As people of the vast region of Asia and the Pacific, we are proud of and strengthened by the multi-cultural and diverse religious traditions that enrich our societies. Both within our nations and in our international relationships, we strive to promote tolerance, unity, and mutual cooperation. Diversity can unite peoples together if the differences do not lead to inequity or oppression. Respect and understanding of positive distinctions among our peoples is a strong foundation for progress and a clear direction for development.
Our efforts to improve reproductive health have highlighted the need to address inequitable and oppressive gender structures which are present in all our nations and are destructive of our best efforts toward social improvement. These structures are antithetical to the values espoused in the Universal Declaration of Human Rights, covenants of the United Nations, the Program of Action of the ICPD, and the Platform for Action of the Beijing Conference on Women. Gender inequity is a major factor that inhibits women from accepting and accessing reproductive health services and deters the prospect of quality of care. It has serious consequences for adolescent’s reproductive health. Gender and socioeconomic inequity exacerbates the fragile reproductive health situation of individuals living in poverty or with limited access to appropriate health services, or with people living in situations of internal conflict.
As gender inequity has serious demographic and social consequences, women and their partners should have appropriate rights and means to achieve their fertility intentions.
Women should also have social and familial support needed to achieve a balance in work and family responsibilities.
Gender equity is the foundation on which the needed improvements in reproductive health for all people can be constructed. We see this in terms of the following basic principles:
We thus declare:
Only through a forthright, critical, and effective promotion of gender equity will be able to ensure reproductive health for all people and development of our societies.
In promoting reproductive health for all, the elimination of all forms of gender inequity and oppression must be a priority for governments, NGOs and other civil society organizations, and international community.
Elements of tradition, religion, law, custom and practices that promote gender inequity or oppression must be subject to public identification and remedial action.
As the promoter of people’s welfare and the agency responsible for justice in civil society, governments should significantly increase resources to eliminate gender inequity in all state institutions, and ensure that reproductive health concerns of all are addressed.
Therefore, we the participants of the Asia Pacific Conference on Reproductive Health held in Manila, February 15-19, 2001, commit to build collaborative relationships among community partners, program administrators, researchers, educators, service providers, program clients, youth groups, elderly, differently able, media, non-government organizations, government organizations, inter-governmental bodies, donors and policymakers, to promote gender equity as the foundation for raising the quality of reproductive health.
Further as NGOs are indispensable partners of government in national and international processes for reproductive health, we are forming a network of NGOs and individuals to ensure the implementation of the ICPD Program of Action.
Indicates the need to link research and advocacy with implementation to improve the reproductive and sexual welfare of the people in Asia and the Pacific.
The plenary and parallel sessions revolve around the following sub-themes:
The conference was attended by about 1500 delegates comprising of activists, doctors, lawyers, parliamentarians and academics from around the region. A combination of plenary sessions, oral presentations, poster presentations, satellite sessions and field trips ran over the course of the conference.
A 7 point call to action for presentation to APEC leaders was created. These points "stressed the importance of sexual and reproductive health and gender equality for overall socio-economic development..."
The Declaration of the APCRSH 2005, Kuala Lumpur was jointly drafted by a group comprising members of the ISC and coordinated by Prof. Dr Jay Satia, ICOMP, Malaysia. Prior to the drafting of the constitution, participants were encouraged to provide input into the Declaration. Participants and donors were then invited to review and provide further comments/suggestions to the Draft Declaration before it was finalised for presentation.
The Declaration of APCRSH 2005, Kuala Lumpur is as follows:
The leaders at the World Summit 2005 committed to: "achieving universal access to reproductive health by 2015, as set out at the International Conference on Population and Development, integrating this goal in strategies to attain the internationally agreed development goals, including those contained in the Millennium Declaration, aimed at reducing maternal mortality, improving maternal health, reducing child mortality, promoting gender equality, combating HIV/AIDS and eradicating poverty." (para 57 g).
We, the Conference participants welcome and share this commitment. This will require implementation of sexual and reproductive rights. Anything less will fail to address key challenges facing our societies. Therefore, we commit ourselves to advocate for inclusion of sexual and reproductive health and rights (SRHR) in national and local policies, plans and budgets, including strategies for achieving the MDGs, poverty reduction and environmental sustainability. Development of health systems and health sector reforms should not deprive people of their rights and access to affordable SRH services.
We will work with the government authorities and civil society including media, NGOs and the private sector to ensure that life-long, high quality, gender sensitive, integrated SRHR information and services are provided on the basis of evidence based program design and monitoring.
