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A FACT SHEET PREPARED BY THE MOBILIZING RESOURCES TASK FORCE U.S. NGOs IN SUPPORT OF THE CAIRO CONSENSUS Keeping America Promises KEERING AMERICA'S PROMISES U.S. Funding for Reproductiv In 1994, at the Health Care at Home and International Conference on Population and Development held in REPRODUCTIVE HEALTH to counseling and condoms can also prevent Cairo, Egypt, the United NEEDS WORLDWIDE new cases of HIV infection and other STDs. However, funding for these efforts falls far States agreed, together Worldwide, poor reproductive health is short of the needs. Despite the growing desire with other nations, to a serious problem-about 3.4 million of couples everywhere to make their own de- make basic reproductive women and men die each year from re- cisions about how many children to have and health services available productive health related and largely when to have them, and the urgent need to preventable causes. Because of early and to all in need of them, promote safer sex, contraceptive and sexual frequent childbearing and poor access to health health services are still-difficult to obtain, and to this end, to care and contraception, about 585,000 women unaffordable, or of poor quality in many coun- increase financial die each year in pregnancy or childbirth, includ- tries. Over 100 million women in developing support to developing ing an estimated 75,000 deaths from unsafe countries who want to delay or avoid another countries: As the fifth abortion; almost all these deaths occur in devel- pregnancy are not using contraception. As a anniversary of the oping countries. Worldwide, in 1997, some 30 result, couples in developing countries increas- million people were living with HIV/AIDS and conference approaches ingly want smaller families, but often have about 1.8 million adults died of the disease. where does the United more children than they would like. With 5.8 million new infections in that year, the States stand with Large family size contributes to future death toll from AIDS is expected to rise. respect to these continuing rapid population growth. In addition, 330 million new cases of other Social and economic changes, together with commitments, both at sexually transmitted diseases (STDs) occur an- improved availability of family planning, have home and abroad? nually worldwide, many of which undermine resulted in dramatic declines in average maternal and infant health. Meanwhile, the larg- family size across the developing world. Still, est group of adolescents in history is at risk of population growth rates remain high in many unwanted pregnancy, HIV and other STDs. countries, especially where the low social Better access to voluntary family plan- status of women contributes to a continuing ning and related health care would pre- desire for large families. UN projections sug- PLUS FIVE vent many deaths from reproductive gest world population could increase from health related causes. Family planning saves 5.9 billion people today to 8.9 billion or the lives of mothers and children by helping more by the year 2050. Currently, the world women avoid high risk pregnancies and increas- is adding 78 million people a year, almost all ing the time between births. Improved access in developing countries. U.S. NGOs IN SUPPORT OF THE CAIRO CONSENSUS C/O 1120 19TH STREET, NW SUITE 550 WASHINGTON, DC 20036 USA SHARE OF U.S. BUDGET ALLOCATED'TO. INTERNATIONAL POPULATION ASSISTANCE 1997 This rapid population growth is outpacing the ability of gov- Foreign Aid 0.9% U.S. International ernments to provide social ser- Population and Family vices and infrastructure, and Planning Assistance 0.02% undermining prospects for en- vironmentally sustainable de- velopment. For example, 24 per- cent of the world lacks access to clean water. Human activity is also having a devastating impact on our environment, threatening natural resources and decimating other Other Federal species. Improved access to family Government Spending planning can accelerate the trend towards smaller families, thereby helping to alleviate the problems associated with rapid population growth while also enhancing repro- Source: U.S ductive health. For example, slower population growth can help avoid conflict over scarce water resources and thus vide women with expanded choices by improv- PD promote global political stability. By making it their access to education, health services and possible for countries to invest more in educa- employment opportunities, and involving them for tion and health, slower population growth fully in policy and decision making. The confer- rates contribute to increased productivity and ence also emphasized the close links between economic growth as well-and to expanded population and development; issues relating to of trade and prosperity in both developed and population, the environment and consumption developing nations. patterns; and the need for partnerships between governments and private organizations. as THE CAIRO CONFERENCE: At the ICPD, nations agreed on a plan to MEETING THE NEEDS a improve individual reproductive health ned The International Conference on Popula- and help slow world population growth. tion and Development (ICPD) held in The conference recommendations call for uni- to Cairo, Egypt, in 1994 revolutionized the versal availability of family planning by 2015 as tive world's approach to population and de- part of a broadened approach to reproductive velopment issues. The conference, attended health and rights that emphasizes meeting indi- and by 16,000 representatives of governments, inter- vidual needs rather than demographic targets. national and nongovernmental organizations, and Other conference goals include further reduc- the media, focused attention on the human and tions in infant, child and maternal mortality. environmental issues surrounding rapid popula- Within the area of reproductive health, the ICPD tion growth and poor.reproductive health. In highlighted the need for: family planning; preven- Cairo, 80 nations took part in negotiations to tion of sexually transmitted diseases including deve recommendations for global action in HIV/AIDS: and basic reproductive health care, the area of population and elopment over including pre natal and post-natal care and safe the 20 years delivery The conference anticipated that address- ing the totality of human reproductive health A major achievement of the ICPD is the needs in a comprehensive way would improve recognition that empowering individual health outcomes while also increasing demand women also benefits society as a whole. for family planning. The conference recommendations, aim to pro The Cairo conference identified the financial com- portionately, declining by 35 percent. These cuts, together mitments needed to implement this plan. The ICPD with punitive delays and restrictions on the release of is unique among other recent global conferences in reach- population assistance funds imposed by family planning ing agreement on the level of financial commitments, and opponents, have created many problems for a successful responsibility for these commitments, needed to fulfill key foreign aid effort. The U.S. Congress has also eliminated all goals. The conference estimated that making quality repro- funding for UNFPA for 1999. ductive health services available in developing countries to The United States is the largest donor but con- all in need of them would cost about $17 billion in the year tributes too little relative to its size and wealth. 2000. The cost would rise to $22 billion in the year 2015, as In 1996, the U.S. government spent $463 million for family a result of both the growing number of women in their re- planning and related health activities, and an additional productive years and the rising demand for contraception $175 million on maternal health and HIV/AIDS programs, as couples increasingly desire smaller families. The confer- for total expenditures of $638 million on population assis- ence agreed donor countries would provide roughly one- tance as defined by the ICPD. As the largest industrialized third of these funds, while developing countries would nation, the United States appropriately contributes the provide the remaining two-thirds. THE U.S. ROLE IN INTERNATIONAL MAJOR DONOR COUNTRY CONTRIBUTIONS TO POPULATION POPULATION ASSISTANCE ASSISTANCE RELATIVE TO NATIONAL INCOME LEVELS Popula tance Expenditures, Million U.S Dollars Since the 1960s, the United States has been a of Gross National Product (GNP) 400 leader in helping poor countries develop popula- tion policies and implement family planning 350 programs. The United States helped establish the United 300 Nations Population Fund (UNFPA), the most important 250 international organization working in this area. The U.S. for- eign aid program, working in close partnership with private 200 American organizations, leads the world in expertise in the 150 delivery of high quality, cost-effective family planning and 100 health services in developing country settings. More re- cently, the United States has also emerged as a leader in 50 AIDS prevention efforts. U.S. population assistance has been highly effec- Denmark Nonetherlands Sweden Finland Kingdom Australia. States Canada Germany. Japan France tive. Countries receiving significant U.S. funds have experi- United UNEPA enced remarkable increases in contraceptive use and de- clines in birth rates. Tens of millions of couples use family planning as a direct result of U.S. assistance; millions more most to international population programs. However, in have benefited indirectly from improvements in services 1996 it ranked eighth out of 20 major donors in its contri- resulting from American advice and innovations. In the 28 bution relative to gross national product (GNP). In that largest countries receiving U.S. funds, average family size year, the U.S. contributed $84 in population assistance for has fallen from about six children in the 1960s to roughly every million dollars of GNP, while Denmark spent $371- four today. In Colombia, Indonesia and Mexico, family size almost five times the U.S. contribution. Denmark's contribu- now close to three children while Taiwan and tion represented for every. Danish citizen, while the Thailand have reached a tworchild family and no longer U.S.contribution represented only $2.36 for every Ameri require U.S. assistance can: The United States with declining overall foreign aid Recently, however, the Congress has slashed funds levels also ranks last-among 21 donor countries in devel for international population assistance Beginning in opment assistance as a-percentage of GNP. 994 President Clinton increased U.S. support for family To pay-its fair share, the United States needs to planning overseas significantly But in 1996,a new and con triple its population and reproductive health assis ser vative Congress development aid dramati- tance by the year 2000. The U.S. share of the year 2000 cally funds for family planning assistance were cut dispro- goal for donor assistance calculated in proportion to respective share of total GNP for the rich industri nations is $1 billion. Because the United States and people of color are also dispropor tionately is by far the largest and richest donor country, it is affected by STDs; topic pregnancy a canse unlikely the overall- CPD goa for donor assistance quence of untreated STDs, is the leading cause can be met without the full U.S. contribution. of death in early pregnancy among African Denmark the Nether and Norway have al American women ready exceeded their own. year 2000 goals sug The poor, minorities, illegal immigrants gesting that fulfilling these financial commitments and adolescents in the United States is largely a matter of political will A chieving the have less than optimal access to repro- U.S. share would cost an additional five dollars ductive health care. Although most people per year for every U.S. citizen- the equivalent rely on private insurance to help.pay for their of one fast food meal reproductive health care, some 30 million Keeping Political attacks continue to undermine Americans health insurance They must el U.S. participation in the international ef ther pay out of pocket or rely on-subsidized ser America's fort to reach a stable and healthy world vices or even emergency room care to cover population. Although the Congress has prohib the costs of contraception STD treatment and ited the use of U.S.-foreign aid funds to support maternity care. Roughly half of the 33 million Promises abort since 1973 conservatives are seeking to women nationwide in need of contraception impose additional policy restrictions relating to including million teens and almost, 12 million The U. S.is the abortion Current proposals would deny U.S. fam low income women have a need for publicly world's largest ily planning assistance to private organizations support services There IS also significant racial overseas if the use other non-U.S. funds to pro disparity in access to early prenatal car :in 1994 industrialized vide legal abortion services or to participate in 83 percent of white women but only 68.per country, but in policy debates over abortion in their own coun- cent of black women receivedisuch, care Age is 1996 it ranked tries. This proposal, termed the "Global Gag also a factor one third of pregnant teens did Rule," is more sweeping than similar restrictions not receive adequate prenatal care eighth out of 20 in effect in the late 1980s and early 1990s in its In addition, private insurance coverage of donor countries effort to curtail basic democratic principles and family planning services is seriously inad- free speech. These restrictions would also harm equate. Although most private insurers cover in population women's health by limiting access to family plan- prenatal care and STD treatment, the same can- assistance relative ning, increasing reliance on abortion and sup- not be said for screening and contraceptive ser- pressing public debate about unsafe abortion. to GNP. vices. Ironically, while most private plans cover REPRODUCTIVE HEALTH NEEDS IN THE UNITED STATES DIMINISHING PURCHASING POWER OF Although reproductive health status is U.S. INTERNATIONAL FAMILY PLANNING ASSISTANCE better in the United States than in devel- 600 oping countries, Americans have signifi- cant unmet needs for reproductive health 500 care. Each year, more than 3 million unintended Total Assistance Assistance adjusted for Inflation and pregnancies occur, 1.4 million of which end in 400 in number of women of childbea ring age abortion. The U.S. teen pregnancy rate is far higher than that of many other developed countries-twice as high as England, France MILLIONS OF U.S. DOLLARS 300 and Canada, and nine times as high as Japan 200 and the Netherlands. Almost one million teen pregnancies occur each year in the United States, 100 of which 4 out of 5 are unplanned. Moreover, of 12 million new STD infections nationwide each year, fully 3 million are in teens. Women 1965 1975 1997 4 the surgical procedures of sterilization and Title X. Moreover, about two-thirds of women abortion, fully half of large insurance plans receiving subsidized family planning are served cover no method of prescription contraception. by clinics funded through Title X, For many family Less than 20 percent of these plans and less planning patients, a Title X-funded clinic may be than 40 percent of managed care programs the only access they have to health care at all. cover all five major reversible contraceptive Federal family planning funds support a methods. As a result, women of reproductive broad range of reproductive health care, age in the United States pay 68 percent more but may not be used to pay for abortion. in out-of-pocket health care costs than men Clinics funded by Title X support the full range of the same age. of contraceptive information and services, rou- PUBLIC FUNDING FOR tine gynecological care, pregnancy testing and other basic reproductive health services. They DOMESTIC REPRODUCTIVE may also choose to provide prenatal care in HEALTH CARE some instances. In addition, family planning clinics The U.S. government provides funding are playing an increased role in STD care; in 1993 Keeping for reproductive health care for unin- STD and AIDS screening, counseling and treat- sured individuals through a variety of ment accounted for roughly one-quarter of the America's programs. In the United States, low income budgets of clinics offering such services. Maternal women and others can obtain subsidized family and child health clinics and community health planning and prenatal services, and Promises STD screening and treatment, DIMINISHING PURCHASING POWER OF FUNDS FOR THE TITLE X through a patchwork of clinic based DOMESTIC FAMILY PLANNING PROGRAM, 1971 TO 1997 United services funded through several States must public health and insurance pro- 250 grams. Clinics serving these popula- increase unding tions often receive government 200 to bramate funds from several sources, including the federal Medicaid and Title X universal access (ten) programs, state government 150 contributions and federal block to basic grants to the states. While the Med- reproductive icaid program is the largest funding source for family planning, providing MILLIONS OF DOLLARS 100 CURRENT DOLLARS health care almost half of all public spending, it $50 both at home does not directly fund clinics or pro- ADJUSTED FOR INFLATION and abroad. vide services. Title X is the only fed- 0 eral program dedicated solely to the 1971 1976 1981 1986 1991 1996 provision of family planning services and related reproductive health care through a national network of clinics and federal centers may also provide family planning services, regulations and guidelines, and STD clinics (which traditionally serve more Public funding, especially through the men than women) usually refer patients for other Title X family planning program, re- reproductive health services. mains important in the United States, Without question, the provision of pub- serving an estimated 6.6 million women licly funded reproductive health services and teens each year. Over half (57 percent) is highly cost effective. Each year publicly of individuals receiving publicly funded family funded contraceptive services help American planning services have incomes below the fed- wamen avoid 1-3 million unintended pregnancies poverty level, Almost 60 percent of some more than 600,000 of which would have ended 100 U.S clinic sites providing subsidi family in abortion Studies show that for every dollar (planning vices are funded at least in part by spent OR publicly funded family planning services over $3.00 is saved impregnancy related costs in 5 the short term. In addition, for each dollar spent organize family planning and health services to to provide prenatal care to low income women, meet a broad range of reproductive health more than $3.30 can be saved in health care needs. To mark the fifth anniversary of the ICPD, costs. Treatment of the consequences of chlamy- the United Nations is planning a series of meet- dia, the most common curable STD in the United ings to assess progress to date, identify remaining States, is estimated to be 12 times greater than challenges and recommend future actions. These the cost of screening and treatment. Expenditures meetings will also-call on governments to recom- on preventive care can also avoid the need for mit themselves to the goals agreed on at Cairo billions of dollars in expenditures on social and Both developing and donor nations are health services and temporary welfare payments far from achieving the ICPD financial as well. goals; in many poor countries a shortage Federal funding for reproductive health of funds is impeding efforts to implement care has fallen in real terms and is inad- the conference recommendations. equate to meet current needs. Between According to the United Nations, governments, 1980 and 1994, total U.S. public expenditures private organizations and households in develop- for family planning fell by 27 percent in constant ing countries spent just under $8 billion on re- K dollars, while funding for the Title X program de- productive health in 1996. This represents about clined by over 65 percent. If Title X funding had 80 percent of total spending from all sources- merely kept up with inflation, it would be funded and 70 percent of the contribution required at nearly $500 million today, rather than the $200 from developing countries in the year 2000. million level where it is currently stagnating. Fed- However, a few developing countries account eral maternal and child health and STD programs for most of this spending; the poorest countries, have also experienced cuts in real terms, with which tend to have the worst reproductive funding remaining largely level. Thus, as health care health status and highest population growth costs have soared and the number of potential rates, spend much less. Meanwhile in 1996, the clients has increased, the ability of these programs donor community spent two billion dollars, or to provide services has been significantly under- just over 35 percent of the year 2000 goal for mined. Some clinics have reduced hours of opera- donor contributions. Thus, the industrialized tion and placed patients on waiting lists for effec- nations are currently paying only one-fifth of tive long-term family planning methods. A lack of the costs of the global effort, rather than the funds is also limiting the role of family planning one-third agreed on in Cairo. clinics in screening and treatment of STDs. Mean- The United States must stand by the while, over the last three years, Congress has at- commitments it made in Cairo. For many tempted to eliminate funding for the Title X pro- years, the United States set an example to other gram in its entirety, to shift family planning dollars governments in its efforts to expand worldwide to other programs, and to impose restrictions access to family planning and support family that would severely limit the ability of. teens to planning servicès for poor Americans. But U.S. receive services-efforts that have been largely leadership has been undermined by budget unsuccessful thus far. cuts-or in the case of domestic budgets, de- CAIRO+5: ASSESSING clines in real terms-and by crippling restrictions on both international and domestic family plan U.S. PROGRESS SINCE ICPD SUP ning funding which can only lead to moreiun, CAH The Cairo conference has had a profound wanted pregnancies and abortions. The United NO o impact on government policies and pro States must up to the responsibility that 1120 sun grams as well as the lives of millions of comes with its wealth and role as a world eader WAS men and women around the world. Since and increase funding to promote universal access 2003 Cairo, many countries have undertaken a broad to basic reproducti health care both at home range of act to simplement the CPD ap and abroad. Better reproductive health and proach including changes population and devel slower population growth will yield benefits opment policies; and constitutional reforms to the global economy and environment, and PRIN REC' to better protect women's rights and promote improve the quality of life for Americans and WIT gender equality and efforts to rengthen and all people. 