A name is a label.A name gives an identity – to people, to things, to organisations.A name is important.A name is political.For those who work in this field, Reproductive Health Matters, or RHM, ha...

On the 23rd March 2018, tens of thousands of Polish citizens came together to stage protests opposing the “Stop Abortion” bill. In what has become known as the #BlackProtest movement, people dresse...

Today, someone with money, woman or man, who is unable to have a child for whatever reason, can buy the services of a “gestational surrogate” somewhere in the world. This woman – most likely quite ...

The politics of population control and its sometimes coercive methods in developing countries documented during the 1960s, 70s and 80s, gave rise to strong opposition by women's groups, and put into question the safety of contraceptive methods that were being developed and introduced into countries. In 1991, the Special Programme on Human Reproduction at the World Health Organization, a research programme focused on development of new methods and safety assessments of existing fertility regulation methods, started a process of “dialogue” meetings between scientists and women's health advocacy groups which lasted for nearly a decade. This paper describes the process of these meetings and what they achieved in terms of bringing new or different research topics into the agenda, and some of the actions taken as a result.

This Guide seeks to provide insight and resources to actors interested in the development of rights claims around sexuality and sexual health. After engaging with the vexed question of the scope of sexual rights, it explores the rules and principles governing the way in which human rights claims are developed and applied to sexuality and sexual health, and how that development is linked to law and made a matter of state obligation. This understanding is critical to policy and programming in sexual health and rights, as it supports calling on the relevant range of human rights, such as privacy, non-discrimination, health or other universally accepted human rights, as well as demanding the action of states under their international and national law obligations to support sexual health.

Although past resistance to sexual rights in global debates has often been grounded in claims to culture, nation and religion, opposition voices are now using, rather than rejecting, the frame of international human rights. This Commentary argues that, despite opponents’ attempts to defeat sexual rights with other rights claims, a careful understanding of the principles of international human rights and its legal development exposes how the use of rights to oppose sexual rights should, and will ultimately, fail. The Commentary briefly takes up three kinds of “rights” claims made by opponents of sexual rights: limiting rights to protect rights, textual basis, and universality, and explores the rationales and impact of their application to countering sexual rights. Because sexuality and reproduction intersect as well as diverge in the opposition they face, this struggle matters intensely and plays out across advocacy, programmatic and policy worlds. Underpinning this Commentary is the understanding that opposition to sexual and reproductive health rights uses common arguments about rights principles that must be understood in order to be countered.

Since the International Conference on Population and Development, definitions of sexuality and sexual health have been greatly elaborated alongside widely accepted recognition that sexual health requires respect, protection and fulfilment of human rights. Considerable progress has also been made in enacting or changing laws that affect sexuality and sexual health, in line with human rights standards. These measures include legal guarantees against non-discrimination and violence, decriminalisation of consensual sexual conduct and guaranteeing availability, accessibility, acceptability and quality of sexual health information and services to all. Such legal actions have had positive effects on health and specifically on sexual health, particularly for marginalised populations. Yet in all regions of the world, laws still exist which jeopardise health, including sexual health, and violate human rights. In order to ensure accountability for the rights and health of their populations, states have an obligation to bring their laws into line with international, regional and national human rights standards. These rights-based legal guarantees, while insufficient alone, are essential for effective systems of accountability, achieving positive sexual health outcomes and the respect and protection of human rights.

We discuss the history of the World Health Organization's (WHO's) development of guidelines for governments on providing safe abortion services, which WHO published as Safe Abortion: Technical and Policy Guidance for Health Systems in 2003 and updated in 2012.We show how the recognition of the devastating impact of unsafe abortion on women's health and survival, the impetus of the International Conference on Population and Development and its five-year follow-up, and WHO's progressive leadership at the end of the century enabled the organization to elaborate guidance on providing safe abortion services.Guideline formulation involved extensive review of published evidence, an international technical expert meeting to review the draft document, and a protracted in-house review by senior WHO management.

