UNITED NATIONS POPULATION INFORMATION NETWORK (POPIN)
UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
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94-09-07: Statement of UNICEF, Mr. James P. Grant
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The electronic preparation of this document has been done by the
Population Information Network(POPIN) of the United Nations Population
Division in collaboration with the United Nations Development Programme
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AS WRITTEN
Statement by Mr. James P. Grant
Executive Director of the United Nations Children’s Fund (UNICEF)
at the
International Conference on Population and Development
Cairo – 6 September 1994
Since the conference on population in Mexico City in 1984, it has
become increasingly clear that development must be responsive to a new
paradigm. If it is to be sustainable today, development must not only
produce economic growth, sustainable in the environmental sense. It also
must be sustainable in a human sense — it must break the grip of
poverty on the bottom half or third of society and slow population
growth, while sustaining democracy, human rights, people’s participation
in the development process and peace.
This conference can reap the fruits of two decades of deepening
understanding of population growth and its determinants by embracing the
“total approach” that is reflected in the draft Programme of Action.
This approach recognizes that the only hope we have of obtaining a world
population compatible with sustainable development is by combining
universal access to better health services, resulting in lower child and
maternal death rates; progress toward gender equality; universal access
to effective education (particularly for girls); and the universal
availability of family planning information and services adapted to each
country’s needs and values.
This will hasten solutions to the main problems that vex and
threaten humankind on the threshold of the 2l st century — the problems
of poverty, population, and environmental degradation that feed off of
one another in a downward spiral that brings instability and strife in
its wake.
My message to you today is simply this: these actions are now
within our grasp. They are possible. They are achievable within a decade
or two. They would be politically popular in both developing and
developed countries. They would respond to the needs of women and
children, of families and communities. The synergism of simultaneous
action could produce results beyond the expectations of most by the
years 2000, 2015 and 2050. This is the historic challenge of the last
phase of the 20th century success would lay the foundation for more
balanced development in the 2l st century.
All of these improvements in the human condition would cry out
to be achieved even if there were no such thing as a population
challenge.. But it is population growth that is now transforming
social development goals of this kind from being timeless issues of
primary concern to the poor into a race against time in which all have
a stake. Strategies of development which involve rather than
marginalize the poor, which create productive and remunerative work for
the vast majority, and which meet basic human needs for adequate
nutrition, clean water, safe sanitation, primary health care, primary
education, and family planning, have become not only a moral minimum
for our civilization but a practical minimum for ensuring its survival.
Children are at the heart of Cairo deliberations
It is impossible to talk about population and development without
talking about children. A quarter million of them will come into the
world today — and a quarter million will die this week,
unceremoniously ushered into the next world by poverty and neglect.
Children — their survival, development and protection – are at the
heart of our deliberations here this week, no less than women.
For UNICEF, concerned so directly with children and women, the
importance of this conference is clear. Birth spacing and responsible
parenthood are vital ingredients for child survival and development,
and vital also for improvements in women’s health. Many studies from
all parts of the world show that child mortality is significantly
reduced when there is an interval of two years or more between births.
Moreover, births that are too early or too late in a mother’s life,
certainly before 18 and after about age 35, are also associated with
increased risks and increased rates of child and maternal mortality.
Experience has demonstrated the importance of child survival
strategies in combination with family planning, education of girls and
women, and basic health care for mothers and children. Each of these
interventions can make a contribution toward reducing under five
mortality and slowing population growth. Collectively the interventions
act powerfully and synergistically to accomplish these ends.
The child survival-population link
A principal reason that dramatically improving the survival of
infants and children slows rather than accelerates population growth is
that parents gain the confidence they need to more widely space
childbirth’s and to successfully aim for a smaller completed family
size on average. Of particular importance in both areas is widespread
and effective access to family planning information and services. Such
interventions as female education, and maternal and child health care
also play crucial and synergistic roles.
Up to a quarter of all deaths of women of reproductive age in
developing countries are due to pregnancy-related complications. Through
reproductive health programmes, including Safe Motherhood efforts and,
more recently, the Mother-Baby Package of interventions, we can halve
maternal mortality and reduce neonatal and peri-natal mortality by 30-40
per cent by the year 2000. Where women receive proper health care –
particularly during pregnancy and child birth — fertility rates tend to
decline, births are spaced further apart, and family size becomes a more
conscious choice on the part of women and couples.