We will advocate for the availability, accessibility and affordability of the widest possible range of contraceptives including emergency contraception. We will strongly promote male and female condoms for dual protection as well as the improved management of sexually transmitted diseases. We will be alert to the safety of medications and procedures for SRH used by people in our countries. We will especially support initiatives to make pregnancy and childbirth safe, and promote proper breastfeeding practices.
We note that an increasing number of countries have legalized abortion and are actively promoting safe methods of pregnancy termination. Nonetheless women throughout the region remain at risk of illness or death due to unsafe abortion. We will work to promote services to eliminate the harm caused by unsafe abortion while respecting the laws of countries.
We will work to change those norms and masculine roles and behaviours that maintain gender inequities. In this we recognise the special responsibility that men have in promoting equity. We will advocate for respectful, responsible, pleasurable and safer sexual behaviours. We will campaign for zero tolerance of violence against women, and exploitation of women and children.
In SRHR education and services, we will seek to acknowledge the special needs and rights of marginalized and vulnerable groups including migrants, ethnic minorities and people with disabilities. We will work to end stigma and discrimination and promote social justice for all in each of our countries.
We will foster closer linkages between HIV/AIDS and SRHR policies and programmes. In solidarity with people living with HIV/AIDS we will advocate for effective prevention, affordable ARV treatment and comprehensive care programs to address the epidemic.
We fully acknowledge and recognize the Young People’s Declaration which calls for respect of their reproductive and sexual rights regardless of marital status. We will work together to mobilize meaningful youth participation in SRHR policies and programs.
We recommend that the organizers of this and the next APCRSH carry forward this declaration in full partnership with youth and report on the progress of our commitments to the next APCRSH.
The objectives of the conference:
To the leaders of the countries of Asia and the Pacific
[Specifically addressed to the members of government and civil society organizations with responsibility for reproductive and sexual health in the country of the participant]
I have recently joined with colleagues from across the region in Hyderabad, India for the 4th Asia and Pacific Conference on Reproductive and Sexual Health and rights. This meeting undertook a review of the progress our region has made in fulfilling the promises and challenges of achieving full reproductive and sexual health and rights.
The human rights promises of the 1994 ICPD Programme of Action on Population and Development, the commitments to gender equality from the 1995 Beijing Declaration on gender equality, and the practical adoption of indicators for the Millennium Development Goals have all been commitments accepted by virtually all the governments of our region. These promises have been reiterated in numerous regional and national meetings. The NGO fora organised at these meetings have proven to be excellent platforms wherein the civil society committed and recommitted itself to these promises.
We are disappointed in our failure to live up to the many commitments made over the past two decades, and grievously saddened by the millions of women and men who continue to suffer from entirely preventable maladies
In 1987 governments and NGOs met in Nairobi to call for an end to the 570,000 global and 332,100 Asia and Pacific annual maternal deaths caused by women’s lack of access to contraception, skilled birth assistance, safe abortion, nutrition and respect. Today we see that there are still 242,910 maternal deaths in our region annually, a small decline in comparison with our expectations. Across Asia and the Pacific large numbers of women are still denied access to contraception and safe abortion services either through their poverty, or the barriers erected against comprehensive reproductive and sexual health services. Some countries have made progress in addressing gender based violence, and some have worked hard to reduce the harm of unsafe abortion by ensuring women have access to contraception and high quality methods of safe abortion. But progress is too slow and the cost of this continuing failure is too high.
Too many of the girls born in 1987 on the dawn of the Safe Motherhood commitments are today facing the same terrible threats to life and wellbeing that their mothers suffered two decades ago. Young people of the region and the children born today deserve better. They must have access to sexual and reproductive health services that can preserve their lives, irrespective of their poverty or marital status. This is their right. This is our responsibility.
As agents of change we feel that a much greater drive and acceleration of efforts is needed by all of us to save the lives of women and men living in resource poor settings. We would like to reiterate here that poverty today has moved from its earlier definition that encompassed only economic parameters. Today social poverty inhibits and constrains access to already scarce development resources by young people, by people living with HIV and AIDS, by women seeking safe abortion and all people living in vulnerable circumstances irrespective of their economic status.
Today, young people face significant barriers to sexual reproductive health information, resources and services. In some countries, young people represent half of all new HIV infections. Programmes and policies have not proven effective to stop or even decrease the problems related to sexual and reproductive health and rights. These must be re-assessed and that reassessment should include the meaningful involvement of young people. It is essential that young women and men have access to age-appropriate comprehensive sexuality education that is evidence-based and non-judgmental. Young people must be recognized as autonomous individuals who have the right to make decisions regarding their own lives. In addition, HIV prevention programmes need to be carried out for all, regardless of their gender and sexuality.
