Sexual and Reproductive Health for All: twenty Years of The Global Strategy

Thirty years back, the International Conference on Population and Development (ICPD), kept in Cairo, Egypt, underscored the right of all individuals to attain the highest standard of sexual and reproductive health and rights (SRHR). In 2004, WHO released a reproductive health strategy – validated by 191 Member States at the Fifty-seventh World Health Assembly – that reinforced the centrality of SRHR to societies and economies (Resolution WHA57.12). These frameworks are grounded in gender equality and acknowledge the changeless importance of sexual health in achieving health for all.

WHO scientists worked with Member States, civil society and neighborhoods across all regions to operationalize an International Strategy to cover the 5 essential pillars for enhancing SRHR:

– enhancing antenatal, perinatal, postpartum and newborn care

– supplying household preparation services

– removing risky abortion

– combatting sexually transmitted infections (STIs).

– promoting sexual health.

Resolution WHA57.12 further notified SRHR policies and guiding files in a number of regions and Member States. For example, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Plan of Action from 2016 (structure upon the initial 2006 plan) both include language and ideas strengthening and maintaining SRHR.

 » The worldwide strategy is the fundamental policy document that centres WHO’s mandate for sexual and reproductive health to date, » said Dr Pascale Allotey, Director of the UN Special Programme on Human Reproduction (HRP) and WHO’s Department of Sexual and Reproductive Health. « The text stays essential in contributing to directing research study priorities and working with countries to develop helpful resources to ensure thorough SRHR throughout the life course. »

Significant development has been made over the last 20 years within each of the five pillars, including these examples.

– The Global strategy came about as the world was reeling from the HIV and AIDS epidemic. Today, the variety of people acquiring HIV has actually fallen by 38% since 2010 alone, due in part to the Strategy’s emphasis on eliminating STIs including HIV.

– As of March 2022, 60% of WHO Member States have actually included the human papillomavirus vaccine (HPV) in their regular immunization schedules, considerably advancing efforts to remove cervical cancer as a public health risk.

– Prioritizing services and birth control gain access to led to WHO’s Family preparation: an international handbook for suppliers reference guide, which has actually been disseminated over a million times. Accordingly, the proportion of ladies utilizing modern-day contraceptive approaches increased from 467 million in 1990 to 874 million in 2022, while a wider variety of contraceptive choices is now offered.

A 2020 research study found that there has actually been a worldwide reduction in unexpected pregnancy. Furthermore, evidence-based medical abortion routines have actually improved international access to abortion, and over 60 countries have liberalized abortion laws in the past thirty years in line with proof on the importance of such efforts to guarantee the health of ladies and adolescent women.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for assisting create crucial scientific evidence on SRHR that has actually added to some of these shifts. « A few of the terrific advances that we have actually seen – consisting of the way civil society has actually taken up the cause to argue for access to safe and legal abortion – are because of the Strategy and the systematic generation of proof over these past 20 years, » she said.

Despite early gains, nevertheless, current years have seen signs of stagnancy. From 2000 to 2020, the maternal mortality rate stopped by 34% worldwide – but a 2023 report found that progress has actually largely stalled since. The uneasy trend was highlighted during a recent event showcasing worldwide datasets on the evolution of SRHR considering that ICPD. High maternal mortality rates continue a few countries and sexual health concerns, such as endometriosis, infertility and sexual erectile dysfunction, are typically ignored or normalized.

Dr Allotey and Dr Manjulaa Narasimhan, researcher at WHO and HRP, noted in a recent commentary in the WHO Bulletin that the SRHR program stays incomplete and in some circumstances has fallen back due to geopolitical stress, economic declines, the international food crisis, environment change, humanitarian crises and COVID-19.

There are emerging opportunities to catalyse development – for instance, by improving human rights-based approaches in SRHR and embedding concepts like non-discrimination, including in crisis situations. Improving health systems with a main health-care technique can enhance equity and broaden access to comprehensive SRHR services. New technologies and alternative service shipment approaches can enhance SRHR by broadening gain access to, option and autonomy.

Other future-looking focus areas within SRHR consist of research study on the transformative role of synthetic intelligence and innovative contraception techniques, further work on strengthening health systems, and the enduring prioritization of favorable pregnancy and childbirth experiences.

At a broader level, Dr Allotey called for an ongoing emphasis on the fundamental value of SRHR. « Sexual and reproductive health ought to never be relegated to the margins of healthcare, however acknowledged as important for the overall well-being of people and the neighborhoods in which they live, » she said.