burning issue

Revision of the Cairo Programme of Action’s cost estimates. The Millennium Development Goals (MDGs), including a 50-percent reduction in global poverty and hunger by 2015, are likely to be jeopardized by the economic turmoil worldwide. One of the eight MDGs includes universal access to reproductive health services, along with the reduction of maternal mortality by three-quarters. The HIV/AIDS crisis is far worse than anticipated, while infant, child and maternal mortality remains unacceptably high in many parts of the world. The financial targets set by the International Conference on Population and Development (ICPD) in Cairo 15 years ago do not meet the current needs that have grown dramatically over the last decade. The key agenda before the 42nd session of the Commission on Population and Development (CPD) was the contribution of the Cairo Programme to the MDGs. According to revision approved by United Nations Members on the 3rd of April, investments of $64.7 billion are needed in 2010 for population programmes that are essential to reduce poverty, promote development and curtail maternal death. One third of this sum, about $21.6 billion, is expected as international assistance, while the remaining two thirds would be domestic investments by developing nations. The new figure of $64.7 billion is a major revision of the $20.5 billion (in 1993 United States dollars) for 2010 that was adopted at the 1994 Cairo International Conference on Population and Development (ICPD). This is the first time in 15 years that the Cairo Programme of Action’s cost estimates have been reviewed, as demanded by that global consensus. A report of the United Nations Secretary-General says the revision was urgently needed due to the dramatic growth in current needs, with health-care costs skyrocketing and data collection costs rising, as many countries prepare for the 2010 round of censuses. United Nations Members approved the new figures in recognition of the “dire need to increase the financial resources for the implementation” of the Cairo Programme, according to a resolution they adopted. They were particularly concerned about funding for family planning, which was far below requirements. The $64.7 billion is broken into work categories adopted in Cairo. The total 2010 costs for sexual and reproductive health, which include family planning and maternal health, are estimated at $27.4 billion; $32.5 billion for HIV/AIDS; and $4.8 billion for basic research, data collection and policy analysis. The figures change annually, rising from some $67.8 billion in 2011 to $69.8 billion in 2015. The new estimates more accurately reflect current needs and are more in line with the investments required to achieve the Millennium Development Goals (MDGs).

Source: UNFPA

regional updates

ASTRA’s letter to DG Sanco concerning conscientious objection.The practice of conscientious objection arises in the field of health care when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. As a follow-up of the intervention at the EU Open Health Forum in Brussels in December 2008 regarding patients right to access health services in Europe, ASTRA’s and Center for Reproductive Rights’ issued a letter to DG Sanco concerning conscientious objection. Both non-governmental organizations expressed the belief that to achieve health security and to realize patients’ rights in Europe, barriers to accessing health care must be addressed. The letter urges DG SANCO to address the unregulated practice of conscientious objection in Europe as one such barrier.

The letter is accessible at the ASTRA’s website: www.astra.org.pl

EU News: European Parliament adopted resolution on MDG contracts that makes specific mention of SRHR.The final text of a resolution adopted by the Parliament to help regulate the Commission’s MDG contracts places a high emphasis on health, and a specific mention of the importance of SRH services, information and supplies. It states that the EC should strengthen “measures to facilitate access for all women to information about sexual and reproductive health and to universal sexual and reproductive health services; improved access to and greater use of family planning methods; long-term measures to promote women's education and emancipation; and measures to combat sex discrimination and foster gender equality.” Socialist Rapporteur MEP Hutchinson urged the Commission to ensure the involvement of developing country parliaments and civil society at every stage of the MDG Contracting process.

Source: EuroNGOs

The adopted text can be found here: European Parliament

Directive of the European Parliament and of the Council on the application of patients’ rights in cross-border health care.Despite several clear European Court of Justice rulings confirming that the EU Treaty gives individual patients the right to seek healthcare in other Member States and be reimbursed at home, uncertainty remains over how to apply the principles of this jurisprudence more generally. The general aim of the draft directive on cross-border healthcare is to ensure that there are no obstacles to patients who seek treatment in an EU Member State other than their own. It also clarifies the right for patients to be reimbursed after treatment in another Member State. The report by British Conservative John Bowis, which was adopted during the plenary session on 23rd of April, focuses on patient’s rights to seek healthcare abroad more easily. MEPs called for the clarification of a patient’s right to be reimbursed after treatment up to the level they would’ve received in their home country. It will be left to individual countries to decide whether to cover other costs like accommodation and travel. Parliament has added special rules for patients with rare diseases and disabilities that might need special treatment. Patients affected by rare diseases should have the right to reimbursement, say MEPs, even if the treatment in question is not provided for by the legislation of their Member State and this shall not be subject to prior authorization. Parliament voted to exclude long-term care and organ transplants from the directive. It is important to note, that the directive’s effectiveness might be limited due to the clause reading that patients will be able to seek abroad health care services that they would have been provided at home and that they will bear the financial risk of any additional costs arising while they seek health services abroad. As reproductive health services are not fully accessible in some of the countries, the risk arises that persons unable to access services they are entitled to in their respective countries, will be forced to pay for these services while accessing them abroad.