1998 (airo CAIRO PLUS FIVE TOP TEN Q&A Through July of 1999, a process referred to as "Cairo Plus Five" or "ICPD+5" will increasingly involve the international development community - including the U.N. Population Fund (UNFPA), the United States and other governments, nongovernmental organizations (NGOs), the media and the general public. The process involves a global review of population-related developments in the five years since the International Conference on Population and Development (ICPD) was held in Cairo, Egypt, in 1994. This brief, produced by U.S. NGOs in Support of the Cairo Consensus, provides answers to ten of the most commonly asked questions about the process. Q. What is "Cairo Plus Five?" A. In September 1994, the United States and delegations from 179 nations and thousands of NGO representatives met in Cairo to discuss ways to address world population growth and promote global economic and human development. The ICPD reached consensus on a historic shift in policies to address rapid population growth: to move away from demographic targets to a 20-year goal of meeting individuals' reproductive health and development needs. This visionary approach is reflected in the final conference document, a 16-chapter Programme of Action that offers concrete actions for improving the quality of life for all people. Key recommendations include: empowering women in the economic, political and social arenas; removing gender disparities in education; integrating family planning with related efforts to improve maternal and child health and prevent the spread of HIV/AIDS and other sexually transmitted diseases (STDs); increasing financial and human resources commitments; and strengthening cooperation between the public and private sectors in implementing these goals. Nations and NGOs involved in population and development issues will now meet in a series of high- level meetings to assess the progress made in the five years since Cairo. These meetings, and their preparatory regional and technical conferences, will identify successful programs and strategies and share lessons learned. They will also review the status of commitments made at the ICPD and identify key actions needed to move the Cairo agenda forward. Q. What is at stake during this review process? A. Life itself is at stake for millions of mothers and their children who die each year from the complications of pregnancy and childbirth, including unsafe abortion. Action is urgently needed to prevent these deaths, as well as to reduce unintended pregnancy, abortion, and to stem the spread of HIV/AIDS and other STDs. Although family planning services are more widely available than ever, more than 100 million women in the developing world want to space or limit their childbearing, but are not using modern contracep- tion. And that number is growing. At the turn of the millennium, nearly 1 billion of the Earth's 6 billion people will be teenagers. Now entering their reproductive years, these young people have an enormous unmet need for reproductive health information, education and services — in addition to jobs, educa- tion, housing and health care. The planet's demographic future is also at stake. World population today stands at 5.9 billion, and is expected to reach 6 billion in late 1999. About 78 million people are added to the world's population each year, 95 percent of them in developing nations. Depending on how successful the world is in implement- ing the ICPD Programme of Action, the latest U.N. projections show that by the year 2050 (in our children's lifetime), the world's population could be as low as 7.3 billion people or as high as 10.7 billion. In many countries, rapid population growth is straining the ability of governments to provide social services and jobs, and undermining prospects for environmentally sustainable development. If fully implemented, the ICPD Programme of Action would enable individuals, communities and governments to cope better with these and other challenges and decrease political friction over scarce resources, including natural resources such as fresh water and arable land. By making greater investments in social services possible, slower population growth rates can help foster economic development and political stability - above and beyond the benefits of such social investments to individuals and families. Q. Is Cairo working? A. Cairo, as represented in the Programme of Action, is an ambitious document with a 20-year timetable. Although early in the process, there is evidence that the new approach to population and development that is at the heart of the document is working. The U.N. is conducting a global review, and independent case studies are underway in at least 16 countries. Early findings indicate broadening commitments to women's advancement (such as girls' education and legal rights); increasing integration of family plan- ning with other basic health services; new ways to provide family planning to adolescents, rural residents and other under-served people; and expanding public-private partnerships among governments, NGOs and other sectors of civil society such as religious and business leaders. Progress among countries is uneven, however. Huge disparities remain in women's status, family size, child health, and educational opportunities for boys and girls. Millions of couples still don't have access to basic reproductive health services, including family planning. Many donor countries are not living up to their share of the funding goals agreed to at the ICPD. Just as with the 1994 Cairo conference, NGOs hope that the Cairo Plus Five process, by requiring each nation to assess its progress and participate in global consensus-building, will help strengthen and affirm commitments made at Cairo and move implementation forward. Q. Why are women a central focus of the Programme of Action? A. In much of the world, women's low status means they have little control over their reproductive lives, including pregnancy and childbirth, whether contraception of any sort is used, whether to marry or even whether to have sex. Teenage women have the least freedom and are most vulnerable in these areas, including young women in the United States. In many developing countries, women often see few options for their lives beyond childbearing. Edu- cation and broader social, political and credit opportunities for women, however, have been proven to raise most indicators of economic wellbeing as women postpone marriage and children. Even short periods of education for women on nutrition, health care, sanitation and environmental stewardship - areas where women tend to have primary responsibility - tend to boost family health and resource conservation, and improve economic wellbeing. Q. Are we forcing this program on poor women and on poor nations? A. No. Women surveyed worldwide have expressed a consistent demand for family planning services, saying they wanted fewer children than they now have. Fertility rates were falling worldwide before Cairo, and the reasons are generally acknowledged: increasing educational achievement for girls, declining infant mortality rates, growing rights for women, the move of people from rural to urban areas, better health care, and especially the availability of quality family planning services. To ensure 2 that these trends continue, developing nations have embraced the ICPD Programme of Action as central to their hopes for sustainable social and economic development. Overall, developing countries shoulder three-quarters of the cost of meeting the demand for family planning and other reproductive health services. For the poorest countries, however, assistance from international agencies and donor countries is crucial and the help currently forthcoming from the donor community falls far short of what is needed. Q. Isn't the Vatican opposed to the ICPD recommendations on birth control and family planning? A. While opposed to the use of contraception, other than natural family planning, the Vatican sup- ported ICPD recommendations for empowerment and education of women and for economic, political and social development. The ICPD Programme responded to the broad and urgent demand for effective family planning services across the spectrum of world religions and cultures, recognizing that opinion and practice would differ. No ICPD recommendation seeks to promote abortion but rather to reduce the demand for abortion by ensuring access to safe, effective and affordable methods of contraception. But it also states that there should be treatment for women suffering from the complications of unsafe abortion, and that where abortion is legal, it should be safe. Despite highly visible opposition from the Vatican, most Protestant and Jewish denominations in the United States have positions supporting contraception and a woman's right to choose abortion. Q. What is the role of nongovernmental organizations (NGOs) in dealing with these issues? A. NGOs provided much of the field knowledge and program experience that guided drafting of the ICPD Programme of Action, and were especially influential in pressing for action on women's needs. NGOs continue to hold governments accountable for promises made in Cairo, to monitor progress and to gener- ate additional support for ICPD implementation, as well as to discover and test new techniques and approaches to service delivery. NGOs also play a key role in educating and informing policy makers, the media and the general public of current issues in the field and in providing the individual stories of human success and challenge that make those issues real to the world audience. Q. How has the United States done on its ICPD commitments? Hasn't Congress cut funding? A. The United States played a leadership role in Cairo, strongly stating its commitment to ICPD goals and incorporating them into key policies. Programs to implement ICPD goals are in place at the U.S. Agency for International Development (USAID), the State Department, the Department of Health and Human Services, the Environmental Protection Agency, Labor, and the Census Bureau, among other agencies. Beginning in 1994, President Clinton increased U.S. funding for population programs overseas. But in 1996, a new and conservative Congress cut overseas development aid dramatically; funds for USAID family planning assistance were cut disproportionately, declining by 35 percent. These cuts, together with punitive delays and restrictions on the release of population assistance funds imposed by family planning opponents, threaten to cripple U.S. assistance to the foreign NGOs that deliver international family planning services to much of the world. Based upon its share of overall wealth and the year 2000 goal for donor assistance contained in the ICPD Programme of Action the United States' "fair share" is $1.9 billion. Because the United States is by far the richest donor country, it is unlikely that overall ICPD goals for donor assistance can be met without the full U.S. contribution. Denmark, the Netherlands and Norway have already exceeded their year 2000 "fair share" of donor assistance. Achieving the U.S. share would cost an additional $5 per year for every U.S. citizen - the cost of one fast food meal. Q. Why should the average American citizen care about Cairo Plus Five? A. The world is increasingly interconnected. Threats to the environment, basic human rights and public health in any nation now cross international borders. Such threats are made more serious by rapid 3 population growth. Indeed, the prospects for peace and economic development in the 21st century will depend, among other things, on meeting human needs and slowing population growth. The promise of Cairo also affects Americans more directly. Here in the United States, high teenage pregnancy rates have begun to drop, as have rates of unintended pregnancy and abortion, partially due to improving sexuality education programs that have led to fewer teens having sex and more teens using contraceptives. New programs have been instituted to build self-esteem among young women and to involve young men in responsible family planning, and others seek to improve women's access to credit, family planning and legal services. Q. How fast is population growing in the U.S. and other industrialized nations? A. The United States is the world's third largest nation, with 274 million people. Americans are having babies at a rate slightly higher than most industrialized nations, 2.1 children per woman. This fact, combined with relatively high levels of teenage pregnancy and immigration, means that the U.S. population is growing at 0.8 percent per year. At this rate, U.S. population is expected to increase by at least 50 percent by the year 2050. Italy has the world's lowest child-bearing levels at 1.2 children per woman, with Japan, Spain and a number of other European countries not far behind. Some pundits have argued that these trends and the social factors that caused them will inevitably continue and spread without further effort on our part, leading in 40 years or less to depopulated nations, a huge dependent elderly population and widespread loneliness. Such notions ignore the reality of inevitable population growth generated by the large numbers of young people just entering their childbearing years. They also ignore very different conditions in poorer parts of the world where health care is challenged by poverty and widespread resurgent dis- ease, where women's rights are often circumscribed, and where much of the population remains with- out access to reliable and affordable contraception. In 40 African nations, for example, fertility remains at six children per woman. In addition, the rising number of people over age 65 is likely to prove a benefit rather than a burden, as medical and nutritional advances are boosting their vitality and productivity. In environmental terms, the impact of each American on the planet is much greater than their sheer num- bers indicate. Americans, with 5 percent of the Earth's people, generate 25 percent of its waste and pollution. Cairo Plus Five At a Glance: A three-day Special Session of the U.N. General Assembly (30 June-2 July, 1999) will mark the formal culmination of the five-year review of the ICPD. Events leading up to the Special Session began in April and include the following: Roundtables focusing on key themes of the ICPD Programme of Action: Adolescent sexual and reproductive health (April 1998); Reproductive rights and reproductive health programs (June 1998); Participation of civil society in ICPD implementation (July 1998); Population and macro-economic linkages (November 1998). The Hague Forum on ICPD implementation (8-12 February 1999, The Hague), organized by the United Nations Population Fund (UNFPA), will bring together national delegations, U.N. organizations and NGOs. Events preceding the Forum include a forum for NGOs, including youth (6-7 February 1999, The Hague), and a meeting of parliamentarians (4-6 February 1999). See page 4. The 32nd Session of the Commission on Population and Development (22-30 March 1999, New York) will serve as the preparatory committee (PrepCom) for the U.N. Special Session scheduled for 30 June-2 July 1999. Here in the United States, an informal network of NGOs is involved in activities as part of the Cairo Plus Five process. U.S. NGOs in Support of the Cairo Consensus currently comprises four task forces working to build public awareness of and support for ICPD implementation. See http://www.cedpa.org/cairo. PRODUCED BY U.S. NGOS IN SUPPORT OF THE CAIRO CONSENSUS, IN CARE OF 1120 19TH STREET NW, SUITE 550, WASHINGTON. DC 20036 USA 202-659-1833 Focus on Population And Development The U.S. and the UN International Conference on Population and Development World leaders gathered in Cairo, have improved the lives of millions groups and the citizens of developing Egypt, in September 1994 to address of people, but they have periodically countries. It also is a product of crucial problems facing humanity at drawn criticism for narrowly focusing improved understanding of the com- the third decennial UN conference on on lowering birthrates and insuffi- plex context in which decisions about population. The International Confer- ciently addressing human rights, childbearing are made. There is now ence on Population and Development women's health, and cultural differ- broad agreement that development and (ICPD) presented a critical oppor- ences. Previous UN conferences on family planning can work separately to tunity to develop a program of action population were marked by heated slow population growth but that they to address problems that cause immea- debates on how to address population work most effectively when pursued surable human suffering in all parts of growth and, indeed, whether popula- together. There also is increasing the world. tion growth is a problem at all. recognition that population growth is Delegates to the ICPD agreed on a At the World Population Confer- part of a constellation of factors that Program of Action that will help guide ence in Bucharest in 1974, the U.S. and can cause environmental degradation. the population programs of the United other industrialized countries advo- And it is widely acknowledged that Nations and national governments into cated programs to slow growth rates, family planning should be provided as the next century. The Program of while the developing countries coun- part of broader primary and reproduc- Action is not a binding treaty, but it tered that "development is the best tive health initiatives, that population will serve as a benchmark and standard contraceptive." By 1984, when the policy should encompass economic toward which governments and UN held its second conference on opportunity for women, and that legal agencies should strive. population in Mexico City, many and social barriers to gender equality The U.S. Government fully partici- positions were reversed. The develop- should be eliminated. pated in both the preparations for ing countries acknowledged the need The preparatory process for the Cairo and the conference itself-and in for population programs, but the U.S. Cairo conference also benefited from a articulating a new approach to popula- delegation pronounced population a high level of citizen participation. More tion policy. The new approach enjoys "neutral factor" and scaled back family than 1,200 representatives of citizens' the support of a majority of the world's planning efforts worldwide. During the groups attended the last preparatory nations. Grounded in a commitment to 1992 earth summit in Rio de Janeiro, meeting in New York and more than health, development, and empower- delegates vigorously debated the role 2,000 attended the conference. They ment, the new approach strengthens of population in sustainable develop- played an important role in drafting families and communities, promotes ment. conference documents. Many of the economic and social development, and In welcome contrast, the Cairo representatives were women from affirms, in the words of the UN conference was characterized by an diverse backgrounds and all regions of Charter, "the dignity and the worth of extraordinary degree of international the world. The U.S. delegation in- the human person." agreement. The new consensus cluded 15 citizen representatives, reflects, in part, the degree to which including women's health experts, An Emerging Consensus population professionals have re- environmentalists, and population The new international consensus on sponded to concerns voiced by women's experts. population policy is a recent develop- The Administration actively sought ment, but it has been decades in the the input of citizens and organizations To obtain a copy of the Program making. Since they were implemented in the development of its new policies. of Action, call the UN Interna- on a broad scale in the 1960s, popula- State Department representatives tional Conference on Population tion and family planning programs have participated in town meetings from and Development on (212) 297- enabled millions of men and women coast to coast and conducted meetings 5222 or write to the following to plan the size and spacing of their encouraging participation in document