Just a couple of weeks ago, I attended the Nairobi Summit on ICPD25, which marked the 25th anniversary of the International Conference on Population and Development held in Cairo in 1994. The trip was particularly meaningful to me, having been at the Cairo meeting where 179 governments made women’s sexual and reproductive health and rights a priority goal of global development.
The anti-rights opposition movement called it “the abortion summit,” but in truth, it was far from it. In my opinion, that’s a shame, because we — the global health, sexual and reproductive health, and development fields — need an abortion summit.
Each year, 56 million abortions occur globally. Of those, 25 million are unsafe, and approximately 44,000 women and girls die as a result. And 7 million more women in low-income countries suffer serious, often permanent, injuries.
Unsafe abortion is the cause of at least 8% of maternal deaths worldwide. The vast majority of these deaths and injuries are preventable and occur in places of widespread poverty. When we are talking about improving women’s health — specifically reproductive health — we can’t leave out abortion.
Only 2 of the 141 sessions included the word “abortion” in the title; that’s why I think we really do need an abortion summit. We are all invested in working to meet the ICPD promise of zero unmet need for contraception, zero preventable maternal deaths, and zero gender-based violence and harmful practices.
In a featured session on financing, one speaker noted that the cost of preventing maternal death in the next 10 years would be $115.5 billion. And meeting the need for contraceptives for women who want them but aren’t using them would cost $68.5 billion in the same time frame. The global development community must also focus efforts on expanding access to safe abortion to truly get to zero maternal deaths. The cost of not doing so is too great. The annual cost of treating complications from unsafe abortion is around $550 million.
Nearly 60,000 women risk their lives with an unsafe abortion every day, and nearly 7 million women go to the hospital in the countries in the global south each year as a result of these complications. We know several factors contribute to reducing abortion-related mortality: abortion law reform and implementation of induced-abortion services; improved access to contraception and safe abortion care; and increased access to medical abortion, including self-managed abortion.
Reducing the burden of unsafe abortion on women, their families, health care providers, and often fragile health care systems is a challenge — yet one that can be met.
This is why Ipas — in partnership with the Asian-Pacific Resource & Research Centre for Women, Center for Reproductive Rights, CHOICE for Youth and Sexuality, Marie Stopes International, Realizing Sexual and Reproductive Justice, SPECTRA, and Vecinas Feministas por la Justicia Sexual y Reproductiva de America Latina y el Caribe, a network of feminists working for sexual and reproductive justice in Latin America and the Caribbean — co-drafted the Global Declaration on Abortion.
The declaration, signed by more than 350 organizations, calls for governments, United Nations agencies, civil society organizations, health providers, the private sector, and the donor community to follow these five recommendations:
Make abortion — including abortion self-care — legal, accessible, and affordable by decriminalizing it. My colleague Ernest Nyamato, director of Ipas Africa Alliance, said in one session at the Nairobi Summit that liberalizing abortion laws and reducing stigma “would prevent millions of unsafe abortions in Africa.” In the same session, another speaker echoed his statement, saying that criminal abortion laws “confirm women’s lesser legitimacy.”
Ensure that universal health coverage integrates abortion into a comprehensive SRH package. Achieving UHC is going to require donors, NGOs, and community-based organizations to work side by side to influence the implementation of UHC at the national level.
Provide young people with comprehensive sexual education that supports their right to informed choice and autonomy, including evidence-based information on contraception and abortion.
4. Promote equality
Promote gender equality and autonomy for women and girls by implementing interventions at all levels to change harmful social and gender norms around sexuality, pregnancy, and abortion, and by engaging partners, relatives, and community members as supportive advocates for sexual and reproductive rights and abortion.
5. Be inclusive
Meet the SRH needs of marginalized groups such as young women, indigenous women, women with disabilities, unmarried women and girls, and transgender men.
I urge development actors to embrace these recommendations. We also need to work with communities to amplify their demand for comprehensive sexual and reproductive health services and ensure their voices are being heard. I know Ipas — and our partners — will continue to develop interventions to address and eradicate abortion stigma, to train more providers, to ensure women who choose to manage their own abortions have the information and support they need, and to advocate for safe and legal abortion, to name a few.
Abortion is health care. And health care is a human right. We will not achieve the Sustainable Development Goals without making abortion safe, legal, available, accessible, and affordable. It is time the broader development community recognizes this. We have to come together to move beyond ICPD25 to build a collective vision of what sexual and reproductive health, rights, and justice will look like for everyone — and maybe we could do that in a global abortion summit.