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second edition
– Learning to Speak MDGS, 2nd edition –


A publication of:
Youth Coalition
190 Maclaren Street, suite 200
Ottawa, Ontario
K2P 0L6

Tel +1 (613) 562-3522
Fax +1 (613) 562-7941
E-mail: admin@youthcoalition.org
Website: www.youthcoalition.org

Copyright © 2005, 2009 The Youth Coalition

This publication may be reproduced in whole or in part for educational or nonprofit purposes without special
permission from the copyright holder, provided that acknowledgment of the source is made. The Youth Coali-
tion would appreciate a copy of any document that uses this publication as a source.

No part of this publication may be used for commercial or resale purposes. The contents of this booklet solely
represent the opinions of the authors and not necessarily the views or policies of its financial contributors.
Table of Contents


    The MDGs: A Glossary								                                6


    Introduction									                                       7


    Chapter 1
    Learning to Speak MDGs							                               8


    Chapter 2
    Goal 2: Achieve Universal Primary Education					            11


    Chapter 3
    Goal 3: Achieving Gender Equality and Empowering Women			   13


    Chapter 4
    Goal 5: Improve Maternal Health						                       15


    Chapter 5
    Goal 6: Combat HIV/AIDS, Malaria and Other Diseases			      17


    Chapter 6
    Advocacy Opportunities for Youth Participation				          19


    References									                                         22




4
Acknowledgements

The Youth Coalition would like to extend its sincere appreciation to all of those who took the
time to work on this booklet. This project is over a year in the making and we are eager to
share the results of all our hard work with everyone.
For the first version of this publication, thank you to Monika Rahman, Sonu Chhina, Pamela
Pizarro (past YC Communications and Outreach Officer), Prateek Suman, and Tanya Baker
for their work on the English edits, to Gabriela Cano Azcarraga for her work on the layout and
art work and to Joana Chagas for her efforts in coordinating the work of the booklet.
For her work in coordinating the 2nd edition of this booklet, we would like to thank Tanya
Baker, as well as Emily Turk for her design work. We would also like to thank UNFPA for their
generous support, without which it would not have been possible to develop an updated ver-
sion of this resource.




                                                                                                 5
The MDGs: A Glossary

    Millennium Assembly: The 55th session of the UN General Assembly, which opened on
    September 5, 2000, was designated the “Millennium Assembly” to mark the turn of the mil-
    lennium.
    Millennium Summit: High-level meeting of heads of state convened September 6-8, 2000
    during the Millennium Assembly in order to discuss “The Role of the United Nations in the
    Twenty-First Century”.
    Millennium Forum: Representatives from over 1000 NGOs and 100 countries gathered in
    New York during May 22-26, 2000 prior to the official Millennium Summit. The “We the Peo-
    ples Millennium Forum Declaration and Agenda for Action” was drafted at this gathering in
    order to articulate a common civil society vision for the global agenda for heads of state to
    consider during the Millennium Summit.
    Millennium Declaration: The Declaration is the resolution passed by the member states at
    the Millennium Summit, rearticulating their commitment to the principles and values of the UN
    and outlining the hopes and challenges of the new century.
    Millennium Development Goals: Recognizing the plight of the world’s poor to be a major
    point of concern on the global agenda, eight specific development goals emanated from the
    Millennium Declaration. These goals are accompanied by specific targets to be achieved by
    the year 2015 and indicators to monitor progress towards the targets and goals (see Appen-
    dix).
    MDG Framework: As used in this booklet, the ‘MDG framework’ refers to the approach that
    has been adopted by UN agencies, governments and NGOs to use the MDGs as a guide for
    planning and implementing development activities. This involves observation and monitoring,
    analysis, as well as campaigning and mobilization around the MDGs.
    Millennium Project: Responsible for a large part of the analytical portion of the MDG frame-
    work, the Millennium Project was commissioned by Secretary-General Kofi Annan to propose
    the best strategies for meeting the MDGs. The Project is being directed by Professor Jeffrey
    Sachs of Columbia University and consists of 10 Task Forces concentrating on different as-
    pects of the MDGs.
    Global Millennium Campaign: This global campaign is being led by the United Nations De-
    velopment Programme (UNDP) to increase financial and trade opportunities for countries in
    the South and garner support from developed countries. The primary objectives of this Cam-
    paign are to disseminate data and analysis about the MDGs, to make connections between
    national campaigns and the global campaign, and to promote networking and partnership
    amongst key actors.
    Millennium Development Goal Reports (MDGRs): These are national progress reports
    prepared collaboratively by UN agencies working in different countries (UN Country Teams)
    in consultation with civil society and the government.




6
!
Introduction

The Youth Coalition for Sexual and Reproductive Rights (YCSRR) is an international orga-
nization of young people between the ages of 15 and 29 committed to advocating for sexual
and reproductive health and rights at the national, regional and international levels. The YC
has been active since 1999 in training young leaders in advocacy, as well as supporting and
actively advocating for youth sexual and reproductive health and rights at various United
Nations conferences and meetings. We recognize that the only way governments will honor
their commitments to young people is by having young people involved in the design, imple-
mentation and evaluation of programmes and policies that affect their lives.
The Millennium Development Goal (MDG) framework, which currently drives the develop-
ment agenda, lacks an important youth analysis and perspective, even though young people
are disproportionately affected by many of the development issues addressed by the goals.
Thus, in 2005 the Youth Coalition convened a global group of 60 young leaders working in
fields related to sexual and reproductive health and rights (SRHR), to learn about, and reflect
on the MDGs and to analyze the goals, targets, and indicators on Education, Gender Equal-
ity, Maternal Health, and HIV/AIDS with a youth perspective. This is an updated analysis of
the original publication produced in 2005 to complement the 10-year review of the MDGs in
2009.
This booklet is meant for young activists, individuals, non-governmental organizations
(NGOs), governments, and UN agencies that are working within the MDG framework. Learn-
ing to Speak MDGs provides a background of the origins of the MDGs and what they mean.
It analyzes the link between sexual and reproductive health and rights and development; and
reviews the current level of youth participation within strategies to achieve the MDGs. The
original publication included recommendations from the International Youth Forum on the
goals, targets and indicators related to Education, Gender Equality, Maternal Health, and HIV/
AIDS, however it is not included in this version in order to keep the information condensed
and due to the understanding that the establishment of new goals, targets and indicators re-
quire an in-depth understanding of health statistic and information gathering which is beyond
this document.
This booklet was entirely organized and realized by young people. As such, it is a clear rep-
resentation of young people’s issues, needs, and recommendations. We appreciate all the
hard work and commitment that individuals, organizations, governments, and agencies have
done in improving the quality of lives of current and future generations, and we hope you ap-
preciate all our hard work in creating this analysis and use our recommendations to reach the
Millennium Development Goals.




                                                                                                  7
1
    Chapter 1: Learning to Speak MDGs

    What are the Millennium Development Goals?
    The Millennium Development Goals (MDGs) originate from the Millennium Declaration1,
    which was unanimously adopted by 189 United Nations (UN) Member States at the Millen-
    nium Summit, a high-level meeting of heads of state, convened during the 55th session of the
    UN General Assembly in September 20002. The Millennium Declaration was a reaffirmation
    of the values, principles and objectives that are the foundation of the UN’s work, and also
    recognized new and continuing challenges to humanity that require universal collaboration
    and commitment to overcome. However, like other political declarations that result from world
    conferences and summits, the Millennium Declaration is not legally binding; its implementa-
    tion rests upon the political will of state leaders and decision-makers.
    As a follow-up to the outcome of the Millennium Summit, the UN General Assembly issued
    a resolution recognizing the necessity for creating a framework for the implementation of the
    Millennium Declaration and requested the UN Secretary-General (SG) to prepare a long-term
    “roadmap” that specifically detailed how these commitments could be fulfilled3. The UN Sec-
    retariat and some UN agencies worked in collaboration with the International Monetary Fund
    (IMF), the World Bank and the Organization for Economic Cooperation and Development
    (OECD) to issue the “Roadmap towards the implementation of the United Nations Millennium
    Declaration”4 in September 2001, which established the following eight MDGs:
                1.	            Eradicate extreme poverty and hunger.
                2.	            Achieve universal primary education.
                3.	            Promote gender equality and empower women.
                4.	            Reduce child mortality.
                5.	            Improve maternal health.
                6.	            Combat HIV/AIDS, malaria and other diseases.
                7.	            Ensure environmental sustainability.
                8.	            Develop a global partnership for development.


    The goals themselves are broad and ambitious, however they also include a set of time-
    bound targets and indicators that aim to track progress and provide a focus for those working
    within the MDG framework (see the Appendix for a complete list of the MDGs, and accom-
    panying targets and indicators). All the goals are interlinked and cannot be achieved without
    the others: we cannot eradicate extreme poverty and hunger if women do not have equal
    opportunities; we cannot achieve universal primary education if girls are at home taking care
    of relatives affected by HIV and AIDS; and we cannot achieve any of the first seven goals if
    developed countries do not provide financial support for development.
    It is significant that 189 nations have achieved consensus over a common international devel-
    opment framework that has changed the focus from economic targets to social ones. Setting
    goals and targets enables all relevant actors to agree on priorities for the development agen-
    da, nurtures a feeling of solidarity and can be successful in fostering support from decision-
    makers and high-ranking political figures that are integral to realizing such goals. However,
    countries remain in various stages in development and in some cases have already achieved
    the targets set by the MDGs. In this case, it is the responsibility of these governments to
    raise the bar and define new targets to further advance the implementation of the Millennium
    Declaration.




    1   United Nations Millennium Declaration (A/RES/55/2), 18 September, 2000 - http://www.un.org/millennium/declaration/ares552e.pdf   	
    2 For more information on the Millennium Assembly and Summit, visit http://www.un.org/millennium/. 	
    3   General Assembly Resolution 55/162 - http://www.un-ngls.org/MDG/A-RES-55-162.pdf.   	
    4 Roadmap towards the implementation of the United Nations Millennium Declaration http://www.un.org/documents/ga/docs/56/a56326.pdf.	


8
Where did the Millennium Development Goals come from?
The MDGs are certainly not the first set of development goals that have emerged on the
global agenda. Since the creation of the UN, the international community has lived through                                                                 Box 1.
                                                                                                                                                                               Abridged List of
four “development decades” (starting in the 1960s) that have produced numerous sets of                                                                                         Recent World
                                                                                                                                                                               Conferences
goals aiming to improve the quality of people’s lives. Most recently, the 1990s and early years
of the 21st century saw a series of world conferences that brought together all the key UN
players, national level decision makers and included unprecedented levels of civil society                                                                 1990 - World Summit for Children
participation. Each of these conferences focused on a specific topic area, identified relevant                                                             Outcome: World Declaration on the
areas of concern and resulted in commitments by UN member states to agreed programmes                                                                      Survival, Protection and Development
                                                                                                                                                           of Children and Plan of Action
of action (see BOX 1).
                                                                                                                                                           1992 - UN Conference on Environ-
                                                                                                                                                           ment and Development
Many are calling the Millennium Summit the pinnacle of these conferences. Indeed, the Mil-
lennium Declaration reaffirms the outcomes of these conferences, as well as important in-                                                                  Outcome: Rio Declaration and Agen-
                                                                                                                                                           da 21
ternational human rights treaties, such as the Convention on the Rights of the Child (CRC)
                                                                                                                                                           1993 - World Conference on Human
and the Convention on the Elimination of All Forms of Discrimination Against Women (CE-                                                                    Rights
DAW). The MDGs and targets are also meant to reflect the commitments that governments                                                                      Outcome: Vienna Declaration and
made during the world conferences. However, they do not adequately capture the compre-                                                                     Programme of Action
hensive set of goals and recommendations that had been set throughout the 1990s and the                                                                    1994 - International Conference on
early years of this century. Most blatantly missing in the original agreed declaration was any                                                             Population and Development

reference to Sexual and Reproductive Health and Rights. Fortunately during the five year                                                                   Outcome: Cairo Programme of Action
review of the MDGs, Sexual and Reproductive Health was considered a cross-cutting issue                                                                    1995 - Fourth World Conference on
(http://www.unmillenniumproject.org/reports/srh_main.htm). And in 2006 Kofi Anan, the then                                                                 Women

UN Secretary General announced that there would be a new Reproductive Health target ‘to                                                                    Outcome: Beijing Declaration and
                                                                                                                                                           Platform for Action
achieve universal access to reproductive health’ under MDG 5.
                                                                                                                                                           1995 - World Summit for Social De-
Further criticism of the MDGs includes it being too narrow and lacking the human rights per-                                                               velopment

spective that framed the outcomes of the world conferences. Finally, the framework may be                                                                  Outcome: Copenhagen Declaration
                                                                                                                                                           on Social Development and the Pro-
too limited by the small number of numeric indicators that are supposed to assess progress                                                                 gramme of Action
towards the achievement of improved quality of life for all of the world’s people5.                                                                        1996 - Second UN Conference on
                                                                                                                                                           Human Settlements

                                                                                                                                                           Outcome: Istanbul Agenda and Habi-
                                                                                                                                                           tat Declaration
How does the MDG framework “work”?
                                                                                                                                                           1996 - World Food Summit
Achieving the MDGs requires the participation of all the actors working towards development
                                                                                                                                                           Outcome: Rome Declaration and Plan
and numerous interrelated strategies. The then UN Secretary General Kofi Annan appointed                                                                   of Action
United Nations Development Programme (UNDP) Administrator Mark Malloch Brown as chair                                                                      2001 - World Conference against
of the UN Development Group, to coordinate the integration of the MDGs throughout the work                                                                 Racism, Racial Discrimination, Xe-
                                                                                                                                                           nophobia and Related Intolerance
of the UN worldwide and also to mobilize the support and participation of civil society and gov-
                                                                                                                                                           Outcome: Durban Declaration and
ernments. UNDP has developed a framework to accomplish this, at the foundation of which                                                                    Programme of Action
three core strategies that are hoped will help achieve the goals rest upon6:
                                                                                                                                                           2002 - World Summit on Sustain-
                                                                                                                                                           able Development
Observation and Monitoring - Continuous collection of data is underway to compile statis-
                                                                                                                                                           Outcome: Johannesburg Declaration
tics regarding each of the targets and indicators in the MDG framework in order to assess                                                                  and Plan of Implementation
whether progress towards the goals has been made. The UN Department of Economic and
Social Affairs on the global level, and the Regional Commissions on the regional level, in col-
                                                                                                                                                           *NOTE: Five and ten-year reviews meetings
laboration with various UN agencies, are keeping track of all the latest statistics available7.                                                            have been held for most of these conferences
                                                                                                                                                           and summits in order to review progress of the
The UN Inter-Agency and Expert Group (IAEG) on MDG Indicators and its subgroups regu-                                                                      implementation of the conference outcomes.
larly review the indicators to monitor their suitability, feasibility of data collection (or estima-
tion) and global availability of data.
The General Assembly also requested that the SG prepare a comprehensive report every
five years, supplemented by an annual report on progress achieved towards the Millennium
Declaration8. The first five-year report “In Larger Freedom: Towards Security, Development
and Human Rights for All”9 was launched on March 21st, 2005.