In this report, we describe how human rights can help to shape laws, policies, programmes, and projects in relation to contraceptive information and services. Applying a human rights perspective and recognising the International Conference on Population and Development and Millennium Development Goal commitments to universal access to reproductive health including family planning, we support measurement of unmet need for family planning that encompasses more groups than has been the case until recently. We outline how human rights can be used to identify, reduce, and eliminate barriers to accessing contraception; the ways in which human rights can enhance laws and policies; and governments' legal obligations in relation to contraceptive information and services. We underline the crucial importance of accountability of states and identify some of the priorities for making family planning available that are mandated by human rights.

The range of medicines and technologies that are essential for sexual and reproductive health care is well established, but access to them is far from universally assured, particularly in less developed countries. This paper shows how the pharmaceutical industry plays a major role in the lack of access to essential medicines for sexual and reproductive health care, by a) investing in products for profit-making reasons despite their negative health impact (e.g. hormone replacement therapy), b) marketing new essential medicines at prices beyond the reach of countries that most need them (e.g. HPV vaccines), and c) failing to invest in the development of new products (e.g. microbicides and medical abortion pills). Small companies, some of them non-profit-making, struggle to fill some of that demand (e.g. for female condoms). International patent protection contributes to high prices of medicines, and while international agreements such as compulsory licensing under TRIPS and the Medicines Patent Pool allow for mechanisms to enable poorer countries to get access to essential medicines, the obstacles created by "big pharma" are daunting. All these barriers have fostered a market in sub-standard medicines (e.g. fake medical abortion pills sold over the internet). An agenda driven by sexual and reproductive health needs, based on the right to health, must focus on universal access to essential medicines at prices developing countries can afford. We call for greater public investment in essential medicines, expanded production of affordable generic drugs, and the development of broad strategic plans, that include affordable medicines and technologies, for addressing identified public health problems, such as cervical cancer.

