I just came back from the first Latin American and Caribbean Inter-Governmental Conference on Population and Development, which concluded in Montevideo, Uruguay, on August 15, 2013. There, the 38 governments of the region reached an unprecedented and groundbreaking consensus to advance sexual and reproductive health and rights, including a call to revise restrictive laws on abortion. This agreement, the Montevideo Consensus, is the most forward-looking document on sexual and reproductive health and rights ever agreed to at any diplomatic negotiation. What an exciting outcome!
The Conference featured the most impressive and diverse group of civil society I have seen at an intergovernmental meeting in the region. Many indigenous, Afro-descendent, Caribbean, and young activists attended the conference, and IWHC, together with DAWN and RESURJ, supported 35 young activists from the region to participate actively. Together, civil society worked hard to make their voices heard and to push their governments to adopt a bold and progressive agenda.
And the governments listened.
As the host country, Uruguay exerted impressive leadership, with strong support from Ecuador, Argentina, Guyana, Cuba, Mexico, Brazil, Bolivia, Colombia, the Dominican Republic, Costa Rica, Belize, Antigua, Barbados, Trinidad and Tobago, Puerto Rico and others. After such broad support, it will be difficult for anyone to claim that developing countries are not committed to women’s rights and sexual and reproductive health and rights, or find these matters “too controversial.”
The 38 countries not only reaffirmed their commitment to the 1994 Cairo Programme of Action and the 1999 Cairo+5 Further Key Actions, they went well beyond. They reaffirmed their view “that a secular State is one of the elements fundamental to the full exercise of human rights, the deepening of democracy and the elimination of all forms of discrimination,” and asserted the crucial importance of “sexual rights and reproductive rights for the achievement of social justice and the national, regional and global commitments to the three pillars of sustainable development: social, economic and environmental”—pillars which will form the basis of the post-2015 development agenda.
The Montevideo Consensus also included groundbreaking language on sexual rights and strong commitments to promoting sexual and reproductive health and rights for youth and indigenous people, to ensuring access to emergency contraception without a prescription and to male and female condoms, and to protecting marginalized groups such as sex workers and lesbian, bisexual, and transgender women from violence and discrimination.
Adolescent Sexual and Reproductive Health and Rights
Governments expressed particular concern at the high rate of adolescent pregnancy in the region, which, “especially in the case of girls under the age of 15, is usually associated with forced marriage, abuse or sexual violence.” They agreed to “ensure the effective implementation from early childhood of comprehensive sexuality education programmes, recognizing the emotional dimension of human relationships, with respect for the evolving capacity of the child and the informed decisions of adolescents and young people regarding their sexuality, from a participatory, intercultural, gender-sensitive, and human rights perspective,” and to “implement comprehensive, timely, good-quality sexual health and reproductive health programmes for adolescents and young people, including youth-friendly sexual health and reproductive health services with a gender, human rights, intergenerational and intercultural perspective.”
Furthermore, they agreed to “guarantee access to safe and effective modern contraceptive methods, respecting the principles of confidentiality and privacy, to enable adolescents and young people to exercise their sexual rights and reproductive rights, to have a responsible, pleasurable and healthy sex life, avoid early and unwanted pregnancies, the transmission of HIV and other sexually transmitted infections, and to take free, informed and responsible decisions regarding their sexual and reproductive life and the exercise of their sexual orientation.”
Governments also pledged to introduce or strengthen policies and programs to prevent pregnant adolescents and young mothers from dropping out of school, and to “prioritize the prevention of pregnancy among adolescents and eliminate unsafe abortion through comprehensive education on emotional development and sexuality, and timely and confidential access to good-quality information, counselling, technologies and services, including emergency oral contraception without a prescription and male and female condoms.”