The text of the directive is accessible at: European Parliament

HIV testing will be obligatory for pregnant women in Poland.Prevention of mother-to-child transmission (MTCT) requires a comprehensive package of services that includes preventing primary HIV infection in women, preventing unintended pregnancies in women living with HIV, preventing transmission from pregnant women living with HIV to their infants, and providing care, treatment and support for women living with HIV and their families. HIV testing in pregnancy has a number of benefits in terms of prevention and care for mother and child, although to avoid or minimize negative consequences testing must be voluntary and confidential and accompanied by quality counseling. The Polish Ministry of Health has just issued the guidelines recognizing the importance of universal HIV testing of pregnant women in Poland as the key to prevention of MTCT. Receiving information about HIV infection, prevention of MTCT of HIV, and HIV antibody testing has not been earlier included in prenatal program of healthcare and currently only less than 10% of pregnant women decides to undergo a routine HIV antibody testing.

Source:TVN24

Discussion on anti-discrimination law in the Czech Republic. Although the Czech Republic should have adopted anti-discrimination law (ADL) before its entry into the EU, it has not done so until now (when an approval of the new European anti-discrimination directive is under way). The Czech Republic has already been condemned by the European Court of Justice, has not taken a proactive stance towards approving the ADL even during the ongoing Czech presidency of the EU. If the ADL is not adopted before the early elections, the Czech Republic will have to initiate the whole process of adopting ADL again from the very beginning. The Czech Women's Lobby held a roundtable focused on gender aspects of anti-discrimination legislation. In her opening speech, Iva Laňová (Member of Vladimír Špidla’s – Commissioner’s for Employment, Social Affairs and Equal Opportunities - Cabinet) outlined the wider European context of the fight against discrimination. She stressed that the European Commission perceives the issue of discrimination as belonging to its main agenda – with an even stronger acuteness during the period of the financial crisis. On the contrary, "the Czech presidency has decided to continue in discussions (on the topic of discrimination), but on a technical level alone," said Laňová. Laňová, further, mentioned intended activities of the EU in the field of anti-discrimination. A summit is planned for the period of the Swedish Presidency, which will be devoted to the issue of multiple discrimination and the exchange of relevant best practices. In 2010, a report will be produced and published, providing a summary of possible extensions of anti-discrimination legislation related to gender.

For further information, please visit:Gender Studies

The state support for family planning in France is finally re-established.In January, the French State foresaw to reduce grants usually given to “Establishments of Information, Consultation and Family Counseling” by 42%. This cutting directly endangered the access to methods of family planning, information and sexual education. However, after a consequent mobilization of associations and individuals (inter alia, a petition signed by 140,000 people), led by the main organization for sexual and reproductive health and rights, the French Movement for Family Planning, the decision has been reviewed. On March 11, 2009, a protocol has been agreed, guaranteeing the maintaining of the budget up to 2,6 millions euros for the next three years.

Source:Le Planning Familial

Abortion bill approved in Monaco. The Monaco Parliament (National Council) has unanimously approved a bill authorizing medical abortions. The bill was passed in a 26-0 vote, despite the fact that 90% of its population is formally Catholic. The legislation had been in process for five years and it is the first case of legalizing abortion in the country where Catholicism is the state religion.

Source:Genethique

Assisted reproduction law reviewed by Italian Constitutional Court. Following several judicial rulings – particularly that of January 2008 in which the Rome administrative court ruled in favour of PGD (pre-implantation genetic diagnosis) for IVF, and which has since been authorized in Italy, the Italian Constitutional Court reviewed the assisted reproduction law. The court published an outline ruling saying that parts of the current law were contrary to constitutional principles. In particular it ruled as unconstitutional the stipulation that a maximum of three eggs could be fertilized at one time The Court also rejected the appeal against the provisions banning reducing the number of embryos in the uterus and embryo cryopreservation. The Court’s decision reaffirms that the health of the woman must prevail over other considerations.