Under five mortality and fertility rates are today so closely
linked, and respond so powerfully to such interventions as greatly
broadened access to primary health care and basic education, that
declines in one are unlikely to take place in the absence of declines in
the other. This suggests that, to achieve their own goals, those who work
to stabilize world population early and at relatively lower levels could
virtually adopt as a priority the achievement of the World Summit for
Children goal of reducing under five deaths. Conversely, those who seek
the greater survival of infants and children could well seek as their
own priority the spacing of births and responsible parenthood.
The reality, of course, is that neither group needs to abandon its
own cause. They have only to make common cause, because achievement of
either goal — increased child survival or slowed population growth –
virtually presupposes and requires accomplishment of the other.
Effective child survival strategies work in tandem with effective family
planning services to significantly weaken the links among poverty,
population growth and environmental deterioration.
Last year, Population Council President Margaret Catley Carlson
proposed, in her Paul Hoffman Lecture, that “a ‘child first’ policy
should be explored as a basis for policies and programs among those
concerned with population.” She noted that early population activists
used to stress that ‘every child should be a wanted child’. She
continued:
“I am not sure at the time we understood what this could actually
mean. Armed with the information we have about the possibility of
discrimination among children and the daily evidence on the
streets of many large cities of the abandonment of children, it is
time that child rights, along with adults’ reproductive rights,
enter into thinking about what human rights, when fully explored,
Will mean to population policy. Among other things, we must
increase children’s claim on the emotional and economic resources
of both their parents.”
The great potential of this conference
This meeting holds the promise of being a most historic world
gathering. The several reasons include:
First, the great breakthrough at the core of the Programme of
Action awaiting your endorsement is the recognition that only a holistic
approach to problems of population and development can succeed. If
effectively carried out, this approach can produce results that few
envisage today. For the first time, the world community is coming
together behind a common understanding of the inter-relationships and
synergisms between improved family planning information and services;
efforts to reduce infant, child and maternal mortality; literacy and
basic education; gender equality and empowerment of women throughout the
life cycle, starting with girls — which are the main factors
influencing the choices of individuals and couples regarding family
size.
As noted in the Preamble, implementing the goals and objectives of
the present 20 year Programme of Action would address many of the
fundamental population, health, education and development challenges
facing the entire human community. What is more, it would also result in
world population growth during this period and beyond at levels close to
the United Nations low variant — that is, peaking in the year 2050 at
less than 8 billion and declining thereafter.
Discussing population in the context of sustainable development
also helps us to avoid some of the pitfalls that have made the debate on
population issues so difficult. Most importantly, the emerging Cairo
consensus does not “blame the victim”; that is, the population problem
is not reduced to blaming the poor, especially poor women, for having
too many children. This simplistic and quite frankly, dangerous thesis
gave rise to population control efforts which — however well-
intentioned -were widely interpreted as thinly disguised campaigns
against the poor and to control women’s lives.
The sustainable development perspective says that population is
not merely an issue of numbers, but primarily one of poorly distributed
and wasted resources, of unsustainable production and consumption
patterns. Population is now being viewed both as a common problem of the
wasteful, overconsuming North as well as of the rapidly-growing,
underdeveloped South. What is needed, then, is a partnership of North
and South to chart a path toward population policies rooted in equitable
and sustainable development for all. Instead of coercion, the new
approach to population policy must broaden the rights, opportunities and
choices of women and families.
From this common understanding of the problem, a concerted, global
effort needs to be mounted without delay.
Second, by embracing the concrete goals set forth in the Programme
of Action, this conference can help accelerate momentum in an area where
unprecedented progress is already underway -improvements for children –
which will in turn have a major synergistic impact on slowing population
growth.
At the 1990 world Summit for Children — the first-ever global
summit, the world’s leaders noted the important impact of reductions in
child mortality on fertility levels. In their Plan of Action, they
pointed out that:
“Achievement of the goals for children and women [goals
subsequently endorsed by the Earth Summit and incorporated into
Agenda 21, I would add parenthetically] would also contribute to
lowering population growth, as sustained decline in child death
rates towards the level at which parents become confident that
their first children will survive is, with some time lag, followed
by even greater reduction in child births.”
The child survival effect is especially strong when women and
couples also have access to education and family planning information
and services.
I have recently seen a draft study presented at Harvard’s Center
for Population and Development and soon to be published by the
University of Pennsylvania that attempts to quantify the
interrelationship of child mortality reduction and fertility change,
along with many of the other factors directly and indirectly influencing
them.