5 Robinson, Mary. “Mobilizing People to Claim Rights” in Seeking Accountability on Women’s Human Rights. Women’s International Coalition for Eco-
nomic Justice (WICEJ): Mumbai, 2004.    	
6 The UN and the MDGs: a Core Strategy http://www.un.org.dj/UNDJ-RC/the%20UN%20and%20the%20MDG%20A%20Core%20Strategy.pdf	
7   For Millennium Development Goals Indicators visit the United Nations Statistics Division at http://unstats.un.org/unsd/mi/mi_worldmillennium_new.asp

8 General Assembly Resolution 55/162 - http://www.un-ngls.org/MDG/A-RES-55-162.pdf. For SG Reports, visit http://www.un.org/millennium/	
9   ”In Larger Freedom: Towards Security, Development and Human Rights for All” (A/59/2005) www.un.org/largerfreedom       	

                                                                                                                                                                                 9
On the national level, UN Country Teams (made up of all UN agencies involved in each coun-
                                     try) are supporting governments to produce periodic national progress reports in close con-
                                     sultation with NGOs and the private sector and to collect national data to monitor progress.
                                     In some countries and regions, civil society is also monitoring the goals parallel to UN and
                                     governmental efforts as ‘shadow reports’ to highlight those issues or progress that may not be
                                     adequately reflected in the formal reports.
                                     Analysis - In order to identify the best strategies to meet the MDGs, the Millennium Project10
Millennium Project         Box 2.    was launched in July of 2002 under the guidance of the Secretary-General and Professor
       Task Forces                   Jeffrey Sachs of Columbia University’s Earth Institute. This project convened 10 Task Forces
                                     comprised of scholars, policy-makers and practitioners, who analysed the different issue ar-
Task Force 1: Poverty and Eco-       eas covered by the MDGs (see Box 2). Each Task Force has launched a report that reviewed
nomic Development                    innovative practices and identified promising strategies to successfully achieve each goal.
Task Force 2: Hunger                 The final Millennium Project Report “Investing in Development” brings together all the rec-
Task Force 3: Primary Education      ommendations and presents an operational framework that would allow even the poorest
and Gender Equality                  countries to achieve the MDGs by 2015. Individual country studies are also being undertaken
Task Force 4: Child Health and Ma-   by governments, NGOs, the World Bank, the International Monetary Fund (IMF) and donor
ternal Health
                                     countries in order to identify necessary changes in institutional structures and assess what
Task Force 5: HIV/AIDS, Malaria,
TB, Other Major Diseases, and Ac-
                                     kind of financing options would be necessary to make the MDGs possible.
cess to Essential Medicines

Task Force 6: Environmental Sus-
                                     Furthermore, Sexual and Reproductive Health (SRH) and Energy were found to be cross-
tainability                          cutting issues which are necessary to be addressed in order to reach the MDGs. These
Task Force 7: Water and Sanita-      groups have separate reports and recommendations as part of the Millennium Project. In
tion                                 the reports and background papers related to SRH, there was an emphasis on adolescents
Task Force 8: Improving the Lives    as a key theme related to poverty and gender inequality (http://www.unmillenniumproject.org/
of Slum Dwellers
                                     reports/srh_main.htm).
Task Force 9: Open, Rule-Based
Trading Systems                      Governments also regularly analyze their progress to towards reaching the MDGs. There are
Task Force 10: Science, Technol-     national, regional and donor MDG reports that are done in collaboration with national gov-
ogy and Innovation
                                     ernments and UN bodies to monitor the progress of reaching the goals and determine which
                                     areas need to be improved. (http://www.undg.org/index.cfm?P=3)
                                     Campaigning and Mobilization - Because achieving the MDGs requires the commitment of
                                     many sectors of society beyond the UN system, including political leaders and civil society,
                                     the process of mobilizing different actors to build awareness and foster collaboration is sup-
                                     ported and/or led by UN agencies. The results of monitoring and analysis will be provided to
                                     support campaigns and the UN will also provide direction for the establishment of network-
                                     ing and partnership building between actors. Campaigning and mobilizing popular support is
                                     important to direct public pressure towards political leaders to fulfill their commitments. It is
                                     also crucial to gaining support from local and national organizations that are central to the
                                     actual implementation of strategies. Global-level campaigning is also being done through the
                                     Global Millennium Campaign11 to put pressure on developed countries to provide support to
                                     developing countries through aid, trade, debt relief and other necessary means.




                                     10 See http://www.unmillenniumproject.org for more details and final reports.
                                     11 See http://www.millenniumcampaign.org for more details

                10
2
Chapter 2: Goal 2: Achieve Universal Primary
Education

“To ensure that (…) children everywhere, boys and girls alike, will be able to complete a full
course of primary schooling and that girls and boys will have equal access to all levels of
                                                                                  education.”
                                      Millennium Declaration, adopted on 18 September 2000


Universal primary education is more than getting all children to sit in schools to learn how to
read and write so that they may secure better employment as adults. Education is critical in
providing individuals with the tools and knowledge to make informed decisions, to have the
ability to undertake analysis and to live their lives to their fullest potential. Primary education
is a crucial stage when children and adolescents begin to form attitudes about sex, gender
roles, and sexual identity. As such, it is also an opportunity for change in social attitudes and
norms to occur.
Learning about sexual and reproductive health and rights is a core part of every individual’s
development process. Sexual and reproductive education must be scientifically based and
comprehensive. Special emphasis should be placed on combating the taboos and myths
about sexuality, reproduction and gender that impede young people’s ability to make as-
sertive choices, to protect their health, and to develop to their highest potential. Moreover,
education should instill respect for different cultures, religions, ethnicities, genders and sexual
diversities.
During primary education, children and adolescents must receive information about their hu-
man rights, including their sexual and reproductive rights. Young people, adolescents, and
children are particularly vulnerable to sexual violence, exploitation and coercion. Creating
awareness of their rights is a way to provide them with tools to confront the challenges they
face.
Moreover, it is urgent that governments take measures to address gender disparities and
inequalities in schools. In regions such as Africa and Asia Pacific, girls continue to struggle to
achieve the same educational levels as boys, while in many other regions the percent of girls
and boys attending school is generally equal. It is also critical to ensure that school curricula
and educational settings do not reinforce traditional gender roles that subordinate women and
girls, but that they are gender sensitive and promote gender equality and empowerment.


MDG#2 – for or against our rights?
The narrow focus of Goal # 2, concentrating only on primary education, is problematic. The
gains made early by ensuring parity in enrollment are often lost due to the low completion
rates of not only girls but that of boys as well. For many young people worldwide, formal
education ends just before the stages of secondary and tertiary education. Higher education
contributes more than primary education alone towards improving conditions in the lives of
young people, especially women. Their societies and local communities also stand to gain
from their continuation of education onto higher levels.
The enrolment and completion indicators for MDG 2 are broad and general and do not take
into account region-specific situations. The type and quality of education a child receives is
dependent on where she or he is born and where they grow up. The main barriers to edu-
cation are: poverty; discrimination against marginalized communities; cultural and religious
beliefs; rural versus urban disadvantage; taboos against sexuality education; gender discrimi-
nation; disability; armed conflict; HIV status; inefficient or corrupt school systems; incorrect
and biased content of school curricula; and educational initiatives by dictatorial or autocratic
governments among others. In implementing MDG 2, efforts must be taken to address these
barriers and to ensure equal access to education for all.
The goal of education must be to enable people to live fulfilling and empowered lives. While



                                                                                                      11
literacy - the ability to read, write, and count - is one crucial aspect of education, an improved
                                            literacy rate alone does not necessarily mean that people have gained the tools they need
            Goal 2:
   Achieve Universal                        to improve their lives and prospects, and subsequently their health. It does not mean that
  Primary Education
                                            everyone has access to the crucial preparatory knowledge they need to protect themselves
  Target 3:
                                            against abuse, exploitation, unintended pregnancies, sexually transmitted infections including
  Ensure that, by 2015, children ev-        HIV/AIDS. Moreover, it also does not necessarily translate into citizens being able to exercise
  erywhere, boys and girls alike, will
  be able to complete a full course of      their human rights. Education is incomplete without sexual and reproductive health and rights
  primary schooling                         information and education. Education is incomplete if children and adolescents do not learn
  Indicator 6:                              about gender equality and human rights. Incomplete or inaccurate education, such as promo-
  Net enrolment ratio in primary edu-
  cation                                    tion of abstinence only education, violates young people’s human rights and can negatively
  Indicator 7a:
                                            impact their ability to make informed decisions about all aspects of their lives.
  Proportion of pupils starting grade 1
  who reach grade 5                         In many countries, the primary school curriculum still does not include a component on gen-
  Indicator 7b:                             der equality to combat gender stereotypes that result in the unfair treatment of girls. Primary
  Primary completion rate                   education is a crucial opportunity to address discrimination, promote gender equality, the
  Indicator 8:                              empowerment of women and girls and to reduce their vulnerability.
  Literacy rate of 15 to 24 year-olds
                                            Special efforts need to be made to ensure that girls have the opportunity to complete full
                                            courses in primary, secondary and tertiary education. Girls who are educated are more likely
                                            to delay marriage and first pregnancy, and this consequently leads to reductions in maternal
                                            and infant mortality rates. Women with tertiary levels of education have more opportunities
ICPD+5, 35b                                 and skills that can be translated into genuine women’s empowerment. An empowered woman
Include at all levels, as appropriate, of   can overcome the strongest social and cultural barriers and gender-inequality challenges.
formal and non-formal schooling, edu-
cation about population and health is-
sues, including sexual and reproduc-        The most important agents of change, those who have the ability to address barriers to edu-
tive health issues, in order to further
implement the Programme of Action
                                            cation and ensure education for all, are national governments, international development
in terms of promoting the well-being        organizations (such as UNICEF, UNIFEM, UNDP, UNFPA), community and religious leaders,
of adolescents, enhancing gender
equality and equity as well as respon-      the media, role models, multinational organizations, the private sector, peacekeeping forces,
sible sexual behavior, protecting them
from early and unwanted pregnancy,
                                            NGOs and youth themselves.
sexually transmitted diseases includ-
ing HIV/AIDS, and sexual abuse, in-
cest and violence.

Convention of the Rights of the
Child, Article 28
1. States Parties recognize the right of
the child to education and with a view
to achieving this right progressively
and on the basis of equal opportunity,
they shall, in particular:
(a) Make primary education compul-
sory and available free to all;
(c) Make higher education accessible
to all on the basis of capacity by every
appropriate means;
3. States Parties shall promote and
encourage international cooperation
in matters relating to education, in
particular with a view to contributing
to the elimination of ignorance and
illiteracy throughout the world and fa-
cilitating access to scientific and tech-
nical knowledge and modern teaching
methods. In this regard, particular ac-
count shall be taken of the needs of
developing countries.

Article 29
1. States Parties agree that the edu-
cation of the child shall be directed to:

(a) The development of the child’s
personality, talents, and mental and
physical abilities to their fullest po-
tential;

(d) The preparation of the child for re-
sponsible life in a free society, in the
spirit of understanding, peace, toler-
ance, equality of sexes, and friendship
among all peoples, ethnic, national
and religious groups and persons of
indigenous origin.




                    12
3
Chapter 3: Goal 3: Achieving Gender Equality
and Empowering Women

“To promote gender equality and the empowerment of women, as effective ways to combat
        poverty, hunger and disease and to stimulate development that is truly sustainable”
                                      Millennium Declaration, adopted on 18 September 2000


Gender is a social construct, which defines the roles human beings are expected play in soci-
ety based on our biological bodies. Gender roles are also related to culture, religion, tradition
and customary practices that exist in our societies. They establish social expectations for
what people do, but more than that, they set expectations about who people are.
Historically, women’s political and social identities have been constructed in terms their bio-
logical and reproductive roles: women are first seen as mothers and wives who look after the
well being of the family. Due to their role in the family, women have often been obliged to
remain in the home and their participation in the economic, social and political processes in
their societies has traditionally been limited. Because the home is in the private sphere, there
are often no mechanisms to prevent women from being oppressed or treated with violence or
abuse, which frequently makes the home a place where women’s human rights are violated.
Women’s contributions to society have often been under-valued: the work ascribed to women,
the reproductive work done in the private sphere of the family and home, has been seen as
less important than the productive work done traditionally by men in the public sphere. When
women’s lives are constrained to the private sphere of the family, it is easy for governments
and their institutions to ignore women’s needs and rights.
In most societies, stereotypes about gender roles that place women in a subordinate position
to men have been embedded in legal frameworks and social structures. This has resulted
in systemic gender inequality and discrimination, which limits women’s and girls opportuni-
ties for personal development and empowerment, has negative consequences on women’s
and girls health, education, and participation in economic, social and political processes and
increases women’s vulnerability to violence.
Many threats to a woman’s and girl’s development and empowerment are experienced during
adolescence and young woman stages of her life cycle. For example, one way that gender
inequalities are reinforced in most societies is by controlling and suppressing young women’s
sexuality. This manifests in early and unwanted marriage and pregnancy, sexual violence,
abuse and coercion and trafficking for sexual exploitation. Some cultural norms and religious
traditions often devalue the girl-child and lead to numerous undesirable practices, including
prenatal sex-selection, son preference, female genital mutilation/cutting and interruption of
educational opportunities. Not only are they often-harrowing experiences, but they impede a
woman’s right to access education, employment and income-generating opportunities, freely
develop her sexuality and sexual orientation, and the capacity to control her own body, life
and destiny.


