On 12-14 November, public health professionals, activists, academics and community members, along with government officials and donor representatives, converged in Nairobi for the ICPD+25 Nairobi Summit. UNFPA and its two co-sponsoring governments – Denmark and host country Kenya – had billed the event to be a landmark for sexual and reproductive health and rights (SRHR). It wasn’t.
From the onset of the registration period in August, the warning signs emerged. Civil society applicants for the conference submitted online registrations that went unanswered for months, in many cases through the end of the conference – precluding their participation. That was despite the ICPD+25 website’s promise of “Integrity” and “Transparency”. On the opening day, the hours-long queue for those who had registration approvals and simply needed to collect a badge to enter the venue signalled not simply poor organization, but a lack of resources and attention for SRHR. Many in the queue commented that they were missing sessions – at which they were the scheduled speakers.
Tokenism for civil society and SRHR
The opening and subsequent plenaries revealed more doubts about real commitments to SRHR at ICPD+25. Speaker after speaker delivered meaningless platitudes while studiously avoiding any mention of sex, abortion or women’s rights. The indomitable Gita Sen stood out as a fearless exception in the opening plenary, indirectly highlighting others’ self-censorship or fear of mentioning ideas that most participants view as settled issues, a quarter century after Cairo.
Women who had been at Cairo openly questioned the regression in high-level discourse around SRHR. Mary Ann Burris of TICAH angrily recalled, “We were describing female orgasms in Cairo! Here [twenty-five years later, in Nairobi] they won’t even mention the word sex!”
Governments issued their conference commitments in a dedicated space, but many of those used the vocabulary of SRHR without its meaning. For instance, ministers pledged to eliminate unwanted pregnancies, as if that were a new initiative. Several of those delegates paused dramatically while reading their statements, waiting for applause for an unoriginal ‘commitment’ that landed with a whimper. The Minister of Health from India stood out, only because he appeared ready to drag his country back to a population control model; clearly, he was unaware not only of the discussions at Cairo but also the changes in public health in the two and a half decades since then.
Was it Cairo+25, or Nairobi-26?
So, what would a real ICPD+25 have brought to the world of public health? Surely, there have been changes in the world of SRHR, population and development over twenty-five years. Issues such as the rights of transgender people, and their access to services, merited a plenary. Likewise, how does the rise in migration and refugees interact with SRHR and development? With the MDGs having come and gone, and the SDGs approaching a midpoint, the conference could have addressed the unfinished work of the Cairo ICPD in the context of those global priorities. And with SDG 3 focusing on Universal Health Coverage (UHC), ICPD+25 could have examined the variations in UHC models with respect to advances in gender equity, SRHR and abortion. Sadly, all those were left behind.
On the other hand, some bright spots were seen with civil society and even WHO. Gender and health advocate Dr. Priya Nanda spoke of innovations in technology and improving sexual health. Dr. V. Chandra-Mouli of WHO’s RHR introduced a special issue on adolescent sexual health. In a rare sighting, a trio of Chinese civil society dramatized youth concerns on sexual health. On Day 3, we finally had a full parallel session on human rights and health, but the plenaries largely avoided that link.
Conclusion
In the end, there was an unsettling sense that ICPD+25 allowed governments and international agencies to claim they held a successor to ICPD on its 25th anniversary, without actually addressing the substantive gains of the Cairo conference and the progress in SRHR since then. Much of ICPD+25 appeared to be either a check-box (governments read out their commitments; NGOs had their safe space; we all marched for ICPD+25; all is well) or worse, choreographed entertainment to mollify civil society from seeing the underlying structural challenges to SRHR. If so, let’s look forward to the backlash.