address: ICPD, 22nd Floor, 220 families. In large part, these services drafting. Continuous outreach for East 42nd St., New York, NY input has been at the crux of U.S. 10017. preparations. The increased interna- U.S. Department of State September 1994 Bureau of Public Affairs Office of Public Communication tional involvement of citizen groups The theme of the Cairo conference, and extended families caring for the signals an important shift-from top- "Choices and Responsibilities," encap- elderly. Improved health care and down imposition of "population control" sulated the new approach to population greater economic security, which are measures to community-based pro- issues. This emphasis reinforced the discussed in detail, are recommended grams that are crafted to respond to U.S. conviction that the decision to to bolster the capacity of family the needs of individuals and families. bear a child is a profoundly personal members to sustain and care for each one and that men and women have the other. The Program of Action asks North-South Agreement right to decide freely the number and governments to ensure that men spacing of their children. With choice, shoulder their full share of responsibil- At previous UN population confer- however, comes responsibility. The ity as parents, for example, through the ences, the fault lines of debate tended Cairo conference underscored the enforcement of child support laws. to separate industrialized and develop- responsibilities of parents to their Governments are urged to help ing countries. The Cairo process, in children, of men and women to each increase the earning power of poor contrast, has prompted far more other, of governments to their citizens, women, especially those with children, cooperation between North and South. of caregivers to their clients, and of through training and self-help pro- This may imply a greater understand- current to future generations. grams. The Program of Action also ing that political boundaries are calls for measures that enable parents porous-that modern-day plagues of A Program of Action to combine family responsibilities and environmental devastation and disease labor-force participation. An example do not respect national borders and Following is a broad outline of the of such policies is the Family and that increasing globalization has drawn Program of Action which was approved Medical Leave Act, signed into law by more tightly the bonds that connect by consensus in Cairo. The U.S. President Clinton in 1993, which us. The problems facing the human Government supports the programs guarantees that no worker will have to community-although they differ and policies embodied in this document. choose between keeping his or her job greatly in magnitude-are the same Therefore, the following also is a and caring for a new child or sick family the world over. We all aspire to have statement of U.S. population policy. member. strong families, secure livelihoods, U.S. domestic policies in this area are Elderly men and women are valued high-quality health care, and a healthy identical to those it supports interna- members of the family. In the devel- environment. We share a concern tionally. about the world that our children will oped countries, falling birth rates and inherit and struggle to maintain our Principles. The Program of Action medical advances have created a sharp moral compass in a world that is is guided by a set of principles agreed increase in the number of elderly men rapidly changing. to by 180 countries. These call for full and women: By the year 2025, people respect for religious diversity, critical over 60 years of age are expected to These shared concerns are each, in some way, enmeshed with the issue of values, and cultural backgrounds; comprise nearly one-fourth of the international human rights standards; population. Sadly, the erosion of population growth. The size and rate and national laws when implementing extended family networks has left of growth of the human population certainly affects the quality of public population and development programs. many older men and women without health, opportunities for employment, They are based on the interrelationship adequate care and support. The Cairo and the ability of families and societies between population and sustainable Program of Action seeks to repair to provide for their members. But development. frayed support networks by promoting there are other, equally important The Family. Families are the basic the strengthening of social security factors: the way resources are used unit of society. They are the nurturers, systems and enhancing the ability of and distributed and the economic, caregivers, role models, and teachers families to care for elderly members. who instill shared societal values. Sustainable Development. political, and social factors that moder- ate access to opportunity. Participants Around the world, they also are Despite the great technological ad- in the Cairo conference addressed challenged as never before. The num- vances of the last half-century, a global population growth not simply as a ber of single-parent homes has soared chasm of inequity still separates rich to as many as one in three worldwide. and poor. While a billion of the world's problem of numbers but as one of many factors that shape the human prospect. Families are sundered for many people live in relative affluence, an- The conference's guiding vision was reasons-divorce, death, war, or other billion exist on the knife-edge of migration in search of economic survival; one person in five does not stabilized population growth and sustainable development to meet the opportunity. But the result is often have enough to eat. Despite decades of needs of current generations without the same: Most single-parent families development efforts, the gap between are headed by women, many are rich and poor nations-and inequalities compromising the ability of future desperately poor, and children are within nations-remains wide. generations to meet their needs. Successfully realized, this goal will denied the benefits of an intact family. In much of the developing world, assure broad-based economic growth; The Cairo Program of Action seeks poverty is both a cause and effect of protect the environment; and enhance to preserve the integrity of families population growth. Mortality rates human rights, health, and potential. and help those that face special chal- have fallen steeply due to public health lenges, such as single-parent families advances, but fertility remains high, in 2 part, because poor families rely on world's income. This inequity exacts Maternal and child mortality is children for social and economic another toll in women's lives, health, closely associated with insufficient security. A destructive synergism and potential and is closely associated family planning services and reproduc- takes hold: Rapid population growth with high fertility. Where they are tive health care. At least 100 million perpetuates poverty by straining the denied education, secure livelihoods, women in the developing world-one ability of families and societies to and the full legal and social rights of in six married women outside China- support their members, and economic citizenship, women depend on children wish to avoid or postpone pregnancy uncertainty, in turn, fosters rapid as their only means of attaining status but lack access to modern contracep- population growth. and security. Efforts to increase tion. And even where family planning Among the greatest challenges we women's self-determination have been and reproductive health services are face as a global community is that of shown to improve the health and well- available in developing countries, the assuring secure livelihoods for the being of women and their children and quality of care is often poor. When world's people. This problem is acute to slow the pace of population growth. couples lack the ability to plan and in the developing countries, where the For example, women with even a space their pregnancies, high fertility UN estimates that a half-billion people primary school education have fewer, takes a great toll on women's lives and currently are unemployed or underem- healthier, and better-educated children health. The leading causes of maternal ployed. To accommodate their growing and are far less likely to die in child- deaths are postpartum hemorrhage— populations, those countries must birth than their uneducated peers. which is most common among poor create 30 million new jobs each year to Improving the status of women women who have had several closely maintain current employment levels. is a core objective of the Program of spaced pregnancies-and unsafe abor- Few consider it likely that the strained Action, which urges governments to tion. Between 50 and 60 million abor- governments of the developing world close the gender gap in education and tions are performed each year, nearly can generate increases of that magni- political life and to eliminate all forms half of which are illegal and often tude. of institutionalized discrimination unsafe. At the UN Conference on Environ- against women, for example, in hiring High fertility takes a toll in ment and Development (UNCED) practices, access to credit, and prop- children's lives as well. A child born in Rio in 1992, world governments erty-ownership laws. It condemns the less than two years after a previous agreed to "Agenda 21"-a worldwide preferential treatment of boys and birth is more likely to die before his or blueprint for sustainable development. encourages affirmative measures to her fifth birthday. Child mortality and The ICPD Program of Action rein- improve the health, nutritional status, high fertility form another destructive forces many of the UNCED objectives, and self-esteem of girls. synergism: Where infant and child without rewriting Agenda 21. The Health. In the past 50 years, global mortality rates are high, parents tend Program of Action recommends steps life expectancy has increased by nearly to have more children in the hope that to both stabilize population growth and 20 years, and the risk of dying in the some will survive, yet high fertility foster broad-based economic develop- first year of life has fallen by almost results in an even greater number of ment. It asks the international commu- two-thirds. While these gains are infant and child deaths in the absence nity to rethink trade policies to maxi- significant and encouraging, they of necessary health services. mize job creation in the industrial, mask persistent disparities between The ominous advance of AIDS and agricultural, and service sectors; to rich and poor. Poor people world- other sexually transmitted diseases seek methods of reducing the debt wide-particularly women and chil- (STDs) poses another threat to global burden on developing countries; and to dren-sicken and die by the thousands health. The World Health Organization promote development strategies that from health problems that are readily estimates that, in 1994 alone, approxi- enhance the personal and economic preventable and curable. mately 2 million people will become potential of the world's poorest citizens Every year, 500,000 women die of infected with HIV, the virus that through health care, education, and pregnancy-related causes. The vast causes AIDS. Women are the fastest- training. For their part, developing majority of those deaths take place in growing population of persons living country governments are urged to the developing world. An African with AIDS and HIV infection. In some create and sustain democratic institu- woman, for example, is 200 times more U.S. cities, AIDS already has become tions, curtail corruption, and redirect likely than a European woman to die in the leading cause of death among domestic budget priorities to human childbirth. The infant mortality rate in vulnerable groups of women, especially resource development. the developing countries is six times those between the ages of 15 and 45. Gender Equity. Another inequi- higher and the child mortality rate is The Cairo Program of Action table divide separates boys and girls, seven times higher than in developed recommends several measures to halt men and women. In many parts of countries. Disparities exist within these pandemics of disease and death. the world, girls are fed less, given countries as well. In the U.S., infant It calls for extending integrated less medical care, withdrawn from mortality among whites is at 8 per primary, maternal, and child health school earlier, and forced into hard 1,000 births, while African-American services to all, and ensuring universal labor sooner than boys. Women, infant mortality is at 18 per 1,000- access to prenatal care, immunization who perform an estimated 60% of a rate higher than that in Cuba or coverage, and programs to combat the world's work, own only 1% of the Poland. malnutrition. Such programs are urged world's land and earn just 10% of the to pay particular attention to the most 3 vulnerable and under-served groups in are marrying later in many parts of the children about moral and responsible the population and to remove barriers world, adolescent marriages are still behavior and recommends programs to access. The Program of Action asks common in some areas. In Mali, for that support and strengthen that role. governments to develop multisectoral example, the average age for marriage The Environment. Our planet's strategies to combat AIDS and other is 16. And in the U.S., one in five 15- thin layer of life is threatened as never STDs, particularly through early year-old girls has had sex at least once; before. Ozone depletion, climate diagnosis and treatment and public the comparable figure for boys is two change, and species loss are all red education campaigns stressing the in five. Many adolescents lack the alerts that we have strained the importance of safe and responsible emotional and cognitive maturity to regenerative capacity of ecological sexual behavior. enter into responsible sexual relation- systems. These problems have deeply Improved family planning and ships. disturbing implications for future reproductive health services are a Whether it takes place within or generations. As the U.S. National cornerstone of the Program of Action's outside marriage, early sexual activity Academy of Sciences and the Royal recommendations to improve health. risks the lives and well-being of young Society of London warned in 1992, "If The Program of Action asks govern- women and their children. Adolescent current predictions of population ments to assess the extent of unmet mothers are twice as likely to die in growth prove accurate and patterns of need for family planning services and childbirth as mothers aged 20-24, and human activity on the planet remain to provide universal access to the their babies are more than twice as unchanged, science and technology may full range of safe contraception and likely to die in their first year of life. not be able to prevent either irrevers- reproductive health services. It rejects Moreover, adolescent motherhood— ible degradation of the environment or the use of incentives, such as cash gifts particularly among the unmarried-can continued poverty for much of the to those who agree to use contracep- sharply limit a young woman's educa- world." tion, as well as disincentives, such as tion and earning potential, as well as Population growth per se is not a policies that punish families for having her children's horizons. And sexually direct cause of environmental prob- more than a certain number of children. active adolescents risk exposure to lems; the effect of any given population The Program of Action does not deadly STDs, including increased on the environment can be magnified or promote abortion, but it does recognize incidence of AIDS among teenagers. mitigated by patterns of resource the need to address unsafe abortions as Among unmarried teens, STDs and consumption and technology. The a critical public health concern. This unplanned pregnancies may reflect industrialized world has the most issue also generated controversy at the their lack of access to family planning environmentally damaging habits and conference, because although abortion and reproductive health services, which technology, and, therefore, contributes is permitted under some circumstances are often limited to married couples. the lion's share to trends attributed to in 173 of 190 countries, national laws on These problems are expected to global environmental degradation. abortion vary. The Program of Action grow along with the burgeoning world Estimates show that, with only 22% will be implemented by each country in population of adolescents which, by of the world's population, the devel- accordance with national law and the year 2000, is expected to number oped countries use two-thirds of all international human rights standards. 1 billion. Accordingly, the Program of resources consumed and generate 75% Nearly all countries at the conference Action offers several strategies to of all pollutants and wastes. Many agreed on reducing the need for address sexual activity and fertility. analysts believe that the earth cannot abortion through the provision of safe It asks governments to enforce laws support all of its current-much less and effective family planning services. governing the minimum age of consent future-inhabitants at contemporary The Program of Action urges govern- and age at marriage. The Program of developed-country levels of consump- ments to consider including a commit- Action also recommends programs to tion. A central challenge for the ment to women's health and well-being curtail adolescent pregnancy by international community is, therefore, in their policies. It supports women's encouraging young teens to delay the to craft a paradigm of development access to quality health care services, initiation of sexual activity. In addition that meets human needs at lower including reliable information, counsel- to emphasizing the importance of environmental cost. ing, and medical care to enable them to interpersonal relationships and respon- The Program of Action emphasizes terminate their pregnancies in those sibilities of sexuality, the Program of the role of unsustainable resource use cases allowed by law, as well as access Action advocates measures to ensure as a cause of environmental problems to services to provide for the manage- that adolescent girls have alternatives and urges the development and sharing ment of complications of unsafe to early childbearing, such as educa- of environmentally sustainable tech- abortions. tional and employment opportunities. nologies and practices. It also calls for Adolescents. Adolescent sexual Governments are asked to ensure that the integration of population dynamics activity and fertility pose a special set those teens who are sexually active into planning for sustainable develop- of problems and challenges. Adoles- have access to appropriate counseling, ment and asks governments to inte- cents often are directly or indirectly family planning, and reproductive grate women into matters of natural coerced into early sexual activity, health services. The Program of Action resource protection and management. either through forced marriage or the recognizes that parents have a central Urbanization-Migration. Whe- seemingly inexorable forces of peer role in teaching their adolescent ther from country to city or from one pressure. Although men and women country to another, many people have 4 traditionally moved in search of particularly irregular migration, which increase its current contribution, after improved opportunities-a better job; can destabilize both sending and doubling its investment over the past better surroundings; a better quality of receiving countries. four years, and the European Union life. In recent decades, millions have The Cairo Program of Action announced recently that its contribu- sought better lives by moving to urban reflects a growing awareness that more tions will increase tenfold to $350 mil- areas, and cities have mushroomed. must be done to address the root lion by the year 2000. Australia and The number of cities with populations causes of irregular migration. Stepped- the United Kingdom also are reported of more than 1 million rose from 111 up border control measures, while to be planning significant increases. in 1960 to 288 in 1990, more than two- necessary, will not be sufficient to cope Developing countries, which provide at thirds of which are in the developing with illegal immigration; nations need least two-thirds of the financing for world. Building capacity to provide to address the panoply of social and population programs, will foster local housing, employment, and sanitation environmental problems that impel partnerships with non-governmental for growing urban populations is a people to leave their homes. Govern- organizations to make optimal use of major challenge for many countries. ments are asked to take measures to those resources. To meet that challenge, the Program improve the quality of life in migrant- of Action promotes urban development sending countries by, for example, Conclusion that is both participatory and environ- fostering employment, opening mar- The International Conference on mentally sustainable. It also urges kets, promoting good governance, and governments to provide services for preventing land degradation. The Population and Development is a migrants from rural areas, in order to Program of Action also urges govern- crucial milestone on our long journey improve their health and earning ments to adopt effective sanctions toward population stabilization and potential. against those who profit from smug- sustainable