Investing in Sexual and Reproductive Health and Rights for the MDGs in Asia and the Pacific
Priorities leading up to 2015 and beyond
As 2010 marks the year of the adoption of the UN Millennium Development Goals (MDGs), representatives from NGOs, governments, donor and multilateral agencies active in Asia and the Pacific identified ways to scale up investments in sexual and reproductive health and rights (SRHR) in the region to reach the MDGs and to move beyond. Below find the Summary and Highlights of the 10th Conference of the Asia Pacific Alliance (APA) held on 5 and 6 October in Penang, Malaysia.
Speeches, presentations of speakers and outcome recommendations can be found on the APA website.
Report Summary and highlights
Day 1
Setting the Stage – “We need to strengthen the collective input of our initiatives in Asia and the Pacific to ensure that actions for progress towards MDG and ICPD are taken”. With these words, Rose Koenders and Sumi Ishii of APA welcomed the participants and invited the speakers to set the stage for the conference.
Nobuko Horibe of UNFPA Asia and the Pacific Regional Office highlighted that investment in maternal and sexual and reproductive health is cost effective and contributes to all other MDG goals. She informed participants on the outcomes of the MDG Summit: the ‘Global Strategy for Women and Children’s Health’ and the resolution ‘Keeping the promise: unite to achieve the MDGs’ containing an unprecedented number of references to ICPD issues. She emphasized that the world knows sufficiently why our issues are important. “In the next five years we have to concentrate on the how part and improve how we implement what we know. We must do better. We need to improve convergence of many initiatives and programs”.
The crucial role of gender issues in effectively achieving all MDGs was stressed by Shoko Ishikawa of UNIFEM (part of UN-Women). She highlighted that the Millennium Declaration narrowly interprets gender equality and progress has remained slow. Gender discrimination continues to keep girls out of school, a lack of women’s representation in politics still exists and MDG 5 on maternal mortality is one of the most off‐track of all the goals, with one in seven maternal deaths caused by unsafe abortion.
Sai Jyothimai Racherla of Asian Pacific Resource Centre for Women presented the unmet needs in several countries in the region, including high rates of maternal mortality and adolescents’ fertility, lack of political participation of women, barriers for safe and legal abortion, lack of law enforcement on legal age of marriage, and cervical cancer. It was highlighted that a rights based, gender sensitive centered framework is needed to effectively address the challenges the region is facing.
Advocacy - Inspiring speakers showcased best practice advocacy interventions. Fitri Putjuk of John Hopkins Center in Indonesia presented lessons learned from the Advanced Family Planning (AFP) on how to raise priority in family planning, in specific on expanding 
access to high quality, long-term methods and provision to the unmarried. Katherine Mc Donald of Action Canada for Population and Development presented how Canada’s foreign policy shift has put women’s lives at risk and shared the dynamic processes of advocacy leading up to the G8. Media and public opinion and parliamentarian hearings were successful advocacy interventions as well as the WHO Technical Opinion on Unsafe Abortion in realizing maternal health. Sean Mackesy- Buckley of Family Planning International New Zealand presented the ‘Measure of the Future, a risk index for Pacific Women’s Sexual and Reproductive Health’. Challenges included poor regional health systems, high rates of STI, including HIV, unmet needs for family planning and contraceptives, high teenage pregnancies, low ANCs, unsafe abortion and poor maternal mortality rates. In the discussions it was highlighted that an urgent need exist to improve information and available data for the Pacific region to make the case to policy makers to scale up investments in the sub region.
Linkages – Using the Strategic Options for NGOs (SONGs) as a reference document, participants discussed challenges and 
recommendations to improve SRHR interventions on five priority areas identified by the participants prior to the conference: maternal health, HIV/AIDS, environmental sustainability, gender equality and sexuality education. Outcomes showed the importance of harmonizing efforts, the importance of integration and linkages, and to establish broad-based partnerships in the region.