The term “reproductive health” was first adopted at the International Conference on Population and Development (ICPD) in 1994 and heralded a major shift in thinking and approach to population issues – from pure population control through family planning, to a much wider field encompassing not only fertility control but safe sex and pregnancy free from coercion, discrimination and violence. This volume is a collection of 16 critical essays by leading scholars and practitioners in the field of sexual and reproductive health and rights. Each author analyses the legacy of ICPD from a different perspective or focuses on a particular topic. They examine strengths, weaknesses and whether and how the ICPD mandate can still be used to improve sexual and reproductive health. Given the complexities and challenges of implementing and continuing to take forward the ICPD agenda after more than 15 years, the undertaking in this volume is laudable. The essays, however, are somewhat uneven in the depth of treatment, yet all contain some dimension that should be of interest to a variety of readers. Some provide historical background which might otherwise be forgotten. Several other authors point out that the absence of reproductive health in the initial targets for the Millennium Development Goals was a serious setback. While the target of “universal access to reproductive health” has since been added, Tom W Merrick (author of the “Mobilizing resources for reproductive health” chapter) points out that a strong evidence base is needed to demonstrate that poor reproductive health outcomes do, in fact, undermine the chances of the poor to escape poverty. Most of the authors find that ICPD has left a landmark legacy and remains an essential tool in work to improve sexual and reproductive health globally. Mindy Jane Roseman (“Bearing human rights: maternal health and the promise of ICPD”) describes how the connection between human rights and health outcomes forged at ICPD “remains vital, resilient and indispensable” and maintains that the enduring legacy of ICPD is that it articulated the fact that “reproductive health requires functioning and accountable health, education, judicial and other state systems”. Sofia Gruskin (“Approaches to sexual and reproductive health and HIV policies and programs: synergies and disconnects”) notes that one of the weaknesses of ICPD was that it poorly addressed HIV, focusing almost exclusively on prevention and control. This was partly because few organizations and individuals engaged in HIV-related efforts were present at ICPD to help forge a stronger agreement. However, she goes on to show that ICPD was a landmark for legitimizing the use of human rights in both sexual and reproductive health and HIV programming and laid much of the groundwork for subsequent international agreements. While agreeing that ICPD remains a momentous achievement, some of the essays focus on its failures. Marge Berer’s essay (“The Cairo ‘compromise’ on abortion and its consequences for making abortion safe and legal”) analyses the impact of the ICPD’s failure to include reference to the need for safe and legal abortion, one of the most commonly used methods of fertility regulation and a major cause of avoidable mortality and morbidity in women. She argues that making abortion safe, legal and accessible is the only way to reduce this morbidity and mortality. Alaka Basu (“Situating reproductive health within the academy”) shows how reproductive health as conceived of in ICPD has not been translated into curriculum design for medical or paramedical practitioners, and elaborates how this could be done. An important dimension in several essays is an analysis of the United Nations process, demonstrating the political forces at work that contributed to shaping the ICPD Programme of Action and subsequent events. Francoise Girard (“Advocacy for sexuality and women’s rights: continuities, discontinuities, and strategies since ICPD”) gives insights into the negotiating process of ICPD and subsequent follow-up meetings, concluding that “new, bolder agreements are not likely in the near future” as there is “little or no appetite for them at the intergovernmental level”. Frances Kissling (“Examining religion and reproductive health: constructive engagement for the future”) describes the negative influence of the Vatican and some fundamentalist Christian groups on stifling support for ICPD but argues that the world’s religions could be one of the most significant forces for the implementation of ICPD rather than the most significant obstacle. She concludes that “our common commitments to human dignity and poverty alleviation” can forge some of the bonds necessary for moving the agenda forward with representatives of world religions. The concluding essay by Firestone, Reichenbach and Roseman (“Conceptual successes and operational challenges to ICPD: global reproductive health and rights moving forward”) acts like an editorial on the whole volume, highlighting commonalities and differences in the previous essays. It strongly argues in favour of the “enduring value of ICPD’s legacy”, particularly with regard to its core principles and the emphasis on human rights. It suggests three areas, emerging from the essays collectively, for further work by any and all who care about reproductive health and rights: improving measurement and accountability; creating and renewing alliances for strengthened advocacy; and new strategies for mobilizing resources. This is a highly readable volume which should be of interest to anyone – advocate, practitioner, scholar, policy-maker – who is concerned about sexual and reproductive health and human rights. It has an extensive bibliography and an excellent index.

This paper describes the development of a tool that uses human rights concepts and methods to improve relevant laws, regulations and policies related to sexual and reproductive health. This tool aims to improve awareness and understanding of States' human rights obligations. It includes a method for systematically examining the status of vulnerable groups, involving non-health sectors, fostering a genuine process of civil society participation and developing recommendations to address regulatory and policy barriers to sexual and reproductive health with a clear assignment of responsibility. Strong leadership from the ministry of health, with support from the World Health Organization or other international partners, and the serious engagement of all involved in this process can strengthen the links between human rights and sexual and reproductive health, and contribute to national achievement of the highest attainable standard of health.