development. The chal- Other migrants seek better lives gling aliens and to safeguard the lenges before the global community are across national boundaries. Interna- human rights of undocumented mi- great, but we are compelled to act by tional migration encompasses two grants. The international community is moral imperatives to alleviate human distinct phenomena: the voluntary asked to continue to protect refugees suffering and to safeguard our collec- movements of people which are tive future. and asylees, to seek to reduce the beneficial to both migrants and host pressures that fuel refugee movements, There are many sound reasons for countries, such as family reunification and to support international refugee hope. For all the difficulties we face, and legal labor-migration; and what has assistance. we can still say that in the last 50 years been called "irregular" migration- Investments. The Cairo Program we have made more progress in those flows which are involuntary of Action represents more than agree- alleviating human misery than in the (refugees) or illegal (undocumented ment in principle. Both developed and previous two millennia. Life expect- labor migration). While reliable global developing countries have renewed ancy in the developing countries grew statistics are hard to come by, it is safe their commitment to provide resources by one-third, death rates for infants to say that international migration is for family planning, health, and human and children were cut in half, and real increasing. Refugee flows, which take development programs. In the U.S., incomes more than doubled. If we place mostly within and between the President's budget request for could do all that while burdened with developing countries, also have esca- family planning and reproductive the political and economic costs of the lated in size and volatility in recent health programs for fiscal year 1995 Cold War, how much greater should be years. Data linking population growth is $585 million, an $83-million increase the goals we set for ourselves now? to migration outflows are inconclusive over the previous year. Additional The Cairo conference provided an because it is difficult to isolate the role resources also are needed for child unparalleled opportunity to define of population growth from other health, education, and development those goals, and the Program of Action variables influencing migration. But it programs. Japan has agreed to spend approved at the conference provides a is clear that the combined effects of $3 billion over seven years on a broad firm basis for action in support of those rapid population growth, poverty, package that includes family planning, goals. The Clinton Administration resource depletion, and human rights reproductive health, AIDS prevention, intends to carry on the leadership role violations can fuel political unrest and maternal and child health, and basic evidenced in Cairo in support of the drive population growth movements, education-a tenfold increase over programs and policies of the Program current spending. Germany has of Action. indicated that it will significantly 5 1999 Summary of the Programme of Action Forum International Conference on Population & Development (ICPD) DAY OF OBILLION Cairo, 5-13 September, 1994 The Cairo A fter vigorous debate, more than 180 countries agreed to adopt the 16-chapter population ICPD Programme of Action. The 115-page document outlines a 20-year plan to promote sustainable, human-centered development and a stable population, the facts framing the issues with broad principles and specific actions. Some 20 delegations expressed reservations about specific parts of the text. of life Chapters I & II: The Preamble and the Principles set out the development and human rights context of the Programme. The Preamble places the ICPD in global context, noting the interdependence of population and development; recent rapid population growth; the need to mobilize partnerships and international resources; and the links to agreements from other major world conferences and universal standards of human rights. The set of 15 Principles states positions on basic issues discussed in the rest of the document. These include: the universal equality and rights of all as set forth in the Universal Declaration of Human Rights; people-centered sustainable development; gender equity; the context of population programmes; the relationship of population, resources, the environment and development; the eradication of poverty; the rights to education and to physical and mental health; support for the family; the health and development of children; the treatment of documented migrants; the right to asylum; the rights of indigenous people; and sustained economic growth that benefits a broad social base. Each subsequent chapter contains Bases for Action, Objectives, and Actions. Chapter III: Interrelationships Among Population, Sustained Economic Growth and Sustainable Development: Outlines links between the needs and acts of growing numbers of people and the finite "carrying capacity" of natural resources. Action recommendations include: integrating population, production and consumption dynamics into sustainable development policies; investing in human resources, including education, employment and health services, particularly in needs of women and the poor; promoting socially responsive economies; and taking extra measures to end poverty in ecologically vulnerable areas. Chapter IV: Gender Equality, Equity and Empowerment of Women: Addresses imbalances between women and men and the need to empower women, protect the girl child, and achieve gender equity. Action recommendations include: policies and programs to empower women; promoting equal treatment and preventing the neglect and abuse of girl children; and promoting equal responsibility of men in family life, in health, communication and economics. 2 Chapter V: The Family, Its Roles, Rights, Composition and Structure: Recognizes that the family, in all its forms, is the basic unit of society and that population and development policies should promote the family in all its diversity. Action recommendations include: promoting the earning power of poorer families and greater compatibility between work and parental duties; and developing innovative policies to assist families with health, social and/or political disadvantages. Chapter VI: Population Growth and Structure: States that countries where demographic growth outstrips economic growth face special challenges in ensuring a quality of life based on human rights and sustainable development. Action recommendations include: integrating demographic trends with social and economic development; reducing high maternal and child mortality levels that often lead to high fertility rates; meeting the health, education, social, training and employment needs of children and youth; enhancing equity, self-reliance and support systems for elderly people, particularly women; and recognizing the perspectives of indigenous cultures and persons with disabilities and developing responsive policies and programs. Chapter VII: Reproductive Rights and Reproductive Health: States that all couples and individuals have the right to attain the highest standard of sexual and reproductive health. Action recommendations include: providing universal reproductive health services by 2015, including participatory programs for adolescents, men, migrants and displaced persons; seeking universal access to safe, appropriate and adequately-funded family planning programs by 2015, based in the principles of voluntary and informed choice and quality of care; helping women avoid abortion; promoting the prevention, detection and treatment of sexually-transmitted diseases, including HIV/AIDS; developing policies and programs that support comprehensive sexual education and services based on an improved understanding of the need for responsibility, the realities of current behavior, and the prevention of abuse, including female genital mutilation; and ensuring access to appropriate and supportive reproductive health programs and services for adolescents. Chapter VIII: Health, Morbidity and Mortality: Focuses on international and national level commitments to increasing health and life span and improving the quality of life of all people. Action recommendations include: promoting strategies to reduce morbidity and mortality, to recognize the custodial role of women in health, and to reduce local and large-scale environmental health hazards; reducing high infant and child mortality rates to 35 and 45 per 1,000, respectively, and maternal mortality by half by 2015; and mobilizing to prevent and assess the impact of HIV/AIDS, protecting the rights of all those affected. Chapter IX: Population Distribution, Urbanization and Internal Migration: In the context of human rights, outlines the need for countries to foster balanced and sustainable patterns of population distribution through sustainable development and the reduction of "push factors" related to migration, including ending all forced migration and "ethnic cleansing." 3 Action recommendations include: keeping population distribution policies consistent with other development goals, policies and human rights; encouraging the growth of small to medium urban centers; reducing urban bias through rural development incentives, conservation and infrastructure; promoting urban development responsive to growth; maintaining consistency with the Fourth Geneva Convention relative to the Protection of Civilian Persons in Time of War (1949); improving conditions for the urban poor, especially women and street children; and providing displaced persons with basic social services, including health, education, and employment opportunities. Chapter X: International Migration: Considers documented and undocumented migrants, refugees, asylum-seekers and displaced persons, emphasizing the need to address the root causes of migration and vulnerabilities of the displaced. Action recommendations include: addressing economic imbalances between developed and developing countries; addressing circumstances of environmental refugees; gathering sound data on migration factors; addressing discriminatory attitudes and practices; promoting integration and re- integration of the displaced; adopting sanctions for international trafficking, especially against exploitation, prostitution and coercive adoption; enhancing mechanisms for cross-border responsibility; and respecting the principle of non-refoulement, the non-forcible return of persons whose freedom is threatened. Chapter XI: Population, Development and Education: Focuses on the need for universal access to quality education, the relationship between population and sustainable development, and the need to enhance people's ability to "exercise their basic right to decide freely and responsibly on the number and spacing of their children." Action recommendations include: achieving universal access to quality education; promoting job training, non-formal education and literacy programs; integrating reproductive health, gender sensitivity, demographic, health and environmental perspectives into existing programs as appropriate; using the media to expand culturally-appropriate knowledge and motivation in population, health and development; disseminating information on the relationships between population, consumption, production and sustainable development through databases and networks; and strengthening research about population and development issues. Chapter XII: Technology, Research and Development: Outlines the need to collect, analyze and disseminate population, socio-economic, and reproductive health-related data. Action recommendations include: encouraging collection and use of data; setting up databases to link categories such as population, education, environment, health, poverty, family well-being, migration and development issues, including consumption and women's role in economic development; implementing appropriate training programs; refining research on reproductive and sexual health at social, medical and technical levels; improving program recognition of social, cultural and economic differences; applying operations research to evaluations; and investigating gender discrepancies revealed in research. Chapter XIII: National Action: States that each country should incorporate population concerns into national development strategies, involve all sectors of society in development decisions, and mobilize and allocate resources. 4 Action recommendations include: working with partners to promote awareness of population and development strategies, plans, policies and programs; developing human resources, especially women as leaders; promoting experience-sharing and database networking; developing client-centered information systems; mobilizing resources through cost-recovery measures, including more involvement of the private sector, to ensure "universal availability of and access to high-quality reproductive health and family planning services"; and increasing public and development assistance spending in social sectors, including developing reliable cost estimates. Chapter XIV: International Cooperation: States the need for the international community to create an enabling economic environment for implementing the Programme, to develop "people-centered" population and development strategies, and to make a strong commitment to funding population and development programs. Action recommendations include: offering technical assistance and appropriate technology transfer to reinforce national capacity-building; promoting economic policy favoring sustained economic growth; strengthening cooperation between governmental and non-governmental organizations; striving to fulfill the consensus target of .7% of GNP for overall official population and development assistance; coordinating financing and planning based on evaluation, needs assessment, and complementary programs; exploring innovative financing mechanisms and direct South-South funding; and expanding financial aid in population, reproductive, sexual health, and family planning. Chapter XV: Partnership with the Non-Governmental Sector: Calls for greater cooperation and partnerships among all levels of government and the full range of NGOs and the private sector in program design, implementation, coordination, and evaluation. For governments, action recommendations include: promoting partnerships with NGOs, especially women's groups, through dialogue, decisionmaking, program planning, training, outreach and other activities; and promoting partnerships with the private sector and NGOs. For NGOs, action recommendations include: strengthening interaction with communities while joining national, regional and international debates on population and development. For the private sector, action recommendations include: channeling financial and other appropriate support to non-profit NGOs and meeting their employees' needs for information, education and reproductive health services. Chapter XVI: Follow-up to the Conference: Calls for creation of national, subregional, regional and international follow-up mechanisms to promote implementation of the Programme of Action through appropriate, coordinated and specific policies and programs. Action recommendations include: prioritizing political leadership and commitment, dissemination, spending levels, accountability, multi-disciplinary expertise and evaluation, and increasing efficiency in U.N. and aid groups. The ICPD made a global commitment to mobilize $17 billion annually by the year 2000 and over $21 billion by 2015 for population and reproductive health programs. So far less than $10 billion per year is being directed to these programs, four-fifths of it from developing countries. International assistance remains well below the $5.7 billion per year that the ICPD agreed would be required by 2000. Sources: Programme of Action of the International Conference on Population and Development; Document/Conference Summary, Population Communications International; Chapter Summaries, International Women's Health Coalition; State of World Population 1998, United Nations Population Fund. December 1998 1999 The Human Population: rorum Six Billion and Growing DAY OF OBILLION The Cairo PEOPLE O ctober 12, 1999 marks the day the Earth's population reaches 6 billion. Over one billion will be adolescents, just entering their reproductive years. population In 1804: world population reached 1 billion the facts 1927: 2 billion (123 years later) 1960: 3 billion (33 years) of life 1974: 4 billion (13 years) 1987: 5 billion (12 years) 1999: 6 billion (12 years) The fact that the fifth and sixth billion both took 12 years is a sign that at last the rate of increase has begun to slow. (1) But humanity's numbers continue to rise. The seventh and eighth billion will probably take another 14 to 15 years each, but that rate is not guaranteed. The current pace is adding about 78 million more people every year - the population of France, Greece and Sweden combined, or a city the size of San Francisco every three days. Nearly all the increase occurs in the less-developed countries of Africa, Asia and Latin America, where women continue to have four to seven children each over their lifetimes. Early in the next century, nearly all the net annual gain in global population will come in developing countries, as fertility rates in the industrialized nations stabilize at or slightly below 2.1 children per woman. (1) Birth rates are falling worldwide, and death rates are falling even faster. The ultimate peak global population size will depend on the availability of information, access to family planning services and the individual decisions of every person on earth. Those choices will depend in part on whether nations fulfill their commitments to the International Conference on Population and Development (ICPD) Programme of Action. The United Nations projects high, medium and low population-growth scenarios for the next half-century. The ICPD Programme of Action is dedicated to achieving the "medium" scenario or better: The "high" scenario assumes that the slowing of fertility rates continues at its current pace, so that today's global 1.33% annual population growth rate declines to 0.86%, with 10.7 billion people on earth by 2050. The "medium" calculation, regarded as most likely, assumes fertility rates fall still faster worldwide, so that growth slows to 0.34% per year by 2050, bringing the population to 8.9 billion. The "low" projection of 7.3 billion would require an average annual net loss in population of -0.23% by 2050. That means women would be bearing fewer than two children each worldwide over their lifetimes. This is considered unlikely. (1) ICPD participants generally agreed with world demographic researchers on the chief causes of continued population growth: Population momentum from the global postwar baby boom, with the planet's unprecedented 1 billion teenagers just entering their reproductive years; Unwanted and unplanned pregnancies, where an estimated 350 million couples lack access to the full range of contraception and other reproductive health services. (2) A demand for large families where, for example, childhood death rates are high, or where poverty reduces people's options. The ICPD and researchers also generally agreed on the reasons fertility rates decline: Broader horizons for girls and women in education, rights and health care, including reproductive health care; and in opportunities for work, credit, training, and political and economic activity, which lead them to postpone childbearing; Availability of better quality health care and affordable family planning services and technology that allow women and men to make their own choices; and Urbanization, which tends to reduce family size. Modern medical knowledge and better living conditions have dramatically lowered the global death rate, especially for infants and children but also for women of childbearing age and for the elderly. The result: with continued commitment of resources to expanded primary and reproductive health care, the world population profile is beginning to shift from a short pyramid toward becoming a taller pillar, where the number of people over 65 will begin to approach the number of children. In 1950, average life expectancy in the developing world was just under 40 years. Today it is 61, although AIDS and other factors are expected to bring it down once more in some nations, mostly in Africa. At the same time, life expectancy in the industrialized nations rose from 66 to 75 years. (3) In about 71 nations and territories in Africa, Asia, the Mideast and Latin America, more than 40% of the population is under 15. In the 46 nations with fertility levels below the replacement level of 2.1 children per woman, mostly in Europe and the industrialized world, people older than 65 are an unprecedented 10 to 15% of the population today and are expected to reach 20 to 30% by 2050. (4) The number of older people is increasing so fast worldwide that for the first time, the UN this year lists separate categories for people aged 80 to 90 (58.6 million), 90 to 100 (7.3 million) and over 100 (100,000). In 2050, these numbers are expected to be 11.1 million, 56.9 million and 2.2 million, respectively - more than a sixfold increase. (1) Sources: (1) United Nations Population Division, "1998 Revision, World Population Estimates and Projections" (New York: Department of Economic and Social Affairs, Nov. 28, 1998). (2) UNFPA, Advocating Change (New York: 1998). (3) Population Reference Bureau, 1998 World Population Data Sheet (Washington DC: PRB 1998). (4) UNFPA, "The State of World Population 1998" (New York: UNFPA 1998) December 1998 1999 The Myth of Shrinking Population