Access for all: supplying a new decade for reproductive health
Mr. Bunmi Makinwa
Africa Regional Director
UNFPA, United Nations Population Fund
Statement by UNFPA Executive Director Babatunde Osotimehin, presented by Mr. Makinwa, in Ethiopia
It is wonderful to be here with all of you. Together we have a big job ahead of us – access for all to reproductive health supplies.
I want to thank all of you for work that you have done so far to get us to this point. I want to thank Dr. Benoit Kalasa, our UNFPA Country Representative here in Ethiopia. I want to thank Julia Bunting, the chair of the RH Supplies Coalition.
And I want to express my gratitude to the Honourable Dr. Tedros Adhanom Ghebreyesus, the Minister of Health of the Federal Democratic Republic of Ethiopia.
I also want to pay tribute to the champion of advocacy for RH supplies, a great lady, Terri Bartlett. Terri, we will make you proud. Your indomitable spirit is with us.
My friends, I am proud to lead UNFPA and I am proud of the work that we are doing together. We have come a long way. Ten years ago, the Meeting the Challenge gathering in Istanbul helped put the issue of reproductive health supplies on the global agenda.
As a long-time doctor and former minister of health, I am acutely aware of just how much we depend on these crucial supplies – and how little we can do without them.
Truly, without supplies, our ICPD and Millennium Development Goal promises are just dusty dreams in the distance. Reproductive health supplies underpin success in maternal health, family planning and HIV prevention.
In Barcelona recently I was told by a colleague from the Netherlands, who has been very involved and influential in the supplies movement for years, that the Istanbul meeting led to two things. One, it led to the Reproductive Health Supplies Coalition, and two, it led to UNFPA’s Global Programme to enhance Reproductive Health Commodity Security.
It’s amazing what can be achieved by a small group of committed individuals.
Ten years on, this gathering is testimony to the effectiveness of the Supplies Coalition – in shaping and developing the global response to the challenges of getting more money for reproductive health supplies.
The initial dozen groups have expanded into a vibrant community of more than 125 organizations. These organizations come together to address shared challenges according to their comparative advantages.
I am aware of how much all of you have brought to the area of reproductive health supplies, and how committed you are to further progress. I salute your efforts and recognize your breadth of experience and expertise, and how you have forged yourself into a community united by a common goal.
UNFPA is proud to be associated with all of you. We are proud to have played a prominent role in the Coalition, and look forward to continued collaboration. And we are proud to fund and host the Access RH.
We are also proud of UNFPA’s Global Programme to enhance Reproductive Health Commodity Security. The Global Programme was launched in 2007 as a strategic mechanism to get RH supplies on the global agenda, prioritized and mainstreamed within UNFPA and at the national level.
The Programme was in response to a gauntlet that was thrown down: UNFPA was challenged to show the world that it could deliver and really add value. I am proud to say that the Global Programme is working. We have channeled more than $300 million through this effort.
Today, 25 of the 45 focus countries now have specific budget lines for RH supplies – up from 18 countries in 2008. And 36 of the 45 focus countries have formulated and are implementing national RHCS strategies, compared to five countries in 2008.
It is perfect that we are here today in Addis. Because five years ago, Ethiopia blazed a trail in becoming the first Global Programme Stream 1 country.
I am told, Honorable Minister Tedros, that when you came to New York in January 2007 to sign the Global Programme’s first Memorandum of Understanding, you said:
“Thank you for making this valuable additional support possible. One plea: please allow us the time to make our own mistakes.”
We never forgot this. And indeed, we made it a fundamental principle of the programme. The funding provided is flexible and responds to national priorities. By allowing countries to set their own pace, I believe that the seeds we are sowing have deeper roots than they might otherwise have.
As we have heard from the Minister, the Global Programme has provided catalytic funds to support the Health Extension Worker Programme. Through this, family planning services have expanded rapidly throughout the country, and the contraceptive prevalence rate rose from 15 per cent in 2005 to 32 per cent in 2009.
We are seeing the best progress in countries that have received the most funds and for the longest period of time.
Here, I would like to point to Niger’s Husbands’ School initiative. This is an exciting effort to encourage men to support family planning, and it has led to marked improvements in health indicators in communities.
The contraceptive prevalence rate and the use of antenatal care services have tripled;
The use of neonatal care, child immunization and birth attendance by qualified personnel have doubled;
And contraceptive prevalence for modern methods rose from 12 per cent in 2006 to 21 per cent in 2010.
My friends, this is real progress. And this progress has been made possible thanks to the ongoing active support and collaboration of key partners represented in this room.
But, as we all know, while we have made progress, we still have a long road ahead of us. As long as there are 215 million women in developing countries who want to plan and space their births but do not have access to modern contraception, we have much work to do.
At UNFPA, we are determined to address the unmet need for family planning, as we strive for universal access to reproductive health. UNFPA is fully committed to the Hand-to-Hand campaign and we are fully committed to the UN Secretary-General’s Global Strategy for Women’s and Children’s Health.
As part of this global effort, UNFPA has pledged to increase modern contraceptive prevalence by two percentage points per year in 45 target countries by 2015.
My friends, we are here in Addis because we have a real opportunity to take our work to the next level. I believe we need to think big, because we have a big job in front of us and we need to focus on success. We owe it to women and young people who need our support.
1. I believe that we should provide joint support to countries to develop fully integrated supply systems. I see systems that can effectively deliver all health supplies to meet people’s needs – from RH commodities to child vaccines, malaria bed nets and AIDS treatment. We need one supply system for all.
We have the resources in this room to make this happen and we can mobilize other partners to support this effort. We need to identify and recognize all of the elements required and to succeed, we need all partners to commit to this initiative in its entirety. For this, we need to engage with the global partners who can really make a difference in terms of the high capital investments that are required.
I think we can all agree that infrastructure financing is not – and should not be – a core strength of UNFPA. Yes, we will do our part – we will partner, advocate and promote stronger investment in supply systems. I would like to note that friends from both the World Bank and the European Commission are present and I hope that we can strengthen engagement towards these ends.
Building one supply system for all requires all of us to work together to support countries as never before.
We need stronger country ownership, including ownership of funding for RHCS. We need to get the issue of reproductive health supplies mainstreamed into national health plans and budgets. To do this, we have to get this issue higher on the national agenda. For this, we need to reach out to partners in ministries of finance and planning. This is essential.
We also have to reach out in a more systematic, strategic and less ad hoc manner to parliamentarians. We need to build awareness and understanding about reproductive health supplies and related issues and, over time, facilitate the emergence of a more conducive legal environment in-country.
So we need stronger advocacy as well as monitoring to make sure that we build momentum and sustainability.
We need to reach people where they live. It is not enough to talk about reaching the marginalized and the vulnerable. Right now, we are marginalized from success and we are vulnerable to failure. To succeed, we need to walk the talk, and we need to walk the extra mile.
I remember Terri Bartlett always used to say, “If I can get a can of coke or a cigarette, why can’t I find a condom?”
We have to reach out. Now is the time to turn to the private sector and ask them how it is done. We have to learn more about getting products to people. We have a duty to do so – these supplies must get to women and young people so they can exercise their reproductive rights.
And we have to learn from countries like Ethiopia and their community health workers spreading out across the land. For years we have been grappling with engaging communities. We still need to learn much more and the best way to learn is by doing new things, being proactive and learning from our mistakes.
As we look to the future and take our work to the next level, we in UNFPA are developing a business plan to mobilize resources to allow us to deliver more in line with this vision. We thank the many partners who are working with us on this.
In essence, we need to build on and scale-up the good work we have begun to ensure access for all.