Re-Discovering U.S. Leadership: An Unlikely Contender

Fifteen years ago, a conference in Cairo -- the International Conference on Population and Development (ICPD) -- established a groundbreaking commitment from the international community to provide universal reproductive health. The U.S. answered the call to action, and the U.S. State Department became a global leader in working toward ensuring that women had access to lifesaving reproductive health services. Fifteen years after the conference in Cairo, it is apparent how much is left to do to meet the reproductive health needs of women around the world, especially refugee and displaced women.

70 million people are currently displaced from their homes. The daily realities for women around the world can be cruel, but for refugee women, it is especially brutal. Rape and sexual exploitation escalate during conflict, increasing women's risk of HIV infection and unintended pregnancies. The challenges of accessing basic health care are overwhelming and pregnancy and childbirth become a death-defying feat. Of the 10 countries with the worst maternal mortality rates, eight are conflict-affected.

That women bear the brunt is little surprise; as one Eastern Congolese woman said, "We are victims of war. We don't take up arms, but we, the women suffer the most." As the world focuses on the continuing conflict in Afghanistan and the escalating crises in Pakistan, it is important to remember how dangerous it is to be a pregnant woman in this region. According to a UN survey, Badakhshan, a province of Afghanistan, acquired the dubious honor of having the highest maternal mortality ratio in the world. A woman in Badakhshan is 600 times more likely to die in childbirth than a mother-to-be in North America. This is not simply a women's issue. When a mother dies, the whole family suffers and communities are weakened.

Most of these deaths can be prevented with cost-effective strategies, and these solutions are wanted by women around the world. In fact, 200 million women globally would like to use, but do not have, family planning and contraceptives. While inaccessible to many, family planning alone can prevent maternal deaths by up to 40%. Investments in family planning and other low-cost strategies have big results. In fact, if unmet need were satisfied, the savings in maternal health would be $4.2 billion USD.

Today [Friday, January 8], at an event commemorating the 15th anniversary of the ICPD, Secretary of State Hillary Clinton will emphasize the U.S.'s commitment to advancing reproductive health worldwide. There will be strong words and very good intentions. However, what is needed is strong action and the political will to do what it takes to save lives and strengthen communities around the world.

As we celebrate the groundbreaking commitment to women's health first made in 1994, the U.S. has an important opportunity. We are beginning to see that seemingly backburner issues, such as providing reproductive health, are integral to the broader issues of mitigating conflict and increasing economic opportunity around the world. If the U.S. continues to fulfill the ICPD pledge vowing reproductive health for all, it would not only help to avert maternal and infant deaths, but also slow the spread of HIV and create greater choice and opportunities for communities worldwide. Within this context of saving and improving lives, the U.S. is poised to provide leadership on the global stage.