Reproductive Health and the Millennium Development Goals: Politics, Ethics, Evidence and an ‘Unholy Alliance’

Abstract

BWPI Working Paper 105Creating and sharing knowledge to help end poverty 1 University of Manchester David.hulme@manchester.ac.uk Brooks World Poverty Institute ISBN : 978-1-907247-04-0 www.manchester.ac.uk/bwpi AbstractThis paper provides a chronological account of the evolution of the concept and policy of reproductive health and its initial entry, and subsequent exclusion, from UN declarations. In the 1990s effective lobbying by sexual and reproductive rights activists established reproductive health for all as a UN goal. However, at the Millennium Assembly of 2000 and in the Millennium Development Goals (MDGs), an 'unholy alliance' of the Holy See and a handful of conservative Muslim governments managed to keep reproductive health off the agenda. This was successful political manoeuvring for the short-term, but the alliance fell apart and the power of the theoretical and empirical case in support of reproductive health saw it return to the MDGs in 2005. The moral standing of religious institutions, such as the Holy See, is undermined by such opportunistic, short-term political behaviour and, in particular, the ambiguous legal status of the Holy See at the UN is called into question.

Political challenges to prioritizing gender in global health organisations

“…While some governments champion the issue, conservative governments resist the agenda -many viewing gender equality to be a Western imposition and/or a threat to their cultures -prompting global health organisations to act cautiously for fear of offending key constituents (I8, I13) [47]. For instance, in the early 2000s a number of Islamic states and the United States under the George W. Bush administration blocked inclusion of reproductive health in the Millennium Development Goals (MDGs) [48]. Most recently, proponents fear that the international wave of populist politics will inhibit global health organisations (I1, I13, I14, I15, I16, I19), one commenting that (I15), "politics is throwing up more and more rightwing misogynist leadership.…”

Why Global Goals and Indicators Matter: The Experience of Sexual and Reproductive Health and Rights in the Millennium Development Goals

“…In 1996, the OECD's Development Assistance Committee launched a document entitled "Shaping the 21st Century," which outlined seven global International Development Goals (IDGs) adapted from the recent flurry of UN conferences, and included a goal on reproductive health as "access through the primary health-care system to reproductive health services for all individuals of appropriate ages as soon as possible and no later than the year 2015" (DAC 1996;Hulme 2009b). The MDGs drew heavily from the themes of the IDGs.…”

“…After the Millennium Declaration was approved, specific targets and indicators were established in a Road Map document to monitor progress on the broad aspirations set out in the Declaration. In the resulting MDGs, there were only two significant deviations from the IDGs: first, MDG 8 was added to develop a "global partnership for development"; and second, the IDG reproductive health goal, separate from the goal on maternal health, disappeared (DAC 1996;UN 2001;Hulme 2009b).…”

Ensuring the inclusion of sexual and reproductive health and rights under a sustainable development goal on health in the post-2015 human rights framework for development

“…While reproductive health was promoted in the international development goals, 10 for complex reasons there was no effective push for sexual and reproductive health and rights during the development of the Millennium Development Goals (MDGs), and they were not included. 11 There were also other glaring omissions, such as no employment goals or targets. So MDG target 1B " Achieve full and productive employment and decent work for all, including women and young people" had to be added following the progress review in 2005 at the same time as target 5B "Achieve, by 2015, universal access to reproductive health".…”