refers to sexual and reproductive health! Large international NGOs such as IPPF use the inclusive health and rights term, SRHR, and so do a number of governments, including Denmark and Holland. Some African countries as well as some large donors (DFID, USAID) however use terms such as Sexual and Reproductive Health, Reproductive Health and Family Planning and do not mention ‘Rights’. While USAID is very generouns in their support to condoms for the purpose of preventing HIV transmission, they do not accept the use of the term ‘Reproductive Health Services’ from countries or global agencies they fund, as they see this as inclusion of family planning services and – even worse – safe abortion services.

In spite of serious challenges in global fora from conservative US based church groups – with substantial money to influence especially African governments – the High-Level Task Force for ICPD, a group of 26 leaders, still uses the term SRHR (ICDP Task Force 2013).

But again – does this ‘war on words’ matter?

We have recently in our news media learnt that Nigeria is likely to follow other African countries and introduce laws which will criminalize homosexuality and abortion. Likewise some weeks ago we read about young women in Uganda who have to leave school and thereby their opportunity for obtaining an education and future earning capacity because they have become pregnant. In a more recent article we learn that 7.3 million girls under the age of 18 become mothers every year – 2 million of them are under 14!!

So yes, it matters because these governments and donors fail to address the issues of sexual and reproductive rights on the ground. They may address and fund access to maternity services and to short term family planning services (condoms and pills) but they are not willing to address the more contentions – but equally important issues such as: provision of access to safe abortion (unsafe abortion is likely to cause 1/3 of all maternal death and disability); the persistently high unmet need for family planning, access to long acting or permanent family planning methods, access to reproductive and sexuality information and services to young people and sexual minorities, and actively addressing child marriage and teenage pregnancies.

So how about donor governments who in their own countries and in international meetings place high importance on the Rights aspect of SRHR and provide funding through multilateral and bilateral assistance?

Denmark provides about 1/2 of their funding through multilateral agencies such as UNFPA and WHO, both UN agencies which cannot support any activity at country level which may be seen as anti government. This means that in more conservative countries, such as a large number of African countries, where safe abortion and homosexuality is a criminal offence, these agencies cannot support local CSOs to undertake advocacy to change the law! Likewise, funding provided through general- or sector budget support will not be used to address reproductive and sexual rights unless the government is strongly in favor – in which case the external funding may not be required!

So what options are available for donors to support a ‘rights based’ ICPD agenda? 

In most of the western countries reproductive and sexual rights were initially introduced by local CSOs, professional groups such as Women’s Medical Associations and passionate individuals. Likewise most countries have individuals and local CSO’s which work to ensure that people know their rights and undertake advocacy to change restrictive laws. Recent studies have documented that funding for such activities is inadequate, ad-hoc and sporadic.

After several years of deliberations the Dutch and Danish Governments have very recently taken the first steps to set up a global mechanism to fund local CSO to undertake advocacy in the area of the Rights aspect of the ICPD agenda – which was agreed almost 20 years ago!! Let us hope this initiative takes off soon and that once it becomes operational, other funding agencies will step up and co-finance.