Sexual and Reproductive Health for All: 20 Years of The Global Strategy

Thirty years back, the International Conference on Population and Development (ICPD), held in Cairo, Egypt, underscored the right of all people to achieve the highest standard of sexual and reproductive health and rights (SRHR). In 2004, WHO published a reproductive health method – ratified by 191 Member States at the Fifty-seventh World Health Assembly – that strengthened the centrality of SRHR to societies and economies (Resolution WHA57.12). These frameworks are grounded in gender equality and recognize the changeless significance of sexual health in achieving health for all.

WHO scientists worked with Member States, civil society and communities across all areas to operationalize a Worldwide Strategy to cover the 5 crucial pillars for enhancing SRHR:

– improving antenatal, perinatal, postpartum and newborn care

– providing household planning services

– eliminating hazardous abortion

– fighting sexually transmitted infections (STIs).

– promoting sexual health.

Resolution WHA57.12 further notified SRHR policies and directing documents in a number of regions and Member States. For example, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Plan of Action from 2016 (structure upon the initial 2006 strategy) both consist of language and ideas reinforcing and promoting SRHR.

” The international strategy is the foundational policy document that centres WHO’s mandate for sexual and reproductive health to date,” said 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 crucial in contributing to directing research top priorities and dealing with countries to develop beneficial resources to guarantee extensive SRHR throughout the life course.”

Significant development has actually been made over the last 20 years within each of the five pillars, consisting of these examples.

– The Global method happened as the world was reeling from the HIV and AIDS epidemic. Today, the number of people obtaining HIV has fallen by 38% given that 2010 alone, due in part to the Strategy’s emphasis on removing STIs including HIV.

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

– Prioritizing household planning services and contraception access caused WHO’s Family preparation: a worldwide handbook for providers recommendation guide, which has actually been distributed over a million times. Accordingly, the percentage of women utilizing contemporary contraceptive techniques increased from 467 million in 1990 to 874 million in 2022, while a broader range of contraceptive alternatives is now offered.

A 2020 research study discovered that there has been a worldwide reduction in unintentional pregnancy. Furthermore, evidence-based medical abortion routines have actually enhanced worldwide access to abortion, and over 60 nations have liberalized abortion laws in the previous thirty years in line with evidence on the significance of such efforts to ensure the health of females and teen girls.

Professor Kate Gilmore, of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for helping generate essential scientific proof on SRHR that has actually added to a few of these shifts. “Some of the fantastic advances that we’ve seen – including the way civil society has actually used 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 past twenty years,” she said.

Despite early gains, nevertheless, recent years have seen signs of stagnation. From 2000 to 2020, the maternal death rate dropped by 34% around the world – however a 2023 report found that progress has mainly stalled considering that. The worrisome pattern was highlighted throughout a current event showcasing global datasets on the evolution of SRHR given that ICPD. High maternal mortality rates persist in a few countries and sexual health problems, such as endometriosis, infertility and sexual erectile dysfunction, are frequently ignored or normalized.

Dr Allotey and Dr Manjulaa Narasimhan, researcher at WHO and HRP, kept in mind in a current commentary in the WHO Bulletin that the SRHR program stays incomplete and in some instances has actually regressed due to geopolitical stress, economic recessions, the global food crisis, climate modification, humanitarian crises and COVID-19.

There are emerging opportunities to catalyse progress – for instance, by enhancing human rights-based techniques in SRHR and embedding concepts like non-discrimination, including in crisis scenarios. Improving health systems with a main health-care approach can improve equity and broaden access to thorough SRHR services. New technologies and alternative service delivery methods can enhance SRHR by expanding access, option and autonomy.

Other future-looking focus locations within SRHR consist of research study on the transformative function of artificial intelligence and innovative birth control techniques, further work on reinforcing health systems, and the enduring prioritization of favorable pregnancy and giving birth experiences.

At a broader level, Dr Allotey required an ongoing focus on the foundational significance of SRHR. “Sexual and reproductive health must never ever be relegated to the margins of health care, but recognized as crucial for the overall wellness of people and the neighborhoods in which they live,” she stated.