Global Institutions
In 1994, the
International Conference on Population and Development
(ICPD) was a watershed
event that altered how the world considers
population growth and sexual and
reproductive health and rights (SRHR).
Since then, many nations have based their
family planning programs on
individual rights and voluntarism, leading not only
to slowing rates of
unintended pregnancy, but also subsequent lower rates of
maternal and
infant illness and death.
The ICPD also
ushered in a new era of empowerment—of women and of civil society in general,
culminating in a proliferation of non-governmental organizations and networks
now better able to hold their governments accountable for improving their access
to sexual and reproductive health services. Many countries have used the
Programme of Action—the resulting document that came out of the ICPD—as an
outline for new domestic policy frameworks. One of the long-term successes of
the ICPD may be the higher level of sophistication of NGOs concerned with SRHR;
this is a double-edged sword, as NGOs seeking to curtail sexual and reproductive
rights have also become more savvy.
The United Nations Population Fund (UNFPA) continues its work in over 140 countries—more than any bilateral donor and less swayed in its presence by geopolitics than individual donor governments. This objectivity sometimes comes with a price—because the Bush administration objects to UNFPA’s presence in China, the United States. has withheld its contributions to the agency. Along with the U.S. Agency for International Development (USAID) and other agencies, UNFPA is one of the leading providers of modern contraceptives globally. PAI is among the groups tackling the complex issue of ensuring adequate reproductive health supplies, as demand outstrips supply in some cases, while other countries face stockouts due to logistical snafus or as an unintended consequence of policies.
With the heightened profile of the HIV/AIDS pandemic, global institutions that are charged with addressing the disease—by definition all those with sexual and reproductive health in their portfolio—have had to learn to negotiate funding and policies, as well as navigating working together, with donor and recipient government agencies and on the ground in affected countries. The Global Fund to Fight AIDS, Tuberculosis and Malaria is one of the most significant of these.
Adopted by world leaders in 2000, the Millennium Development Goals (MDGs) was hailed as a groundbreaking focal point for governments around the world to agree on steps to combating poverty. Universal access to reproductive health care was added as a target in 2006, under Millennium Development Goal 5, the reduction of maternal mortality by three quarters. The glaring omission of reproductive health in the MDGs in the first place was a travesty—raising the standard of sexual and reproductive health is key to lowering rates of maternal and infant mortality, which is a key indicator of poverty.
In recent years, new funding approaches and mechanisms have been put into place, including Poverty Reduction Strategies, Country Strategy Papers, and Sector-wide Approaches (SWAps). Each of these entails new players, targets, structures and competition for already limited funds.
PAI works closely with organizational partners in both developed and developing countries that seek to strengthen the political and financial support their governments give to family planning and other reproductive health programs. Through small grants, PAI supports innovative projects and advocacy trainings in order to leverage greater influence on bilateral and multilateral institutions charged with sexual and reproductive health programs and policies.