MDG#3 – for or against our rights?
While the importance of MDG 3 is obvious, the problem lies in its limitation to a single target:
to eliminate gender disparity in education. In many countries, the gender gap in education
has already been overcome but it certainly does not mean that gender equality has been
achieved. Although we recognize the importance of education for achieving women’s em-
powerment and the promotion of gender equality, we also know that access to education
alone rarely translates into higher access to decent employment, income, or participation in
decision-making in the political arena, especially for young women.
Access to education does not necessarily mean access to quality education. School materi-
als and books often reinforce stereotypical gender identities and roles - for men and women
- as well as power dynamics. School settings aren’t always safe and can sometimes increase
a girl’s risk of physical and sexual violence. Special emphasis needs to be given to ensure
that girls have access to quality, gender-sensitive education that actively combats gender
stereotypes and promotes gender equality and women’s empowerment. In addition, schools

                                                                                                    13
need to be made girl-friendly by increasing the number of female teachers and prohibiting and
                                              punishing teachers and students who perpetrate gender-based violence.
               Goal 3:
Promote Gender Equality
  and Empower Women                           Too often, education is a loaded concept with many restrictions imposed by the state or re-
                                              ligion with respect to history and rights. Emphasis should be given to the improvement of
    Target 4:                                 creative and critical thinking skills, which will increase capacities and allow girls and young
    Eliminate gender disparity in pri-
    mary and secondary education,             women to react thoughtfully to an ever-changing world.
    preferable by 2005 and in all levels
    of education no later than 2015.          Access to education should also mean access to comprehensive, youth-friendly sexuality
    Indicator 9:                              and reproductive health education. In too many cases human sexuality is approached from a
    Ratio of girls to boys in primary, sec-
    ondary and tertiary education.            biological perspective, if it is approached at all, and does not provide young women with the
    Indicator 10:
                                              skills they need to protect their sexual and reproductive health or exercise their sexual and
    Ratio of literate women to men, 15        reproductive rights. Sexuality education must also break down the erroneous social construc-
    to 24 years old.
                                              tions around sexuality, as well as taboos and myths.
    Indicator 11:
    Share of women in wage employ-
    ment in the non-agriculture sector.
                                              Education in schools rarely provides students, male and female, with knowledge concerning
                                              their human rights or with the empowerment to exercise and demand respect for their rights.
    Indicator 12:
    Proportion of seats held by women         Human rights education, including education on gender equality and women’s human rights
    in national parliaments.                  must be a part of school curricula. Sending girls to school alone does not eliminate violence
                                              against women and is not enough to guarantee the re-configuration of social attitudes to-
                                              wards women and gender roles.
                                              Some chosen indicators to measure progress of MDG 3 (labor and political participation indi-
                                              cators) have no linear relation with their target: the fact that there are more women occupying
                                              seats in the parliament (indicator #12) is not a direct result of overcoming gender disparities
                                              in education, nor is the answer to the goal of arriving at real gender equality. Increasing
                                              women’s participation should not be a priority only in the political arena, although this is
                                              important, but in all spheres of social life. The same is true for indicator #11: more women
                                              in wage-earning employment does not necessarily mean that we have overcome gender
                                              disparities in education nor achieved gender equality, since women still earn less than men
                                              for the same job or occupation no matter what their education in most countries. Barriers to
   Fourth World Conference on Wom-            women’s access to decent and productive employment include violations of women’s labour
   en, Beijing Platform for Action
                                              rights, such as sexual harassment in the workplace, the requirement that women produce a
   Paragraph 96 of the Beijing PFA re-        medical certificate establishing that they are not pregnant, and young women’s placement in
   fers to women’s rights “to have control
   over and decide freely and responsi-       low-level positions no matter their capacities, which also need to be addressed.
   bly on matters related to their sexual-
   ity, including sexual and reproductive
   health, free of coercion, discrimina-      Gender also goes beyond women; it also includes men (and masculinities), and other gender
   tion and violence. Equal relationships     identities, such as transsexual, transgender, intersex, and others. So, in order to achieve
   between women and men in matters
   of sexual relations and reproduction,      gender equality, all human beings regardless of their gender identity or sexual orientation -
   including full respect for the integrity
   of the person, require mutual respect,     whether they are straight, lesbian, gay or bisexual - must have the same opportunities to live
   consent and shared responsibility          in dignity, free from violence, prejudice and/or discrimination. Human diversity needs to be
   for sexual behaviour and its conse-
   quences.”                                  understood as a major part of the richness within humanity instead of been seen as a threat
                                              to established patterns of socialization and development.
                                              The majority of the most exploited and poorest women are often women facing multiple bar-
                                              riers created by the intersection of discrimination based on race, religion, ethnicity, class,
                                              ability, sexual orientation and age. Shifting the focus away from their condition and the re-
                                              lationships between these forms of discrimination will thwart our efforts to eradicate poverty
                                              and achieve equality.




                      14
4
Chapter 4: Goal 5: Improve Maternal Health

“… to have reduced maternal mortality by three quarters, and under-five child mortality by two
                                                                 third of their current rates”
                                                          Millennium Declaration, adopted on 18 September 2000


                                                  “ to achieve universal access to reproductive health by 2015”
                                                                            New target established in 2006 under MDG5


There is no internationally recognized and agreed definition of maternal health. To understand
maternal health (or women’s health when they enter the stage of reproduction), we need to
look at how ICPD defines reproductive health. Reproductive health is “a state of complete
physical, mental and social well-being and not merely the absence of disease or infirmity, in
all matters relating to the reproductive system and to its functions and processes....”. This
definition of reproductive health is more encompassing and internationally accepted than the
term maternal health, which is criticized for placing the emphasis on women as merely pro-
creators and mothers, rather than humans with distinct needs and rights. Though women do
have special needs throughout pregnancy, birth and the postpartum period, maternal health
should be framed within a broader and more comprehensive sexual and reproductive health
and rights approach if significant improvements are to be made. Accordingly, experts and
activists worked hard to ensure that reproductive health was included as an additional target
when the MDGs were reviewed in 2005
Unfortunately, progress in maternal health has slowed down.12 More women in develop-
ing countries are dying during pregnancy or childbirth from predominantly five direct and                                                Goal 5:
avoidable obstetrical complications, including hemorrhage, infection, hypertensive disorders,                                            Improve Maternal Health
obstructed labour and unsafe abortion. These direct causes of mortality and morbidity are
intensified by early childbearing, frequent and numerous pregnancies, sexually transmitted                              Target 6a:
infections - including HIV/AIDS, and violence or harmful practices against women and girls,                             By 2015, reduce by three-quarters the
                                                                                                                        maternal mortality ratio
such as female genital mutilation/cutting. These incidents occur or begin at the early stages
                                                                                                                        Indicator 16:
of women’s reproductive years, during adolescence and youth. Thus, maternal mortality                                   Maternal mortality ratio
must be considered a young women’s issue. Furthermore, the vulnerability of girls and young
                                                                                                                        Indicator 17:
women to sexual exploitation and violence is an increasing barrier to improving maternal                                Proportion of births attended by skilled
                                                                                                                        health personnel
health.
There are many barriers that women, especially young women, face in accessing maternal                                  Added in 2006:
health care, such as inadequate health systems (transportation, financial conditions, avail-                            Target 6b:
ability of pharmaceuticals and medical supplies) and lack of proficient health professionals,                           By 2015, achieve universal access to
                                                                                                                        reproductive health
including skilled attendants and emergency obstetrical care providers. When young women,
especially unmarried young women, do attempt to access maternal health care, they are of-                               New proposed indicators for target
                                                                                                                        6b:
ten met with stigma and discrimination and experience a lack of confidentiality and continuity
                                                                                                                          Indicator 18: Contraceptive Preva-
in their care. Therefore, safe motherhood is only achieved through strengthening of health                                lence (CPR) (moved from MDG 6
systems and infrastructures and implementation of previous international commitments that                                 (to combat HIV/AIDS, malaria and
                                                                                                                          other diseases )to MDG 5
recognize, promote and protect sexual and reproductive rights of young women. The 2005
                                                                                                                          Indicator 19: Unmet need for fam-
Millennium Project Taskforce report on maternal and child health goes further, saying that                                ily planning (UMN)
a fundamental shift in the approach to health systems is needed. It states that the current                               Indictor 20: Age-specific fertility
fragmented health systems, which are often promoted in development aid, are inadequate to                                 rate (ASFR) for 15 – 19 years age
                                                                                                                          group
ensure availability, access and utilization of key services. The costs incurred by individuals
through their interaction with the health system can deepen poverty and that as a core social
institution, dysfunctional and abusive health systems can intensify exclusion, voicelessness
and inequality, which is ever more apparent for young women. (Millennium Project Report)


MDG#5 – for or against our rights?
The term ‘maternal health’ reduces the rights of a woman to those of a mother’s rights. It is
regressive in the context of Cairo and Beijing commitments, where reproductive health frames


12 World Health Organization (WHO), World Health Report, 2005 [http://www.who.int/whr/2005/en/]


                                                                                                                                          15
a more holistic, informed choice model of women’s health.
Convention on the Elimination of
All Forms of Discrimination against           The goal is precise but the original indicators were limited and incomplete. Averting death
Women (CEDAW) in 1981:
                                              from pregnancy or childbirth related causes and increasing access to maternity facilities does
The “right to decide freely and respon-
sibly on the number and spacing of
                                              not sum up to the attainment of maternal health. For that, every woman, during the early
their children and to have access to          stages of her life, has to be made aware of her right to decide freely on the number and spac-
information, education and means to
enable them to exercise these rights”         ing of her children and her right to make decisions concerning reproduction free of discrimi-
(Article 16.1) was codified in formal law
as a woman’s human right (Source:
                                              nation, coercion and violence.13 As a reflection of this, new recommended indicators for the
UN 1979)                                      recent target of universal Reproductive Health include the Contraceptive Prevalence rate and
The Programme for Action of the UN            the unmet need for family planning (UMN). The UMN can also serve as a useful indicator of
International Conference on Popula-
tion and Development definitions of
                                              the response of the health system in general to the needs of women and families. (Technical
reproductive health and reproduc-             consultation on RH indicators)
tive rights (Source: UN 1994)

Reproductive health is a state of             Full access to sexual and reproductive health information and services is also considered
complete physical, mental and social
well being and not merely the absence
                                              critical (Millennium Project – Child and Maternal Health). This includes having access to
of disease or infirmity, in all matters       comprehensive SRH education that enables her to make informed decisions about all as-
relating to the reproductive system
and to its functions and processes.           pects of her sexual and reproductive lives and access to comprehensive sexual and repro-
Reproductive health therefore implies
that people are able to have a satis-
                                              ductive health services, including modern, safe contraceptives, the means to protect herself
fying and safe sex-life and that they         from STIs/HIV and safe abortion services.
have the capability to reproduce and
the freedom to decide if, when and how
often to do so. Implicit in this last con-    A complex set of social, cultural and economic forces are barriers to attaining young people’s
dition are the right of men and women
to be informed and to have access to
                                              sexual and reproductive rights. In many parts of the world, girls marry before the age of 18.
safe, effective, affordable and accept-       Early marriage reduces girls’ educational and skills building opportunities and starts them on
able methods of family planning of
their choice, as well as other methods        a path toward early childbearing.14
of their choice for regulation of fertility
which are not against the law and the         Younger women, especially teenagers are biologically at an increased risk for complications
right of access to appropriate health-
care services that will enable women          during pregnancy, most apparently from obstructed labour due to their not yet fully mature
to go safely through pregnancy and
childbirth and provide couples with the       pelvis. Even when adolescents deliver their babies in health facilities, they suffer higher rates
best chance of having a healthy infant.       of mortality than older women.15 Giving birth at an early age often leads to frequent child-
In line with the above definition of re-
productive health, reproductive health-       bearing, which, without adequate spacing, can deplete nutritional stores of the woman thus
care is defined as the constellation
of methods, techniques and services           increasing the likelihood of death or disability with each pregnancy. When young women are
that contribute to reproductive health        faced with unwanted pregnancies, they are more likely to resort to unsafe and self-induced
and well being through preventing and
solving reproductive health problems.         abortion and to postpone abortion until later in pregnancy, which drastically increases their
It also includes sexual health, the
purpose of which is the enhancement           health risks.16 Legislation must be passed to; criminalize child marriage, allow young preg-
of life and personal relations, and not       nant women and mothers to continue their education with their peers and ensure access to
merely counseling and care related to
reproduction and sexually transmitted         safe abortion services. In recognition of the specific reproductive health needs and risks of
diseases (paragraph 7.2).
                                              adolescent girls and young women, a new indicator was suggested to specifically determine
Bearing in mind the above definition,         the Age-specific fertility rate (ASFR) for the 15 – 19 years age group. (Technical consultation
reproductive rights embrace certain
human rights that are already recog-          on RH indicators)
nized in national laws, international
human rights documents and other
consensus documents. These rights             Health systems in developing countries must be improved to provide women-centered, in-
rest on the recognition of the basic          formed-choice family planning and timely access to emergency obstetrical services.17 Al-
right of all couples and individuals to
decide freely and responsibly the num-        though Emergency obstetric care (EmOC) was considered an indicator for the reproductive
ber, spacing and timing of their children
and to have the information and means         health target, it was not recommended because there is a limited baseline set of data, lack of
to do so and the right to attain the high-    data collection systems and lack of a standardized approach. (Technical consultation on RH
est standard of sexual and reproduc-
tive health. It also includes their right     indicators) The reproductive health supplies that go to developing countries must be sustain-
to make decisions concerning repro-
duction free of discrimination, coercion      able; patent, trade and aid restrictions of these essential commodities must be addressed.
and violence, as expressed in human           (ref: RH supplies initiative)
rights documents. In the exercise of
this right, they should take into account
the needs of their living and future chil-    The rights of HIV positive pregnant women to gain access to free, voluntary testing and coun-
dren and their responsibilities towards
the community. The promotion of the           seling, as well as affordable ARV treatment to prevent mother-to-child transmission, is an
responsible exercise of these rights for      essential aspect of the maternal health care framework. Treatment, care and support for
all people should be the fundamental
basis for government and community-           HIV positive women cannot end after the baby is born and must be provided throughout their
supported policies and programmes
in the area of reproductive health,           lifespan. In order to make effective, culturally specific and well-received messages regarding
including family planning. As part of         sexual and reproductive health, young people must be involved in the design, implementa-
their commitment, full attention should
be given to the promotion of mutu-            tion and monitoring of policies and programmes, including those aimed at training healthcare
ally respectful and equitable gender
relations and particularly to meeting         providers to be more responsive to young women’s needs.
the educational and service needs of
adolescents to enable them to deal in a
positive and responsible way with their
sexuality (paragraph 7.3).


                                              13 Convention on the Elimination of all Forms of Discrimination (CEDAW) 1981	
                                              14 UNFPA State of the World Population 2003:Making 1 billion count, investing in Adolescents’ Health and Rights [http://www.unfpa.org/swp/2003/eng-
                                              lish/]

                                              15 Millennium Project Taskforce on Maternal and Child Health, 2005 [http://www.unmillenniumproject.org/reports/tf_health.htm]	
                                              16 UNFPA State of the World Population 2003
                                              17 Freedman, Lynn, Strategic advocacy and maternal mortality: moving targets and the millennium development goals	

                   16
5
Chapter 5: Goal 6: Combat HIV/AIDS, Malaria and
Other Diseases

“To have (…) halted, and begun to reverse, the spread of HIV/AIDS, the scourge of malaria
and other major diseases that afflict humanity. (…) To provide special assistance to children
                                                                    orphaned by HIV/AIDS.”
                                      Millennium Declaration, adopted on 18 September 2000


HIV and AIDS is considered one of the most devastating illnesses on the world’s sexual and
reproductive health report card. The brunt of this pandemic is being borne by the world’s
youth, especially in developing countries. The fact that approximately 45% of new infections
are being recorded in the 15 - 24 age bracket (UNAIDS) is the most compelling evidence of
the lack of comprehensive sexual and reproductive health services and education for young
people and part of the larger realm of the denial of sexual and reproductive rights for youth
globally.
Consider this: most young people living with HIV are unaware that they are even carrying the
virus. Many millions more, even in high prevalence regions, know nothing or very little about
how to protect themselves. Many young people who do have a little bit of knowledge about
HIV and AIDS often do not protect themselves, because they lack the life skills or the means
to adopt safe behaviors. Even young people who are informed of the methods to prevent
infection may be unable to, due to poverty, sexual violence and/or the absence of youth and
gender-friendly health services. Furthermore, young women are increasingly becoming the
face of HIV and AIDS due to gender-based discrimination and violence, harmful traditional
practices, early marriage, among many others.
The lack of political commitment and unsound national and donor driven polices, such as the
Abstinence - Be faithful - Use Condoms when necessary (ABC) approach have heavily con-
tributed to the impact of HIV and AIDS among young people. The ABC approach does not
give young people a sound and comprehensive understanding of the root causes of transmis-
sion or the knowledge and services they need to protect their sexual and reproductive health
and exercise their sexual and reproductive rights; consequently young people face a void of
desperately needed information, skills and services.
The fact remains that HIV and AIDS is overwhelmingly transmitted by unprotected sex – par-
ticularly in the poorest countries. Approximately 80% of HIV infections around the world are
transmitted sexually. Therefore, one of the most effective ways to address HIV and AIDS is
to ensure sexual and reproductive health and rights for all.


