Gender equality and right to health are fundamental human rights

“We are not on track to realise the right to health and gender equality. Despite committing to Agenda 2030 with a common vision and work plan, we are not doing well on delivering on the promises of UN Sustainable Development Goals,” said Dr Tlaleng Mofokeng, the United Nations Special Rapporteur on the Right to Health.

In lead up to 2025 World Health Day, Dr Tlaleng was addressing a side event organised at the 69th United Nations Commission on the Status of Women (CSW69) by Global Center for Health Diplomacy and Inclusion (CeHDI), Women’s Global Network for Reproductive Rights (WGNRR) and CNS. This important side event of CSW69 marks the 30th anniversary of the fourth UN World Conference on Women and adoption of the Beijing Declaration and Platform for action in 1995. It also marks 10 years since the 2030 agenda for sustainable development and its sustainable development goals were adopted.

Gender equality and right to health are fundamental human rights

“Violations of human rights are an early warning system. We need to use racial equity and anti-colonial frameworks to advance progress on right to health. Human rights unite all of us and not divide us. We should resist and push back harder on the (wrong) notion that human rights are divisive. Human rights are the actual basis of how we can move forward with something in common as humans. Protecting human right to health requires a constant analysis of power. None of us can imagine a future without a commitment to constantly analyse power, how it moves and shifts through us as individuals, and how it moves and shifts through our own organisations, and other multilateral systems,” said Dr Tlaleng, UN Special Rapporteur on the Right to Health.

“The idea that one can dislocate the right to health from other human rights is impossible. It is also good to remember that when we realise the right to health, we enable many other human rights. Therefore, by realising the human right to health, we can actually get to gender equality too,” said Dr Tlaleng.

Crossroads: Will governments take the right path?

“We are at the crossroads when it comes to gender equality and human right to health. The assault on the right to health is more than any other time. This is a time that we need to unite and make sure that everyone has the right to health regardless of gender, sexuality or where they are born. That is why the Global Center for Health Diplomacy and Inclusion (CeHDI) was established to raise the voice of the global south in global health negotiations,” said Dr Haileyesus Getahun, Chief Executive Officer of HeDPAC, an organization dedicated to strengthening south-to-south partnerships in health development and founder of Global Center for Health Diplomacy and Inclusion (CeHDI). He earlier served as the founding Director of Quadripartite Joint Secretariat on Antimicrobial Resistance (AMR), and the World Health Organization (WHO).

“Most global health negotiations are happening in Geneva and the existing multilateral system did not address the need of the Global South during the COVID-19 pandemic. We are still living with those tragic lessons of the COVID-19 pandemic where the Global South was neglected, was not benefiting from the health benefits that happened during the pandemic. So, that is why if at all there is another pandemic at least for our children and their future, we need to make sure that what happened during COVID-19 will not be repeated. So, that is why we are working to enhance South-South partnerships, to enhance likeminded multilateralism between North and South, by bringing governments to be the ones who are solely responsible for the right to health. Right to sexual and reproductive health is the cornerstone for everyone,” added Dr Haileyesus Getahun.

Return on investing US$ 1 in family planning & maternal health in developing countries is US$ 8.40

“30 years ago, the International Conference on Population and Development (ICPD)’s Programme of Action of 1994 and the Beijing Declaration’s Platform for Action of 1995 were remarkable because they both placed gender equality and women’s empowerment at the heart of development. These conferences established that a woman’s control over her fertility is fundamental to all her rights. The vision that also drives the 2030 Agenda and the call for universal sexual and reproductive health and rights is central to achieving SDG5 on gender equality and SDG3 on health and well-being,” said Dawn Minott, Advisor on Gender and gender-based violence, at United Nations Population Fund (UNFPA).

“Access to sexual and reproductive health empowers women and girls, leading to improved health, economic opportunities and her stronger agency. Globally maternal mortality has fallen by 34% in the past 30 years. Modern contraception use has doubled and as a result this has reduced unintended pregnancy in adolescent girls. There is also more recognition of gender-based violence with 162 countries globally having enacted laws against domestic violence now,” said Dawn Minott of UNFPA.

She added: “I think the most significant step forward has been on SDG indicator 5.6.1 which measures a woman’s ability to make her own decisions about her sexual and reproductive health. Initial analysis suggests that over half (56%) of the married or in union women are now in the driver’s seat – and that – 44% of partnered women still cannot make these essential decisions about their own healthcare, contraceptives, or their sexual decisions. There’s a UN study that says it will take us 300 years to get to gender equality at the pace at which we are progressing.”

