Sexual and reproductive health and climate change

Sexual and reproductive health and climate change

The Lancet, Volume 374, Issue 9694, Page 949, 19 September 2009

Earlier this year a Lancet Commission stated that “climate change is the biggest global health threat of the 21st century”. Countries in the developing world least responsible for the growing emissions are likely to experience the heaviest impact of climate change, with women bearing the greatest toll. In tandem with other factors, rapid population growth in these regions increases the scale of vulnerability to the consequences of climate change, for example, food and water scarcity, environmental degradation, and human displacement.

Over 200 million women want, but currently lack, access to modern contraceptives. As a result, 76 million unintended pregnancies occur every year. Meeting this unmet need could slow high rates of population growth, thereby reducing demographic pressure on the environment. There is now an emerging debate and interest about the links between population dynamics, sexual and reproductive health and rights, and climate change.

In Berlin recently, non-governmental organisations (NGOs) from more than 130 countries reviewed progress on commitments made in 1994 at the landmark International Conference on Population and Development (ICPD) Programme of Action consensus in Cairo, which defined the needs of individuals for universal education and sexual reproductive health care and rights as the best road to sustainable development.

Although there have been some successes, overall, progress has been inadequate. A deplorable lack of financial investment and political will has dominated the inertia in the past 15 years. Many of the NGOs still seem to be working in silos, avoiding the multisectoral engagement required to change societal attitudes. Whether ICPD is really relevant today, now the Millennium Development Goals are the focus of the world's attention, and what happens after 2015 is unclear. It is disappointing to see that there are still tensions between the population and some of the sexual and reproductive health and rights community.

However, the discussions on how the sexual and reproductive health community are grappling with the emergent environmental crises that now shadow the landscape of women's health drew much attention at the Berlin meeting.

A study of the first 40 National Adaptation Programmes of Action (NAPAs) submitted by least developed countries to the UN Framework Convention on Climate Change showed that 37 such countries made the link between population growth and climate change. But only six of them identified family planning as part of their adaptation strategy—likely because of the fact that family planning falls under the remit of the Ministries of Health rather than Environment, who are responsible for the NAPA documents.
Additionally, only 7% of the 448 projects across the 40 NAPAs were in the health sector.

Clearly, a health response is missing from adaptation efforts and could make a much needed contribution. Furthermore, a case study from Ethiopia that trained people in sustainable land management practices, while increasing availability of family planning, saw an immediate improvement to the environment with better agricultural practices, which in the long term will be sustained and not eroded by a rapidly increasing population. Additionally, an economic case is made in a new UK report, Fewer Emitters, Lower Emissions, Less Cost, which found that family planning is five times cheaper than conventional green technologies to combat climate change. The report models the consequences of meeting the global unmet need for family planning and found that each US$7 spent on basic family planning over the next four decades would reduce global carbon dioxide emissions by more than 1 tonne.

The sexual and reproductive health and rights NGOs are a powerful constituency whose rights-based agenda in the framework of justice, equality, and equity is a key strength. The concerns and vision of Cairo are as relevant today as they were back in 1994, but perhaps it is time for the sexual and reproductive health community to use the climate change agenda to gain the traction women's health deserves. Undoubtedly, more research specifically looking at the links between reproductive health and climate change require greater investment and clarification of the issues to allow an informed dialogue with the environmental groups.

With less than 3 months to go, the UN Copenhagen conference on climate change provides an opportunity to draw attention to the centrality of women. The sexual and reproductive health and rights community should challenge the global architecture of climate change, and its technology focus, and shift the discussion to a more human-based, rights-based adaptation approach. Such a strategy would better serve the range of issues pivitol to improving the health of women worldwide.

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