Source:BMJ

New German law bans genetic tests of fetuses for adulthood illnesses. After 10 years of debate the German parliament has passed a strict law aimed at preventing misuse of genetic tests. According to the health minister, the purpose of the law is to protect individuals from discrimination because of their genetic constitution. The law limits the use of genetic testing on a fetus to purely medical purposes. Parents are not allowed to determine the sex of their unborn children, and genetic tests cannot be used to identify predispositions to illnesses that appear in adulthood, such as breast cancer or Huntington’s disease. However, doctors will be allowed to test prenatally for genetic conditions that appear immediately after birth or during childhood, such as Down’s syndrome. Parents have to undergo obligatory counseling before any genetic test is carried out.

Source:BMJ

Ponton: What Sexuality Education? The group of peer educators affiliated with the Federation for Women and Family Planning started new action headed towards promotion of comprehensive sexuality education in Polish schools. Poland lacks a nationwide program of sexuality education and the access to sexuality education and other reproductive rights and services is often obstructed under pressure of Catholic morality. Ponton peer educators encouraged Polish teenagers to send their comments and impressions regarding sexuality education. During three months of action, volunteers collected around 800 personal testimonials.

For Ponton’s report on summer hotline for teenagers:PONTON

Kyrgyzstan New Law Curbs Commercial Baby Formula Advertisements. A law came into force this month restricting powdered milk advertisements, in order to encourage breastfeeding in Kyrgyzstan. As Eleonora Mambetshakirova reports, formula milk products are in wide use in Kyrgyzstan and the campaign to highlight the health benefits of breastfeeding is just taking off. „Only 30 per cent of babies under six months in Kyrgyzstan are fed exclusively on their mothers’ milk,” said Tursun Mamurbaeva, who heads the nutrition department at the National Centre for Mother and Child Care. “The rest get a formula product. On the one hand, this it is bad for the child’s health, and on the other it’s unnecessary household expenditure.”.

Source:Institute for War and Peace Reporting

Afghanistan - President Karzai Vows to Review Family Law. President Hamid Karzai ordered a review of a new law that has been criticized internationally for introducing Taliban-era restrictions on women and sanctioning marital rape. The president defended the law, which concerns family law for the Shiite minority, and said Western news media reports were misinformed. Nevertheless, he said his justice minister would review it and make amendments if the law was found to contravene the Constitution and the freedoms that it guarantees. According the new law, a Shiite woman would be allowed to leave home only “for a legitimate purpose,” which the law does not define. The law also says, “Unless the wife is ill, the wife is bound to give a positive response to the sexual desires of her husband.” Critics have said that provision legalizes marital rape. Human rights officials have also criticized the restrictions it places on when a woman can leave her house, and for stating the circumstances in which she has to have sex with her husband. Moreover, although the law applies only to Shiites, who represent approximately 10 percent of the population, its passage could influence a proposed family law for the Sunni majority and a draft law on violence against women.

Source:New York Times

Czechs use more contraception, are more faithful in marriage-poll. Czechs use more contraception and are more faithful in marriage, according to a survey carried out by the Sexological Institute of the 1st Medical Faculty of Charles University in Prague. The survey showed that 30 percent of people started to protect themselves against unwanted conception by condoms or pills rather than interrupted intercourse or the method of infertile days. Yet, 37 percent of men and 47 percent of women do not use any protection in sex with a random partner, according to the survey. Young people are more responsible in their first intercourse. The number of those who do not use any protection has decreased by 12 to 15 percent compared with 1993. Men usually use a condom, women hormonal contraception. The age of the first intercourse is not much changing and remains at around 18 years of age. The survey also revealed a trend in marital faithfulness. Ten years ago two thirds of men and a half of women admitted having sexual relationship with somebody else than their spouse, last year it was only a half of men and one third of women.

Source:CTK National News Wire (U.K.)

Positive Lives Exhibition in Warsaw. On April 7th 2009, the opening ceremony of the exhibition “Positive Lives” took place in the Warsaw University Library. The photos shown present people suffering from AIDS and HIV and are accompanied by their stories. The exhibition was opened by the MP Izabela Jaruga-Nowacka and MP Marek Balicki (former Minister of Health). Both politicians spoke on HIV/AIDS issues in developing countries. The hostess of the event, Wanda Nowicka of the Federation for Women and Family Planning, made a speech on the aims and activities of the True Development Through Health Project undertaken by the Federation for Women and Family Planning. The opening was also the opportunity to distribute the recent report “Sexual and Reproductive Health and Rights in developing countries”.

Source:Federation for Women and Family Planning

More about the report:Federation for Women and Family Planning