Nineteen years ago, the United Nations convened the Fourth World Conference on Women in Beijing. The Conference, which was held from Sept. 4-15, 1995, adopted the Beijing Declaration and Platform for Action, both of which institutionalize the notion that women's rights are fundamental human rights, and human rights are the right of every woman. In honor of the upcoming 20th anniversary of the Beijing meeting, the Roosevelt Institute recently held its first ever Women and Girls Rising Conference, bringing together a multi-generational group of policy makers, activists, and scholars from around the world to assess the progress that has been made since Beijing. Speakers included Gloria Steinem, Malala Yousafzai (by video), and Former Secretary of State Hillary Clinton, and representatives from the UN, the World Bank, and the Council on Foreign Relations, among many others, participated in rich discussions about the political, social, economic, and cultural inequities and injustices that women and girls still face.
Among the topics discussed -- integrating women into global development, ending violence against women and girls, the importance and impact of girls' education, and women's claims on environmental sustainability -- one issue in particular resonates quite saliently within the context of the United States' poor track record of championing women's rights as human rights: sexual and reproductive health. There seemed to be consensus among all participants that sexual and reproductive health and rights are in jeopardy more than any time in the past 20 years, and that it would not be possible today to secure the same commitments to women's health that were agreed upon in Beijing. The United States is certainly no exception.
The U.S. has had significant successes advocating for family planning and reproductive health (FP/RH) internationally through its support of the World Health Organization (WHO), the UN, and other national and multilateral agencies. The U.S. Agency for International Development (USAID) advances and supports family planning and reproductive health programs in more than 45 countries, and is the world's largest family planning bilateral donor. In 2009, the Obama Administration launched the $63 billion Global Health Initiative (GHI), a six-year initiative and global partnership to improve health outcomes, with "women, girls, and gender equality" as a key priority focus. In fact, the U.S. Government has a long history of engagement in international family planning and reproductive health issues: USAID first started their FP/RH programs in 1965, and today the U.S. government is one of the largest purchasers and distributors of contraceptives internationally. In addition, the Centers for Disease Control and Prevention (CDC), the U.S. Department of State, and the National Institutes of Health (NIH) all contribute towards advancing FP/RH internationally.
These efforts have been important, but imperfect. While the United States remains one of the world's largest donors for international family planning efforts, contributions today are below the peak level in 1995 (when adjusting for inflation). According to the Kaiser Family Foundation, designated FP/RH funding has not kept pace with U.S. global health funding overall, and has declined from 22 percent of the U.S. global health budget in FY 2001 to about 6 percent in FY 2013.
Additionally, U.S. ideologically driven policies -- like the Helms Amendment and Mexico City Policy (also known as the Global Gag Rule, which was repealed by President Obama) -- have prevented women worldwide from accessing comprehensive reproductive health care. Such restrictions prevent U.S. funds from supporting abortion counseling, lobbying, referrals, and procedures, and in turn hamper U.S. efforts to curb the more than 47,000 maternal deaths that occur each year as a result of unsafe abortions.
The same ideologies and anxieties about women's sexuality and bodily autonomy that made way for the Helms Amendment have also driven the erosion of sexual and reproductive health and rights in the United States. The Hyde Amendment, passed just a few years after Helms went into effect, prevents federal funding for abortion in the United States. Since 2011 we have see historic numbers of regressive state-level reproductive health measures: family planning cuts, arbitrary regulations on abortion providers, and restrictions on some of the safest abortion methods. These and other efforts have contributed to the closing of clinics and the dismantling of a critical health infrastructure on which U.S. women -- particularly poor women, women of color, young women, and immigrant women -- rely.
While the Affordable Care Act (ACA) represents historic progress in guaranteeing comprehensive reproductive health care -- mandating the coverage of comprehensive reproductive health services, many without cost sharing, and prohibiting gender discrimination in health care for the first time in U.S. history -- political intransigence has weakened the law and will leave those in greatest need without access to care. Efforts to undermine the original intent of the ACA will undoubtedly hinder U.S. efforts to combat maternal mortality, new HIV/AIDS infections, high rates of unintended pregnancy and abortion, and high rates of economic insecurity in too many U.S. communities.
As Nancy Northrup, President of the Center for Reproductive Rights, said at the recent Roosevelt event:
"If [women] don't have access to essential obstetrics care, a certain percentage of women will die...If women do not have access to contraceptives and contraceptive choices, than many will have numerous pregnancies, some of which will compromise their health, some of which -- in some cases -- will cause them to die, and some of which will alter their life paths that they may have chosen for themselves otherwise. If women do not have access to safe and legal abortion, again, women will die...And, if women don't have an ability to exercise their own sexuality and choose their own sexual partners, then they cannot live a fully human life."
U.S. policymakers purport that we are the global leaders at, well, everything. But on women's health this is simply not the case. Honoring human rights at home will allow us to promote them abroad; we should be leading by example, enacting sound, evidence-based policies that enable all women to live free of health, social, and economic insecurities.
Millennials are key to making this happen. The Roosevelt Institute has started to pave the way, giving young people a platform to engage in policy development and advocacy, not only through convenings such as the Women and Girls Rising Conference, but also through its Campus Network. With over 120 chapters in universities across the country and over 10,000 members, the Campus Network is the largest student-run public policy think tank in the world, and trains millennials to become thought leaders in a variety of policy areas.
It was Prime Minister of Pakistan Benazir Bhutto who nearly two decades ago proclaimed in Beijing, "We must do much more than decry the past. We must change the future." Today's youth hold the key to the future. We need to engage them, fund their work, encourage their participation and lift up their voices if we are ever to achieve comprehensive reproductive health access for all.