The practical commitment of governments to recognize the human rights of their citizens can make a difference. The technologies are available to achieve a revolution in reproductive and sexual health but programs need resources which are not beyond the scope of national budgets as the benefits of investment in reproductive health are far greater than the costs involved. This needs to be done through an urgent transformation of budget priorities in favour of health, education and development of women and men. Of course budget decisions alone will not solve the problems.
As leaders, we will work with our governments so that we can make a very practical difference to catalyse the legal, programmatic and budgetary reforms that are required to make reproductive and sexual health services accessible to all. The expenditure of funds needs to be carried out in an institutional structure that facilitates efficient action. Today too many governments remain shackled by external pressures, outmoded laws and regulatory structures undermining reproductive health. At the core is the need to recognize reproductive rights including the right of all people to accurate sexual and reproductive health information appropriate to their stage of life and the right of women to make decisions on their own reproductive lives in a context of safety and social support. Integrated responses to HIV and AIDS and reproductive and sexual health are required to realize these rights. We require urgent action now to turn the rights that governments have recognized in conventions and treaties into reality in the lives of all citizens.
As we leave this conference with a spirit of constructive partnership, we are committed to hold ourselves accountable for the reproductive and sexual health responsibilities we have agreed to shoulder. As a group we will support the effective monitoring of significant allocations of development resources whether they are managed by governments or the civil society in the region and report progress to the next meeting, to be held in China in 2009. As individual researchers, service providers, activists and youth representatives in our nations and across the region we will commit our skills to the mobilization of our colleagues to form effective partnerships, in the belief that the whole of civil society needs to be alert to the actions of governments in reproductive and sexual health. This is the time for governments to make the total commitment to reproductive and sexual health. We stand committed to work with governments to take up an active policy of programmatic integration as well as legal and budgetary reform.
Objective of the Conference:
Background. Over one quarter of the world’s people were born since the ICPD, yet even today they do not fully enjoy the guarantees of services and rights promised by 179 nations in 1994. Many adolescents remain ignorant of their reproductive and sexual rights. In some societies they are taken out of school prematurely to be thrust into marriages arranged without regard to their personal preferences. Too often they are subject to gender based violence and disrespectful treatment. Women and men continue to struggle in many societies to obtain the services that would guarantee safe childbearing and achievement of their family formation goals. The elderly remain victims of social stereotypes that relegate them to the category of “dependent” despite the continuing contributions they make to society. Their sexuality is overlooked by most programmes of reproductive and sexual health.
The Asia-Pacific community represents an intricate mosaic of cultures and religions, reflecting a full range of reproductive and sexual health and behaviour challenges. It is this region that many sexual and reproductive challenges are clearly manifested, and it is in consideration of these challenges that we representatives of civil societies, universities, parliaments, governments, donors and youth organizations have gathered for the 5th APCRSHR in Beijing.
We recognize that reproductive and sexual rights and the associated need for universal access to relevant education, social and health services are critical for the development of each individual. Reproductive rights guarantee that all couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so. Sexual rights include the right to have control over and decide freely and responsibly on matters related to their sexuality, free of coercion, discrimination and violence. These are crucial for achieving gender equality, and are key components of effective programs to eradicate poverty and achieve equitable sustainable development. Governments, parliaments, and civil society organizations across the Asia-Pacific region urgently need to act on these issues.
We the participants of the 5th APCRSHR reaffirm our individual and collective commitment to collaborate to achieve the full realization of the Programme of Action of the International Conference on Population and Development (ICPD) by 2015. We recognise that this requires the simultaneous reaffirmation to achieve the Beijing Platform for Action of the Fourth World Conference on Women, and the Millennium Development Goals (MDGs).
We recall the outcomes of previous APCRSHR conferences in Manila (2001), Bangkok (2003), Kuala Lumpur (2005), and Hyderabad (2007), and acknowledge that progress has been made on several issues, especially the integration of population concerns into socio-economic development strategies, the adoption of laws and policies to protect women’s rights and empower women, and efforts to increase access to reproductive and sexual health services. But much remains to be done, and the need for action is urgent, particularly in the following areas:
Reproductive Health and Rights. Governments should fully recognize sexual and reproductive rights through effective education, policies and services supported by adequate budgets. To do so requires greater commitments to comprehensive family planning and health education and services. This is the most effective way to achieve the ICPD and MDG 5B targets of universal access to reproductive health by 2015. Continuing high levels of mortality surrounding pregnancy and childbirth should alert everybody to the need to include voluntary family planning, skilled birth attendance and emergency obstetric care in efforts to strengthen primary health care services. Research by WHO and other organizations has reminded us that even in countries where abortion is legal women suffer from the risks of unsafe procedures. In many countries debates about morality of abortion eclipse the commitments made to protect the health and well-being of women. While recognizing the value of traditional health practices, governments need to ensure that medications and practices provided for reproductive and sexual health are safe and effective. In facing all these challenges governments need to ensure that poverty and lack of education are removed as barriers to services for reproductive health and safe childbearing.