Reproductive Health, Including Abortion
Governments reaffirmed their view that “maternal mortality is an affront to human rights and recogniz[ed] that the overwhelming majority of maternal deaths are preventable.” They emphasized that continued high rates of maternal mortality are “due largely to difficulties in obtaining access to proper sexual health and reproductive health services or to unsafe abortions, and … that some experiences in the region have demonstrated that the penalization of abortion leads to higher rates of maternal mortality and morbidity and does not reduce the number of abortions, and that this holds the region back in its efforts to fulfill the Millennium Development Goals.” Therefore, they agreed to “ensure, in those cases where abortion is legal or decriminalized under the relevant national legislation, the availability of safe, good-quality abortion services for women with unwanted … pregnancies,” and urge[d] “States to consider amending their laws, regulations, strategies and public policies relating to the voluntary termination of pregnancy in order to protect the lives and health of women and adolescent girls.”
Sexual Rights, Sexual Orientation and Gender Identity
Regarding sexual and reproductive rights more broadly, governments agreed to “promote policies that enable persons to exercise their sexual rights, which embrace the right to a safe and full sex life, as well as the right to take free, informed, voluntary and responsible decisions on their sexuality, sexual orientation and gender identity, without coercion, discrimination or violence, and that guarantee the right to information and the means necessary for their sexual health and reproductive health,” thus agreeing to a definition of “sexual rights” for the first time ever in an inter-governmental negotiation.
The governments also agreed to design policies and programs to eradicate discrimination based on sexual orientation and gender identity, bearing in mind that “violence against girls, women and LGBT persons (lesbian, gay, bisexual and transsexual), in particular sexual violence, is a critical indicator of marginalization, inequality, exclusion and gender discrimination against women and affects their autonomy, self-determination, individual and collective health and the exercise of human rights.” They also noted “that discrimination and violence on the basis of sexual orientation and gender identity places persons of diverse sexuality in a vulnerable position, preventing their access to equality and to the full exercise of citizenship.”
The governments agreed to take specific measures to stop violence against children and to “enforce existing policies and adopt, on the one hand, preventative and punitive measures, and on the other measures for protecting and caring for women in order to eradicate all forms of violence and stigma against women in public and private spheres, especially the gender-motivated violent murder of girls and women, and ensure effective and universal access to fundamental services for all victims and survivors of gender-based violence, with special attention to women in high-risk situations, such as older women, pregnant women, women with disabilities, culturally diverse groups, sex workers, women living with HIV/AIDS, lesbians, bisexuals, transsexuals, Afro-descendant, indigenous and migrant women, women living in border areas, asylum-seekers and victims of trafficking.”
This list of persons vulnerable to violence was unprecedented in such an agreement, and it was the first time sex workers, lesbians, bisexuals and transsexuals were explicitly mentioned in any inter-governmental agreement outside the field of HIV/AIDS. In other sections, governments agreed specifically to guarantee indigenous women and Afro-descendant women and girls the exercise of their sexual and reproductive health and rights.
Gender Equality and Women’s Empowerment
The Montevideo Consensus also contained important commitments to extend social protection and social security systems to domestic workers and rural women; promote parity and other mechanisms to ensure women’s access to elected office; adopt legislative measures and institutional reforms to prevent, punish, and eradicate political and administrative harassment of women who reach decision-making positions by electoral means or by appointment at national and local levels, as well as in political parties and movements; develop and strengthen universal care policies and services based on the highest human rights standards, from a gender equality and generational perspective, in order to share the delivery of services between the State, the private sector, civil society, families, and households and between men and women; promote legislation and design and strengthen public policies in order to eliminate gender discrimination and asymmetries in relation to access to decent employment, job security, wages, and decision-making on labor issues, as well as to recognize the productivity of unpaid domestic work and care work; and strengthen the participation of women in high-level and decision-making positions in companies.
Similar regional negotiations on population and development will take place in September for Africa in Addis Ababa, Ethiopia, and for Asia and the Pacific, in Bangkok, Thailand. The outcome of all these regional negotiations will help set the global agenda for sustainable development when the Millennium Development Goals expire in 2015. Will governments in other regions put forward their vision for the future, as their Latin American and Caribbean counterparts just did so eloquently? In order to have true sustainable development, they need to commit to gender equality and ensure sexual and reproductive rights and health for all.