Day 2
Money Matters –Examining ways to enhance donor support through better understanding of funding sources and the current aid environment was one of the main objectives of the second day. Senator Pinit Kullavanijaya - Secretary General of Asian Forum of Parliamentarians on Population and Development. He highlighted parliamentarians’ recognition that maternal deaths are one of the greatest moral, human rights challenges of our time. To ensure adequate financing, he stressed parliamentarians’ commitment to strengthen capacity for oversight and budget analyses, increase accountability and improved and specific accounting for budgetary allocation in both recipient and donor countries.
Marina Durano of Development Alternatives with Women for a New Era provided insights on how to restore rights, engage states and reframe aid for SRHR. She highlighted how MDGs 4, 5, and 6 have contributed to fragmentation, most especially when its implementation is taken outside of the ICPD - Program of Action and human rights obligations. Aid effectiveness cannot address fragmentation as macro-economic policy has been de-linked from the discourse on official development assistance. She concluded that the next best option is aid effectiveness if it is funneled into policy and programmatic silos and the need to strengthen scope of influence throughout the budget cycle. Maria Bordallo presented the Report Making Sexual and Reproductive Health and Rights Count. The Asia and Pacific Resource Flows Project published by APA. The report indicates the gap between unmet needs and available resources in the region for SRHR. She highlighted the report’s recommendations to encourage bilateral donors in the region to increase their ODA at least to meet the donor average of 0.47 per cent and to increase the share of ODA given to health and to SRHR.
Donor dialogue – In an interactive panel, Sono Aibe of Pathfinder International asked different donors about their current and future
strategies. Lana Dakan of the David and Lucile Packard Foundation presented the focus areas of the Foundation’s Population and Reproductive Health Program and Global Advocacy Program including financial and political commitment for reproductive health, access to services and empowerment and leadership of women and young people. Lana highlighted that the Foundation remains a strong supporter of investing in safe abortion and post abortion care and the Foundation is trying to raise its importance with other donors. Keiko Osaki of Japan International Cooperation Agency highlighted JICA’s efforts for Integrated Maternal, Neonatal and Child Health Services and their emphasis on health system strengthening and scaling up services in Laos PDR. In the discussions, the involvement of Civil Society in the formulation of Japan’s new Global Health Policy through regular dialogues between Civil Society and the Ministry of Foreign Affairs was highlighted.
Dr. Kittipong Saejeng of Ministry of Public Health Thailand highlighted the country’s key successes on reproductive health, including the 100 per cent condom use program and PMTCT programs. On reproductive health issues, the
government is focusing on prevention of teenage pregnancies. Thailand’s efforts to share their experiences in neighboring countries such as Cambodia, Laos, Myanmar, Vietnam and some countries in Africa on HIV/AIDS were highlighted in discussions. However, funding based on request, depending on what receiving countries put forward. Discussion continued about the Paris Declaration and Thailand’s reputation on strong ownership on development policy.
One participant raised the struggle of Civil Society in the Pacific to identify donors to engage with, especially on HIV/SRHR linkages. She mentioned the lack of available information on donors and of capacity of civil society to engage with donors. Challenges such as writing proposals and complicated application forms were brought forward: “Have you seen a Global Fund forms? They are a nightmare!” Lana Dakan stated that it is important that donors support capacity building of Civil Society to access other donor funding. At the end of the session, Keiko Osaki highlighted that although donors and civil society have different roles to play, maintaining dialogue to harmonize efforts are crucial.
2015 and beyond - Dr. Wasim Zaman of ICOMP presented the visionary questions for the session on the gaps and challenges for 2015 and beyond 2015, actions to address gaps and challenges, and what visions they have in terms of partnerships.
