Reproductive Health Matters submitted the following contribution to the online consultation for “The World We Want 2015”. It’s in the “Health in the Post-2015 Development Agenda” consultation under the “Lead Theme” on AIDS, health and development.
1.Successful AIDS responses have involved comprehensive prevention, treatment, care and support, taking account of social determinants of health. HIV is an STI, with implications for many other sexual and reproductive health (SRH) problems, and HIV prevention and treatment must be closely linked to comprehensive SRH care. In general, health cannot be ensured without ensuring sexual and reproductive health and rights (SRHR).
2.The MDGs have shown that sensitive issues have not gone away by being marginalised. Opposition to SRHR has grown, and it is more crucial than ever to endorse all SRHR, including sexual rights (Beijing, 1995 Para. 96) and women’s right to safe abortion. Moreover, all health-related goals, including those addressing population dynamics, must respect, protect and fulfil human rights (Rio+20, Paras. 145/146).
3.Lessons learned from the MDG framework need more time to evolve into recommendations. MDG indicators and targets and imbalances in funding heavily influenced which issues were prioritised. Public health imperatives were sometimes ignored and successes distorted. Equity and health disparities were not addressed. These mistakes must not be repeated. Measurement requires a public health and human rights approach, which needs new thinking.
4.We are in broad agreement with the WHO discussion paper’s analysis on positioning health in the post-2015 agenda, and particularly that: “…promoting a long list of competing health goals will be counterproductive. The alternative is to build the case that health… is influenced by as well as contributing to policies across a wide range of sectors. The challenge then becomes one of deciding how “health” in this broad sense can be characterized…”.
5.We disagree that “universal health coverage”, as defined and outlined in WHO’s paper, is acceptable as the basis of a health goal for the future. Health services alone are not enough, and the financing issues are fraught with difficulty and must be confronted. We have shown in SRHR that the right to health, equity, access, reduction of disparities, and the external determinants are all undermined by private ownership of services, private financing and private control (RHM journal 2009-2012). It is crucial to address where financing should come from, who has responsibility for health systems, and public vs private ownership, control and provision of health care. We support strengthening of public health systems above all else.
The theme for RHM 41 is creating new development paradigms to achieve sexual and reproductive health and rights: critical analysis and reflection. The call for papers is here.