Population Action International

 Email this page     Print this page

Moving Forward Together from Istanbul to Secure Reproductive Health Supplies

Prevention • Consensus • Clarity of Roles

The Challenge:

There is a crisis in availability of reproductive health supplies, in particular contraceptives and condoms for HIV/AIDS prevention, that threatens human rights and realization of the goals of the 1994 International Conference on Population and Development. Half of all pregnancies are unintended; every minute, 40 women undergo an unsafe abortion, 10 people are infected with HIV/AIDS, and 650 people are infected with a curable sexually transmitted infection (STI). This reality is compounded by the largest ever generation of young people aged 15-24, the rapidly growing demand for family planning and other reproductive health services, and the global AIDS pandemic. Poor reproductive health—and especially HIV/AIDS—is impoverishing individuals, families and communities in those countries least prepared to cope, undermining sexual and reproductive rights, and underscores the need to ensure that the supplies to confront this challenge are available to all who need them.

  • The cost of quality contraceptives and condoms needed is projected to rise from $810 million to $1.8 billion, between 2000 and 2015.
  • The cost of ensuring the quality of services needed to deliver and provide these supplies is projected to increase from $4 billion to $9 billion over the same period.

The Response:

In recognition of this crisis, non-governmental organizations, governments, private foundations, bilateral and multilateral agencies met as equal partners in Istanbul, Turkey, 3-5 May, 2001 to develop concrete and immediate actions to meet the challenge of securing reproductive health supplies. They agreed that:

  • There is an urgent need to build awareness of and generate action on this crisis.

  • Response strategies must be country-specific, designed and led by governments that fully involve civil society, and flexibly supported by donors.
  • Prevention of unintended pregnancies and STIs, especially HIV/AIDS, is a cornerstone of good reproductive health care and must have priority within sector strategies and budgets.
  • Effective implementation demands clearly defined roles, responsibilities and accountability for all partners.
  • UNFPA’s mandate to assist countries in ensuring availability of and access to reproductive health supplies and services is a critical component of this effort.

Arenas for Action:

An effective and successful response to this challenge requires action in four areas:

Advocacy
Advocacy is needed at all levels to build political commitment to the priority of reproductive health supplies and services, and to mobilize the financial and other resources needed to ensure a consistent, adequate, and appropriate supply of reproductive health products.

National capacity building
 At the national level, security in reproductive health supplies requires the capacity to forecast, finance, procure, and deliver good-quality and reliable supplies and services, over the long term, to all men and women who need them. Many countries need technical and financial assistance to achieve this.

Financing
To ensure sustainability of sexual and reproductive health services and supplies will require full and sustained financing and cost-sharing both between donors and developing countries and, within countries, the involvement of the public, non-governmental and private commercial sectors. It is critical to identify the most appropriate role for each financing source, and use each to its best advantage. Not only do resources need to be increased, but they need to be efficiently applied.

Donor coordination
 Donors can best help countries address their needs by flexible and simplified procedures, to maximize the benefit and timeliness of their assistance, at minimal cost. Building on existing mechanisms, countries should take the lead in coordinating donor efforts. Donors should strive for greater consistency and coherence in their policies and practices.

Concrete Actions:

All stakeholders will transmit the outcomes of this meeting to their governments, and advocate for their inclusion in the Declaration of Commitment on HIV/AIDS at the UN General Assembly Special Session, as well as in deliberations of the LDC3, G-8, and use any and all opportunities that arise to promote them. In particular, the role of civil society organizations in spurring and taking action on this issue demands recognition and support. South to South cooperation should also be involved and encouraged.

At the national level

  • Develop national strategies for achieving security in reproductive health supplies no later than 2003, to ensure that the right supplies are at the right place, at the right time, at the right cost, including to identify financing options and market alternatives;
  • Secure and implement agreement from donors to build on existing mechanisms for ensuring their coordination;
  • All partners should promote the appropriate integration of sexual reproductive health services, including family planning, maternal health care, and STI/HIV prevention and care, especially for young people;
  • Governments should work with WHO to include essential reproductive health supplies in their national essential drugs list.

At the global level

  • Donors must ensure that reproductive health supplies are a core component both in existing commitments and in any new commitments of financial resources;
  • The UN system, donor governments and civil society should reinforce their support for AIDS activities in countries in the framework of UNAIDS;
  • All partners should endorse UNFPA’s leadership role in helping to make the implementation of the Global Call to Action a reality;
  • UNFPA should be supported in strengthening its coordination of international assistance;
  • UNFPA/WHO should finalize a short list of essential reproductive health supplies;
  • Donors should improve the efficiency and transparency of procurement systems and procedures;
  • All stakeholders, including the Istanbul meeting network, should work together to organize regional meetings based on the Istanbul model.

Conclusion

The Istanbul meeting is a milestone in a dynamic process of partnerships, solidarity and commitment to action that stakeholders pledge to continue. We know what to do about this crisis of shortfalls in reproductive health supplies, and how to do it. We endorse the outlines of the action plan for advocacy, national capacity building, financing and donor coordination developed at this meeting. Now is the time to act to safeguard our future and that of young people everywhere.

5 May 2001
Istanbul, Turkey

v