Gender Equality and Empowerment of Women. Governments and civil society organizations need to increase their efforts to promote gender equality and equity through laws and policies protecting women’s sexual and reproductive health and rights. They should take action to eliminate all forms of violence, trafficking and exploitation of women and girls. This will require them to address inequitable and outmoded cultural practices that stand in the way of women’s empowerment. Men and boys who challenge the patriarchal norms and laws that reproduce gender inequalities from generation to generation deserve the recognition and support. They help to establish the necessary foundations of gender equality and empowerment of women, and in doing so they create new and more socially productive roles for men.
Youth. We recognize the distinctive content of the Youth Declaration made by the youth participants to this conference and support its full implementation. We join them in urging Governments to provide universal access to non-judgmental and respectful sexual and reproductive health services including counselling. Such initiatives will be enhanced by increased resources for meaningful youth participation in decision-making processes.
Ageing Population. Though the populations of the Asia Pacific region are ageing rapidly, this is not necessarily the disaster portrayed by many observers. Older people continue to make productive contributions to their families and communities, and are in fact major carers of members of their own and younger generations. Governments have responsibilities to establish effective social welfare systems and would do well to promote self reliance of older persons by facilitating their continued participation in a full range of economic and social activities. Society in general also needs to respect the continuing sexual health needs and rights of older people, including appropriate health services. Issues of sexuality among older people should be informed by social realities rather than blind stereotypes and judgmental expectations.
Migrants. In a region of massive internal and international migration there are numerous ways in which the sexual and reproductive needs and rights of migrants are ignored or violated. Trafficking is frequently connected to sexual exploitation. Governments have attempted to control the worst aspects of this trade, but much more needs to be done. There is a need for greater international cooperation and national action to protect migrants, including well designed programmes addressing the sexual and reproductive health needs of all migrants, especially those displaced by conflicts and natural disasters. In this context civil society organizations play a crucial role in advocacy and services of vulnerable people.
Climate Change. There are complex linkages between population, resource consumption, and the environmental concerns exemplified in current international discussions of climate change. These are justifiably commanding the attention of governments, and sparking debates about steps to be taken for prevention and amelioration of environmental degradation. Nations should remember the crucial contributions rights based reproductive and sexual health services can make a direct contribution to sustainable development and welfare in the face of environmental challenges from climate change. We need to avoid false and fruitless competition for ODA and national funding. These are complementary issues, not financial trade-offs.
HIV/AIDS. While HIV/AIDS remains the single most recognised disease focus of international health collaboration its setting within sexual and reproductive health behaviours is often overlooked. We urge governments to link HIV/AIDS interventions more effectively within established programmes of primary health care and comprehensive reproductive health services as a means to strengthen efforts to prevent the transmission of HIV. Effective programs must specifically address mother to child transmission of the virus and ensure that all people living with the virus have access to appropriate life extending medications, free from stigma and discrimination.
Resources and Partnerships. The current global economic crisis has hit developing countries particularly hard with damaging fallout for the achievement of the MDGs. They have been hit by the double blow of reduced domestic resources and failures in international development assistance. Despite the tardy recognition of reproductive and sexual health in the MDGs through the adoption of MDG 5B, there has been a lacklustre reaction by governments, donors and development institutions to the calls for predictable and long-term financing of policies and programs. We urge governments and donors to increase their official development assistance to create and support strong and sustainable reproductive and sexual health programmes.
This is not exclusively or even primarily the responsibility of governments. Civil society institutions and private enterprises play an important role both on their own and in partnerships with governments. To be effective they need adequate funding. This requires the mobilization of domestic resources and the coordination of innovations across a range of sectors including efficient use of development assistance funds.
We strongly urge rapid response by civil society, parliamentarians, governments, donors and young people address our call to action on the unfinished agenda of the ICPD to achieve universal access to reproductive health by 2015.
