In a global health report that speaks as much to the powerlessness of women as it does to the diseases that are killing them, the World Health Organization said this week that the leading cause of death for girls and women aged 15 to 44 is now AIDS. The report also found that in poor countries, unsafe sex and lack of contraception is the single leading risk factor for death and disability, resulting in unsafe abortion and range of infections including HIV. Domestic violence poses an additional risk to sexual and reproductive health.
Studies like the WHO report highlight the critical intersections between women’s disempowerment and health outcomes–issues the United Nations desperately needs to focus on. But for more than five years, the UN has been dancing around a proposal to create a high-powered, well-financed agency for the world’s women. In a last-minute decision in September, before the start of a new UN year, the final session of last year’s General Assembly approved the step in principle. But nothing concrete has happened since, and there are plenty of UN members willing to stall implementation, at least into next year.
Progressives may well ask, Didn’t the idea of ghettoizing women’s issues go out with newspapers’ women’s pages? That was also the theory around the United Nations, where for decades the buzzword was “mainstreaming,” meaning that women would be factored into all the work of the organization. As it turned out, a majority of nations among the UN’s 192 members never took seriously the concept of mainstreaming female sexual and reproductive health and rights in development, though the status of women is widely acknowledged to be critical to progress on many fronts from the economy to the environment.
No mention of reproductive rights, aside from maternal health, appears in the Millennium Development Goals, the eight-point plan for reducing poverty and disease worldwide. Ever since the 1994 UN Conference on Population and Development in Cairo, a relentless Vatican campaign aligned with a claque of nations–among them some in which women most need good reproductive healthcare and rights of all kinds–continues to scaremonger. In its sloganeering, gender equality and sexual/reproductive rights become code words for abortion, feminism and lesbianism.
The debate over gender rights exposes deep fissures in the UN system. One of them is the divide between the expert UN agencies, bodies staffed largely by professionals, and the majority-rules General Assembly, which can box in the international civil servants of the Secretariat and constrain even a secretary general. In the weeks before he resigned in 2006, Kofi Annan tried to jump-start the creation of the new women’s agency and was slapped down by member governments. (Among the opponents at the time were large and important nations such as the United States and India.)
Annan’s successor, Ban Ki-moon, got the message and shied away from action when he took office at the beginning of 2007, turning the issue over to the Assembly, a surefire way to stall something innovative. Does this sound like the American healthcare debate?
On the other side of this UN divide are the autonomous or semiautonomous UN agencies where policies are set and decisions made with less political pressure. When Margaret Chan, a former director of health in Hong Kong, took over as director-general of WHO in 2007, she vowed that women’s health would be a priority, and she has been active on that front. So, to varying degrees, have the leaders of the UN Development Fund for Women (UNIFEM), the Population Fund (UNFPA) and UNICEF, the children’s fund.