Anna Whelan of IPPF ESEAOR shared the challenges of decline in funding, its effect on core funding of member organizations, and the performance-driven focus of donors. She also highlighted the trend of donor phase-out in some countries in Asia and the Pacific and the urgent need of those governments to take responsibility and to ensure that they priorities SRHR. She stressed the need for “a regional 
strategy for Asia and the Pacific as we need to convince donors that the region is still facing unmet needs. Advocacy is needed, we have to continue and strengthen our message”. She also emphasized the diversity of the region and the importance to work in partnerships in addressing the diverse needs.
Nino Susanto of the Youth Coalition shared challenges from a youth perspective: “Until now, even after ICPD and MDGs, we are still demanding for the same thing as 15 years ago: meaningful youth participation”. In the recent MDG outcome document, youth issues were overlooked. He emphasized the need to focus on implementation of the ICPD Programme of Action on national level, capacity building of youth leaders in advocacy and to establish partnerships with the broader youth movement beyond the sexual rights field. On the role of youth, Nino asked for more trust in the potential of youth organizations: “The Youth Coalition nurtures leadership. Support and trust us, we can deliver!”
Masaki Inaba of the African Japan Forum presented the broader global developments and the change of the global power structures after the global economic and financial crisis. He raised the concern that the development policies beyond 2015 will likely be more economic growth oriented. He recommended that Civil Society needs to raise more voice for 0.7 per cent ODA target and to advocate in the G8 and G20 for equity burden‐sharing for MDGs by pushing emerging countries to contribute for fair‐share. In order to improve health and development, he stressed the need for advocacy for effective use of the money (aid effectiveness) through the integration and mutual complement of issue-based and health system strengthening approaches.
Nobuko Horibe of UNFPA APRO emphasized the need to increase national commitment and ownership and to ensure that government budget is allocated. Other priority areas of UNFPA are rights and equity, revitalizing family planning, focus on married and unmarried young people, linkages of HIV and RH services, and gender sensitization in sexuality education. Regarding modalities, she shared that it is still uncertain what will happen after 2015 with ICPD or MDGs but emphasized that ICPD is a visionary and an important guiding document. With regard to the MDGs, she highlighted the need to have different targets and to ensure more cross-cutting linkages as reproductive health is only linked with maternal health in the current MDG framework. “We need to focus on aspect of quality and stick to a rights based approach”. She commented that UNFPA can play a better liaison role, ensuring that other stakeholders, civil society and national partners can participate and pursue advocacy through partnerships and evidence based key messages.
Discussions – On the question about the best advice to be given to the incoming UNFPA Executive Director on the region, Nobuko Horibe replied: “Asia is a good place to invest in. It is one of the largest and dynamic regions with capacity of governments and national partners to ensure implementation, leading to value and results for the money. UNFPA’s global strategic planning has to ensure that it reflects Asia’s challenges and issues”.
Another question was raised on the rising influence of the G20 and how NGOs in non G8 and G20 countries can become international advocates, and how can we ensure their capacity building. Masaki Inaba stressed the importance of capacity building and explained that the non G20 countries are not only influential as receiving countries but also countries that are responsible for global governance. Sumie Ishii shared an example on capacity building through the APA network, where Japanese NGOs could learn from the Canadian NGOs on doing G8 advocacy. With the upcoming G20 meeting in Korea, Japanese NGOs can share their experiences with Korean NGOs.
Unmet family planning needs in South Asia in light of declining funds were also highlighted. Anna Whelan addressed that repositioning MDG5 and FP are important, but it is important that a rights based approach is applied.
One of the main outcomes of the Conference was that stakeholders at all levels – governments, donors and civil society organizations (CSOs) should work towards providing access to comprehensive sexual and reproductive health services as one of the most effective development interventions. This includes integration and linkages with other health - and non-health - sector programs and harmonizing our efforts through partnerships at all levels. Whilst this broad-based, integrated approach will accelerate progress towards achieving the MDGs, we need targeted, evidence-based advocacy for political commitment and action to achieve universal access to SRHR as a key to achieving success – resulting in impact that is real and sustainable.