Meeting in Beijing recalls the proverb that "In today’s actions, take the perspective of 1000 autumns." In other words, the actions we begin today will determine the welfare of our region, not only tomorrow, but for the whole millennium to come. For this reason, we urge governments to act wisely and decisively.
The objectives of the conference:
Reproductive and Sexual Health is a universal concern around the globe. All people – young and old, masculine and feminine, rich and poor – are at risk of problems related tosexual and reproductive health, including communicable and non-communicable diseases. People’s needs for care, treatment, education and advice change across the life span, but at no time do they disappear entirely. It is because of the universality of need that the member states of the United Nations have adopted a large number of principles and declarations calling for states to promote reproductive and sexual health.
The International Conference on Population and Development in Cairo in 1994 explicitly linked reproductive and sexual health to human rights, and stressed that states should pay particular attention to girls and women since they most often suffer from negative health consequences due to social inaction. However just six years later world leaders gathered to adopt the key Millennium Development Goals (MDGs) were unable to include an explicit statement on sexual and reproductive rights in their final communiqué due to objections raised by a number of member states. The Cairo promises remain on the UN agenda and have been strongly promoted by the UN family of agencies, but it is clear that international consensus remains difficult.
In 2011 many states are falling short of the commitments they made 17 years ago. Their promises did not include the one key element that might ensure reproductive and sexual health – that being respect for individual reproductive and sexual rights. Without respect for the dignity of individuals, social programs of intervention become hollow, guarantees of protection become empty, and hopes for improvements become illusive.
In November 2006 a meeting of world experts on human rights related to gender identity and sexual orientation launched a series of guidelines for governments to promote respect for individual sexual rights. In four days of meetings of the 6th Asia Pacific Conference of Reproductive and Sexual Health and Rights in Yogyakarta the participants reviewed experience from across our huge region and came to the sobering conclusion that previous calls to action have fallen short of the needs of the peoples of the region. Asian and Pacific communities are all heterogeneous in the forms of political, religious and normative beliefs they espouse, but at times they disrespect the rights and needs of individuals and minorities in their midst, especially those with different sexualities.
While women are not a minority, they continue to suffer from the relics of patriarchy embedded in political and social institutions. Throughout the region they continue to die from preventable and treatable causes. Many cultural practices and beliefs about family life and interpersonal relationships continue to foster discrimination against women and fail to respect the rights of young people as they are growing up.
The first day of the Conference was devoted to and led by youth drawn from across the region. They set the pace by raising awareness of the frequently overlookedSRHR perspectives of school and university aged people. Their concerns deserve to be acknowledged in political and bureaucratic discussions of reproductive and sexual health. Youth are more often the targets of moralization rather than the partners and beneficiaries ofpolicies and programs of information and services. We fully endorse the Youth Declaration’s call for governments to implement comprehensive sexuality education and services for all youth.
Looking at the persistent issues of intolerance, inequity and discrimination the Conference spent two days discussing papers on contested reproductive and sexual rights, including such controversial issues as unsafe and safe abortion and the special needs of marginalized and socially-excluded communities.
In a final day of discussion and debate participants looked at how reproductive and sexual rights might best be claimed by all citizens, and what role civil society organizations might pursue to guarantee the health and rights of coming generations.
Whenever people preventdiscussion about different forms of sexuality as sensitive or even taboo, they reflect a form of intolerance that constitutes disrespect for their fellow citizens’ deepest emotions and commitments. Throughout the world lesbian, gay, bisexual, transgender, queer and intersexed (LGBTQI)people struggle to be accepted for their skills and contributions to society rather than isolated or persecuted because of their sexual orientation or gender identity. Participants were concerned to learn of physical and legal assaults made on the sexual rights of their fellow citizens. The attacks on their sexuality are hurtful, but of greater damage is the lack of protection offered by government organs when they are assaulted. The protection of their rights requires that their safety and security also be protected.
The theme of these meetings was “Claiming Sexual and Reproductive Rights in Asian and Pacific Societies”. For governments this means the enforcement and protection of rights approved and ratified through the many international conventions relevant to reproductive and sexual health.
We have concluded that the first step in citizens’ claims for rights is a claim for respect. This is the claim we are making today; of our governments, and of our families, friends and fellow citizens. We, who represent people from different walks of life, different forms of sexuality, and including a wide range of religious and political beliefs, claim respect for our own situations, and promise to respect our fellow citizens’ situations. But when we talk of respect we don’t want it to end with talk. It needs to be demonstrated in everyday actions by all citizens. We call on our societies to endorse this declaration by institutionalizing respect and tolerance in all policies, programs and services of reproductive and sexual health.