Twenty years after the landmark International Conference on Population and Development in Cairo, the world’s youth are still facing many of the same problems that prevent them from leading healthy and fulfilled lives. Today, an estimated 1.4 million young people die of suicide, HIV, violence, and pregnancy-related causes annually.
The 20-year Programme of Action that came out of Cairo aimed to tackle these issues by calling on governments to meet “the educational and (health) service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality.” But as activists and policymakers now acknowledge, progress has been unequal and painfully slow.
On Thursday, the International Women’s Health Coalition, the World Health Organization (WHO), and the Population Council co-hosted a panel discussion to preview a special supplement of the Journal of Adolescent Health on where the world stands on adolescent sexual and reproductive health and rights. The supplement presents evidence of promising programs and initiatives in five issues areas: increasing access to effective, youth-friendly sexual and reproductive health services; preventing intimate partner violence and sexual violence; increasing youth participation in sexual and reproductive health policymaking; and addressing the key social, cultural, economic, and political factors that impact young people’s ability to lead healthy lives.
The panel, which featured Dr. Satvika Chalasani of the United Nations Population Fund (UNFPA), IWHC President Françoise Girard, Dr. Rama Lakshminarayanan of the WHO, and Nicole Haberland of the Population Council, acknowledged several gaps in research on adolescent sexual health. However, as Girard noted, “we know enough to act.”
In particular, Haberland, who co-authored a paper on comprehensive sexuality education (CSE) that will be featured in the Journal, noted that we have evidence that programs that teach CSE with a gender and power approach—that is, teaching girls and boys about gender equality, building healthy relationships, and their human rights—are most effective. “CSE that deals with gender and power actually impacts health outcomes,” Girard added. “That’s the holy grail. It reduces teenage pregnancy and STI acquisition. So we need to spread the word that sexuality education needs to have that empowerment and gender approach embedded at the center of it.”
Chalasani spoke about UNFPA’s efforts to reach young married girls with CSE. “We have an ethical obligation to reach them,” she said. “We’ve already failed them once—if they married as girls, we failed to protect them.” Noting that many young married girls, especially in India, are done childbearing by their early 20s, UNFPA is targeting them as they re-enter the workforce by deploying CSE programs in vocational and secondary schools.
Despite the evidence and several government commitments since ICPD, sexuality education is still controversial. “There’s considerable anxiety among governments around this topic,” Haberland said, “all the way from the national to the local school board level. It’s still a lightning-rod issue in most settings.” She added: “By international agreement, young people are entitled to CSE. They need CSE. But we’re sorely lacking on the implementation front.”
The panel agreed that inclusion of adolescent sexual and reproductive health and rights, including CSE, in the Post-2015 Development Agenda is critical. Girard noted that the UN General Assembly’s Open Working Group proposal for the Sustainable Development Goals, which will inform the development of the Post-2015 Agenda, doesn’t go far enough: “On adolescents, we don’t have enough of what we need. We just don’t have focused attention on adolescents and their specific situation,” she said. Lakshminarayanan added: “We have an unprecedented opportunity that could be a missed opportunity if [these issues are] not included in Post-2015 talks.”
Twenty years have passed since that first commitment to youth health and rights was made at Cairo. With the current population of young people between the ages of 10-24 alive today at 1.8 billion, there couldn’t be a more urgent need for us to fulfill this promise. As the event closed, Chaslasni commented: “This has been a wonderful discussion, and I hope we won’t be having it again 20 years from now.”
The special supplement of the Journal of Adolescent Health will be published on December 18, and available online for free.