Forum DAY OF OBILLION The Cairo W omen worldwide are having half the number of children that their mothers population did in the 1950s. Lifetimes are lengthening and child survival rates are improving in most of the world, while opportunities and education for women and the facts men are generally on the rise. In 61 nations, women's fertility rates have fallen below the "replacement level" of 2.1 children per woman. (1) However, world population of life continues to rise by 78 million people per year. The reasons for falling fertility are many: broadened horizons for girls and women, who respond by delaying childbearing; health care advances that keep babies alive, reducing the demand for more; broad availability of reliable and inexpensive family planning services; and urbanization. In short, the planet seems to have averted--at least for now - the threat of a population bomb. However, environmental security and sustainability require continued effort. We have come perhaps half the distance to population stability. The danger now is that we will declare victory and go home. Some vocal contrarians are recommending just that. They argue that the trends leading to our current progress are irreversible and could lead to depopulated nations of a few lonely young people struggling to support vast numbers of dependent senior citizens. They oppose further work to curb population growth. They are wrong. The trends are not irreversible. The need instead is for renewed commitment to the steps outlined at the 1994 International Conference on Population and Development (ICPD). Of the world's 6 billion people, more than 1 billion are teenagers, the largest "youthquake" ever. (2) Now just entering their reproductive years, their sheer numbers guarantee an enormous "momentum" of population growth through 2050 and an urgent global need for reproductive health information and services, even with a continued decline in fertility rates. More than 95% of those teens live in less-developed nations (2) where many governments are already struggling to meet current needs for social and infrastructure services, education, jobs, family planning information, and reproductive and other health care. While 44% of the world's people (2.6 billion) live in the 61 nations where women have fewer than 2.1 children each, these "total fertility rates" don't give the full picture. A country's population growth rate includes migration and longevity. Among those 61 nations, for example, 31 will experience population declines by 2050, but population will rise in the other half, because of their young population structures and migration patterns. (1) Just to stay even with current living conditions, the world must somehow provide for 78 million more people every year--another Great Britain plus New York City--for another generation. More than 840 million people, one in 7, do not have enough to eat. (3) Mostly, they are too poor to pay for food, even with historically low prices. Clearly, the "Green Revolution" has not reached many poor farmers, and in 75 nations, per capita food production has declined over the last 15 years. (3) Opportunities for women, key to lowering fertility rates, are being circumscribed rather than expanded in Afghanistan and elsewhere. Health care advances have not reached millions of people where resurgent disease is challenging impoverished medical systems, especially in the developing world. Rising urbanization has led to declining fertility, chiefly because of urban prosperity. But nothing guarantees that prosperity will continue to rise as population does. And, most people in poor nations still live in rural areas where birth rates remain high. Developing nations pay 80 % of the costs of family planning services themselves, relying on industrialized nations for help with the rest. But that help has not always been forthcoming. U.S. aid has been cut severely in recent years. Any projection of depopulation in some countries ignores the likely migration from crowded places. The world may change its appearance but it is in no danger of being depopulated. The keys to further progress are obvious: the roles of women, whose options and opportunities in every sphere of life must continue to expand; and the education and participation of young people, women and men alike, in the changes necessary to construct a workable future. Their demand for reliable and inexpensive family planning services, currently unmet in many crucial places, must be satisfied on a continuing basis well into the next century. Sources: (1) United Nations Population Division, "1998 Revision, World Population Estimates and Projections" (New York: Department of Economic and Social Affairs, Nov. 28, 1998); (2) UNFPA, The State of World Population 1998 (New York, 1998); (3) UN Development Programme, Human Development Report 1998 (New York: 1998) December 1998 1999 AIDS/HIV: The New Trends Forum DAY OF OBILLION The Cairo A IDS/HIV is reversing decades of progress in improving the quality of life in developing countries. It has slashed life expectancies and forces choices between health and dozens of other investments vital for development. If AIDS affects 5% of population the population, for example, total national spending on health will increase by 40%. (1) the facts Affected governments need to place AIDS at the center of their development of life priorities, not just on the health agenda, to ensure that the crisis is addressed in every policymaking arena. They need to lead in creating a helpful legal environment and programs for education and counseling so as to raise awareness of the disease and to promote behavioral changes, safe sex practices, the use of condoms and treatments for sexually transmitted diseases (STDs). Partnerships are vital - among governments and NGOs, churches and the private sector. Prevention education works. In several southern African factories, the rate of new infections was reduced by over a third at the cost of only $6 per employee through peer education, condom distribution, voluntary testing and counseling, and job- sponsored health benefits and disability packets. AIDS is the Number One Killer Worldwide, 33.4 million people are infected with AIDS/HIV, including 1.3 million children. The incurable disease has claimed 13.9 million lives since the epidemic began, 3.2 million of them children. In 1998, 2.5 million people died of AIDS. Fully 30% of all tuberculosis deaths are due to HIV/AIDS infections, and if those deaths are counted, AIDS in 2020 will be the single largest cause of adult death from infectious diseases (2). AIDS is Spreading Fastest in the Developing World By 1990, AIDS had already caused more adult deaths than malaria in the developing world. By 2020, it will cause 37% of adult deaths due to infectious disease in those nations. New infection rates are slowing in most of the industrialized world, but 5.8 million infections still occurred in 1998, 70% of them in sub-Saharan Africa. A total of 21.5 million adults are infected there and 75% of all adult deaths result from AIDS or AIDS- related diseases. The vast majority are age 20-50, the most productive years (2). In Botswana, 25% of all adults are HIV-positive. In Zimbabwe and Namibia the rate is 20%; Zambia 19% ; Swaziland 18% and in several other African countries, 10% or more. In Botswana, where relatively few HIV cases have progressed to AIDS, the virus in 1997 cost companies 0.7% of their wage bill. In 2002, an expected sevenfold rise in HIV infections will bring health-related costs to nearly 12% of the wage bill. Women, the most important agents of development, are especially vulnerable because of social and economic inequality. In Africa, women under 25 have the fastest-rising infection rate. In South and Southeast Asia, 6.4 million people now live with HIV/AIDS, while another 1.7 million became infected in 1997. The latest UN report described an "explosion" of the disease in cities of India, evidently because of migrant workers and truckers. The epidemic in Asia could be bigger than the one in Africa. The HIV infection rate is not expected to level off in Africa until the next decade, and in Asia not until after 2010. AIDS has slashed life expectancies in many developing nations. Average life expectancies increased from 39 years to 55 years by 1990 in most of the developing world. But AIDS has wiped out 2/3 of this advance in Burkina Faso and Cote d'Ivoire. Botswana's 1990 life expectancy of 61 years has dropped to 47 years. In Zimbabwe, life expectancy was on course to reach 66 years by 2005, but because of AIDS, children born today can expect to live only 35 years. The population is expected to stop growing because of AIDS and by 2015 will be 19% smaller. AIDS Orphans are a Growing Tragedy More than 8 million children have lost one or both parents to AIDS since the epidemic began. In 23 countries studied by UNFPA, the number of these "AIDS orphans" is expected to double by 2000, and the total in the worst-hit 19 African nations will be 40 million by 2010. AIDS orphans typically suffer from malnutrition and are more likely to stop going to school, to have to support themselves and take on adult responsibilities in the home, and to leave home or lose their homes. Often they become street children. Girls may feel increased pressure to marry. In Uganda, where HIV infection rates have fallen from 35 to 30% and apparently leveled off, AIDS orphans are estimated to number 1.7 million. Signs of Hope Concerted government-led programs involving health education, promoting condom use and discouraging sexual promiscuity have slowed HIV infection rates in some poor nations including Thailand, Uganda and Brazil. In Thailand, a vigorous campaign involving brothels raised condom use to over 90%. The number of patients with STDs other than AIDS has dropped dramatically, and the HIV infection rate among army conscripts has dropped from 4% to less than 2%. In Nairobi, Kenya, a programme that treated STDs of 500 prostitutes raised their condom use to 80% and is estimated to have prevented 10,000 infections per year among their clients, clients' wives and other partners. In Brazil, condom sales rose from 406,000 in 1991 to nearly 27 million in 1996. Sources: (1). Except where noted, all figures in this paper are taken from UNFPA, State of the World Population 1998 (New York: 1998) and from UN Department of Economic and Social Affairs, Population Division, World Population Estimates and Projections, 1998 Revision (New York: October 1998); (2) Joint UN Program on HIV/AIDS and World Health Organization, AIDS Epidemic Update: Decmeber 1998, (New York: Dec 1998), www.unaids.org/highband/document/epidenio/wadr98e.pdf December 1998 1999 Equality, Equity and Forum The Empowerment of Women DAY OF OBILLION The Cairo D espite many international agreements affirming women's human rights, girls and women are still much more likely than men to be poor, malnourished population and illiterate, and to have less access than men to medical care, property ownership, credit, training and employment. They are far less likely than men to be politically the facts active and far more likely to be victims of domestic violence. of life Where women are poor, uneducated and have little participation in the wider society, family size tends to be large and the population growth rate high. Population and development programs are more effective when they center on improving the education, rights and status of women. Childbearing has been women's chief source of security and status for centuries. This is still the case, especially where women are denied education, reproductive health care, secure livelihoods and full equal rights. Successful population and development programs must offer women options for their lives beyond childbearing. Women in developing nations are usually in charge of securing water, food and fuel and of overseeing family health and diet. Therefore they tend to put into immediate practice whatever they learn about nutrition, preserving the environment and natural resources, and improving sanitation and health care. Of the 960 million illiterate adults in the world, two-thirds are female. Higher levels of women's education are strongly associated with both lower infant mortality and lower fertility. In poor countries, every additional year of a woman's schooling is associated with a 5 to 10% decline in child deaths. (1) Children born to mothers below age 18 are 1.5 times more likely to die before age 5 than those born to mothers age 20-34. Yet three of every four teenage girls in Africa are mothers, and 40 percent of births there are to women under 17. (2) Programs that offer girls alternative life choices can help them stay in school and, consequently, delay childbearing. This lengthens the time span between generations. Such women tend also to have fewer children - three or four rather than six or more. (3) Laws and customs often deny women the right to own land, inherit property, establish credit, receive training or move up in their field of work. Laws against domestic violence are often not enforced on behalf of women. Achieving gender equality in these areas will require the support of men who exercise most of the power in these spheres of life. The involvement of men is critical to women's rights and to population policy success. In Cameroon, Burkina Faso, Niger and Senegal, for example, men want between two and four more children than their wives do; in Cameroon, Mali and Senegal, fewer than half of men approve of family planning. Birthrates in those West African nations are higher than in most of East Africa, where with the exception of Tanzania, more than 90% of both men and women favor family planning. (4) The roles that men and women play in society are not biologically determined - they are socially determined. Often justified as required by culture or religion, they still vary widely by locality and change constantly; they are not immutable. Slavery, torture and racial and ethnic prejudice are also centuries-old practices now rightly condemned worldwide when they involve people of color, political dissidents, Jews or other ethnic groups. Violations of women's human rights must receive the same international censure. Because roles are deeply embedded social practices, programs are needed that work with young people to orient them toward gender equality. The ICPD Programme of Action commits nations to: Close the gender gap in education and political life; eliminate illiteracy and legal political and social barriers to women; and ensure equal representation of women in aid programs. Combat violence against women and girls, including sexual violence. Ratify all agreements that further women's rights. Design programs for the aging that address the special needs of elderly women. Urge employers to help workers manage their family and work responsibilities through flexible hours, parental leave, daycare facilities and so on. Involve men in family planning and responsibilities and in the prevention of sexually transmitted diseases. Ensure that children receive appropriate financial support by enforcing child support laws, among other things. Enforce laws on minimum age of consent and marriage. Eliminate female genital mutilation. Provide adolescents not only with information and services, but also education and life choices. Sources: (1) UNFPA, "Population Issues Briefing Kit 1998," (New York: 1998); (2) Alan Guttmacher Institute, "Issues in Brief: Family Planning Improves Child Survival and Health" (Washington DC: Alan Guttmacher Institute, 1997). and Nafis Sadik, "Investing in Women: The Focus of the '90s," in Laurie Ann Mazur (ed.), Beyond the Numbers: A Reader on Population, Consumption and the Environment (Washington DC, Island Press, 1994); (3) Population Reference Bureau, A Citizen's Guide to the International Conference on Population and Development, 1993; (4) James E. Rosen and Shanti R. Conly, Africa's Population Challenge: Accelerating Progress in Reproductive Health (Washington DC: Population Action International, 1998). December 1998 1999 Youth and Population Momentum Forum DAY OF OBILLION A t 1.05 billion, this is history's largest generation of young people between 15 The Cairo and 24, and their number is rapidly expanding in many countries. It is critical Cousensul that all societies address their education, health and employment needs. (1) population The reproductive behavior of these young people will determine the planet's future. the facts If they are enabled to realise their potential, they will be a real "demographic bonus"--an unprecedented bulge of human resources for future development. of life Ending Discrimination Against Girls Discrimination against girls and women is a persistent barrier to generational achievement. Several national declarations and treaties have labeled it a violation of human rights as well as a threat to development. Ending discrimination must be a priority worldwide. Discrimination against girls often begins before birth in the preference for sons, and in too many places continues with denial of medical care and education and with forced teen or even preteen marriage, sex and pregnancy. Women may be restricted to the home, sexually and physically abused without remedy, and denied rights to own or inherit property, to receive training or credit, or to take part in political and social discourse. Girls may be prepared by their societies only to be mothers, restricted in education and employment. Boys may be prepared only to be providers and heads of families, restricted in emotional, communication and caring skills. At puberty, both girls and boys have specific needs that should be addressed. Adolescents, more than other age groups, are exposed to reproductive health risks. As the average age of marriage goes up worldwide, the period of sexual activity before marriage is increasing. But young people are often denied the information and the means they need to avoid unwanted pregnancy and sexually transmitted diseases (STDs). Of the 260 million women aged 15-19 worldwide, about 11% (29 million) lack access to effective contraceptive protection. A majority of these (16.2 million) are married and say they want to delay childbirth; 9.8 million are unmarried and sexually active; 3.2 million are adolescents, both married and unmarried, who use traditional methods. (2) Half of all new HIV infections occur in people aged 15-24. The infection rates among young women are higher than among young men. Marginalized young people, such as street children, show higher infection rates than do better-off young people. (2) Providing Quality Information In most of Asia, Latin America, the Caribbean, North Africa and the Middle East, more than 60% of adolescents (often more than 80%) have heard of a modern method of family planning. (2) But that does not mean they always know how to use it properly. Better communication about sexuality, gender relations, unwanted pregnancy and STDs is essential if young people are to make responsible choices and broaden their life options. A survey of secondary school students in Kenya found that only one in three males and one in four females knew that contraceptive pills had to be taken by the woman and not by the man. Even fewer knew the pills had to be taken daily, not just before sex. (2) In Latin America, surveys show that 44 to 76% of the pregnancies of young unmarried women are unwanted. In Kenya, 74% of unmarried women aged 15-19 (and 17% of the married women) report their current pregnancy unwanted. (2) Many women suffering from an unwanted pregnancy seek abortion whether it is legal or not. Young women are more likely to get an unsafe abortion because they often lack the money and the information to get it done in a safe way. (2) Families remain the strongest influence on adolescents' behavior and choices, but traditional sources of sex and gender education - grandparents, teachers and community leaders-are losing influence to modern media culture and urbanization. Teens see their elders' lives and priorities as less relevant to their own. While teenagers and service providers may seek to avoid pregnancy and other consequences of sexual activity, their elders may see sexual activity itself as the problem. A tribal chief of southern Malawi responded this way to a sex education radio program: "A foreign dress mode is something we can easily accept, but should we wholesale adopt everything foreign, including shamelessly talking about sex in public?" Family and community leaders need to be included in population policy decisionmaking so that the helpful effect of such programs is understood. Sex education does not increase promiscuity. Of 68 studies on family life and sex education in a scientific review, 65 found no associated increases in sexual behaviour. Of the 53 studies that evaluated specific interventions, 21 found that young people taking part in such programs had higher levels of abstinence, later start of sexual activity, higher use of contraceptives, fewer sexual partners and/or reduced rates of STDs and unplanned pregnancy. (3) Broadening Sex Education Beyond the Schoolroom Sex education must not be restricted to school students. Not all young people are students, and in some countries they are not even the majority. Restricting sex education to secondary schools further reduces those reached, because the gender gap in education is biggest in secondary school and a large percentage of girls will be missed. In many countries, students may also enter primary school as teenagers and go no further. In sub- Saharan Africa and South Asia, a majority of adolescents who are in school are in primary schools. (4) Millions of young people, many of them children, live on their own and/or on the streets. They are more at risk than their peers. Special rehabilitation