Statement by Dr. Babatunde Osotimehin
Executive Director and Under Secretary General, United Nations
Population Fund (UNFPA)
Sexual Health and Rights in Africa: Where are we?
Delivered by: Mr Bunmi Makinwa, Director, Africa Regional Office.
The 5th Africa Conference on Sexual Health and Rights on:
Sexual Health and Rights in Africa: Where are we?
Safari Hotel, Windhoek, Namibia
19 September 2012
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HE President Hifikepunye Pohamba of the Republic of Namibia,
Her Excellency, Madam Penehupifo Pohamba, First Lady of the
Republic of Namibia,
First Lady of the Republic of Zambia Dr Christine Kaseba-Sata
Honourable Minister of Health and Social Services, Dr. Richard Kamwi
Members of the Diplomatic Corps; Ministers; members of Parliament
IPPF RD, Lucien Kouakou
Members of parliament
Distinguished Colleagues from Development Agencies, Foundations
Civil Society Organisations and UN
Representatives of Youth Organisations,
Ladies and Gentlemen
Media Representatives
All protocol observed.
I want to sincerely thank HE President Hifikepunye Pohamba and
people of the Republic of Namibia for hosting the 5th Africa Conference
on Sexual Health and Rights under the theme “Sexual Health and Rights
in Africa: Where are we?” I also want to thank the Namibia Planned
Parenthood Association (NAPPA) for leading the local organisation of
the Conference, and for ensuring good representation from different
groups, especially young people.
Mr. President, before I go further, I would like to restate the apologies of
my Executive Director who at the last minute had to abort the trip to join
you. I am privileged to be here with you. There is no better time than
now to have this conference under the theme Sexual Health and Rights
in Africa: Where are we? We wish for better sexual and reproductive
health in Africa. Alongside progress in the economy, in governance and
improved indicators in social development, Africa is making good
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progress in sexual and reproductive health, including access to
information and services for young people. There is growing recognition
that universal access to sexual and reproductive health and rights is a
human right in the continent.
In 2010 young people aged 15-24 years accounted for 20.2% of the total
African population, a total of 209 million. In 2010, there was an
estimated 125.08 million young people between the ages of 10 to 24
years in Eastern and Southern Africa (ESA), making up 32.76% of the
population. The large numbers of young people entering the
reproductive ages in the region, ushering them into healthy and
productive adults who contribute to national development is a stated
priority for most countries. For UNFPA, ensuring that young people are
empowered, and are able to live a purposeful life is key. They should
have correct information on sexual and reproductive health. They should
be protected from unwanted pregnancies, unsafe abortions, sexually
transmitted infections, including HIV infection. This is essential to
ensure that young people fulfil their potential and contribute to the
development of Africa.
In the last decade, many sexual and reproductive health (SRH) and HIV
prevention programmes have been implemented for in- and out ofschool youth using various strategies. This investment has borne fruits
as a recent analysis by UNAIDS indicates that 15 out of 21 high
HIV burden countries achieved a more than 25% reduction in HIV
prevalence among young people 15 to 24 years. Thirteen of these
countries are in Sub-Saharan Africa; twelve are in the epicenter of
the HIV epidemic, in East and Southern Africa (ESA). The same
analysis discovered a strong correlation between the trend in reduction
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of HIV prevalence and behaviour changes among young people, such as
delayed sexual debut, fewer sexual partners, and increased condom use.
There has been a slight decrease in Adolescent fertility rate from 13.46%
of 1000 births to 10.76% in 2010. Evidence has shown that with rising
education, childbearing at adolescent age decreases. The contraceptive
prevalence rate and the condom use at last high risk sex in ESA is
slightly higher than the average in Sub-Saharan Africa.
Great benefits will flow from universal access to sexual and
reproductive health, including family planning. But first and foremost, it
is everyone’s right. That alone is sufficient reason for all our efforts. If
there is good investment in young people and they have access to sexual
and reproductive health to protect themselves, Africa can benefit from
the demographic dividend of its youthful population.
What do we mean when we talk about the “demographic dividend”?
Many African countries have young populations – on average, children
below the age of 15 years account for about 44 per cent of their
populations. This is the result of high total fertility rates, or number of
births per woman, along with improved child survival in many of our
countries. Fertility is falling slowly, and today’s young people will
probably have fewer children than their parents did. So Africa is
experiencing a “youth bulge” which in the coming years will mean a
large increase in the working-age population – both in numbers and as a
proportion of the total population. They will have fewer elderly people
and children to support than their parents did. The quality of their lives
can be better.
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For individuals, for their families, and for African countries, the youth
bulge represents an enormous one-time dividend from lower fertility and
smaller family size. As the women and men of the youth bulge grow into
maturity, go to work and increase the family income, a window of
opportunity opens for them and their countries. They can improve the
quality of health care and other social services; invest in education and
skills development. They can increase economic output and stimulate
economic growth. But as the people who made up the youth bulge
themselves begin to grow old and leave the workforce, the numbers of
elderly will increase, and the window will close again. Economists call
this one-time window of opportunity to create wealth and economic
growth “the demographic dividend”. It is absolutely important that
young people have universal and unhindered access to sexual and
reproductive information and services for Africa to enjoy the
demographic dividend.
We have a good example of this in East Asia’s economic miracle. As
early as the 1950s, countries in East Asia developed strong public health
systems that ensured child survival, promoted women’s health, including
smaller families, and made contraception acceptable and easy to obtain.