MDG#6 – for or against our rights?
While the goal and target are broad and ambitious, the indicators do not reflect the necessary
data to adequately measure the progress of combating HIV and AIDS.
First of all, it is bizarre that the most useful of statistics on HIV and AIDS – HIV prevalence
rates - is missing. HIV prevalence is only mentioned within indicator 18 – and quite specific
by only assessing the prevalence rates of pregnant women aged 15 to 24. This indicator does
not take into account all young people and limits women to a motherhood role/discourse. It
also fails to consider vulnerabilities of all young women and modes of transmission specific to
women, such as gender-based violence (at work, at school, in the family and so on), sexual
exploitation (rape, trafficking, sugar daddies – sex between young girls and older men etc.),
greater biological vulnerability, rape as an instrument of war, harmful traditional practices and
cultural-social norms which put women at risk (female genital mutilation/cutting, ignorance of
sexuality/sex) among others. In addition, by focusing on the role of women as mothers, this
indicator may also be interpreted to suggest women to be the sole “transmitters” of HIV via
mother-to-child transmission.
Therefore, it is important for indicator 18 to consider all sexes and ages to understand the
specific nature of the pandemic by disaggregated data, especially amongst young people. It
also needs to give special attention to the vulnerabilities and diversity of young women.


                                                                                                    17
In order to address gender dynamics and inequities, bold efforts to involve men and boys
                                                 need to be taken. The Cairo Program of Action had a strong definition of male involvement
                Goal 6:
Combat HIV/AIDS, Malaria                         and responsibility, which has not been implemented. Men need to be engaged in innovative
    and Other Diseases                           programming to tackle HIV and AIDS. They also need to take responsibility in negotiating
                                                 safe sex by using preventive methods. Male responsibility involves the transformation of
     Target 7:
     Have halted by 2015 and begun to            gender and power dynamics including norms of masculinity and femininity. Fighting gender
     reverse the spread of HIV/AIDS              inequalities and inequities is a powerful instrument for improving sexual and reproductive
     Indicator 18:                               health and rights.
     HIV prevalence among pregnant
     women aged 15 to 24 years.
                                                 Indicator 19b (percentage of population aged 15 to 24 years with comprehensive correct
     Indicator 19:
     Condom use rate of the contracep-
                                                 knowledge of HIV/AIDS) makes a reference to “correct knowledge”, which is very ambiguous
     tive prevalence rate.                       terminology. What is understood to be “correct” is highly subjective depending on the social,
       19 a: Condom use at last high-            political and religious context. This indicator falls short of providing comprehensive and cor-
       risk sex                                  rect knowledge to include awareness and behavior change strategies, life and negotiations
       19 b: Percentage of population            skills and should be empowering for both males and females to make informed decisions.
       aged 15 to 24 years with compre-
       hensive correct knowledge of HIV/         Comprehensive knowledge for young people means having the right to access factual in-
       AIDS.                                     formation about sexuality and reproduction, including access to scientific-based education
       19 c: Contraceptive prevalence            describing the different options available, not influenced by religious values.
       rate. (now moved to MDG 5 indi-
       cator)
                                                 Indicator 20 (ratio of school attendance of orphans to school attendance of non-orphans aged
     Indicator 20:
     Ratio of school attendance of orphans
                                                 10-14 years) does not measure progress towards combating HIV and AIDS, since school at-
     to school attendance of non-orphans         tendance is not directly connected to HIV prevention, unless comprehensive sexuality educa-
     aged 10-14 years.
                                                 tion is included in the curriculum. We are aware that orphans of HIV and AIDS parents suffer
                                                 stigma and discrimination, and we agree that this issue should be addressed since it is a vio-
                                                 lation to their human rights, however, they are not the only ones. Stigma and discrimination is
                                                 faced by many different groups, including young people and other vulnerable groups such as
                                                 women, people who are lesbian, gay, bisexual, transgender, queer or intersex, people living
                                                 with HIV and AIDS, ethnic groups, sex workers, orphans, etc. These groups have the most
                                                 difficulties accessing health services. Thus, stigma and discrimination must be addressed,
                                                 but we must take into account all groups affected by HIV and AIDS.
                                                 Overall, we notice that the indicators only emphasize HIV and AIDS prevention. Millions of
                                                 young people are already living with the virus and need to have access to voluntary testing
     The UNGASS Declaration of Com-
     mitment indicated several areas in          (VCT), counseling, treatment and support. To effectively respond to HIV and AIDS also in-
     which gender and HIV/AIDS inter-            cludes setting indicators for accessing VCT and modern drugs and treatments for HIV and
     sect and calls on countries to:
                                                 AIDS and related opportunistic diseases. Furthermore, recognizing and accessing the spe-
     “develop and accelerate the imple-
     mentation of national strategies that       cific SRHR needs of HIV-positive young people is fundamental.
     promote the advancement of women
     and women’s full enjoyment of all hu-
     man rights; promote shared respon-
                                                 Strengthening of individual countries health systems should be viewed as an integral as-
     sibility of men and women to ensure         pect of improving information and services surrounding HIV and AIDS. Countries seeking to
     safe sex; and empower women to
     have control over and decide freely         strengthen their health systems should include; professionals trained in youth-friendly coun-
     and responsibly on matters related to
     their sexuality to increase their ability
                                                 seling and education services, as well as sustainable and affordable access to medical com-
     to protect themselves from HIV infec-       modities, including rapid testing and treatment for HIV and AIDS. Emphasis in funding should
     tion.” (paragraph 59)
                                                 be given to strengthen overall health systems, with transparency and accountability, rather
                                                 than on a project basis of improving skills of professionals and access to medical commodi-
                                                 ties.




                       18
6
Chapter 6: Advocacy Opportunities for Youth
Participation

How has civil society, including youth, been involved with the MDGs?
As we saw from the description of the MDG framework, participation of civil society in areas of
both advocacy and service-delivery is necessary. An assessment of previous MDG Reports
(MDGRs - National Progress Reports) has shown that civil society engagement in the pro-
cess varies widely across countries.18 While NGOs have been actively involved in the whole
process of preparing the reports, in many instances they were included in a tokenistic manner
through public consultations, or were completely excluded. Furthermore, the assessment
states “[i]nvolvement of NGOs [at the country-level] has to go well beyond participation in
the preparation of the MDGRs.” The study considers whether NGOs would be the best ad-
vocates for the MDGs, but acknowledges that sometimes it is governments themselves that
discourage the participation of NGOs. They can be seen as adversaries rather than as part-
ners. Nonetheless, in most countries it is the NGOs that often do the majority of the work on
the ground towards achieving the goals and the Millennium Declaration calls for governments
to work in partnership with them in developing and implementing strategies for development.
At the regional and international levels, there has been plenty of criticism of the MDG frame-
work from members of civil society, which is most often directed to the following issues:
      ● Implications for commitments made in the past - The Millennium Summit, the Millenni-
      um Declaration and the MDGs are said to be the summation of the conferences that were
      held throughout the 1990s, however, civil society groups that were encouraged to partici-
      pate in the past conferences and worked towards setting goals and targets in many such
      areas, such as human rights, sustainable development, sexual and reproductive health
      and rights, gender equity and youth empowerment are now questioning what embracing
      the MDG framework implies for those past commitments, which remain unfulfilled.19
      ● Participation of civil society - Participation by all relevant stakeholders in international
      political processes (including, but not limited to, government) has now become standard.
      It is now recognized that affected groups should contribute to decisions that will influence
      their lives. The UN conferences of the 1990s have been heralded for their inclusion of
      relevant stakeholders, including government, the private sector and NGOs. However,
      there was little civil society participation at processes leading to adoption of the Millen-
      nium Declaration and MDGs.
      ● Inadequacy of the framework - Participants at a civil society gathering that paralleled
      the high-level UN meeting known as the Millennium Summit expressed hopes to fulfill the
      many commitments made by governments in past conferences but were disappointed
      with the limited nature of the Millennium Declaration and Development Goals.
However, with these criticisms in mind, the MDGs are recognized as a ‘work in progress’. The
targets and indicators can be limited, but they are included because they can be most easily
and accurately determined in all countries in order to realistically judge any improvements or
regressions that are made. The MDGs provide a broad development framework which gov-
ernments can use to look at the bigger picture and make more informed decisions regarding
priority setting and budget allocation based on the perceived strengths and weaknesses of
reaching the goals. Finally, the MDGs sets the tone for all development projects, from donors
to recipients, thus it is important to understand this framework and learn to work within it ef-
fectively.


Youth Participation
The participation of youth in the MDG process thus far is not easy to measure. We are not
aware of young people having participated at the Millennium Forum back in 2000 but youth




18 Millennium Development Goals Reports: An Assessment. Volume 1: Main Report [http://www.undp.org/eo/documents/MDGRs_Volume_1.pdf]	
19 Bissio, Roberto. “Civil Society and the MDGs.” UNDP Development Policy Journal. Vol 3. April 2003. Available at http://www.choike.org/documentos/
mdg_bissio.pdf.



                                                                                                                                                       19
groups have become more organized since then and have produced important documents on
     how to include a youth perspective to the Millennium Development Goals.
     Some opportunities for youth participation have been organized by the United Nations. The
     first of them is the Youth Leadership Summits promoted by the United Nations Office of the
     Special Adviser to the Secretary-General on Sport for Development and Peace to engage
     young people in the drive to reach the goals. Regional Youth Leadership Summits were or-
     ganized and culminated in the World Youth Assembly at the United Nations in New York just
     ahead of the UN General Assembly, which marked the 60th anniversary of the signing of the
     United Nations Charter, and reviewed the progress that developing countries had made in
     achieving the MDGs, among other issues.
     Youth advocates and organizations have also found themselves in the midst of a debate
     similar to the kind of debate occurring amongst organizations working for gender equality
     and women’s issues. On one hand, there are critics of the MDGs who have argued against
     the need for groups such as youth and women to fit themselves into yet another framework
     handed down from top levels of decision-making. These critics argue that young people, in
     the last three decades, have worked through a series of world conferences to bring these
     issues to the stage and create strategic programmes for action. Reducing all this work and
     strategy to 8 goals without consulting civil society is not considered to be acceptable. They
     stress that many commitments have already been made by governments and do not see the
     value of pressuring governments to keep their commitments within yet another framework.
     However, there is increasing evidence that young people must pay attention to the MDG
     process, precisely because it has become the mandate for so many organizations and gov-
     ernments. The MDGs are a call to the international community for collective action and not
     responding may leave young people disconnected in the face of allied UN agencies and gov-
     ernments. Finally, as the 2003 Human Development Report stresses, the MDGs are a means
     to holding governments responsible to their commitments in the form of MDG report cards.


     How can young people working in sexual and reproductive rights engage the MDGs
     processes?
     Reviewing the progress made towards the MDGs is an integral part of the framework and it is
     hoped that yearly monitoring will emphasize the urgency of achieving the goals.
     In addition to the Secretary-General’s yearly reports, a process was in place for the five-year
     review of progress towards achieving the MDGs. The General Assembly convened in Sep-
     tember of 2005, at the commencement of its sixtieth session, a high-level plenary meeting
     known as the 2005 World Summit. This meeting included:
          ● A review of the progress made in fulfilling the commitments stated in the Millennium
          Declaration
          ● A review of the international progress made in achieving the eight MDGs, including
          whether global partnership between key actors was underway
          ● A review of progress made at the national and regional levels in achieving the MDGs,
          and
          ● A review of progress made of the outcomes and commitments of the major UN confer-
          ences and summits in the last 15 years.
     The summit also tackled issues such as peace and security, the promotion and protection of
     human rights and strengthening the United Nations.
     The only civil society participation to this process was the invitation of one representative
     each from NGOs, civil society and the private sector to address the plenary of the Summit.
     According to UN Secretary-General’s report on the modalities, format and organization of the
     high-level plenary meeting of the 60th session of the General Assembly, “for security reasons
     and the space limitations in the United Nations building, the broader participation of civil so-
     ciety is unfortunately not possible. However, I believe that civil society can make a valuable
     contribution to the preparatory process, in terms of both substantive contributions and of
     creating awareness of the issues.”20 In an effort to ensure that civil society at least had some



     20 http://www.un-ngls.org/MDG/A.59.545-modalities-millennium+5.doc

20
say in the process, informal interactive hearings were organized to take place in June of 2005.
Youth activists were selected to speak at and also participate in the hearings.
It is currently not clear what the participation and objectives of the next 5 year review of the
MDGs will be. However, young activisits will continue the challenge of advocating for youth
sexual and reproductive health and rights to be recognized as central towards achieving the
MDGs. This could be accomplished by the integration of additional indicators that draw atten-
tion to the specific situation of young people’s health and needs. More comprehensive strate-
gies that are sensitive to the needs of young men and women are also needed. By putting a
spotlight on these issues through the MDG framework, it is hoped that more resources and
efforts might be directed to young people’s SRHR, either through national shifts in funding
priorities or increased donor support. It is therefore crucial to convince member states of the
UN that perspectives and participation of youth are crucial for the implementation of the entire
MDG framework. This is especially important, as the many coordinated efforts to achieve
the MDGs among international organizations, NGOs and governments are affecting young
people and their role in the development process.


Perhaps the most effective way for young people to advocate for the integration of young
people’s sexual and reproductive health and rights within strategies to achieve the MDG is
at the national level. In the coming years, governments will be challenged to prepare poverty
reduction strategy papers and long-term development plans aimed at achieving the goals. In
order to ensure that young people’s needs and rights are considered in these national-level
plans, it is essential that young people be involved in the process of developing them, as well
as implementing them and monitoring them once they have been adopted to make sure that
governments are living up to their commitments.