Introduction The world health rePort2008 draws attention to the significance of policies for achieving primary health care objectives, including both those necessary to make health systems function properly and those beyond the health sector that contribute to health. (1) This emphasis is welcome, in particular the inclusion of policy beyond the remit of the health sector. The report adopts an inclusive to policy--incorporating not only policy but also law, regulation, intervention and even practice. While the term human rights is not used, concern for human rights permeates much of what is presented both in terms of inequalities highlighted and the approaches suggested to address them. Human rights increasingly form part of the language and of many international organizations, governments, nongovernmental organizations and civil society groups concerned with sexual and health. This application is now so widely accepted that human rights have been named as central to achieving the goals and targets of the Millennium Declaration, and also as guiding principles in the World Health Organization's (WHO's) 2004 Health Strategy. (2) Yet it is only recently that there has been recognition of the range of human rights that combine to make up reproductive rights. The international community's first affirmation that the enjoyment of health is based on these rights was made at the International Conference on Population and Development in 1994: Reproductive health ... implies that people are able to have satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.... Bearing in mind the above definition, rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents. These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly on the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and health. It also includes their right to make decisions concerning reproduction free of discrimination, coercion and violence. (3) (Emphasis added) A major achievement of this conference was recognition of the responsibility of governments to translate international commitments into national laws and policies that promote sexual and health. Consequently, as recognized in The world health report2008, policies and laws that act as barriers to the availability, accessibility, acceptability and quality of sexual and health services (whether for the entire population or only for certain population groups), are serious area of concern. (1) Since 1994, human rights have been incorporated in diverse ways into the approaches used to address sexual and health, as well as other health issues including the provision of essential medicines, (4) HIV/AIDS (5) and child health. (6,7) Some organizations such as the Center for Rights carry out fact-finding missions and strategic litigation, focusing on human rights violations such as forced sterilization of Roma women in Slovakia and high rates of maternal mortality due to unsafe abortion in Mexico. (8) Others develop and use what has been termed a rights-based approach to sexual and health programming. Organizations including United Nations agencies such as the United Nations Children's Fund (UNICEF) (9) and the United Nations Population Fund (UNFPA), (10) and nongovernmental organizations such as CARE (11) and Save the Children, (12) have generally focused on three key principles: the participation of affected communities; ensuring discrimination does not occur in programme design or implementation; and the existence of accountability mechanisms. …

Since female genital mutilation (FGM) was first recognized internationally in 1958, it has now become widely accepted and anchored in international law that FGM is a violation of girls' and women's human rights. Declines in the practice, however, are slow overall, and continued work for its elimination requires action and investment at many levels. Where the practice has diminished, community action has been widespread and sustained. Governments, who are ultimately responsible for the eradication of FGM, must take many measures to outlaw the practice and protect girls' and women's rights, through legislation, policy, education, and resource allocation. Among the other key actors, health care professionals have a particularly important role in treating women and in preventing FGM by actively opposing any medicalization of the practice.

BJOG: An International Journal of Obstetrics & GynaecologyVolume 115, Issue 3 p. 301-303 Sexual and reproductive health in conflict areas: the imperative to address violence against women J Cottingham, Corresponding Author J Cottingham a Department of Reproductive Health and Research and b Department of Gender, Women and Health, World Health Organization, Geneva, SwitzerlandDr J Cottingham, Department of Reproductive Health and Research, World Health Organization, 1211 Geneva 27, Switzerland. Email [email protected]Search for more papers by this author a C García-Moreno, C García-Moreno a Department of Reproductive Health and Research and b Department of Gender, Women and Health, World Health Organization, Geneva, SwitzerlandSearch for more papers by this author b C Reis, C Reis a Department of Reproductive Health and Research and b Department of Gender, Women and Health, World Health Organization, Geneva, SwitzerlandSearch for more papers by this author b J Cottingham, Corresponding Author J Cottingham a Department of Reproductive Health and Research and b Department of Gender, Women and Health, World Health Organization, Geneva, SwitzerlandDr J Cottingham, Department of Reproductive Health and Research, World Health Organization, 1211 Geneva 27, Switzerland. Email [email protected]Search for more papers by this author a C García-Moreno, C García-Moreno a Department of Reproductive Health and Research and b Department of Gender, Women and Health, World Health Organization, Geneva, SwitzerlandSearch for more papers by this author b C Reis, C Reis a Department of Reproductive Health and Research and b Department of Gender, Women and Health, World Health Organization, Geneva, SwitzerlandSearch for more papers by this author b First published: 08 January 2008 https://doi.org/10.1111/j.1471-0528.2007.01605.xCitations: 12Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. 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