We have come a long way since 1994, when the International Conference on Population and Development (ICPD) Program of Action enshrined sexual and reproductive rights as a cornerstone of global development. In these past 25 years, we have achieved marked progress toward the promise of ICPD, but the fight for these rights is far from over.
At the inaugural conference, PAI played a seminal role. Our representatives served on the U.S. delegation and civil society steering committee, hosted events with Vice President Al Gore and Secretary General Nafis Sadik and directed steps to success at and beyond ICPD. This included former staff and board members like Dr. Fred Sai, who was selected as the Main Committee Chairman, and Dr. Sharon Camp, who wrote the first draft of the landmark Program of Action that acknowledges sexual and reproductive health and rights as critical to comprehensive, sustainable international development.
Since then, we have worked tirelessly with other civil society actors to hold 179 governments accountable for the commitments initiated at ICPD. The 16 chapters of the Program of Action have been a blueprint for civil society interventions around the world, ranging from policy to service delivery. Although legal landscapes and health outcomes have globally improved over the past two and a half decades—abortion has been legalized or liberalized in nearly 50 countries and rates of child marriage and maternal mortality have decreased by approximately 10% and 40%, respectively—these positive global trends have not emerged equitably. For the 4.3 billion people of reproductive age worldwide, progress has lagged for key populations, such as those living in poverty, young people, as well as indigenous and LGBTI communities.
The Nairobi Summit to commemorate ICPD is taking place at a precarious time. It coincides with the rising tide of populism and authoritarianism, a trend that not only endangers human rights—including sexual and reproductive rights—but seeks to further disenfranchise the most vulnerable and marginalized populations by closing space for civil society and silencing advocates. Considering this reality, the Nairobi Summit is an inherently political moment. To maintain the gains since ICPD, progressive governments will need to stand strong against those like the U.S. administration seeking to delegitimize the rights afforded through the Program of Action.
Since taking office, the Trump-Pence administration has been fervent in its opposition to sexual and reproductive rights. Nationally, officials have limited women’s access to health services, undermined LGBTI rights and zealously supported making abortion illegal. Internationally, the administration has put millions of lives in jeopardy through reinstatement and expansion of the Global Gag Rule and now, within the United Nations (U.N.) system, is claiming that international human rights frameworks, including the Program of Action, are illegitimate. This has occurred time and time again—most recently at the U.N. General Assembly and U.N. Security Council—and we should expect nothing different from them in Nairobi.
At this week’s Nairobi Summit, civil society leadership is crucial for ensuring every individual’s right to sexual and reproductive health. But the responsibility of fulfilling these rights and guaranteeing access to quality sexual and reproductive health services does not belong to civil society alone. Governments must reaffirm their commitments to all the sexual and reproductive rights afforded under ICPD, without compromise.
The conveners of the Nairobi Summit have outlined 12 global, voluntary commitments in their Nairobi Statement to “serve as a broad framework and guide for the formulation of specific and ambitious national, organizational and individual commitments.” In line with the ICPD Program of Action, the statement calls for universal availability of quality, affordable contraceptives; access to safe abortion; adolescent-friendly information, education and services; as well as domestic financing of sexual and reproductive health, gender equality and women’s empowerment programs. This language should not be up for discussion. We cannot afford to dilute the Program of Action or absolve governments from their collective responsibility to implement and assure sexual and reproductive rights for all, as guaranteed by their commitment to ICPD.
We urge governments and members of civil society to recommit to advancing the full suite of rights outlined in the ICPD Program of Action. Ultimately, universal access to sexual and reproductive health and rights requires sustained action and cooperation. To propel advancement on the Program of Action, Nairobi Summit commitments must be transparent, aligned with existing national strategies, sufficiently funded and include clear mechanisms for accountability. For women, girls and those who still lack critical services, there is no alternative.