UN Report on Sexual and Reproductive Justice Highlights Global Progress (and Lost Ground)

A new United Nations report examines global progress and retrenchment in the area of sexual and reproductive health. Major setbacks occurred—notably, the overturning of Roe v. Wade, sexual violence in the context of forced migration from the war in Ukraine, and the interruption of reproductive health services during COVID-19—yet substantial progress has been achieved, especially in the

Global South.

Over the past two years, among developing countries tracked by United Nations Population Fund, at least 77 have created plans to implement their national commitments to sexual and reproductive health, integrated commitments into policies and/or developed systems to monitor progress.

“It is heartening to see many nations implementing interventions that embrace a powerful vision of sexual and reproductive justice for all. At the same time, much more work is needed, particularly in the context of continuing humanitarian crises and growing challenges from transnational anti-democratic movements,” says Terry McGovern, professor and chair of the Heilbrunn Department of Population and Family Health and lead author of the report titled “High-Level Commission on the Nairobi Summit on ICPD25 Follow-Up.” A full list of report authors is available in the report.

The 2019 Nairobi Summit, also known as ICPD+25, held in Nairobi, Kenya, brought together governments, United Nations agencies, private sector organizations, women’s groups and youth networks to discuss and agree on initiatives to further advance the implementation of reproductive health and the empowerment of women and gender equality as pillars of sustainable development—goals first outlined at the 1994 International Conference on Population and Development (ICPD) in Cairo. Highlights from the report:

COVID-19

“The COVID-19 pandemic demonstrated the harm done by the failure of many governments to craft a gender-informed response. This undermined sexual and reproductive health and rights through the restriction and interruption of services deemed unessential, unequal access to digital technology, and structural barriers to care faced by diverse women, adolescents, persons with disabilities, low-income individuals, refugees and persons of diverse sexual orientation and gender identity. Financial insecurity, lockdowns, and constrained health, social and legal services allowed gender-based violence to proliferate. Numerous governments hesitated to enact additional protections for victims and survivors.”

Overturning Roe v. Wade

“Abortion is currently banned in 17 states, with additional states expected to enact restrictions. In many states, exceptions do not exist for abortion in cases of rape or incest, violating international law. Black and brown people and individuals below the poverty line – who already face limited access to sexual and reproductive health services like contraception while experiencing inequities across broader social and economic dimensions – are likely to bear the burden of these restrictions as they make up the majority of those who obtain abortions in the United States. The Commission remains concerned about the effects of this decision, as it fears it will only increase the number of unsafe abortions and result in more maternal deaths. It will likely strengthen anti-abortion and conservative movements seeking to restrict progress on sexual and reproductive rights worldwide.”

Ukrainian Refugees

“The invasion of Ukraine by the Russian Federation has forced millions of women and girls to flee their homes. This has subjected them to acts of sexual violence, such as gang rape and coercion, and put them at increased risk of human trafficking for sexual exploitation and transactional sex. The invasion has also created serious challenges and barriers to accessing sexual and reproductive health care. The WHO has documented over 500 confirmed attacks that impacted health-care facilities.”

Systemic Racism

“Globally, systemic racism drastically undercuts sexual and reproductive justice. Racial, ethnic and indigenous disparities in maternal mortality persist in many areas of the world, for instance. In Ecuador, the maternal mortality rate for women of African descent is triple the overall maternal mortality rate. In Colombia, the rate for women of African descent is 1.8 times higher; in Brazil, it is 36 per cent higher. Black women in the United Kingdom are four times more likely to die in pregnancy than White women. Asian women are almost twice as likely to die. Systemic racism is also apparent in the fact that 86 per cent of global maternal deaths occur in sub-Saharan Africa and South Asia.”

Progress in Latin America and Africa

“What has transpired in the United States contrasts with recent progress in Latin America and Africa, which has become an inspiration for the fight for sexual and reproductive justice worldwide. On the heels of successful advocacy by women’s movements in Mexico and Argentina, Colombia legalized abortion in 2022. In November 2021, Benin’s Parliament voted to legalize abortion in most circumstances, a groundbreaking move on the African continent, where 92 percent of women of reproductive age live under restrictions. The Democratic Republic of the Congo, the first country in Francophone Africa to broaden access to abortion care, endorsed guidelines to implement the directives of the African Protocol on the Rights of Women (the Maputo Protocol). In July 2022, Sierra Leone took steps to overturn colonial-era abortion laws following decades of advocacy by the women’s movement and government officials. Parliament will debate a draft bill decriminalizing abortion that has drawn high-level political support; it is expected to pass before the end of 2022.”