“UNFPA estimation shows that return on investing every dollar in family planning and maternal health in developing countries is US$ 8.40. Currently, health financing is inadequate. In 2022 less than 1% of global aid went to stopping gender-based violence. Only 1% of health research focussed on non-oncology female-specific conditions. So, we must prioritize sexual and reproductive health and rights in health budgets, explore innovative financing and direct more resources to women-led and feminist organisations,” said Dawn Minott of UNFPA.

Women in Sub-Saharan Africa are 130 times more likely to die from pregnancy or childbirth than women in Europe or North America

“Maternal deaths have plateaued globally, but more alarming is that maternal mortality is on a rise in some regions. Inequalities in access to sexual and reproductive health services also persist. Gender-based violence remains rampant. We have one in five girls that are married before they are 18 years of age, and a woman dies every two minutes due to pregnancy or childbirth. In this day and age, a woman should not die giving life. When we bring in the race and geography, then we see stark determinants. Women in Sub-Saharan Africa are 130 times more likely to die from pregnancy or childbirth than women in Europe or North America. Even within the Americas, African-descendent women and girls face higher rates of obstetric mistreatment contributing to significantly worse maternal health outcomes. These inequalities sadly extend also to gender-based violence. When we break data down by age, sexuality, race and ethnicity, we see alarming trends,” said Dawn Minott of UNFPA.

Reach those who are furthest behind

A recent UNFPA report highlighted a very concerning trend because the progress that we have seen or that we have made has largely benefited those who are already close to accessing sexual and reproductive health programmes and services. “This means then that the gap in terms of inequality to access is greater if we are reaching those who are already closer to service. This is why we need to move away from a ‘one-size fits all’ approach and really focus on reaching those who are furthest behind,” said Dawn Minott.

“To reach those who are furthest behind we need to know who it is that is left behind and how far behind they are being left. That underpins the importance of data. If we truly want to advance sexual and reproductive health and rights we need to have national data systems that have the ability to inform us better. This also means that we need to make the investment in collecting data which is disaggregated by age, ethnicity, race, disability status, sexual orientation, among other indices,” said Dawn Minott of UNFPA. “We need to recognise that sexual and reproductive justice is fundamentally intertwined with the broader fight for social justice.”

It is also critical for us to integrate sexual and reproductive health, and gender-based violence prevention and response services into all phases of humanitarian responses.

Assault on multilateralism and global health institutions is challenging

“Fundamental human rights are being under threat and particularly the right to health, and sexual and reproductive health, rights and justice (SRHRJ). Assault on multilateralism and global health institutions is one of the core challenges confronting us today. From funding cuts and political interference in technical bodies that are driving health and gender agenda, to attacking frameworks that we have been working on for years. Just this month we had a political declaration (at CSW69) but what is a political declaration without the recognition of sexual and reproductive health, rights and justice? These attacks undermine the very concrete agreements which gave us a human rights approach to population and development. These agreements are not irrelevant, rather they deeply reflect the lived realities of women and the recognition that women have bodily autonomy and the recognition that women and girls and gender diverse peoples have a right to health and a right to sexual and reproductive health,” said Fadekemi Akinfaderin, Chief Global Advocacy Officer, Fòs Feminista.

“Anti-rights and anti-gender movements are trying to roll back the hard-fought gains and wins towards gender equality and human rights. It is alarming to recognise that anti-rights movements are using the similar-sounding frameworks that they seek to dismantle to advance their own (anti-gender and anti-rights) agenda. For example, the (regressive) Geneva Consensus Declaration, which is not an internationally recognised instrument and not legally binding, rather it is just basically a group of friends that came together and said, ‘this is what we think’ (and undermines gender equality and rights),” added Fadekemi Akinfaderin.

Agrees Dr Payal Shah, Director of Legal, Research, and Advocacy at Physicians for Human Rights: “I call for immediate action by global stakeholders to address critical attacks on gender equality and healthcare, including funding freezes and the growing criminalization of healthcare. We also have to demystify the concept of “reproductive violence” in conflict and crisis settings with a focus on devastating, systematic deprivation of reproductive autonomy (for example, in Gaza and Ethiopia).”

“World is not on track to deliver on SDG5 which promises gender equality by 2030 where no one is left behind. Whatever progress has happened towards this goal and the Beijing declaration of 1995 is threatened by the global anti-rights push that we are seeing today. Regressive Geneva Consensus Declaration, the Madrid commitment, and gag rule or Mexico City policy are only a few examples of this violent curtailment of rights and bodily autonomy that we are seeing. It is necessary for us to communicate the urgency that we must act with in order to protect bodily autonomy and ensure that gender inequity ends with us, said Biruk Tewodros, Advocacy Officer, Global Center for Health Diplomacy and Inclusion (CeHDI)