Five years have passed since the achievement of a global consensus on population and reproductive health issues at the International Conference on Population and Development (ICPD) in Cairo, Egypt. AVSC was an active participant at ICPD itself and today continues to be at the center of efforts to make the promises agreed to in Cairo a reality.

At ICPD in 1994, 179 governments reached unprecedented agreements to implement policies and programs that place population-growth issues in the context of women's health, rights, and empowerment. Its objectives, stated in a 20-year Programme of Action (POA), include calls for global access to and improved quality of reproductive health services. The POA also seeks to reduce infant, child, and maternal mortality rates and to educate and empower women and adolescents.

AVSC President Dr. Amy E. Pollack (fourth from left), with other members of the U.S. delegation to the Preparatory Committee. Joining them is Rachael N. Pine (first from left), AVSC's public affairs director.

This year, governments and nongovernmental organizations (NGOs) embarked on an effort to review the progress made so far in implementing the POA and to determine what resources and actions are required to achieve all objectives by 2015. This process, called "Cairo+5," has provided an opportunity to regroup, reflect on, and reinvigorate the commitments made in 1994.

The Cairo+5 Process

The process consists of three international meetings: the Hague Forum, which was sponsored by the United Nations Population Fund (UNFPA); the United Nations Commission on Population and Development Acting as Preparatory Committee (Prep Com); and the U.N. General Assembly Special Session (UNGASS). The last of these meetings will occur after this article goes to press.

Sharing Experiences

The main objective of the Hague Forum, held from February 6 to 12 in the Netherlands, was to produce a draft report evaluating progress in key areas of the POA and identifying steps necessary to achieve the POA's goals.

Approximately 2,000 participants gathered to examine policies and share experiences. They included government officials, parliamentarians, and representatives of the U.N., NGOs, youth groups, and the media.

Notably, U.S. First Lady Hillary Rodham Clinton attended and gave a strongly worded keynote speech supporting reproductive rights for women and the responsibilities of governments to respect and support those rights.

"...Government can and must play a critical role in helping women and families lead full and productive lives, and that includes making available voluntary family planning," she said.

Seeking Consensus

In an effort to reach consensus on the language of the report drafted in the Hague, country delegates and NGOs convened at the U.N. from March 24 to April 1 for Prep Com.

To finalize the report, delegates proposed additions, deletions, and changes and attempted to negotiate differences and reach consensus. However, the beginning of negotiations was significantly delayed by the G-77, a large group of developing country delegations. Though attempting to operate with a single voice in negotiations, these countries were unable to reach agreement within their own ranks on many of the issues addressed in the report.

Even at the end of Prep Com, contentious debate among G-77 members and between other delegations persisted in several areas. These included government investment in sexual and reproductive health programs for youth, sex education in the schools, allocation of resources to promote underutilized contraceptive methods such as emergency contraception and the female condom, and punitive abortion laws.

Time ran out before debate could even take place on the preamble to the report and the sections on funding and resources, partnerships between governments and civil society, and health programs for adolescents. Two informal sessions were scheduled for May and June in order to resolve conflicts on all remaining sections before the UNGASS meeting.

AVSC's President Plays Important Role

AVSC has been actively involved in the review process. Dr. Amy Pollack, AVSC's president, attended the Hague Forum and was then chosen as one of a select group of NGO representatives to be part of the U.S. delegation for Prep Com.

"These meetings are about the politics of global change," noted Pollack. "Ultimately, the outcome of this process will empower workers on the ground to help transform the face of family planning service delivery."

As an agency committed to increasing access to desperately needed family planning and other reproductive health services, AVSC's work is all about implementing the ICPD objectives. Working hands-on with health care providers in over 40 countries, AVSC is a link in the chain connecting the grand goals of ICPD with the realities of service delivery.

AVSC has also contributed research findings, helped mobilize NGO participation in Cairo+5, and worked on media and public-education outreach efforts. The agency recently published "Putting Cairo into Practice," a pamphlet that highlights AVSC's global programs and examines lessons learned from our work on the ground.

Lindsay Beller, a public affairs assistant at AVSC, attended the Prep Com meeting at the U.N.