News

Hard Talk! Sexual and reproductive health and rights and HIV prevention for most left behind adolescent girls

8 July 2019
The spotlight at Women Deliver was firmly on why young women and adolescent girls are being left behind. © UNFPA Mozambique/Natalia da Luz

VANCOUVER, Canada—As the 2030 Agenda nears its fifth birthday, work is off track on reaching international targets specific to adolescent girls and young people, which were adopted by UN Member States in the 2016 United Nations Political Declaration on Ending AIDS.

This was evident at the recent Women Deliver Conference in Vancouver, Canada, where discussions on youth, menstrual health, and the 25th anniversary of the International Conference on Population and Development (IPCD) were in focus.

A key commitment is to reduce the number of adolescent girls and young women newly infected with HIV globally each year to below 100,000 in 2020. However, in 2017 there were 340,000 new HIV infections among adolescent girls and young women, which was well below the target.

Similarly, while the international community celebrates substantial progress made 25 years since the groundbreaking ICPD held in Cairo, Egypt in 1994, some 21 million adolescent girls aged 15 to 19 years become pregnant every year in developing regions, and 23 million who want to avoid pregnancy are not using contraception.

Call for governments to step up and deliver

Why are around 7,000 young women and girls becoming infected with HIV every week? And why, in sub-Saharan Africa, are girls aged 15 to 19 years three times as likely to become infected with HIV than boys the same age?

These are some of the questions that were asked by young people at an event co-convened by UNAIDS and the United Nations Population Fund (UNFPA), which put the spotlight on why young women and adolescent girls are being left behind.

We all know the issues. What are you going to do next?

Speakers discussed the importance of engaging young people as leaders of change. Representing the voices of young people across the East and Southern Africa region, Gogontlejang Phaladi, Director of the Pillar of Hope Project in Botswana, called for governments to step up and deliver. “We all know the issues. What are you going to do next?” she asked.

Young women on the panel welcomed the increased availability of new self-administered methods for medical abortion and HIV testing. A new investment in co-formulated contraceptive pills for dual protection was announced by Miles Kamplay, Executive Director, Adolescence, CIFF.

The need for investment in youth leadership through improved access to financial support and involvement in the design and implementation of programmes at scale was highlighted. Investing in community organizations will be critical, and taking small projects that work to the national level.

“People are watering the leaves, but not the roots. We need to move away from paper and pen to implementation on the ground,” Nyasha Sithole, from Athena Network.

I have interacted with fearless adolescent girls and young women from across Africa and I know that this generation is not voiceless, they don’t need us to speak for them.

Monica Geingos, First Lady of Namibia, responded: “I have interacted with fearless adolescent girls and young women from across Africa and I know that this generation is not voiceless, they don’t need us to speak for them.” On the issue of financing, “The reality is that we have no choice but to integrate sexual and reproductive health and HIV.”

A major issue preventing young women and girls from accessing HIV services is the requirement by many countries that young people have to be over the age of 18 before they can access health services, including sexual and reproductive health and HIV services, without parental consent.

As part of efforts to remove these barriers to young people accessing timely and effective HIV prevention, testing and care, Dr. Julitta Onabanjo, UNFPA Regional Director for East and Southern Africa, highlighted the Fund’s work on harmonization of laws and policies with the removal of barriers to young people’s access to family planning information and services, comprehensive sexuality education, and HIV treatment. “We have to focus on integration, be innovative and inclusive, and work in partnership if we are to achieve our targets,” she said.

I see an action-oriented generation of young female warriors here to take the agenda forward—so that by 2030 every young person can fulfil their best potential. These young women are and will continue to be the drivers of change.

She reiterated the call for support to continued investment in young women’s leadership. “I see an action-oriented generation of young female warriors here to take the agenda forward—so that by 2030 every young person can fulfil their best potential. These young women are and will continue to be the drivers of change.” This is part of an ongoing discussion that will feed into the recommendations at the ICPD summit being held in Nairobi, Kenya in November, she said.

Let’s talk about it. Period!

In 1994, the ICPD marked a revolution as it reimagined how the world thinks about population, development and reproductive rights. However, its Programme of Action made no explicit mention about menstrual health or hygiene. As a result, menstruation as a priority within the sexual and reproductive health and (SRHR) agenda was non-existent. 

However, in the past decade, due to strengthened global and localized advocacy and an increased body of evidence to document the challenges faced by adolescent girls and women during their menstrual periods, the issue of menstrual health management has gained greater attention. Africa, and the rest of the world, has witnessed numerous shifts in the political and social realm in response to menstruation, and menstrual health is now considered a priority within the sexual and reproductive health community.

At a session entitled ‘Let’s Talk about it. Period!’, Dr. Onabanjo welcomed the increased recognition that menstrual health is a human right and as a development issue that must be addressed to achieve the Sustainable Development Goals.

When between a quarter to a third of the world’s population are menstruating on any given day, clearly this must stand out as a development priority.

“When between a quarter to a third of the world’s population – more than 800 million women and girls between 15 and 50 years – are menstruating on any given day, clearly this must stand out as a key global, regional and national development priority,” she said. 

Advances have been made in the Africa region since the 2018 East and Southern Africa Symposium for Menstrual Health Management and the subsequent launch of the African Coalition for Menstrual Health Management.

“UNFPA is immensely proud to have a leading role in this partnership, and to be a member of other related initiatives at global, sub-regional and national level,” she said. She encouraged partners to work together to position menstrual health in the final outcome of the ICPD25 Summit in Nairobi in November.

- Maja Hansen