                                                                                                   21
References

     Chapter 1:
     1. United Nations Millennium Declaration (A/RES/55/2), 18 September, 2000 - http://www.un.org/millennium/declara-
     tion/ares552e.pdf
     2. For more information on the Millennium Assembly and Summit, visit http://www.un.org/millennium/.
     3. General Assembly Resolution 55/162 - http://www.un-ngls.org/MDG/A-RES-55-162.pdf.
     4. Roadmap towards the implementation of the United Nations Millennium Declaration http://www.un.org/documents/
     ga/docs/56/a56326.pdf.
     5. Robinson, Mary. “Mobilizing People to Claim Rights” in Seeking Accountability on Women’s Human Rights. Wom-
     en’s International Coalition for Economic Justice (WICEJ): Mumbai, 2004.
     6. The UN and the MDGs: a Core Strategy http://www.un.org.dj/UNDJ-RC/the%20UN%20and%20the%20MDG%20
     A%20Core%20Strategy.pdf
     7. For Millennium Development Goals Indicators visit the United Nations Statistics Division at http://unstats.un.org/
     unsd/mi/mi_worldmillennium_new.asp
     8. General Assembly Resolution 55/162 - http://www.un-ngls.org/MDG/A-RES-55-162.pdf. For SG Reports, visit
     http://www.un.org/millennium/
     9. “In Larger Freedom: Towards Security, Development and Human Rights for All” (A/59/2005)
     10. See http://www.unmillenniumproject.org for more details and final reports.
     11. See http://www.millenniumcampaign.org for more details

     Chapter 4:
     12. World Health Organization (WHO), World Health Report, 2005 [http://www.who.int/whr/2005/en/]
     13. Convention on the Elimination of all Forms of Discrimination (CEDAW) 1981
     14. UNFPA State of the World Population 2003:Making 1 billion count, investing in Adolescents’ Health and Rights
     [http://www.unfpa.org/swp/2003/english/]
     15. Millennium Project Taskforce on Maternal and Child Health, 2005 [http://www.unmillenniumproject.org/reports/
     tf_health.htm]
     16. UNFPA State of the World Population 2003
     17. Freedman, Lynn, Strategic advocacy and maternal mortality: moving targets and the millennium development
     goals
     18. UNFPA State of the World Population 2003
     19. Laura Reymond, Asha Mohamud, & Nancy Ali. The Wallace Global Fund / PATH, 2000

     Chapter 6:
     20.. Foster, John. “The Millennium Declaration: Mobilising Civil Society Organizations.” UNDP Development Policy
     Journal. Vol 3. April 2003. pp.161-172.
     21. From Millennium Development Goals Reports: An Assessment. Volume 1: Main Report. See: http://www.undp.
     org/eo/documents/MDGRs_Volume_1.pdf.
     22. Bissio, Roberto. “Civil Society and the MDGs.” UNDP Development Policy Journal. Vol 3. April 2003. Available at
     http://www.choike.org/documentos/mdg_bissio.pdf.
     23. http://www.un-ngls.org/MDG/A.59.545-modalities-millennium+5.doc




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Learning to Speak the MDGs (2009)