programs, including sex education and reproductive health services, are needed to reach them. Mass media campaigns have succeeded in addressing some reproductive health needs, such as HIV/AIDS. Soap operas, comic books, posters, teenage magazines, drama and music are effective ways to inform young people. Surveys show they are especially useful when combined with training programs for young people who can then spread the word among their peers. Sources: (1) UNFPA, State of the World Population 1998 (New York: UNFPA), p. 2; (2) Alan Guttmacher Institute, Into a New World (Washington DC: 1998), pp. 24-29; (3) UNFPA, State of the World Population 1998 (New York: UNFPA), P. 31; (4) Ibid., P. 32; (5) IPPF, Generations, 1998. December 1998 1999 U.S. Scorecard Forum DAY OF OBILLION In Growth The Cairo PEOPLE The US population in November 1998 was 274 million, third highest in the world population and about 15 million higher than when the ICPD met in Cairo in 1994. China is still first at 1.25 billion and India is next at 982.2 million, up 84.8 million from 1994. the facts World population as of mid-1999 is 6 billion, up 400 million in the past five years. (1) of life The US rate of natural population increase, excluding immigration, is now 0.6%-1.6 million people per year. Among industrialized nations, only New Zealand (0.8%) and Australia (0.7%) are higher. Europe, Russia and several other countries of the former Soviet Union have a slightly negative natural growth rate. The world average, however, is 1.4%. (2) U.S. legal immigrants will probably number 820,000 in 1999, according to the Census Bureau. (3) Counting both legal immigrants and natural increase, the total U.S. growth rate is 0.9%-faster than all industrialized nations except Canada and Australia. (4) The U.S. fertility rate (average number of births per woman) is 1.96, highest of all industrialized nations. Yemen has the world's highest fertility rate, 7.6, with Oman (7.2), Uganda (7.1) and Niger (7.1) close behind. The lowest rate is 1.19, in Italy. (5) These growth rates are declining, but the U.N. estimates that U.S. population in 2025 will still grow to be 332.5 million, with global humanity numbering 8.039 billion-about 360 million fewer than in estimates made five years ago. (5) In Mortality U.S. life expectancy is now 73.4 years for men, lower than in 22 other nations including Cuba, Costa Rica, Hong Kong, Japan, Israel, Kuwait, Canada and most of Europe. U.S. women can expect to live 80.1 years, less than in Western Europe (80.9), Greece, Puerto Rico, Canada, Hong Kong and Japan. (5) Globally, the average life is 63.4 years long for men, 67.7 years for women, but in least developed countries it is 50.9 and 53.0 respectively, more than 20 years shorter than in North America. Life expectancy in shortest in Malawi, at 40.3 years for men, 41.1 years for women. (5) U.S. infant mortality is 7 deaths per 1,000 live births, well below the world average of 57 but higher than that in 14 other industralized countries, and about the same as that in eight other nations. Japan's rate is lowest at 4 deaths per thousand live births, and Sierra Leone is highest at 169. (5) In Consumption Each U.S. citizen consumes an average of 260 lbs. of meat per year, the world's highest rate. That is about 1.5 times the industrial world average, three times the East Asian average and 40 times the average in Bangladesh (6.5 lbs). (6) The U.S. population is 4.6% of global humanity, but it produces 24% of the world's carbon dioxide output, largely from the burning of fossil fuels. (6) Directly or indirectly, each U.S. citizen consumes his or her own body weight in primary resources every day: oil, coal, other minerals, and agricultural and forest products. (7) A child born today in the United States will have a lifetime impact on the environment that is 30 times greater than a child born today in a developing nation such as India. (8) In Fulfilling the ICPD Commitment Prior to 1995 budget cuts, U.S. family planning aid was $583 million per year. The FY1999 level is $385 million, down 30%. (9) Sources: (1) UN Population Division, Department of Economic and Social Affairs, 1998 Revision: World Population Estimates and Projections (New York: United Nations), Oct. 28, 1998; (2) Population Reference Bureau, 1998 World Population Data Sheet (Washington DC: 1998); US Bureau of the Census, "Population Projections of the United States by Age, Sex, Race and Hispanic Origin: 1995 to 2050," Current Population Reports, (Washington DC: US Government Printing Office, 1996: 28, Table Q; (4) US Bureau of the Census Web site (http://www.census.gov/population/estimates); (5) UNFPA, The State of World Population 1998; (6) UNDP, Human Development Report 1998; (7) Alan Thein Durning, How Much is Enough? The Consumer Society and the Future of the Earth (New York: W.W. North & Co., 1992); (8) Al Gore, Report of the President's Commission on Sustainable Development (Washington DC: June 1993); (9) Population Action International, "Politics of Population Assistance," PAI Web site (http:/www.populationaction.org). December 1998 1999 NGOs and the Role of Forum Civil Society DAY OF OBILLION The Cairo PEOPLE Coold population O ne of the many contributions of the 1994 International Conference on Population and Development (ICPD) was increased visibility and participation for civil society in all UN proceedings thereafter. Before the ICPD in the facts Cairo, non-governmental organizations (NGOs) had only an informal presence at of life best at UN conclaves. In 1994, however, hundreds of NGOs took part in the ICPD as members of delegations, activists and lobbyists, providing much of the language for the Programme of Action. They helped set the agenda that focused clearly on improving the quality of people's lives instead of on achieving demographic targets. Their work was recognized in Programme language promoting NGO involvement in global policymaking and implementation, the strongest such language ever to emerge from a UN conference. Many nations have reformed their population and family planning efforts in large part due to NGO participation: Most nations no longer accept targets, incentives or coercion, instead using integrated approaches that make services, education and quality of care the central elements. India dropped numerical targets and is progressing on a major project in the north that integrates family planning with maternal and child health services. Several developing countries, particularly in Africa, are reorganizing reproductive health programs so as to reach more young people and the unmarried. NGOs have made substantial progress in networking for advocacy and lobbying: In Europe, NGOs have forged an advocacy movement through formal and informal alliances to build political support for the ICPD Programme in donor countries as well as in developing nations. Communication among NGOs and decisionmakers has increased in quality as well as quantity in many countries, where NGOs are being invited more and more to take part in policy debates. NGO advocacy has shaped national population policy development and helped mobilize financial resources in a number of donor and developing countries, including Denmark, the Netherlands, India and Uganda. NGOs have certain advantages over government agencies that allow them to design and implement more innovative, flexible and responsive programs with extensive grassroots participation. NGOs often have constituencies that are poorly served by government or hard to reach through government channels. NGOs may be more free to approach sensitive issues. In Pakistan, for example, an Islamic NGO can discuss reproductive issues more openly than the government can. NGOs' functions can vary according to need. They have helped establish sexual and reproductive health as a movement, acted as watchdogs, set and monitored performance standards, become donors and provided technical assistance, among other work. The Women's Environment and Development Organization (WEDO) has monitored and documented the promises each government has made at all UN conferences since Cairo. Their findings are publicly available and posted on their World Wide Web internet site: www.wedo.org. Future Needs and Challenges NGOs need to strengthen their policy expertise and capacity for advocacy, especially in countries where the political environment remains unreceptive to the ICPD Programme of Action. NGO partnerships with government need strengthening in countries where governments still view NGOs as unwelcome competitors for donor funds. Governments need to increase their transparency in decision making and information, and to be more open to NGO involvement in policy development. Such NGO involvement should be institutionalized. Governments need to modify cofinancing requirements, overhead limitations and other bureaucratic procedures that constrain NGOs' effectiveness in advocating for population and reproductive health programs and in implementing them. December 1998 1999 From Family Planning to Forum Reproductive Health DAY OF OBILLION The Cairo PEOPLE Consenour T he 1994 International Conference on Population and Development (ICPD) Programme of Action calls for an approach to reproductive health that is population comprehensive and client-centered. This consensus resulted from intense discussions in the field among governments, policymakers and international donors. the facts of life The ICPD or Cairo consensus process worked to build a bridge between advocates for women and family planning organizations. The family planning groups wanted to provide services in a more inclusive and empowering way. Advocates realized that the ability to make responsible and informed choices about sexual and reproductive health is both a condition and a vehicle for improving the status of women. Service providers worldwide, facing the spread of HIV/AIDS, found it increasingly irresponsible to provide the means of family planning without counseling clients on sexually transmitted diseases (STDs). The Cairo consensus rejected coercion in any form in reproductive health services. Implementing the Cairo Consensus Ideally, reproductive health services should include: (1) Family Planning attendants Range/choice of methods STD/AIDS Service Counseling on: Delayed childbirth for adolescents Prevention Sex/sexuality education Male responsibility Condom promotion/ distribution Safe sex Attention to unmet need/demand Treatment/referral/ screening Male support Research on safety/side effects Prenatal screening (syphilis) Women's support Sterilization reversal Symptomatic case management Parental/family support Implant removal Adolescent treatment Pre-/early adolescence AIDS/ Quality services Identification of high risk-takers STDs Policy dialogue Abortion Pregnancy Care Data collection Family planning/methods Prenatal care Sterilization Tetanus toxoid Abortion-related Services Iron folate/iodine supplements Management of complications Public Education on: Safe delivery Post-abortion family planning AIDS/STDs Access to caesarian section Improved sex education and Violence Access to blood transfusions family planning services where Gender discrimination High-risk birth screening abortion is restricted Female genital mutilation Transport Legal matters Complications detection/ Infertility Services Nutrition management/referral Prevention and management Sexual/ reproductive rights Postpartum care Unintended pregnancy Postpartum contraception Provider Training Smoking/substance abuse Technical competence Breastfeeding Gender sensitivity Management Information As a family planning nethod Adolescent nutrition System (MIS) for male/female Lactation management Training for physicians, nurses, clients For newborn/child care midwives and traditional birth Key Factors in Implementation of the ICPD Advocacy: Political will and commitment are needed at every level. The support of community leaders is effective if not essential for the success of reproductive health programs. In South Africa, reproductive rights are now part of the constitution. In Uganda, government officials implemented the new system with support from community and religious leaders. Among the Sabiny people in northern Uganda, elders were included in a campaign to eradicate female genital mutilation. Program development: The process can be as important as the outcome. Those involved should range from grassroots organizations and client representatives through service providers and policymakers. Setting priorities: Providers may need to choose between providing basic services for everybody in an area or a broad range of services for fewer people. They may need to make crucial choices at the clinic level -for example, whether or not to provide IUDs where no screening is available for reproductive tract infections. Clients' involvement is essential, as their priorities are not necessarily the same as those of service providers. A clinic in Indonesia, for example, learned that clients saw information supported by drawings on family planning as more important than blood pressure testing, which was available at the market for little money. Infrastructure, referral and logistics: Reproductive health providers function properly only with a guaranteed regular supply of drugs and equipment. Clients lose interest when they make time and effort to visit a clinic, only to find nothing available for them. Referrals can direct clients to other providers. For example, birth assistants in some areas have been trained to diagnose complications at an early stage of pregnancy. Training: Service providers need continuous training and support to face their new challenges. Issues to be covered include quality and continuity of care, technical competence, sensitivity to client needs, and commitment to informed choice. Monitoring and evaluation: As for any new concept, monitoring and evaluation at every level will ensure that follow-up visits are useful for clients and that timely Programme adjustments can be made. Sources: (1) This list was compiled from documents of the International Planned Parenthood Federation; USAID; the World Bank; UNFPA; The International Projects Assistance League; International Women's Health Coalition; the Older Women's League; Population Action International; the Rockefeller Foundation; and the World Health Organization. December 1998 1999 Poverty, Population and Forum Development DAY OF OBILLION PEOPLE Cairo F ew people now deny the link between economic development and slower population growth. But development is neither an automatic product of slower population population growth nor vice versa. Instead, family planning, reproductive health care and development programs can work together to reduce the rate of population the facts growth and improve the quality of life. of life Sustainable development must include the following: Provision of reproductive health care reduces child and maternal mortality rates, which encourages smaller families, later childbearing-and planned spacing of births. Investment in education for women and in expanding their access to credit, training, property and legal rights gives them options for achieving status and satisfaction in life through more means than childbearing. It also liberates their economic potential. Smaller family size releases resources that individuals can then invest in work, health care, education, or other economic activity. Fewer children to educate means higher achievement levels for all of them and a smaller total bill. In developing nations, 800 million people are unemployed or under-employed - a number greater than the entire current workforce of the industrialized countries. (1) Those nations must create 40 million new jobs per year just to stay at this level.(2) They also need to guarantee the health and education of their record number of young people (one billion teenagers in 2000) in order to generate prosperity and to care for the growing number of the elderly, and for future generations. Globalizing markets bring benefits and dangers: A village in rural China is now as likely to be linked to Hollywood movies and advertising on a community TV as it is to be linked to the next town by road or railroad. Expectations for the future are changing accordingly, increasing pressure on governments for advanced development. Every nation now receives a constant stream of new products, often produced far away in unknown conditions. Advertising, now a $435 billion business (3), is the predominant source of product information; consumer safety laws or movements are absent or rudimentary in many developing nations. Unfamiliar products have often brought dangers: tobacco from the New World, alcohol to the Americas, infant formula to areas where no clean water exists. Developing nations seeking income are vulnerable to the "dumping" of commercial imports that may be hazardous such as expired medications, toxic wastes, contaminated food or pesticides banned in the country of origin. Impoverished areas are also the most likely to be the site of polluting industries and waste dumps that threaten their health and livelihoods. Products grown for export purposes may be capital-intensive cash crops, replacing or crowding out those that make up the local food supply. Yet the poor often cannot afford imported replacement foods. Disparities continue and investment is needed: In 1960, the richest 20% of humanity claimed 70% of all income; by 1997 their share had risen to 86%. Meanwhile the poorest fifth saw their share fall from 2.3% to just 1.3%. The three richest people in the world have assets that together exceed the combined gross domestic product of the 48 least-developed nations. (3) Of the 4.4 billion people in developing nations, a fifth have no access to modern health services of any kind. A quarter do not have adequate housing. A third have no access to clean water. Fully 60% lack access to safe sewers. (4) Attention to the needs of the poor for basic sanitary and transportation services, education, access to productive land and job opportunities will reduce pollution, resource use and stress on the environment. Institutional solutions are needed for management of common global resources of air, water, fisheries, forests and pasture, and for controlling emissions and wastes. Some of the gains in health, education and nutrition during the 1960s and 1970s have since been reversed. In Africa, the proportion of malnourished children rose from 5% to 25% between 1983 and 1993, and primary school enrollment fell from 79% to 67%.(5) The average African household today consumes 20 percent less than it did 25 years ago.(4) Sources: (1) International Labor Organization, World of Work, (Washington DC: 1998); and United Nations Population Fund, The State of World Population 1998 (New York: 1998); (2) Population Action International, Why Population Matters, (Washington DC: 1996); (3) United Nations Development Programme, Human Development Report 1998 (New York, 1998), P. 63; (4) UNDP, Human Development Report 1998, p. 30; (5) UNDP, Human Development Report 1998, p.2; (6) Lawrence H. Summers, US Government, statement to members of the African Development Bank, Abidjan, May 1993. December 1998 1999 Population and the Forum Environment DAY OF OBILLION The Cairo PEOPLE T he link between population and environmental impact seems obvious at first population glance: more people consume more resources, damage more of the earth and generate more waste. As nations develop, they increase consumption. This simple the facts reasoning is true as far as it goes, but the larger picture is more complex. of life A very small proportion of the population consumes the majority of the world's resources. The richest fifth consumes 86% of all goods and services and produces 83% of all carbon dioxide emissions, while the poorest fifth consumes 1.3% of goods and services and accounts for 3% of C02 output. (1) Per capita municipal waste grew 30% in developed nations since 1975 and is now two to five times the level in developing nations. (1) An average American's environmental impact is 30 to 50 times that of the average citizen of a developing country such as India. (1) The need is to balance the requirements of a growing population with the necessity of conserving earth's natural assets. Rising levels of industrial and agricultural pollution threaten the air we breathe, the oceans, the diversity of Earth's species and the ozone layer that protects life itself. Every 20 minutes, the world adds another 3,500 human lives but loses one or more entire species of animal or plant life -at least 27,000 species per year. This is a rate and scale of extinction that has not occurred in 65 million years. (2) Spreading deserts and declining water tables in a third of the planet are contributing to famine, social unrest and migration. Two thirds of the world's population lives within 100 miles of an ocean, inland sea or freshwater lake: 14 of the world's 15 largest megacities (10 million or more people) are coastal. Their impacts include growing loads of sewage and other waste, the drainage of wetlands and development of beaches, and destruction of prime fish nurseries. (3) Technological advances can mitigate some of the impact of population growth, and market mechanisms raise prices for some diminishing resources, triggering substitution, conservation, recycling and technical innovation so as to prevent depletion. But market systems often subsidize industries such as logging, mining and grazing without tallying environmental costs. No market considers commonly held resources such as groundwater levels or atmospheric and ocean quality. Nor do markets consider questions of equity and social justice. A world conclave of 58 national Academies of Science agreed in 1993 that unchecked consumption and rapid population growth are likely to overwhelm technological improvements in affecting the environment. (4) Clearly, the greatest environmental threat comes from both the wealthiest billion people, who consume the most and generate the most waste, and from the poorest billion, who often damage their meager resource base in their daily struggle to avoid starvation. In addition, the billions in between are doing their best to increase their standard of living, in part through increased consumption. Although the world's supply of water remains constant, per capita water consumption is rising twice as fast as world population. At least 300 million people live in regions with severe water shortages now; by 2025, the number could be 3 billion. (5) The world's forests have shrunk from 11.4 to 7.3 square kilometers per 1,000 people since 1970. The loss is concentrated in developing countries, mostly to meet the demand for wood and paper by the industrialized world. Wild species are becoming extinct 50 to 100 times faster than they naturally would. (1) Over the last 50 years, 12% of the planet's soils have been severely degraded. That's nearly 2 billion hectares, the size of China and India combined. (1) Global emissions of carbon dioxide, a "greenhouse gas" most researchers say, have caused global warming and disruption in weather patterns, have quadrupled since 1950, largely from deforestation and the burning of fossil fuels. Where the industrialized world now produces 60% of it, the developing world will be producing 60% of it by 2015.