This work-in-progress suggests that achievement of the child
mortality reduction goal of the World Summit for Children — a one third
reduction by the year 2000 — would contribute to a world population
that is even lower than the UN’s low projection.
I emphasize this not to single out child mortality reduction as
the principal driving force for slowing population growth — we know
this is not the case — but simply to stress its importance alongside
the other major factors and conditions that converge and inter-act to
enable individuals and couples to choose to have smaller families. No
population in the developing world has experienced a sustained fertility
reduction without first having gone through a major decline in infant
and child mortality.
Progress for the world’s children
We have seen great progress in preventing child deaths over the
past three decades. When I came to the United Nations Children’s Fund in
1980, 15 million children were dying every year of largely preventable
causes; today, with births more than 15 per cent greater, the
figure has been brought down below 13 million. With our vastly greater
capacity to reach all children with the fruits of modern science and
medicine, we now have a good shot at cutting 1990 levels by another 2
million annually by the end of next year if a series of mid-decade goals
already agreed to by the developing countries in the follow-up to the
World Summit for Children are met by December 1995. This will give us
momentum to achieve the year 2000 goals that will cut further millions
from this obscene and unnecessary death toll. National Programmes of
Action to meet these goals have been issued or drafted by some 120
countries to date and now cover about 90 percent of the world’s
children.
A good start has been made, as reflected in achievement of the
1990 goal of immunizing fully 80 per cent of all the world’s children
against the six main killer diseases of childhood. It is also now clear
that a majority of developing countries are already on track to achieve
a majority of the 13 mid-decade goals; with a concerted international
effort over the next 16 months, both of these majorities could be
increased significantly.
Pursuing today’s low-cost opportunities to protect the health,
nutrition, and education of women and children in the developing world
is one of the most immediately available and affordable ways of
weakening the grip of poverty, population growth, and environmental
deterioration, which are among the greatest threats facing humankind on
the threshold of the 21st century.
For these reasons, we are confident that this conference will
unbracket the language contained in Chapter VIII of the Programme of
Action, action point 8.16, which reaffirms the World Summit goals for
infant and child mortality reduction and calls for further progress
beyond the year 2000. Failure to remove the brackets on this section
would set the dangerous precedent of diminishing the commitments made by
the heads of state and governments of 155 countries.
Third, this conference’s recognition of the centrality of women is
absolutely crucial, paving the way toward the World Social summit in
Copenhagen and the Beijing conference on women next year — and,
hopefully, toward major changes in the lives of women everywhere. The
draft Programme of Action in its entirety captures the simple,
incontrovertible truth that there will be no sustainable development, no
stabilization of populations at manageable levels, no lasting solution
to the problems of environment, no true democracy, and no peace, just so
long as half of humanity continues to be subject to gross discrimination
and abuse. We are also particularly gratified that the Programme of
Action recognizes that gender-based discrimination against women can
best be overcome by constructive action throughout the life cycle. Such
action must begin with the girl child, where the foundations will be
laid for equality and empowerment later on in life.
Women have clearly taken the lead in the struggle for an end to
gender discrimination. But speaking as a man and as the father of three
sons, I can say that we males have our work cut out for us; we have a
great deal of learning to do, and a great deal of changing to do, if
gender equality is ever to be achieved.
In your deliberations on the Programme of Action, I urge you to
build on the text of the World Summit for Children Declaration and Plan
of Action, which sets the goal of ensuring “access… to information and
services to prevent pregnancies that are too early, too closely spaced,
too late or too many” — and let me say in this connection that when we
speak of family planning, we are not talking about abortion, which
should not be a method of family planning.
The World Summit Plan of Action also set the goal of empowering
“all women to breastfeed their children exclusively for four to six
months.” It is worth emphasizing that in addition to all its many
extraordinary benefits to children, women and families, breastfeeding
has played and still plays a major supporting role in slowing population
growth, especially in the poorer countries. How many of us are aware
that if there were no breastfeeding tomorrow, births would increase by
an estimated 20 30 per cent? The Institute for Reproductive Health at
Georgetown University estimates that breastfeeding averts between 70 and
90 million births a year. Families, institutions and society at large
must provide women who are mothers with the support and encouragement
they need to breastfeed and thus have healthier children, more space
between births, and greater personal health.
Let me say a word about the importance of youth in the context of
population and development. Investing in the health and development of
young people, particularly adolescents, is one of the most important
actions we can take today. Teens need support, guidance and respect if
they are to safely navigate the difficult transition from childhood to
adulthood and establish healthy behaviours that will stay with them for
the rest of their lives. To do this, we must understand their realities
and listen to their concerns; youth need to be well-informed and
actively involved in all efforts to promote their health and
development.