  • 1.
  • 3. – Learning to Speak MDGS, 2nd edition – A publication of: Youth Coalition 190 Maclaren Street, suite 200 Ottawa, Ontario K2P 0L6 Tel +1 (613) 562-3522 Fax +1 (613) 562-7941 E-mail: admin@youthcoalition.org Website: www.youthcoalition.org Copyright © 2005, 2009 The Youth Coalition This publication may be reproduced in whole or in part for educational or nonprofit purposes without special permission from the copyright holder, provided that acknowledgment of the source is made. The Youth Coali- tion would appreciate a copy of any document that uses this publication as a source. No part of this publication may be used for commercial or resale purposes. The contents of this booklet solely represent the opinions of the authors and not necessarily the views or policies of its financial contributors.
  • 4. Table of Contents The MDGs: A Glossary 6 Introduction 7 Chapter 1 Learning to Speak MDGs 8 Chapter 2 Goal 2: Achieve Universal Primary Education 11 Chapter 3 Goal 3: Achieving Gender Equality and Empowering Women 13 Chapter 4 Goal 5: Improve Maternal Health 15 Chapter 5 Goal 6: Combat HIV/AIDS, Malaria and Other Diseases 17 Chapter 6 Advocacy Opportunities for Youth Participation 19 References 22 4
  • 5. Acknowledgements The Youth Coalition would like to extend its sincere appreciation to all of those who took the time to work on this booklet. This project is over a year in the making and we are eager to share the results of all our hard work with everyone. For the first version of this publication, thank you to Monika Rahman, Sonu Chhina, Pamela Pizarro (past YC Communications and Outreach Officer), Prateek Suman, and Tanya Baker for their work on the English edits, to Gabriela Cano Azcarraga for her work on the layout and art work and to Joana Chagas for her efforts in coordinating the work of the booklet. For her work in coordinating the 2nd edition of this booklet, we would like to thank Tanya Baker, as well as Emily Turk for her design work. We would also like to thank UNFPA for their generous support, without which it would not have been possible to develop an updated ver- sion of this resource. 5
  • 6. The MDGs: A Glossary Millennium Assembly: The 55th session of the UN General Assembly, which opened on September 5, 2000, was designated the “Millennium Assembly” to mark the turn of the mil- lennium. Millennium Summit: High-level meeting of heads of state convened September 6-8, 2000 during the Millennium Assembly in order to discuss “The Role of the United Nations in the Twenty-First Century”. Millennium Forum: Representatives from over 1000 NGOs and 100 countries gathered in New York during May 22-26, 2000 prior to the official Millennium Summit. The “We the Peo- ples Millennium Forum Declaration and Agenda for Action” was drafted at this gathering in order to articulate a common civil society vision for the global agenda for heads of state to consider during the Millennium Summit. Millennium Declaration: The Declaration is the resolution passed by the member states at the Millennium Summit, rearticulating their commitment to the principles and values of the UN and outlining the hopes and challenges of the new century. Millennium Development Goals: Recognizing the plight of the world’s poor to be a major point of concern on the global agenda, eight specific development goals emanated from the Millennium Declaration. These goals are accompanied by specific targets to be achieved by the year 2015 and indicators to monitor progress towards the targets and goals (see Appen- dix). MDG Framework: As used in this booklet, the ‘MDG framework’ refers to the approach that has been adopted by UN agencies, governments and NGOs to use the MDGs as a guide for planning and implementing development activities. This involves observation and monitoring, analysis, as well as campaigning and mobilization around the MDGs. Millennium Project: Responsible for a large part of the analytical portion of the MDG frame- work, the Millennium Project was commissioned by Secretary-General Kofi Annan to propose the best strategies for meeting the MDGs. The Project is being directed by Professor Jeffrey Sachs of Columbia University and consists of 10 Task Forces concentrating on different as- pects of the MDGs. Global Millennium Campaign: This global campaign is being led by the United Nations De- velopment Programme (UNDP) to increase financial and trade opportunities for countries in the South and garner support from developed countries. The primary objectives of this Cam- paign are to disseminate data and analysis about the MDGs, to make connections between national campaigns and the global campaign, and to promote networking and partnership amongst key actors. Millennium Development Goal Reports (MDGRs): These are national progress reports prepared collaboratively by UN agencies working in different countries (UN Country Teams) in consultation with civil society and the government. 6
  • 7. ! Introduction The Youth Coalition for Sexual and Reproductive Rights (YCSRR) is an international orga- nization of young people between the ages of 15 and 29 committed to advocating for sexual and reproductive health and rights at the national, regional and international levels. The YC has been active since 1999 in training young leaders in advocacy, as well as supporting and actively advocating for youth sexual and reproductive health and rights at various United Nations conferences and meetings. We recognize that the only way governments will honor their commitments to young people is by having young people involved in the design, imple- mentation and evaluation of programmes and policies that affect their lives. The Millennium Development Goal (MDG) framework, which currently drives the develop- ment agenda, lacks an important youth analysis and perspective, even though young people are disproportionately affected by many of the development issues addressed by the goals. Thus, in 2005 the Youth Coalition convened a global group of 60 young leaders working in fields related to sexual and reproductive health and rights (SRHR), to learn about, and reflect on the MDGs and to analyze the goals, targets, and indicators on Education, Gender Equal- ity, Maternal Health, and HIV/AIDS with a youth perspective. This is an updated analysis of the original publication produced in 2005 to complement the 10-year review of the MDGs in 2009. This booklet is meant for young activists, individuals, non-governmental organizations (NGOs), governments, and UN agencies that are working within the MDG framework. Learn- ing to Speak MDGs provides a background of the origins of the MDGs and what they mean. It analyzes the link between sexual and reproductive health and rights and development; and reviews the current level of youth participation within strategies to achieve the MDGs. The original publication included recommendations from the International Youth Forum on the goals, targets and indicators related to Education, Gender Equality, Maternal Health, and HIV/ AIDS, however it is not included in this version in order to keep the information condensed and due to the understanding that the establishment of new goals, targets and indicators re- quire an in-depth understanding of health statistic and information gathering which is beyond this document. This booklet was entirely organized and realized by young people. As such, it is a clear rep- resentation of young people’s issues, needs, and recommendations. We appreciate all the hard work and commitment that individuals, organizations, governments, and agencies have done in improving the quality of lives of current and future generations, and we hope you ap- preciate all our hard work in creating this analysis and use our recommendations to reach the Millennium Development Goals. 7
  • 8. 1 Chapter 1: Learning to Speak MDGs What are the Millennium Development Goals? The Millennium Development Goals (MDGs) originate from the Millennium Declaration1, which was unanimously adopted by 189 United Nations (UN) Member States at the Millen- nium Summit, a high-level meeting of heads of state, convened during the 55th session of the UN General Assembly in September 20002. The Millennium Declaration was a reaffirmation of the values, principles and objectives that are the foundation of the UN’s work, and also recognized new and continuing challenges to humanity that require universal collaboration and commitment to overcome. However, like other political declarations that result from world conferences and summits, the Millennium Declaration is not legally binding; its implementa- tion rests upon the political will of state leaders and decision-makers. As a follow-up to the outcome of the Millennium Summit, the UN General Assembly issued a resolution recognizing the necessity for creating a framework for the implementation of the Millennium Declaration and requested the UN Secretary-General (SG) to prepare a long-term “roadmap” that specifically detailed how these commitments could be fulfilled3. The UN Sec- retariat and some UN agencies worked in collaboration with the International Monetary Fund (IMF), the World Bank and the Organization for Economic Cooperation and Development (OECD) to issue the “Roadmap towards the implementation of the United Nations Millennium Declaration”4 in September 2001, which established the following eight MDGs: 1. Eradicate extreme poverty and hunger. 2. Achieve universal primary education. 3. Promote gender equality and empower women. 4. Reduce child mortality. 5. Improve maternal health. 6. Combat HIV/AIDS, malaria and other diseases. 7. Ensure environmental sustainability. 8. Develop a global partnership for development. The goals themselves are broad and ambitious, however they also include a set of time- bound targets and indicators that aim to track progress and provide a focus for those working within the MDG framework (see the Appendix for a complete list of the MDGs, and accom- panying targets and indicators). All the goals are interlinked and cannot be achieved without the others: we cannot eradicate extreme poverty and hunger if women do not have equal opportunities; we cannot achieve universal primary education if girls are at home taking care of relatives affected by HIV and AIDS; and we cannot achieve any of the first seven goals if developed countries do not provide financial support for development. It is significant that 189 nations have achieved consensus over a common international devel- opment framework that has changed the focus from economic targets to social ones. Setting goals and targets enables all relevant actors to agree on priorities for the development agen- da, nurtures a feeling of solidarity and can be successful in fostering support from decision- makers and high-ranking political figures that are integral to realizing such goals. However, countries remain in various stages in development and in some cases have already achieved the targets set by the MDGs. In this case, it is the responsibility of these governments to raise the bar and define new targets to further advance the implementation of the Millennium Declaration. 1 United Nations Millennium Declaration (A/RES/55/2), 18 September, 2000 - http://www.un.org/millennium/declaration/ares552e.pdf 2 For more information on the Millennium Assembly and Summit, visit http://www.un.org/millennium/. 3 General Assembly Resolution 55/162 - http://www.un-ngls.org/MDG/A-RES-55-162.pdf. 4 Roadmap towards the implementation of the United Nations Millennium Declaration http://www.un.org/documents/ga/docs/56/a56326.pdf. 8
  • 9. Where did the Millennium Development Goals come from? The MDGs are certainly not the first set of development goals that have emerged on the global agenda. Since the creation of the UN, the international community has lived through Box 1. Abridged List of four “development decades” (starting in the 1960s) that have produced numerous sets of Recent World Conferences goals aiming to improve the quality of people’s lives. Most recently, the 1990s and early years of the 21st century saw a series of world conferences that brought together all the key UN players, national level decision makers and included unprecedented levels of civil society 1990 - World Summit for Children participation. Each of these conferences focused on a specific topic area, identified relevant Outcome: World Declaration on the areas of concern and resulted in commitments by UN member states to agreed programmes Survival, Protection and Development of Children and Plan of Action of action (see BOX 1). 1992 - UN Conference on Environ- ment and Development Many are calling the Millennium Summit the pinnacle of these conferences. Indeed, the Mil- lennium Declaration reaffirms the outcomes of these conferences, as well as important in- Outcome: Rio Declaration and Agen- da 21 ternational human rights treaties, such as the Convention on the Rights of the Child (CRC) 1993 - World Conference on Human and the Convention on the Elimination of All Forms of Discrimination Against Women (CE- Rights DAW). The MDGs and targets are also meant to reflect the commitments that governments Outcome: Vienna Declaration and made during the world conferences. However, they do not adequately capture the compre- Programme of Action hensive set of goals and recommendations that had been set throughout the 1990s and the 1994 - International Conference on early years of this century. Most blatantly missing in the original agreed declaration was any Population and Development reference to Sexual and Reproductive Health and Rights. Fortunately during the five year Outcome: Cairo Programme of Action review of the MDGs, Sexual and Reproductive Health was considered a cross-cutting issue 1995 - Fourth World Conference on (http://www.unmillenniumproject.org/reports/srh_main.htm). And in 2006 Kofi Anan, the then Women UN Secretary General announced that there would be a new Reproductive Health target ‘to Outcome: Beijing Declaration and Platform for Action achieve universal access to reproductive health’ under MDG 5. 1995 - World Summit for Social De- Further criticism of the MDGs includes it being too narrow and lacking the human rights per- velopment spective that framed the outcomes of the world conferences. Finally, the framework may be Outcome: Copenhagen Declaration on Social Development and the Pro- too limited by the small number of numeric indicators that are supposed to assess progress gramme of Action towards the achievement of improved quality of life for all of the world’s people5. 1996 - Second UN Conference on Human Settlements Outcome: Istanbul Agenda and Habi- tat Declaration How does the MDG framework “work”? 1996 - World Food Summit Achieving the MDGs requires the participation of all the actors working towards development Outcome: Rome Declaration and Plan and numerous interrelated strategies. The then UN Secretary General Kofi Annan appointed of Action United Nations Development Programme (UNDP) Administrator Mark Malloch Brown as chair 2001 - World Conference against of the UN Development Group, to coordinate the integration of the MDGs throughout the work Racism, Racial Discrimination, Xe- nophobia and Related Intolerance of the UN worldwide and also to mobilize the support and participation of civil society and gov- Outcome: Durban Declaration and ernments. UNDP has developed a framework to accomplish this, at the foundation of which Programme of Action three core strategies that are hoped will help achieve the goals rest upon6: 2002 - World Summit on Sustain- able Development Observation and Monitoring - Continuous collection of data is underway to compile statis- Outcome: Johannesburg Declaration tics regarding each of the targets and indicators in the MDG framework in order to assess and Plan of Implementation whether progress towards the goals has been made. The UN Department of Economic and Social Affairs on the global level, and the Regional Commissions on the regional level, in col- *NOTE: Five and ten-year reviews meetings laboration with various UN agencies, are keeping track of all the latest statistics available7. have been held for most of these conferences and summits in order to review progress of the The UN Inter-Agency and Expert Group (IAEG) on MDG Indicators and its subgroups regu- implementation of the conference outcomes. larly review the indicators to monitor their suitability, feasibility of data collection (or estima- tion) and global availability of data. The General Assembly also requested that the SG prepare a comprehensive report every five years, supplemented by an annual report on progress achieved towards the Millennium Declaration8. The first five-year report “In Larger Freedom: Towards Security, Development and Human Rights for All”9 was launched on March 21st, 2005. 5 Robinson, Mary. “Mobilizing People to Claim Rights” in Seeking Accountability on Women’s Human Rights. Women’s International Coalition for Eco- nomic Justice (WICEJ): Mumbai, 2004. 6 The UN and the MDGs: a Core Strategy http://www.un.org.dj/UNDJ-RC/the%20UN%20and%20the%20MDG%20A%20Core%20Strategy.pdf 7 For Millennium Development Goals Indicators visit the United Nations Statistics Division at http://unstats.un.org/unsd/mi/mi_worldmillennium_new.asp 8 General Assembly Resolution 55/162 - http://www.un-ngls.org/MDG/A-RES-55-162.pdf. For SG Reports, visit http://www.un.org/millennium/ 9 ”In Larger Freedom: Towards Security, Development and Human Rights for All” (A/59/2005) www.un.org/largerfreedom 9
  • 10. On the national level, UN Country Teams (made up of all UN agencies involved in each coun- try) are supporting governments to produce periodic national progress reports in close con- sultation with NGOs and the private sector and to collect national data to monitor progress. In some countries and regions, civil society is also monitoring the goals parallel to UN and governmental efforts as ‘shadow reports’ to highlight those issues or progress that may not be adequately reflected in the formal reports. Analysis - In order to identify the best strategies to meet the MDGs, the Millennium Project10 Millennium Project Box 2. was launched in July of 2002 under the guidance of the Secretary-General and Professor Task Forces Jeffrey Sachs of Columbia University’s Earth Institute. This project convened 10 Task Forces comprised of scholars, policy-makers and practitioners, who analysed the different issue ar- Task Force 1: Poverty and Eco- eas covered by the MDGs (see Box 2). Each Task Force has launched a report that reviewed nomic Development innovative practices and identified promising strategies to successfully achieve each goal. Task Force 2: Hunger The final Millennium Project Report “Investing in Development” brings together all the rec- Task Force 3: Primary Education ommendations and presents an operational framework that would allow even the poorest and Gender Equality countries to achieve the MDGs by 2015. Individual country studies are also being undertaken Task Force 4: Child Health and Ma- by governments, NGOs, the World Bank, the International Monetary Fund (IMF) and donor ternal Health countries in order to identify necessary changes in institutional structures and assess what Task Force 5: HIV/AIDS, Malaria, TB, Other Major Diseases, and Ac- kind of financing options would be necessary to make the MDGs possible. cess to Essential Medicines Task Force 6: Environmental Sus- Furthermore, Sexual and Reproductive Health (SRH) and Energy were found to be cross- tainability cutting issues which are necessary to be addressed in order to reach the MDGs. These Task Force 7: Water and Sanita- groups have separate reports and recommendations as part of the Millennium Project. In tion the reports and background papers related to SRH, there was an emphasis on adolescents Task Force 8: Improving the Lives as a key theme related to poverty and gender inequality (http://www.unmillenniumproject.org/ of Slum Dwellers reports/srh_main.htm). Task Force 9: Open, Rule-Based Trading Systems Governments also regularly analyze their progress to towards reaching the MDGs. There are Task Force 10: Science, Technol- national, regional and donor MDG reports that are done in collaboration with national gov- ogy and Innovation ernments and UN bodies to monitor the progress of reaching the goals and determine which areas need to be improved. (http://www.undg.org/index.cfm?P=3) Campaigning and Mobilization - Because achieving the MDGs requires the commitment of many sectors of society beyond the UN system, including political leaders and civil society, the process of mobilizing different actors to build awareness and foster collaboration is sup- ported and/or led by UN agencies. The results of monitoring and analysis will be provided to support campaigns and the UN will also provide direction for the establishment of network- ing and partnership building between actors. Campaigning and mobilizing popular support is important to direct public pressure towards political leaders to fulfill their commitments. It is also crucial to gaining support from local and national organizations that are central to the actual implementation of strategies. Global-level campaigning is also being done through the Global Millennium Campaign11 to put pressure on developed countries to provide support to developing countries through aid, trade, debt relief and other necessary means. 10 See http://www.unmillenniumproject.org for more details and final reports. 11 See http://www.millenniumcampaign.org for more details 10
  • 11. 2 Chapter 2: Goal 2: Achieve Universal Primary Education “To ensure that (…) children everywhere, boys and girls alike, will be able to complete a full course of primary schooling and that girls and boys will have equal access to all levels of education.” Millennium Declaration, adopted on 18 September 2000 Universal primary education is more than getting all children to sit in schools to learn how to read and write so that they may secure better employment as adults. Education is critical in providing individuals with the tools and knowledge to make informed decisions, to have the ability to undertake analysis and to live their lives to their fullest potential. Primary education is a crucial stage when children and adolescents begin to form attitudes about sex, gender roles, and sexual identity. As such, it is also an opportunity for change in social attitudes and norms to occur. Learning about sexual and reproductive health and rights is a core part of every individual’s development process. Sexual and reproductive education must be scientifically based and comprehensive. Special emphasis should be placed on combating the taboos and myths about sexuality, reproduction and gender that impede young people’s ability to make as- sertive choices, to protect their health, and to develop to their highest potential. Moreover, education should instill respect for different cultures, religions, ethnicities, genders and sexual diversities. During primary education, children and adolescents must receive information about their hu- man rights, including their sexual and reproductive rights. Young people, adolescents, and children are particularly vulnerable to sexual violence, exploitation and coercion. Creating awareness of their rights is a way to provide them with tools to confront the challenges they face. Moreover, it is urgent that governments take measures to address gender disparities and inequalities in schools. In regions such as Africa and Asia Pacific, girls continue to struggle to achieve the same educational levels as boys, while in many other regions the percent of girls and boys attending school is generally equal. It is also critical to ensure that school curricula and educational settings do not reinforce traditional gender roles that subordinate women and girls, but that they are gender sensitive and promote gender equality and empowerment. MDG#2 – for or against our rights? The narrow focus of Goal # 2, concentrating only on primary education, is problematic. The gains made early by ensuring parity in enrollment are often lost due to the low completion rates of not only girls but that of boys as well. For many young people worldwide, formal education ends just before the stages of secondary and tertiary education. Higher education contributes more than primary education alone towards improving conditions in the lives of young people, especially women. Their societies and local communities also stand to gain from their continuation of education onto higher levels. The enrolment and completion indicators for MDG 2 are broad and general and do not take into account region-specific situations. The type and quality of education a child receives is dependent on where she or he is born and where they grow up. The main barriers to edu- cation are: poverty; discrimination against marginalized communities; cultural and religious beliefs; rural versus urban disadvantage; taboos against sexuality education; gender discrimi- nation; disability; armed conflict; HIV status; inefficient or corrupt school systems; incorrect and biased content of school curricula; and educational initiatives by dictatorial or autocratic governments among others. In implementing MDG 2, efforts must be taken to address these barriers and to ensure equal access to education for all. The goal of education must be to enable people to live fulfilling and empowered lives. While 11