(1) Sources: (1) United Nations Development Programme, Human Development Report 1998 (New York: Oxford University Press, 1998); (2)Ken Strom, Population and Habitat in the New Millennium, National Audubon Society and The Global Stewardship Initiative (Boulder CO 1998); (3)Population Action International, Why Population Matters (Washington DC: PAI, 1996); (4)Report, Population Summit of the World's Scientific Academies (Washington DC: The National Academy Press, 1993); (5)Simon, Paul, Tapped Out (New York: Welcome Rain Publishers, October 1998). December 1998 1999 Consumption and Resources Forum DAY OF OBILLION The Cairo I n 1994, the International Conference on Population and Development (ICPD) Cousenoul saw that industrialized nations' level of consumption of natural resources was population unsustainable worldwide. One U.S. citizen was consuming 30 times what one citizen of India did; developed nations were 20% of the world's population yet used two- the facts thirds of all resources and generated 75% of the world's pollution and waste. (1) World consumption patterns were undermining the environmental resource base. of life Yet the 1 billion people living in absolute poverty require increased consumption so as to alleviate their malnutrition, disease and illiteracy. The ICPD agreed that countries should reduce and eliminate unsustainable patterns of production and consumption so as to meet people's needs without compromising future generations. Such changes would conserve resources long enough for new policy options to be implemented that would contribute to human development. Consumption disparities are increasingly stark: With world population at 6 billion and rising, the richest 20% of humanity consumes 86% of all goods and services used, while the poorest fifth consumes just 1.3%. The wealthy consumes 45% of all meat and fish, use 58% of all energy produced and own 87% of the vehicles. (2) Meanwhile, 2.6 billion people lack basic sanitation, 1.5 billion have no access to clean water, 1.1 billion lack adequate housing and nearly 900 million have no access to modern health services of any kind. (2) According to the United Nations, Americans and Europeans together spend $17 billion a year on pet food, $4 billion more than the estimated yearly additional amount needed to provide everyone in the world with basic health and nutrition. (2) Production techniques are eroding the resource base: The burning of fossil fuels has almost doubled since 1950. Consumption of fresh water has doubled since 1960, and wood consumption (for household and industry use) is 40% higher than 25 years ago. (2) Commercial fishing is threatened worldwide by over-fishing: one-quarter of all fish stocks are listed as "depleted" or in danger of being depleted; another 44 percent are being fished "at the biological limit." This is driven by export demand for animal feed and oils, not by food needs, but it strains the primary protein source for nearly billion people in 40 developing nations. (2) Producing a quarter-pound of hamburger requires 100 gallons of water, 1.2 lbs. of feed grain and energy equal to a cup of gasoline, causing the loss of 1.25 lbs. of topsoil and producing greenhouse gas emissions equal to a 6-mile drive in a typical U.S. automobile. (3) Americans each consume 260 lbs. of meat per year on average, most of it hamburger; the average in Bangladesh is 6.5 lbs. (2) The trend is toward more consumption worldwide: Global spending on advertising, which stimulates consumption, multiplied nearly sevenfold from 1950 to 1990, when the total was $257 billion, or $48 for each person on the planet. It has nearly doubled again since then, to $435 billion, and is increasing faster than incomes or population, especially in developing nations. (2) Surveys of U.S. households found that the income desired to fulfill consumption aspirations doubled between 1986 and 1994. (2) The definition of "necessity" is changing worldwide. Increased consumption is not producing a parallel increase in happiness. The National Opinion Research Center of the University of Chicago has found that the proportion of Americans who say they are "very happy" has remained at about one-third since 1957, although personal consumption has more than doubled.(4) Sources: (1) United Nations Population Fund, Population and the Environment: The Challenges Ahead (New York: United Nations, 1991); and R.Paul Shaw, "The Impact of Population Growth on the Environment: The Debate Heats Up," Environmental Impact Assessment Review, March-June 1992; (2) United Nations Development Programme, Human Development Report 1998 (New York: Oxford University Press, 1998) P. 5; (3) Alan Durning, Ecological Wakes: The Story of Six Everyday Objects (Seattle: Northwest Environment Watch, 1994); (4) Alan Durning, How Much is Enough? The Consumer Society and the Fate of the Earth (New York: W.W. Norton, 1992) December 1998 1999 The Road to the Cairo Consensus: FORUM DAY OF OBILLION People Rather than Numbers The Chiro PEOPLE global population I n 1946, a Population Division was set up within the UN Secretariat to analyze demographic trends, based on the then-prevailing concern that mortality from war the facts and disease might cause a population decline. Researchers developed demographic analysis and governments in developing countries conducted the first national censuses. of life When 1950 and 1960 findings became available, policymakers became concerned about rapid global population growth. The UN role expanded to include policy development and financial and technical aid to population programs. Improved data collection and analysis, including growth projections, brought the issue to the attention of more policymakers and stimulated national population programs. In 1974, 1984 and 1994, the UN organized international population conferences to help build world consensus on the need to address population issues. These created political support for national policies to promote sustainable populations and voluntary family planning programs. The 1994 International Conference on Population and Development in Cairo was an important watershed. The conference document reaffirmed the importance of slowing population growth for social and economic development, but it also called for a major shift in strategies to achieve this goal: an emphasis on meeting the needs of individual women and men, rather than on achieving any demographic targets. The 1994 ICPD in Cairo The UN Economic and Social Council in 1991 explicitly linked development and population when it named the 1994 gathering. Preparations for a 1992 UN Conference, on Environment and Development (ICED) in Rio de Janeiro, focussed attention on the new concept of "sustainability"-that environmental and population factors are critical in economic growth. Other crucial influence came from the 1990 World Summit for Children and the 1993 Vienna Conference on Human Rights. The ICPD's first preparatory meeting resolved that population, sustainable economic growth and development would be ICPD themes. The ICPD was the largest intergovernmental conference on population and development ever held: 11,000 registered representatives from governments, NGOs, UN agencies and intergovernment agencies. 179 States negotiated on a Programme of Action for the next 20 years, while another 4,000 NGOs held a parallel conference and there was unprecedented media attention. Cairo is Working The key to the Cairo consensus, and perhaps its chief achievement, was recognition of the need to empower women, providing them with more choices through expanded access to education and health services, skill development and employment, and full involvement in policy and decisionmaking at all levels. The ICPD Programme of Action facilitated reforms in population/family planning programs so that they no longer use targets, incentives or coercion. Instead they include integrated approaches where services, education and quality care are central elements. Since Cairo, non-governmental organizations have achieved near-full participation in official conference proceedings. The Programme of Action language on NGOs' role and civil society was the strongest from any UN gathering. Since Cairo, NGOs have participated as official delegates to UN conclaves and have been instrumental in providing language for the final documents. ICPD Plus Five: Reviewing the Results The 1999 ICPD + 5 is the first review in the 20-year course of the Cairo Programme of Action. The UN General Assembly, ordering this comprehensive appraisal of implementation so far, further resolved that the review would not reopen provisions of the Programme but would instead identify ways to advance its implementation. Beginning in April 1998 with the first of four roundtable discussions, a series of events (1) involved program countries, donor countries, the UN system, and civil society including NGOs and the private sector in discussion of current issues. An International Forum convenes in The Hague in February 1999 to recommend next steps in implementation for presentation at the March 1999 meeting of the Commission on Population and Development. The review then culminates in a three-day Special Session of the UN General Assembly in June 1999. The Role of NGOs NGOs will be fully involved in the review process. They have identified five themes that must be addressed if the Cairo Programme of Action is to be realized: Resources and advocacy; Reproductive rights: rhetoric to reality; Putting the Cairo agenda into practice: providing sexual and reproductive health services; Links between population, environment and development; and Partnerships Each theme area will be the focus of a panel discussion during the NGO Forum at The Hague in February 1999. The forum's final document will suggest further steps needed to implement the Cairo Programme of Action into the next century. Sources: (1) The events will concern adolescent sexual and reproductive health; reproductive rights and implementation of reproductive health programmes, women's empowerment, male involvement and human rights; the role of civil society; and population and macro-economic links. December 1998 1999 Journalist's Notebook: Forum What's In A Word? DAY OF OBILLION The Cairo PEOPLE population W hat's in a word? Plenty when it comes to population terminology. Demographic language is often freighted by controversial associations with geopolitics, sex, power, gender, race, religion and personal rights. the facts of life "Population control" is a prime case in point. The term is now out of favor with experts in the field, because it implies force - a negative thing to most. To some it evokes men trying to control women, industrialized nations trying to weaken the power of developing nations' increasing numbers, or whites trying to reduce the future numbers of people of color. To stress the voluntary nature of the actions sought, experts use terms like "stemming," "stabilizing" or "slowing" population growth. Similarly, "family planning" is preferred to "birth control," a term that dates back to the time of Margaret Sanger's crusade for women's right to use contraceptives. "Overpopulation" is also a misnomer. If we have too many people, who are the unneeded? Developing nations and the poor suspect that the wealthy may be referring to them. Besides, a newborn can represent not only a new mouth to feed but two new hands with which to build and a new mind to create the future. The subject of debate is better described as "global population issues" or "population policy," in order to stress the need to assess human numbers in the context of desired living conditions and development. "Immigration" is taking on negative connotations in the U.S. and in western Europe as a globalizing economy and population crowding bring rising numbers of newcomers who could threaten jobs, social services and the predominant culture. As the new wave is largely nonwhite, some whites fear that immigration will dilute their power. In the developing world, however, "migration" tends to connote an admirable ambition and courage to seek work or a better life away from home. Many immigrants migrate again, or return home when conditions change or they achieve their purposes. More than 90% of all births now take place in developing nations, a fact that helps explain relative attitudes toward trans-national human traffic. Doomsday scenarios are passé. Thomas Malthus' dire warnings of rampant disease and famine sparked talk of "triage" and "lifeboats" to describe the coming necessity of deciding who should be allowed to live in a world eaten out of house and home by too many people. The "population bomb" is somewhat discredited. Growth rates peaked in the early 1970s, and we are now living in that explosion's fallout: global numbers doubled from 3 billion in the 1960s to 6 billion in mid-1999, and continue to rise but at a slower rate. Improved health services have managed to keep the increased billions alive, though often in a deprived state. Population specialists now concentrate on "quality of life" of the millions of newborns who will be hard-pressed to find education, health care and work needed for a meaningful life. Today, "population momentum" from the 1960s baby boom continues to drive human numbers upward. Growth will continue for at least another generation as the new millennium's record 1 billion teenagers enter their reproductive years. The question now is: when will we achieve "population stabilization," where growth stops? The answer depends upon whether commitments that the world's nations made at the ICPD in 1994 are fully honored: to programs furthering "birth spacing," "reproductive health" and "women's rights"; boosting "sustainable development"; and improving the earth's "carrying capacity" and the human quality of life." These terms stress not sheer population numbers but the broader vision of global well-being. "Acceptable risk" describes the health risks associated with many modern contraceptives, while "relative risk" compares that small danger to, say, riding a motorbike in city traffic. The definitions of each are under challenge from women's groups, who note that all but two modern methods (condoms and male vasectomies) make women take the risk. Not Just Words It's not just political correctness to watch your population language. Many of yesterday's terms were rooted in detached calculations that dehumanized people and the process of family-building. People universally resist bean-counter reckoning in deciding the size of their families. Population specialists have moved beyond mere number-crunching to understand what population increase means to individuals--and this change in perspective has changed policy and language. Most governments in developing countries have adopted family planning policies in an effort to balance their national populations with available resources. They have shouldered two-thirds of the costs involved, asking industrialized nations' to help with the rest. The term "commitment" involves not only political will but the provision of human and material resources as well. It is this commitment that is at stake today. December 1998 1999 People On the Move: Forum Urbanization & International Migration DAY OF OBILLION The Cairo PEOPLE P eople leave their native lands for many reasons: to find better work, escape political conflict or personal danger, and to find a better environment to live population in. They may migrate again or return home when conditions change or their purposes are accomplished. These factors are often related to population pressures. the facts Both the communities gaining population and those losing it may view the change of life either as threat or benefit. Reliable statistics on the movement of people from country to country do not exist. The best current "guesstimate" from the United Nations Population Fund, however, is that roughly 120 million people were living outside their-countries of birth or citizenship in 1998. The number is thought to be rising for a number of reasons; one is that the native labor pool in the industrialized world is shrinking while the developing world's workforce will soon double. (1) Migration Affects Urbanization Patterns Cities are growing faster than ever. The world was 45% urban in 1995 (2), and cities are expected to hold most of the projected increase in humanity for the next 25 years. The number of cities with more than 1 million people rose from 111 in 1960 to 280 in 1995, and two-thirds of those are in developing nations. (3) By 2010, the developing-world total will be 368 such cities, up from 173 in 1990. This will further strain those nations' capacity to provide services such as energy, education, health care, transportation, sanitation and physical security. Violence Attends Much Migration The United Nations High Commission for Refugees (UNHCR) reports that most of the 22 million people who came under its wing in 1997 were fleeing from conflict, both domestic and international. Most of them fled to poor countries - only 406,000 sought asylum in Western nations, up from 318,300 in 1997.