By mid 1990s, total fertility which used to be about six children per
woman had dropped to two, opening the way for increased official
investment in quality health and education, industrial development and
job creation. These investments and sound economic management made
it possible to absorb the large generation of young adults into the
productive workforce. The GDP in these countries grew on average
about 6% per year between 1965 and 1990. Researchers have estimated
that the demographic dividend accounted for 25 to 40 per cent of this
growth.
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Demographers’ project that many African countries will experience
marked growth in the working-age share of their populations between
2005 and 2025.
I want to acknowledge the efforts of the African Union and its Member
States for their support to women’s health and youth development in the
continent – the well-articulated Maputo Plan of Action (on Sexual and
Reproductive health and rights) and the Africa Youth Charter (on youth
development and their rights). These policies and many others take into
account what needs to be done for Africa to reap the demographic
dividend. The commitment of Member States is well demonstrated by
the 37 African countries that have launched and are implementing
follow-up interventions to the Campaign on Accelerated Reduction of
Maternal Mortality in Africa (CARMMA); the 37 countries that have
given commitments to the UN Secretary-general’s Global Strategy for
Women’s and Children’s Health; the 32 countries that have ratified the
African Youth Charter; and the many others that have signed and are
implementing the Charter.
Mr President, First Ladies, Distinguished Guests, Colleagues
There remains one more essential action. That is for African countries to
increase their own investments in these priorities, to make sure we invest
wisely, and to keep track of our investments. We also need to maximize
returns by focusing on low-cost, high-impact interventions. In the area
of sexual health and rights, these include provision of comprehensive
sexuality education in schools and out of schools to young people,
prevention of unwanted teenage pregnancy and unsafe abortions and
access to family planning. And Research shows that for every dollar
invested in family planning, there is a clear quantifiable return. Family
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planning saves lives – by meeting the current need for family planning
in Africa we could expect a 30% drop in maternal mortality, and a
parallel drop in sickness and injury as a result of pregnancy. African
countries have already reduced maternal deaths by 41% between 1990 to
2010 – but the number of women dying from pregnancy-related causes
is still 165,000 a year, with all its associated costs in terms of emergency
treatment, long-term disability, and family disruption. Ensuring
universal access to sexual health and rights for everyone, including
young people and marginalised people, will improve the health of
everyone and save health care systems much unnecessary expenditure. It
will improve human capital development in Africa.
In the developing world as a whole, the number of women with an
unmet need for family planning for declined slightly between 2008 and
2012, from 226 million to 222 million. However, in the 69 poorest
countries, many of which are in Africa, the number has actually
increased, from 153 to 162 million women. The need is increasing
faster than we can meet it.
Lack of information about family planning and lack of modern, ageappropriate services is a major contributor to unplanned, unwanted
pregnancy. Unplanned pregnancy is a major contributor to abortion.
Abortion is a major source of maternal morbidity and mortality. Also it
is a one way direction to lives spent in the trap of poverty. Many young
women in Africa are married as teenagers. But pregnancy is a threat to
young girls’ lives and health whether they are married or not. A girl who
gives birth before she is 18 is twice as likely to suffer death or disability
as her sister who postpones her pregnancy. Too-early pregnancy is a
major cause of fistula, a dreadful birth injury. Young girls, married or
not, need to know how to protect themselves against pregnancy that
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could kill them or cripple them for life. Can we not do something now?
Family Planning is a way out. Seize it.
In UNFPA, at the request and in the interests of our partner countries,
we promote sexuality education for all young people, male and female
alike – because young men also need to know how to act responsibly,
and why. Unwanted pregnancy is only one risk: safe and responsible
sexual behaviour, including contraception, also protects against sexually
transmitted infections, including HIV. Our joint aim is to enable our
sons and daughters, the people we love, to protect the people they love.
UNFPA is helping countries to meet the need. We are the biggest
international supplier of contraceptives to developing countries but we
assist with all aspects of family planning. We are engaged in an
international effort to ensure a consistent, adequate supply of modern
contraceptives when they are needed, where they are needed and to
whom they are needed. Women and men have different needs, and needs
change at different stages of life. It is important, both for human rights
and contraceptive effectiveness, to ensure that everyone gets the
information and services they need. Our assistance includes helping to
set up and maintain sustainable logistics management; training for health
workers at all levels; education and information for sexual and
reproductive health; and advocacy for family planning in a context of
full knowledge and voluntary acceptance. Many of you already know
UNFPA very well – but let me say to all stakeholders present at this
Conference that we stand ready to help all countries in their provision of
sexuality education and comprehensive sexual and reproductive health,
on their own terms and according to their own priorities.
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Mr. President
That is what we can do at UNFPA. Let me finish with a request to you,
the stakeholders. I call on development partners in Africa to examine
the returns available for investing in sexual and reproductive health,
including family planning, for economic growth in Africa, social
cohesion and human rights. You can play an important role to make
Africa realise its demographic dividends. On this basis, I ask all of us to
work more collaboratively. Let us avoid waste and duplication – and let
us make the most effective use of available resources to reach the
maximum number of people with the best possible services.
I appeal to NGOs to work closely with other stakeholders in identifying
and meeting sexual health and right needs. If I may say so, you can go
where governments fear to tread, or at least do not reach – among young
people and communities of the poor and marginalized groups.
With the massive presence of young, dynamic colleagues here, we look
forward to a powerful, significant outcome from the 5th Africa
Conference on Sexual Health and Rights.
I thank you all for your kind attention.
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