  • 12. literacy - the ability to read, write, and count - is one crucial aspect of education, an improved literacy rate alone does not necessarily mean that people have gained the tools they need Goal 2: Achieve Universal to improve their lives and prospects, and subsequently their health. It does not mean that Primary Education everyone has access to the crucial preparatory knowledge they need to protect themselves Target 3: against abuse, exploitation, unintended pregnancies, sexually transmitted infections including Ensure that, by 2015, children ev- HIV/AIDS. Moreover, it also does not necessarily translate into citizens being able to exercise erywhere, boys and girls alike, will be able to complete a full course of their human rights. Education is incomplete without sexual and reproductive health and rights primary schooling information and education. Education is incomplete if children and adolescents do not learn Indicator 6: about gender equality and human rights. Incomplete or inaccurate education, such as promo- Net enrolment ratio in primary edu- cation tion of abstinence only education, violates young people’s human rights and can negatively Indicator 7a: impact their ability to make informed decisions about all aspects of their lives. Proportion of pupils starting grade 1 who reach grade 5 In many countries, the primary school curriculum still does not include a component on gen- Indicator 7b: der equality to combat gender stereotypes that result in the unfair treatment of girls. Primary Primary completion rate education is a crucial opportunity to address discrimination, promote gender equality, the Indicator 8: empowerment of women and girls and to reduce their vulnerability. Literacy rate of 15 to 24 year-olds Special efforts need to be made to ensure that girls have the opportunity to complete full courses in primary, secondary and tertiary education. Girls who are educated are more likely to delay marriage and first pregnancy, and this consequently leads to reductions in maternal and infant mortality rates. Women with tertiary levels of education have more opportunities ICPD+5, 35b and skills that can be translated into genuine women’s empowerment. An empowered woman Include at all levels, as appropriate, of can overcome the strongest social and cultural barriers and gender-inequality challenges. formal and non-formal schooling, edu- cation about population and health is- sues, including sexual and reproduc- The most important agents of change, those who have the ability to address barriers to edu- tive health issues, in order to further implement the Programme of Action cation and ensure education for all, are national governments, international development in terms of promoting the well-being organizations (such as UNICEF, UNIFEM, UNDP, UNFPA), community and religious leaders, of adolescents, enhancing gender equality and equity as well as respon- the media, role models, multinational organizations, the private sector, peacekeeping forces, sible sexual behavior, protecting them from early and unwanted pregnancy, NGOs and youth themselves. sexually transmitted diseases includ- ing HIV/AIDS, and sexual abuse, in- cest and violence. Convention of the Rights of the Child, Article 28 1. States Parties recognize the right of the child to education and with a view to achieving this right progressively and on the basis of equal opportunity, they shall, in particular: (a) Make primary education compul- sory and available free to all; (c) Make higher education accessible to all on the basis of capacity by every appropriate means; 3. States Parties shall promote and encourage international cooperation in matters relating to education, in particular with a view to contributing to the elimination of ignorance and illiteracy throughout the world and fa- cilitating access to scientific and tech- nical knowledge and modern teaching methods. In this regard, particular ac- count shall be taken of the needs of developing countries. Article 29 1. States Parties agree that the edu- cation of the child shall be directed to: (a) The development of the child’s personality, talents, and mental and physical abilities to their fullest po- tential; (d) The preparation of the child for re- sponsible life in a free society, in the spirit of understanding, peace, toler- ance, equality of sexes, and friendship among all peoples, ethnic, national and religious groups and persons of indigenous origin. 12
  • 13. 3 Chapter 3: Goal 3: Achieving Gender Equality and Empowering Women “To promote gender equality and the empowerment of women, as effective ways to combat poverty, hunger and disease and to stimulate development that is truly sustainable” Millennium Declaration, adopted on 18 September 2000 Gender is a social construct, which defines the roles human beings are expected play in soci- ety based on our biological bodies. Gender roles are also related to culture, religion, tradition and customary practices that exist in our societies. They establish social expectations for what people do, but more than that, they set expectations about who people are. Historically, women’s political and social identities have been constructed in terms their bio- logical and reproductive roles: women are first seen as mothers and wives who look after the well being of the family. Due to their role in the family, women have often been obliged to remain in the home and their participation in the economic, social and political processes in their societies has traditionally been limited. Because the home is in the private sphere, there are often no mechanisms to prevent women from being oppressed or treated with violence or abuse, which frequently makes the home a place where women’s human rights are violated. Women’s contributions to society have often been under-valued: the work ascribed to women, the reproductive work done in the private sphere of the family and home, has been seen as less important than the productive work done traditionally by men in the public sphere. When women’s lives are constrained to the private sphere of the family, it is easy for governments and their institutions to ignore women’s needs and rights. In most societies, stereotypes about gender roles that place women in a subordinate position to men have been embedded in legal frameworks and social structures. This has resulted in systemic gender inequality and discrimination, which limits women’s and girls opportuni- ties for personal development and empowerment, has negative consequences on women’s and girls health, education, and participation in economic, social and political processes and increases women’s vulnerability to violence. Many threats to a woman’s and girl’s development and empowerment are experienced during adolescence and young woman stages of her life cycle. For example, one way that gender inequalities are reinforced in most societies is by controlling and suppressing young women’s sexuality. This manifests in early and unwanted marriage and pregnancy, sexual violence, abuse and coercion and trafficking for sexual exploitation. Some cultural norms and religious traditions often devalue the girl-child and lead to numerous undesirable practices, including prenatal sex-selection, son preference, female genital mutilation/cutting and interruption of educational opportunities. Not only are they often-harrowing experiences, but they impede a woman’s right to access education, employment and income-generating opportunities, freely develop her sexuality and sexual orientation, and the capacity to control her own body, life and destiny. MDG#3 – for or against our rights? While the importance of MDG 3 is obvious, the problem lies in its limitation to a single target: to eliminate gender disparity in education. In many countries, the gender gap in education has already been overcome but it certainly does not mean that gender equality has been achieved. Although we recognize the importance of education for achieving women’s em- powerment and the promotion of gender equality, we also know that access to education alone rarely translates into higher access to decent employment, income, or participation in decision-making in the political arena, especially for young women. Access to education does not necessarily mean access to quality education. School materi- als and books often reinforce stereotypical gender identities and roles - for men and women - as well as power dynamics. School settings aren’t always safe and can sometimes increase a girl’s risk of physical and sexual violence. Special emphasis needs to be given to ensure that girls have access to quality, gender-sensitive education that actively combats gender stereotypes and promotes gender equality and women’s empowerment. In addition, schools 13
  • 14. need to be made girl-friendly by increasing the number of female teachers and prohibiting and punishing teachers and students who perpetrate gender-based violence. Goal 3: Promote Gender Equality and Empower Women Too often, education is a loaded concept with many restrictions imposed by the state or re- ligion with respect to history and rights. Emphasis should be given to the improvement of Target 4: creative and critical thinking skills, which will increase capacities and allow girls and young Eliminate gender disparity in pri- mary and secondary education, women to react thoughtfully to an ever-changing world. preferable by 2005 and in all levels of education no later than 2015. Access to education should also mean access to comprehensive, youth-friendly sexuality Indicator 9: and reproductive health education. In too many cases human sexuality is approached from a Ratio of girls to boys in primary, sec- ondary and tertiary education. biological perspective, if it is approached at all, and does not provide young women with the Indicator 10: skills they need to protect their sexual and reproductive health or exercise their sexual and Ratio of literate women to men, 15 reproductive rights. Sexuality education must also break down the erroneous social construc- to 24 years old. tions around sexuality, as well as taboos and myths. Indicator 11: Share of women in wage employ- ment in the non-agriculture sector. Education in schools rarely provides students, male and female, with knowledge concerning their human rights or with the empowerment to exercise and demand respect for their rights. Indicator 12: Proportion of seats held by women Human rights education, including education on gender equality and women’s human rights in national parliaments. must be a part of school curricula. Sending girls to school alone does not eliminate violence against women and is not enough to guarantee the re-configuration of social attitudes to- wards women and gender roles. Some chosen indicators to measure progress of MDG 3 (labor and political participation indi- cators) have no linear relation with their target: the fact that there are more women occupying seats in the parliament (indicator #12) is not a direct result of overcoming gender disparities in education, nor is the answer to the goal of arriving at real gender equality. Increasing women’s participation should not be a priority only in the political arena, although this is important, but in all spheres of social life. The same is true for indicator #11: more women in wage-earning employment does not necessarily mean that we have overcome gender disparities in education nor achieved gender equality, since women still earn less than men for the same job or occupation no matter what their education in most countries. Barriers to Fourth World Conference on Wom- women’s access to decent and productive employment include violations of women’s labour en, Beijing Platform for Action rights, such as sexual harassment in the workplace, the requirement that women produce a Paragraph 96 of the Beijing PFA re- medical certificate establishing that they are not pregnant, and young women’s placement in fers to women’s rights “to have control over and decide freely and responsi- low-level positions no matter their capacities, which also need to be addressed. bly on matters related to their sexual- ity, including sexual and reproductive health, free of coercion, discrimina- Gender also goes beyond women; it also includes men (and masculinities), and other gender tion and violence. Equal relationships identities, such as transsexual, transgender, intersex, and others. So, in order to achieve between women and men in matters of sexual relations and reproduction, gender equality, all human beings regardless of their gender identity or sexual orientation - including full respect for the integrity of the person, require mutual respect, whether they are straight, lesbian, gay or bisexual - must have the same opportunities to live consent and shared responsibility in dignity, free from violence, prejudice and/or discrimination. Human diversity needs to be for sexual behaviour and its conse- quences.” understood as a major part of the richness within humanity instead of been seen as a threat to established patterns of socialization and development. The majority of the most exploited and poorest women are often women facing multiple bar- riers created by the intersection of discrimination based on race, religion, ethnicity, class, ability, sexual orientation and age. Shifting the focus away from their condition and the re- lationships between these forms of discrimination will thwart our efforts to eradicate poverty and achieve equality. 14
  • 15. 4 Chapter 4: Goal 5: Improve Maternal Health “… to have reduced maternal mortality by three quarters, and under-five child mortality by two third of their current rates” Millennium Declaration, adopted on 18 September 2000 “ to achieve universal access to reproductive health by 2015” New target established in 2006 under MDG5 There is no internationally recognized and agreed definition of maternal health. To understand maternal health (or women’s health when they enter the stage of reproduction), we need to look at how ICPD defines reproductive health. Reproductive health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes....”. This definition of reproductive health is more encompassing and internationally accepted than the term maternal health, which is criticized for placing the emphasis on women as merely pro- creators and mothers, rather than humans with distinct needs and rights. Though women do have special needs throughout pregnancy, birth and the postpartum period, maternal health should be framed within a broader and more comprehensive sexual and reproductive health and rights approach if significant improvements are to be made. Accordingly, experts and activists worked hard to ensure that reproductive health was included as an additional target when the MDGs were reviewed in 2005 Unfortunately, progress in maternal health has slowed down.12 More women in develop- ing countries are dying during pregnancy or childbirth from predominantly five direct and Goal 5: avoidable obstetrical complications, including hemorrhage, infection, hypertensive disorders, Improve Maternal Health obstructed labour and unsafe abortion. These direct causes of mortality and morbidity are intensified by early childbearing, frequent and numerous pregnancies, sexually transmitted Target 6a: infections - including HIV/AIDS, and violence or harmful practices against women and girls, By 2015, reduce by three-quarters the maternal mortality ratio such as female genital mutilation/cutting. These incidents occur or begin at the early stages Indicator 16: of women’s reproductive years, during adolescence and youth. Thus, maternal mortality Maternal mortality ratio must be considered a young women’s issue. Furthermore, the vulnerability of girls and young Indicator 17: women to sexual exploitation and violence is an increasing barrier to improving maternal Proportion of births attended by skilled health personnel health. There are many barriers that women, especially young women, face in accessing maternal Added in 2006: health care, such as inadequate health systems (transportation, financial conditions, avail- Target 6b: ability of pharmaceuticals and medical supplies) and lack of proficient health professionals, By 2015, achieve universal access to reproductive health including skilled attendants and emergency obstetrical care providers. When young women, especially unmarried young women, do attempt to access maternal health care, they are of- New proposed indicators for target 6b: ten met with stigma and discrimination and experience a lack of confidentiality and continuity Indicator 18: Contraceptive Preva- in their care. Therefore, safe motherhood is only achieved through strengthening of health lence (CPR) (moved from MDG 6 systems and infrastructures and implementation of previous international commitments that (to combat HIV/AIDS, malaria and other diseases )to MDG 5 recognize, promote and protect sexual and reproductive rights of young women. The 2005 Indicator 19: Unmet need for fam- Millennium Project Taskforce report on maternal and child health goes further, saying that ily planning (UMN) a fundamental shift in the approach to health systems is needed. It states that the current Indictor 20: Age-specific fertility fragmented health systems, which are often promoted in development aid, are inadequate to rate (ASFR) for 15 – 19 years age group ensure availability, access and utilization of key services. The costs incurred by individuals through their interaction with the health system can deepen poverty and that as a core social institution, dysfunctional and abusive health systems can intensify exclusion, voicelessness and inequality, which is ever more apparent for young women. (Millennium Project Report) MDG#5 – for or against our rights? The term ‘maternal health’ reduces the rights of a woman to those of a mother’s rights. It is regressive in the context of Cairo and Beijing commitments, where reproductive health frames 12 World Health Organization (WHO), World Health Report, 2005 [http://www.who.int/whr/2005/en/] 15
  • 16. a more holistic, informed choice model of women’s health. Convention on the Elimination of All Forms of Discrimination against The goal is precise but the original indicators were limited and incomplete. Averting death Women (CEDAW) in 1981: from pregnancy or childbirth related causes and increasing access to maternity facilities does The “right to decide freely and respon- sibly on the number and spacing of not sum up to the attainment of maternal health. For that, every woman, during the early their children and to have access to stages of her life, has to be made aware of her right to decide freely on the number and spac- information, education and means to enable them to exercise these rights” ing of her children and her right to make decisions concerning reproduction free of discrimi- (Article 16.1) was codified in formal law as a woman’s human right (Source: nation, coercion and violence.13 As a reflection of this, new recommended indicators for the UN 1979) recent target of universal Reproductive Health include the Contraceptive Prevalence rate and The Programme for Action of the UN the unmet need for family planning (UMN). The UMN can also serve as a useful indicator of International Conference on Popula- tion and Development definitions of the response of the health system in general to the needs of women and families. (Technical reproductive health and reproduc- consultation on RH indicators) tive rights (Source: UN 1994) Reproductive health is a state of Full access to sexual and reproductive health information and services is also considered complete physical, mental and social well being and not merely the absence critical (Millennium Project – Child and Maternal Health). This includes having access to of disease or infirmity, in all matters comprehensive SRH education that enables her to make informed decisions about all as- relating to the reproductive system and to its functions and processes. pects of her sexual and reproductive lives and access to comprehensive sexual and repro- Reproductive health therefore implies that people are able to have a satis- ductive health services, including modern, safe contraceptives, the means to protect herself fying and safe sex-life and that they from STIs/HIV and safe abortion services. have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last con- A complex set of social, cultural and economic forces are barriers to attaining young people’s dition are the right of men and women to be informed and to have access to sexual and reproductive rights. In many parts of the world, girls marry before the age of 18. safe, effective, affordable and accept- Early marriage reduces girls’ educational and skills building opportunities and starts them on able methods of family planning of their choice, as well as other methods a path toward early childbearing.14 of their choice for regulation of fertility which are not against the law and the Younger women, especially teenagers are biologically at an increased risk for complications right of access to appropriate health- care services that will enable women during pregnancy, most apparently from obstructed labour due to their not yet fully mature to go safely through pregnancy and childbirth and provide couples with the pelvis. Even when adolescents deliver their babies in health facilities, they suffer higher rates best chance of having a healthy infant. of mortality than older women.15 Giving birth at an early age often leads to frequent child- In line with the above definition of re- productive health, reproductive health- bearing, which, without adequate spacing, can deplete nutritional stores of the woman thus care is defined as the constellation of methods, techniques and services increasing the likelihood of death or disability with each pregnancy. When young women are that contribute to reproductive health faced with unwanted pregnancies, they are more likely to resort to unsafe and self-induced and well being through preventing and solving reproductive health problems. abortion and to postpone abortion until later in pregnancy, which drastically increases their It also includes sexual health, the purpose of which is the enhancement health risks.16 Legislation must be passed to; criminalize child marriage, allow young preg- of life and personal relations, and not nant women and mothers to continue their education with their peers and ensure access to merely counseling and care related to reproduction and sexually transmitted safe abortion services. In recognition of the specific reproductive health needs and risks of diseases (paragraph 7.2). adolescent girls and young women, a new indicator was suggested to specifically determine Bearing in mind the above definition, the Age-specific fertility rate (ASFR) for the 15 – 19 years age group. (Technical consultation reproductive rights embrace certain human rights that are already recog- on RH indicators) nized in national laws, international human rights documents and other consensus documents. These rights Health systems in developing countries must be improved to provide women-centered, in- rest on the recognition of the basic formed-choice family planning and timely access to emergency obstetrical services.17 Al- right of all couples and individuals to decide freely and responsibly the num- though Emergency obstetric care (EmOC) was considered an indicator for the reproductive ber, spacing and timing of their children and to have the information and means health target, it was not recommended because there is a limited baseline set of data, lack of to do so and the right to attain the high- data collection systems and lack of a standardized approach. (Technical consultation on RH est standard of sexual and reproduc- tive health. It also includes their right indicators) The reproductive health supplies that go to developing countries must be sustain- to make decisions concerning repro- duction free of discrimination, coercion able; patent, trade and aid restrictions of these essential commodities must be addressed. and violence, as expressed in human (ref: RH supplies initiative) rights documents. In the exercise of this right, they should take into account the needs of their living and future chil- The rights of HIV positive pregnant women to gain access to free, voluntary testing and coun- dren and their responsibilities towards the community. The promotion of the seling, as well as affordable ARV treatment to prevent mother-to-child transmission, is an responsible exercise of these rights for essential aspect of the maternal health care framework. Treatment, care and support for all people should be the fundamental basis for government and community- HIV positive women cannot end after the baby is born and must be provided throughout their supported policies and programmes in the area of reproductive health, lifespan. In order to make effective, culturally specific and well-received messages regarding including family planning. As part of sexual and reproductive health, young people must be involved in the design, implementa- their commitment, full attention should be given to the promotion of mutu- tion and monitoring of policies and programmes, including those aimed at training healthcare ally respectful and equitable gender relations and particularly to meeting providers to be more responsive to young women’s needs. the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality (paragraph 7.3). 13 Convention on the Elimination of all Forms of Discrimination (CEDAW) 1981 14 UNFPA State of the World Population 2003:Making 1 billion count, investing in Adolescents’ Health and Rights [http://www.unfpa.org/swp/2003/eng- lish/] 15 Millennium Project Taskforce on Maternal and Child Health, 2005 [http://www.unmillenniumproject.org/reports/tf_health.htm] 16 UNFPA State of the World Population 2003 17 Freedman, Lynn, Strategic advocacy and maternal mortality: moving targets and the millennium development goals 16