Unfortunately, for too many girls around the world, with
adolescence comes motherhood, and an overnight leap into adulthood. This
is a cause for concern because young girls are not emotionally or
physically ready for childbearing. Teenage pregnancies both within and
outside marriage diminish young women’s opportunities and increase their
vulnerability to disease, maternal morbidity and mortality and poverty.
As outlined in the Programme of Action, basic education, especially for
girls, is critical to preventing a cycle of early pregnancy and
impoverishment. This, along with access to appropriate information and
services, and the development of “life-skills”, will help young people
make informed decisions to prevent early parenthood and to enhance the
quality of their lives as they grow into the adults of the 2l st
century. And recent studies have shown that delays of just a few years
in marriage and childbearing could significantly contribute to slowing
population growth.
In short, we must see to it that women are empowered to control
their lives and their fertility, through education, jobs and access to
health care, including family planning information and services. We must
place special emphasis on informing, supporting and facilitating the
participation of young people in their quest to live healthy and
productive lives. And we must help men become responsible and
participatory parents.
The 20/20 joint initiative
My fourth and final point refers to the vital question of
resources. The modest funds required to implement the strategies and
meet the goals established in the Programme of Action must be made
available quickly and without conditionalities. There are indications
that, with this conference, greater funding may be forthcoming for
mainly one aspect of the action plan that is before us. As welcome as
any sectoral increases obviously are, it is important to keep in mind
the essential breakthrough taking place at this conference: recognition
that any solution to population and development problems will require a
holistic approach. And holistic funding, too — which ideally, given the
urgency of the inter-related threats facing one and all in the global
village, should involve significant increases in resource availability
for meeting the most critical goals.
Without for a moment renouncing our quest for increases toward
meeting the long established goal of allocating 0.7 per cent of
industrial countries’ GDP to official development assistance (ODA) — a
goal inspired both by justice and prudence — I commend to your
attention the 20/20 initiative being promoted jointly by the United
Nations Development Fund, the United Nations Population Fund, and
UNICEF. It is alluded to on two occasions in the draft Programme of
Action that is before you — both of them in brackets. It is precisely
the kind of holistic approach urgently needed for reallocating current
levels of funding in order to jump-start implementation of the Programme
of Action.
Simply put, what is involves is ensuring that national governments
devote at least 20 per cent of their domestic budgets to providing basic
social services — primary health care including family planning, basic
education, nutrition, and low cost water and sanitation for rural and
peri-urban areas — and that donor countries see to it that at least a
similar proportion of their ODA goes to support these strategic areas
for sustainable human development. On average, current funding is much
less a share of national budgets and of ODA.
From UNICEF’s vantage-point of efforts for children in over 120
developing countries, we see significant progress in the 20/20 direction
mostly on the developing country side. The donor community — which has
done so much to alert the world to the severity of the interlocking
problems that confront us — must do its part if these inescapable
problems are to be tackled in time.
If this conference is followed by serious action to increase and
wisely reallocate resources for population and development in the
holistic manner I described, we will truly be tapping the potential of
the post-Cold War era for international cooperation.
A crisis point in history/an opportunity for concerted action
Before closing, permit me to quote from the Joint Statement on
World Population issued last year by 56 of the world’s Scientific
Academies:
“History is approaching a crisis point with respect to the
interlocking issues of population, environment, and development.
Scientists today have the opportunity and responsibility to mount
a concerted effort to confront our human predicament. But science
and technology can only provide tools and blueprints for action
and social change. It is the governments and international
decision-makers, including those meeting in Cairo … who hold the
key to our future. We urge them to take incisive action now and to
adopt an integrated policy on population and sustainable
development on a global scale. With each year’s delay the problems
become more acute. Let 1994 be remembered as the year when the
people of the world decided to Act together for the benefit of
future generations.”
And I would like to emphasize the “act together”. We must not
allow well-publicized disagreements to obscure or undermine the
unprecedented consensus that has consolidated around the bulk of the
Programme of Action. The extraordinary breadth of agreement that now
exists on most of the fundamentals of population and development is what
must be preserved and enhanced here this week — and especially in the
weeks, months and years of concerted global action ahead.
Our children and grandchildren — and unborn generations to come -
- are depending on us here in Cairo to make the wise decisions that will
determine their future. The choice is in our hands.