  • 17. 5 Chapter 5: Goal 6: Combat HIV/AIDS, Malaria and Other Diseases “To have (…) halted, and begun to reverse, the spread of HIV/AIDS, the scourge of malaria and other major diseases that afflict humanity. (…) To provide special assistance to children orphaned by HIV/AIDS.” Millennium Declaration, adopted on 18 September 2000 HIV and AIDS is considered one of the most devastating illnesses on the world’s sexual and reproductive health report card. The brunt of this pandemic is being borne by the world’s youth, especially in developing countries. The fact that approximately 45% of new infections are being recorded in the 15 - 24 age bracket (UNAIDS) is the most compelling evidence of the lack of comprehensive sexual and reproductive health services and education for young people and part of the larger realm of the denial of sexual and reproductive rights for youth globally. Consider this: most young people living with HIV are unaware that they are even carrying the virus. Many millions more, even in high prevalence regions, know nothing or very little about how to protect themselves. Many young people who do have a little bit of knowledge about HIV and AIDS often do not protect themselves, because they lack the life skills or the means to adopt safe behaviors. Even young people who are informed of the methods to prevent infection may be unable to, due to poverty, sexual violence and/or the absence of youth and gender-friendly health services. Furthermore, young women are increasingly becoming the face of HIV and AIDS due to gender-based discrimination and violence, harmful traditional practices, early marriage, among many others. The lack of political commitment and unsound national and donor driven polices, such as the Abstinence - Be faithful - Use Condoms when necessary (ABC) approach have heavily con- tributed to the impact of HIV and AIDS among young people. The ABC approach does not give young people a sound and comprehensive understanding of the root causes of transmis- sion or the knowledge and services they need to protect their sexual and reproductive health and exercise their sexual and reproductive rights; consequently young people face a void of desperately needed information, skills and services. The fact remains that HIV and AIDS is overwhelmingly transmitted by unprotected sex – par- ticularly in the poorest countries. Approximately 80% of HIV infections around the world are transmitted sexually. Therefore, one of the most effective ways to address HIV and AIDS is to ensure sexual and reproductive health and rights for all. MDG#6 – for or against our rights? While the goal and target are broad and ambitious, the indicators do not reflect the necessary data to adequately measure the progress of combating HIV and AIDS. First of all, it is bizarre that the most useful of statistics on HIV and AIDS – HIV prevalence rates - is missing. HIV prevalence is only mentioned within indicator 18 – and quite specific by only assessing the prevalence rates of pregnant women aged 15 to 24. This indicator does not take into account all young people and limits women to a motherhood role/discourse. It also fails to consider vulnerabilities of all young women and modes of transmission specific to women, such as gender-based violence (at work, at school, in the family and so on), sexual exploitation (rape, trafficking, sugar daddies – sex between young girls and older men etc.), greater biological vulnerability, rape as an instrument of war, harmful traditional practices and cultural-social norms which put women at risk (female genital mutilation/cutting, ignorance of sexuality/sex) among others. In addition, by focusing on the role of women as mothers, this indicator may also be interpreted to suggest women to be the sole “transmitters” of HIV via mother-to-child transmission. Therefore, it is important for indicator 18 to consider all sexes and ages to understand the specific nature of the pandemic by disaggregated data, especially amongst young people. It also needs to give special attention to the vulnerabilities and diversity of young women. 17
  • 18. In order to address gender dynamics and inequities, bold efforts to involve men and boys need to be taken. The Cairo Program of Action had a strong definition of male involvement Goal 6: Combat HIV/AIDS, Malaria and responsibility, which has not been implemented. Men need to be engaged in innovative and Other Diseases programming to tackle HIV and AIDS. They also need to take responsibility in negotiating safe sex by using preventive methods. Male responsibility involves the transformation of Target 7: Have halted by 2015 and begun to gender and power dynamics including norms of masculinity and femininity. Fighting gender reverse the spread of HIV/AIDS inequalities and inequities is a powerful instrument for improving sexual and reproductive Indicator 18: health and rights. HIV prevalence among pregnant women aged 15 to 24 years. Indicator 19b (percentage of population aged 15 to 24 years with comprehensive correct Indicator 19: Condom use rate of the contracep- knowledge of HIV/AIDS) makes a reference to “correct knowledge”, which is very ambiguous tive prevalence rate. terminology. What is understood to be “correct” is highly subjective depending on the social, 19 a: Condom use at last high- political and religious context. This indicator falls short of providing comprehensive and cor- risk sex rect knowledge to include awareness and behavior change strategies, life and negotiations 19 b: Percentage of population skills and should be empowering for both males and females to make informed decisions. aged 15 to 24 years with compre- hensive correct knowledge of HIV/ Comprehensive knowledge for young people means having the right to access factual in- AIDS. formation about sexuality and reproduction, including access to scientific-based education 19 c: Contraceptive prevalence describing the different options available, not influenced by religious values. rate. (now moved to MDG 5 indi- cator) Indicator 20 (ratio of school attendance of orphans to school attendance of non-orphans aged Indicator 20: Ratio of school attendance of orphans 10-14 years) does not measure progress towards combating HIV and AIDS, since school at- to school attendance of non-orphans tendance is not directly connected to HIV prevention, unless comprehensive sexuality educa- aged 10-14 years. tion is included in the curriculum. We are aware that orphans of HIV and AIDS parents suffer stigma and discrimination, and we agree that this issue should be addressed since it is a vio- lation to their human rights, however, they are not the only ones. Stigma and discrimination is faced by many different groups, including young people and other vulnerable groups such as women, people who are lesbian, gay, bisexual, transgender, queer or intersex, people living with HIV and AIDS, ethnic groups, sex workers, orphans, etc. These groups have the most difficulties accessing health services. Thus, stigma and discrimination must be addressed, but we must take into account all groups affected by HIV and AIDS. Overall, we notice that the indicators only emphasize HIV and AIDS prevention. Millions of young people are already living with the virus and need to have access to voluntary testing The UNGASS Declaration of Com- mitment indicated several areas in (VCT), counseling, treatment and support. To effectively respond to HIV and AIDS also in- which gender and HIV/AIDS inter- cludes setting indicators for accessing VCT and modern drugs and treatments for HIV and sect and calls on countries to: AIDS and related opportunistic diseases. Furthermore, recognizing and accessing the spe- “develop and accelerate the imple- mentation of national strategies that cific SRHR needs of HIV-positive young people is fundamental. promote the advancement of women and women’s full enjoyment of all hu- man rights; promote shared respon- Strengthening of individual countries health systems should be viewed as an integral as- sibility of men and women to ensure pect of improving information and services surrounding HIV and AIDS. Countries seeking to safe sex; and empower women to have control over and decide freely strengthen their health systems should include; professionals trained in youth-friendly coun- and responsibly on matters related to their sexuality to increase their ability seling and education services, as well as sustainable and affordable access to medical com- to protect themselves from HIV infec- modities, including rapid testing and treatment for HIV and AIDS. Emphasis in funding should tion.” (paragraph 59) be given to strengthen overall health systems, with transparency and accountability, rather than on a project basis of improving skills of professionals and access to medical commodi- ties. 18
  • 19. 6 Chapter 6: Advocacy Opportunities for Youth Participation How has civil society, including youth, been involved with the MDGs? As we saw from the description of the MDG framework, participation of civil society in areas of both advocacy and service-delivery is necessary. An assessment of previous MDG Reports (MDGRs - National Progress Reports) has shown that civil society engagement in the pro- cess varies widely across countries.18 While NGOs have been actively involved in the whole process of preparing the reports, in many instances they were included in a tokenistic manner through public consultations, or were completely excluded. Furthermore, the assessment states “[i]nvolvement of NGOs [at the country-level] has to go well beyond participation in the preparation of the MDGRs.” The study considers whether NGOs would be the best ad- vocates for the MDGs, but acknowledges that sometimes it is governments themselves that discourage the participation of NGOs. They can be seen as adversaries rather than as part- ners. Nonetheless, in most countries it is the NGOs that often do the majority of the work on the ground towards achieving the goals and the Millennium Declaration calls for governments to work in partnership with them in developing and implementing strategies for development. At the regional and international levels, there has been plenty of criticism of the MDG frame- work from members of civil society, which is most often directed to the following issues: ● Implications for commitments made in the past - The Millennium Summit, the Millenni- um Declaration and the MDGs are said to be the summation of the conferences that were held throughout the 1990s, however, civil society groups that were encouraged to partici- pate in the past conferences and worked towards setting goals and targets in many such areas, such as human rights, sustainable development, sexual and reproductive health and rights, gender equity and youth empowerment are now questioning what embracing the MDG framework implies for those past commitments, which remain unfulfilled.19 ● Participation of civil society - Participation by all relevant stakeholders in international political processes (including, but not limited to, government) has now become standard. It is now recognized that affected groups should contribute to decisions that will influence their lives. The UN conferences of the 1990s have been heralded for their inclusion of relevant stakeholders, including government, the private sector and NGOs. However, there was little civil society participation at processes leading to adoption of the Millen- nium Declaration and MDGs. ● Inadequacy of the framework - Participants at a civil society gathering that paralleled the high-level UN meeting known as the Millennium Summit expressed hopes to fulfill the many commitments made by governments in past conferences but were disappointed with the limited nature of the Millennium Declaration and Development Goals. However, with these criticisms in mind, the MDGs are recognized as a ‘work in progress’. The targets and indicators can be limited, but they are included because they can be most easily and accurately determined in all countries in order to realistically judge any improvements or regressions that are made. The MDGs provide a broad development framework which gov- ernments can use to look at the bigger picture and make more informed decisions regarding priority setting and budget allocation based on the perceived strengths and weaknesses of reaching the goals. Finally, the MDGs sets the tone for all development projects, from donors to recipients, thus it is important to understand this framework and learn to work within it ef- fectively. Youth Participation The participation of youth in the MDG process thus far is not easy to measure. We are not aware of young people having participated at the Millennium Forum back in 2000 but youth 18 Millennium Development Goals Reports: An Assessment. Volume 1: Main Report [http://www.undp.org/eo/documents/MDGRs_Volume_1.pdf] 19 Bissio, Roberto. “Civil Society and the MDGs.” UNDP Development Policy Journal. Vol 3. April 2003. Available at http://www.choike.org/documentos/ mdg_bissio.pdf. 19
  • 20. groups have become more organized since then and have produced important documents on how to include a youth perspective to the Millennium Development Goals. Some opportunities for youth participation have been organized by the United Nations. The first of them is the Youth Leadership Summits promoted by the United Nations Office of the Special Adviser to the Secretary-General on Sport for Development and Peace to engage young people in the drive to reach the goals. Regional Youth Leadership Summits were or- ganized and culminated in the World Youth Assembly at the United Nations in New York just ahead of the UN General Assembly, which marked the 60th anniversary of the signing of the United Nations Charter, and reviewed the progress that developing countries had made in achieving the MDGs, among other issues. Youth advocates and organizations have also found themselves in the midst of a debate similar to the kind of debate occurring amongst organizations working for gender equality and women’s issues. On one hand, there are critics of the MDGs who have argued against the need for groups such as youth and women to fit themselves into yet another framework handed down from top levels of decision-making. These critics argue that young people, in the last three decades, have worked through a series of world conferences to bring these issues to the stage and create strategic programmes for action. Reducing all this work and strategy to 8 goals without consulting civil society is not considered to be acceptable. They stress that many commitments have already been made by governments and do not see the value of pressuring governments to keep their commitments within yet another framework. However, there is increasing evidence that young people must pay attention to the MDG process, precisely because it has become the mandate for so many organizations and gov- ernments. The MDGs are a call to the international community for collective action and not responding may leave young people disconnected in the face of allied UN agencies and gov- ernments. Finally, as the 2003 Human Development Report stresses, the MDGs are a means to holding governments responsible to their commitments in the form of MDG report cards. How can young people working in sexual and reproductive rights engage the MDGs processes? Reviewing the progress made towards the MDGs is an integral part of the framework and it is hoped that yearly monitoring will emphasize the urgency of achieving the goals. In addition to the Secretary-General’s yearly reports, a process was in place for the five-year review of progress towards achieving the MDGs. The General Assembly convened in Sep- tember of 2005, at the commencement of its sixtieth session, a high-level plenary meeting known as the 2005 World Summit. This meeting included: ● A review of the progress made in fulfilling the commitments stated in the Millennium Declaration ● A review of the international progress made in achieving the eight MDGs, including whether global partnership between key actors was underway ● A review of progress made at the national and regional levels in achieving the MDGs, and ● A review of progress made of the outcomes and commitments of the major UN confer- ences and summits in the last 15 years. The summit also tackled issues such as peace and security, the promotion and protection of human rights and strengthening the United Nations. The only civil society participation to this process was the invitation of one representative each from NGOs, civil society and the private sector to address the plenary of the Summit. According to UN Secretary-General’s report on the modalities, format and organization of the high-level plenary meeting of the 60th session of the General Assembly, “for security reasons and the space limitations in the United Nations building, the broader participation of civil so- ciety is unfortunately not possible. However, I believe that civil society can make a valuable contribution to the preparatory process, in terms of both substantive contributions and of creating awareness of the issues.”20 In an effort to ensure that civil society at least had some 20 http://www.un-ngls.org/MDG/A.59.545-modalities-millennium+5.doc 20
  • 21. say in the process, informal interactive hearings were organized to take place in June of 2005. Youth activists were selected to speak at and also participate in the hearings. It is currently not clear what the participation and objectives of the next 5 year review of the MDGs will be. However, young activisits will continue the challenge of advocating for youth sexual and reproductive health and rights to be recognized as central towards achieving the MDGs. This could be accomplished by the integration of additional indicators that draw atten- tion to the specific situation of young people’s health and needs. More comprehensive strate- gies that are sensitive to the needs of young men and women are also needed. By putting a spotlight on these issues through the MDG framework, it is hoped that more resources and efforts might be directed to young people’s SRHR, either through national shifts in funding priorities or increased donor support. It is therefore crucial to convince member states of the UN that perspectives and participation of youth are crucial for the implementation of the entire MDG framework. This is especially important, as the many coordinated efforts to achieve the MDGs among international organizations, NGOs and governments are affecting young people and their role in the development process. Perhaps the most effective way for young people to advocate for the integration of young people’s sexual and reproductive health and rights within strategies to achieve the MDG is at the national level. In the coming years, governments will be challenged to prepare poverty reduction strategy papers and long-term development plans aimed at achieving the goals. In order to ensure that young people’s needs and rights are considered in these national-level plans, it is essential that young people be involved in the process of developing them, as well as implementing them and monitoring them once they have been adopted to make sure that governments are living up to their commitments. 21
  • 22. References Chapter 1: 1. United Nations Millennium Declaration (A/RES/55/2), 18 September, 2000 - http://www.un.org/millennium/declara- tion/ares552e.pdf 2. For more information on the Millennium Assembly and Summit, visit http://www.un.org/millennium/. 3. General Assembly Resolution 55/162 - http://www.un-ngls.org/MDG/A-RES-55-162.pdf. 4. Roadmap towards the implementation of the United Nations Millennium Declaration http://www.un.org/documents/ ga/docs/56/a56326.pdf. 5. Robinson, Mary. “Mobilizing People to Claim Rights” in Seeking Accountability on Women’s Human Rights. Wom- en’s International Coalition for Economic Justice (WICEJ): Mumbai, 2004. 6. The UN and the MDGs: a Core Strategy http://www.un.org.dj/UNDJ-RC/the%20UN%20and%20the%20MDG%20 A%20Core%20Strategy.pdf 7. For Millennium Development Goals Indicators visit the United Nations Statistics Division at http://unstats.un.org/ unsd/mi/mi_worldmillennium_new.asp 8. General Assembly Resolution 55/162 - http://www.un-ngls.org/MDG/A-RES-55-162.pdf. For SG Reports, visit http://www.un.org/millennium/ 9. “In Larger Freedom: Towards Security, Development and Human Rights for All” (A/59/2005) 10. See http://www.unmillenniumproject.org for more details and final reports. 11. See http://www.millenniumcampaign.org for more details Chapter 4: 12. World Health Organization (WHO), World Health Report, 2005 [http://www.who.int/whr/2005/en/] 13. Convention on the Elimination of all Forms of Discrimination (CEDAW) 1981 14. UNFPA State of the World Population 2003:Making 1 billion count, investing in Adolescents’ Health and Rights [http://www.unfpa.org/swp/2003/english/] 15. Millennium Project Taskforce on Maternal and Child Health, 2005 [http://www.unmillenniumproject.org/reports/ tf_health.htm] 16. UNFPA State of the World Population 2003 17. Freedman, Lynn, Strategic advocacy and maternal mortality: moving targets and the millennium development goals 18. UNFPA State of the World Population 2003 19. Laura Reymond, Asha Mohamud, & Nancy Ali. The Wallace Global Fund / PATH, 2000 Chapter 6: 20.. Foster, John. “The Millennium Declaration: Mobilising Civil Society Organizations.” UNDP Development Policy Journal. Vol 3. April 2003. pp.161-172. 21. From Millennium Development Goals Reports: An Assessment. Volume 1: Main Report. See: http://www.undp. org/eo/documents/MDGRs_Volume_1.pdf. 22. Bissio, Roberto. “Civil Society and the MDGs.” UNDP Development Policy Journal. Vol 3. April 2003. Available at http://www.choike.org/documentos/mdg_bissio.pdf. 23. http://www.un-ngls.org/MDG/A.59.545-modalities-millennium+5.doc 22
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