(4) Refugees, especially women, often suffer beatings, rape and other abuses of their human rights while losing access to systems of justice and medical care. The lack of reproductive health care for refugee women is especially acute. Migrants Do Not Fit Stereotypes Immigrants to industrialized nations from developing ones tend to have higher fertility rates for the first generation (25 years). Thereafter their fertility rates equal those of the host country. (5) For the most part, voluntary immigrants are not the world's poorest and most destitute people but those with the energy, intelligence, courage and resources to seek a better life. The ICPD Programme of Action commits nations to: Recognize and address the root "push" causes of migration--armed conflicts, human rights violations, environmental degradation, lack of sustainable economic growth, and insufficient social resources--and also acknowledge the influence of economic "pull" factors. Improve urban planning by encouraging the growth of small or medium-sized urban centers and sustainable development in rural areas. Assess the impact of national economic and environmental policies on residential patterns, and build capacity to manage urban development. Stem undocumented migration by improving law enforcement (especially against profiteering smugglers of aliens) while safeguarding the human rights of undocumented migrants. Protect refugees and asylum-seekers, reduce pressures that lead to refugee movements and support international refugee assistance. Sources: (1) Population Action International, Why Population Matters (New York: 1996), P. 19; (2) UNFPA, The State of World Population 1998 (New York: 1998), P. 70; (3) UNFPA, The State of World Population 1995 (New York: 1995); (4) Intergovemmental Consultations on Asylum, Refugee and Migration Policies, and U.S. Committee for Refugees (World Wide Web site: w/ttp://www.refugees.org/world/statistics/wrs98 table10.htm); (5) Joseph A. McFalls Jr., "Population: A Lively Introduction (Third Edition)," Population Bulletin 53.3 (Washington DC: Population Reference Bureau, 1998), P. 10. December 1998 1999 rogum Money Matters: DAY OF BILLION Financial Resource Commitments The Cairo Cousenour population the facts T o reach the ambitious goals of the ICPD, participating governments - after hard negotiations and much research - agreed to increase spending on population and related programmes to $17 billion per year by 2000. The figure, less of life than one week's global spending on armaments, was to climb to $22 billion by 2015. (1). Two-thirds of the total was to come from developing nations and one-third from the industrialized world. That commitment was a departure from trends prior to 1994, which had showed a steady slight decline in overall development assistance. But the ICPD saw that just to maintain the levels of contraceptive use that had led to global fertility declines, about 100 million more couples would need access to reproductive health and family planning services by 2000. A Good Start In 1995, a global total of $9.5 billion was earmarked for population programmes and projects, a substantial rise from 1994 spending. Donor countries increased their assistance to $2 billion, the highest percentage in a decade. Developing nations provided $7.5 billion, about 78% of total investments, more than projected. China, India and Indonesia accounted for more than half that amount. The funds were channeled to projects directed at expansion of reproductive health care including family planning and sexual health information and services for women and men; and production and distribution of safe, effective and inexpensive contraceptives, maternal health care, essential childbirth and STDs and HIV/AIDS prevention. It also includes advocacy for the ICPD Programme of Action, especially for primary education and sexual health. These were the programmatic priorities agreed upon at the ICPD. Follow-through is Lacking Since 1995, however, donor nations with a few exceptions have been reducing their support for population measures rather than increasing it as promised. Only five donor nations have managed to approach their share: Denmark, Finland, Sweden Norway and the Netherlands. Most others are far short of their commitments. Population aid from all donor nations was 2.46% of official development assistance in 1996, up from 2.32% in 1995 but still short of their share. (2) In 1996, 94% of all population assistance funding came from ten countries: the Netherlands and the United States (55% together); and the United Kingdom, Germany, Japan, Denmark, Sweden, Norway, Canada and Australia. (2) Final 1996 spending by region was as follows: Sub-Saharan Africa $422 million (28%); Asia and the Pacific $367 million (24%); Latin America and the Caribbean $197 million (13%); Western Asia and North Africa $104 million (7%); Europe $25 million (2%). The remaining 26% went to global and interregional aid. (2) The Consequences of Continuing to Fall Short Will Be Severe The UN Population Fund has projected scenarios for low, medium and high rates of shortfall from the Cairo commitments. (1) Constant growth of commitments, the most optimistic, assumes that donor nations continue their current below-target rate of growth in contributions 1995-2000, and that developing nations meet the Cairo targets. This means a shortfall of $2.1 billion in 2000. Some 97 million people who would have chosen contraception will not be able to do so. The number of unintended pregnancies will rise by 130 million. Abortions will increase by 50 million. Unwanted births will rise by 59 million. Maternal deaths will rise by 300,000, and an additional 3.6 million infants and 1.3 million children will die from inadequate health care. Intermediate growth of commitments assumes assistance rises 20% more slowly than in the above scenario. This leads to a $2.9 billion shortfall in 2000. About 130 million people who would have chosen contraception will not be able to do so. The number of unintended pregnancies will rise by 170 million. Abortions will increase by 68 million. Unwanted births will rise by 79 million. Maternal deaths will rise by 400,000, and another 4.8 million infants and 1.8 million children will die from inadequate health care. Low growth of commitments assumes that developing nations also fall short of their targets. This results in a $3.8 billion shortfall in 2000. Some 170 million people who would have chosen contraception will not be able to do so. The number of unintended pregnancies will rise by 230 million. Abortions will increase by 92 million. Unwanted births will rise by 110 million. Maternal deaths will rise by 540,000, and an additional 6.5 million infants and 2.4 million children will die from inadequate health care. Sources: (1) Except where indicated, all figures are from UNFPA, Falling Short: Struggling to Implement the Cairo Programme of Action, (New York: 1997). (2) UNFPA, Global Population Assistance Report, 1996 (New York: 1997), December 1998 1999 Contacts: Forum DAY OF OBILLION United Nations, The Cairo PEOPLE U.S. Government and International population United Nations the facts of life United Nations Population Fund (UNFPA), Stirling Scruggs, Director of Information and External Relations. Contact: Corrie Shanahan, Senior Information Officer, [email protected], (212) 297-5023, www.unfpa.org. United Nations Population Division. Contact: Joseph Chamie, Director, (212) 963-3179. U.S. Government U.S. Agency for International Development, Center for Population, Health & Nutrition, Liz Maguire, Director, Office of Population. Contact: Dianne Sherman, Director of Communication & Outreach, [email protected], (202) 712-4817, www.info.usaid.gov/pop_health. U.S. Department of Health and Human Services. Contact: Sarah Kovner, Special Assistant to the Secretary, (202) 690-6347, www.os.dhbs.gov. U.S. State Department, Bureau of Population, Refugees and Migration, Margaret Pollack, Director, Office of Population. Contact: Suzanne Petroni, Program Officer, [email protected], (202) 663-3029, www.state.gov/www/global/prm, U.S. Information Agency Electronic Journal, "Population at the New Millenium: the U.S. Perspective," www.usia.gov/journals/journals.htm International World Population Foundation, Wouter Meijer, Executive Director. Contact: Joke Van Kampen,[email protected], (31) 35 642 2304, www.wpf.org. December 1998 1999 Contacts: Forum DAY OF OBILLION U.S. Non-Governmental Organizations The Cairo PEOPLE Cairo Plus Five Task Forces: population Building a Grassroots Constituency: Planned Parenthood Federation of America, Gloria Feldt, President, Roberta Synal, Media Relations, [email protected], (202) 785-3351, www.plannedparenthood.org the facts of life Telling the Cairo Story: The Centre for Development and Population Activities (CEDPA), Peggy Curlin, President; Patricia Sears, Public Affairs and Communications Coordinator, [email protected], (202) 667-1142, www.cedpa.org. Mobilizing Resources: Population Action International, Amy Coen, President, Sally Ethelston, Director, Media Relations, [email protected], (202) 659-1833, www.popact.org. Communicating Research Findings: Population Reference Bureau, Peter Donaldson, President; Alene Gelbard, Director of International Programs, [email protected], (202) 483-1100, www.prb.org. Population Council, Margaret Catley- Carlson, President; Sandra Waldman, Director, Public Information, [email protected], (212) 941-5300, www.popcouncil.org. NGOs in Support of the Cairo Consensus: Advocates for Youth, James Wagoner, President. Contact: Darryl Figueroa, Director of Communications, [email protected] (202) 347-5700, www.advocatesforyouth.org Alan Guttmacher Institute, Jeannie Rosoff, President. Contact: Susan Tew, Deputy Director of Communications, [email protected], (212) 248-1111, ext. 2208, www.agi-usa.org. AVSC International, Amy Pollack, President. Contact: Rachael Pine, JD, Director for Public Affairs, [email protected] (212) 561-8470, www.avsc.org. Catholics for a Free Choice, Frances Kissling, President. Contact: Jon O'Brien, Director of Communications and Education, [email protected], (202) 986-6093, www.igc.org/catholicuote/ Center for Health and Gender Equity. Contact: Jodi Jacobson, Co-Director, [email protected], (301) 270-1182. Center for Reproductive Law and Policy, Janet Benshoof, President. Contact: Barbara Becker, Acting Director for Communications, [email protected], (212) 514-5534, www.clrp.org. Communications Consortium Media Center. Contact: Kathy Bonk, Executive Director, [email protected] (202) 326-6767, or Kirsten Sherk, Project Assistant, [email protected], (202) 326-8724. 2 Family Care International. Contact: Jill Sheffield, President,[email protected], (212) 941-5300, www.familycareintLorg. Family Health International, Theodore M. King, President. Contact: Nash Herndon, Managing Editor, [email protected], (919) 544-7040, www.fhi.org. Family Planning Management Development Project/Management Sciences for Health, Catherine Crone Coburn, President. Contacts: Sherri Clark, Information Officer, [email protected], (617) 527-9202 ext. 316, www.msh.org. The Futures Group International, Henry E. Cole, President. Contact: Jeff Jordan, Deputy Director, Policy Project,[email protected], (202) 775-9680, www.tfgi.com. International Women's Health Coalition (IWHC), Adrienne Germain, President. Contact: Hilary Maddux, Director of Communications, [email protected], (212) 979-8500, www.iwhc.org. Ipas, Forrest Greenslade, President. Contact: Charlotte Hord, Deputy Director for Policy, [email protected], (919) 967-7052, www.ipas.org. Izaac Walton League of America, Paul Hansen, Executive Director. Contact: Jim Baird, Carrying Capacity Project Director,[email protected], (301) 548-0150, www.iwla.org. John Snow, Inc., Joel Lamstein, President. Contact: Nancy Pendarvis Harris, Vice President, [email protected], (703) 528-7474, www.jsi.com. Johns Hopkins Center for Communication Programs, Phyllis Piotrow, Director. Contact: Stephen Goldstein, Managing Editor, Population Reports, [email protected], (410) 659-6300, www.jhuccp.org. Meridian Development Foundation. Contact: Victoria Baird, President, v.baird@meridian- group.com, (202) 466-0511. National Audubon Society, John Flicker, President. Contacts: Population and Habitat Campaign, Pat Waak, [email protected], Lise Rousseau, [email protected], (303). 442-2600, website: boulder.earthet.net/popet National Family Planning and Reproductive Health Association, Judith DeSarno, President and CEO. Contact: Marilyn Keefe, Director of Public Policy and Service Delivery, [email protected], (202) 628-3535, www.nfprha.org. National Latina Institute for Reproductive Health. Contact: Aracely Panameño, Executive Director, [email protected], (202) 326-8970, National Wildlife Federation, Norman I. Dean, Senior Vice President. Contact: Peter Belden, Population Specialist, [email protected], (202) 797-6639, www.nuf.org. National Women's Law Center, Marcia Greenberger, Co-President. Contact: Sharon Jenkins, Communications Director, [email protected]. (202) 588-5180, www.nwlc.org. 3 The Park Ridge Center. Contact: Laurence J. O'Connell, Ph.D., S.T.D., President and CEO, (312) 266-2222. Planned Parenthood of Northern New England, Allie Stickney, President/CEO. Contacts: Judy Wechsler, Director, the International Program,[email protected], (802) 878-7232. Population Coalition. Contact: Marilyn Hempel, Executive Director, [email protected], (909) 625-5717. Population Communications International, David Andrews, President. Contact: Patrice Newman, News & Information, [email protected], (202) 687-3366, www.population.org. Population Institute, Werner Fornos, President. Contact: Hal Burdett, Director of Public Information, [email protected] (202) 544-3300, www.populationinsitute.or Program for Appropriate Technologies in Health (PATH), Gordon Perkin, President. Contact: Elaine Murphy, Ph.D., Director of PATH/NCIH Women's Reproductive Health Initiative, [email protected], (202) 822-0033, www.path.org. Religious Coalition for Reproductive Choice, Rev. Carlton Veazey, President. Contact: Marjorie Signer, Director of Communications, [email protected], (202) 628-7700, www.rcrc.org. Research, Action & Information Network for Bodily Integrity of Women (RAINBO), Nahid Toubia, M.D., Executive Director. Contact: Linda Moise, Administrative Officer, [email protected], (212) 477-3318, www.rainbo.org. Save the Children, Charles MacCormack, President. Contact: Mary Beth Powers, Reproductive Health Advisor, [email protected], (203) 221-4269, www.savethechildren.org. Sexuality Information and Education Council of the United States (SIECUS). Contact: Debra W. Haffner, President, [email protected], (212) 819-9770, www.siecus.org. Sierra Club, Carl Pope, President. Contact: Stephen Mills, Director for International Programs, (202) 547-1141, www.sierraclub.org. Winner, Wagner, and Associates. Contact: Sally Patterson, Vice President, [email protected], (202) 333-2533. Women's Commission for Refugee Women and Children, Susan Toole, Executive Director. Contact: Diana Quick, Public Affairs and Communications Coordinator, [email protected], (212) 551-3087, www.intrescom.org/wcrwc.html Women's Environment and Development Organization. Contact: Dianne Dillon-Ridgley, Interim Executive Director, [email protected], (212) 973-0325, www.wedo.org. Zero Population Growth, Peter Kostmayer, President. Contact: Mark Daley, Press Officer, [email protected], (202)745-3179, (800) 767-1956, www.zpg.org. December 1998 CATHOLIC VOICES WITH THE ONSENSUS Catholics and Cairo: A Common Language One of the most daunting tasks in international inflammatory language, such as "population discourse is the discovery and crafting of a common explosion" and "zero population growth." This language. This imperative becomes all the more demographic approach emphasized reduction of difficult and demanding when the issues seeking population and neglected women's human rights. expression are charged with intense feelings, emotions, and differences in worldview. The Programme of Action represents a refreshing step forward. It recognized the The United Nations 1994 International importance of ethics, values, interrelationships, Conference on Population and Development and its sustainability, poverty eradication, and especially the Programme of Action adopted in Cairo constitute a connection between the empowerment of women pivotal moment in the articulation of a common and lower fertility rates. The document articulates a language of conscience. Furthermore, Cairo broad vision that puts human dignity above provided the Catholic church with an unprecedented demographic goals; women's equality and men's opportunity to enter the world dialogue in terms not responsibility over mandated family planning. It unfamiliar to its own traditions and mission. crafted language on reproductive and sexual health and rights. THE CAIRO CONFERENCE AND THE PROGRAMME OF ACTION This year, the five-year assessment of Cairo will be conducted through a series of regional, national, Every ten years since 1974, the United Nations has and international meetings. This assessment is convened an international conference on population enhanced considerably by religious voices reflecting and development. Past conferences have been held on the principles and goals of Cairo and its in Bucharest (1974) and Mexico City (1984). In Programme of Action. Among these religious 1994, 180 governments came to Cairo, Egypt, to groups, a Catholic reflection is especially crucial attend the third United Nations International because of the strong and sometimes controversial Conference on Population and Development role played by the Vatican and the Holy See during (hereafter, Cairo or the Cairo Conference). the Cairo process. At Cairo, the governments of the world agreed THE VATICAN AT CAIRO to a list of proposed actions for the future these are contained in a Programme of Action, which Cairo sought to deal with some of the most volatile spans over 100 pages and comprises sixteen issues in our personal, political, and religious lives: chapters. Chapters three through sixteen develop reproduction, sexuality, development, and women's the qualitative and quantitative goals agreed to at human rights. Remarkably, it chose to link these Cairo. Of particular interest to Catholics and other themes together and to deal with them in the people of faith are the principles in chapter two that overarching categories of rights and responsibilities. provide the ethical framework for the Cairo approach to population and development. Rights emerge from the individual, innate, and inviolable core of each person. Responsibilities are Earlier population conferences were rightly grounded, for the most part, in the community, in criticized for focusing solely on limiting family size the demand to treat others with equal dignity and and reaching demographic targets, often using rights, and in the insistence that the consequences of CATHOLICS FOR A FREE CHOICE 2 all our actions be measured by more than our own or to propose language that could win the support of advantage and identity. The dialogue and tension the world. This difficulty was compounded by the between rights and responsibilities, between Vatican's reluctance to affirm the revolutionary individual and community, between belief and character of the Cairo Conference as it put issues of conscience, between wealth and poverty, indeed population in an overall ethical framework fortified between men and women were addressed in Cairo to by insistence on women's rights and health. an unheard-of level of agreement. To find the words and consensus to express the world's Furthermore, the Vatican's actions at Cairo conscience on such controversial matters is weakened Cairo's message, particularly for the extraordinary. One might have supposed that the Catholic observer. While there are many Catholics Holy See would be gratified by the serious purpose, who do not agree with the positions taken by the religious resonance, Catholic language, and moral Vatican at Cairo, more still do not realize how tone with which Cairo went about its work. consistent the Programme of Action is with Catholic teachings. In reality, Cairo and the Vatican had The field of agreement between the Catholic more areas of concurrence than disagreement. The church and the Programme of Action is large and Vatican came to Cairo with deep suspicions and an impressive. Nonetheless, sharp differences emerged apparent unwillingness to trust the global process of (these are dealt with in part 2 of this paper). reaching agreement on ethical issues, and, therefore, its message at Cairo was often inconsistent with Unique among religious bodies of the world, church teachings. In particular, the Vatican's actions the Catholic church enjoys a privileged status as a distorted what Cairo actually said on women's Non-Member State Permanent Observer at the human rights, health, and family. United Nations through its governmental entity, the Holy See. In this capacity, the Holy See takes part in Reproductive rights are dealt with in the United Nations-conferences and can exercise, as it Programme of Action under the larger rubric of did at Cairo, voting rights. human rights for women. The same strategy is followed in addressing reproductive health through However, any government will not necessarily the more expansive issue of a right to health. This is reflect the beliefs and practices of the people it one of the great contributions of Cairo. It purports to represent. There is a distinction between constantly seeks a larger context, one in which there the Catholic church and its tradition as a whole (i.e. is universal agreement, before it deals with the entire body of believers) and the administration controversial specifics. Thus, all of the world agree of that church as it is represented by the Holy See at on human rights for women even if they may the United Nations. This distinction is especially disagree on reproductive rights. The same is true of important to keep in mind because the laity, a right to health and the more difficult issues of theologians, and the bishops at large have no reproductive health, safe motherhood, abortion, and meaningful voice or vote on the selection of the sexual health. pope and the policies of the Holy See. Therefore, a truly Catholic position on a particular issue must One of these difficult issues turned on the take into account not only the official position of the definition of "family." As Cairo sought a Holy See, but also the way this position is received comprehensive definition, the Vatican feared that a and lived out in the body of believers. This widely consequence of so broad a definition would be the accepted approach insists that Catholic teaching is validation of homosexual unions. made up of two entities: the teaching hierarchy (pope, cardinals, and bishops) and the teaching of The Vatican became most adamant over the the laity - the sensus fidelium. issue of abortion. It finds abortion and contraception immoral in every circumstance. It rightly opposes coercive use of these methods. For all these reasons, the strong Vatican Delegates at Cairo agreed with the need to end rejection of major items in the Cairo document was coercion but also believed that people should be puzzling and disappointing. The Vatican has every informed of all these choices. The Programme of right to state its reservations. The difficulty many Action leaves to religions and conscience the experienced with the Vatican's position derived from dialogue about whether particular individuals or its unwillingness to enter the process of discussion traditions should choose among the options they are CATHOLICS FOR A FREE CHOICE 3 given. In a world climate in which choices seen as While it is written from a Catholic perspective, moral by one side are branded as immoral by the we hope this article will be of use and interest to other, the Cairo Conference had no other way to readers from other religious, ethical, or philosophical proceed. traditions. And by no means does our analysis pretend to be exclusive: Cairo's vision reflects the The articulation of moral choices should never values of many belief systems. be so absolute that they have no reference to the real situations in which people live. Catholic theology PART 1 and teaching have always affirmed the right of AREAS OF AGREEMENT: SHARED conscience and contextualized moral choices. Cairo PRINCIPLES did insist that where reproductive health is concerned, all legal options open to the individual The Vatican claimed that the Programme of Action should be safe and people should be informed fully lacked an ethical framework and was the work of about the consequences of deciding one way or the aggressive Western feminists: "One of the principal other. concerns of the Delegation of the Holy See regarding the Draft Final Document is its lack of a CATHOLICS AND CAIRO clear ethical vision."i The document that the Vatican so soundly excoriated, however, is actually Cairo, in many ways, is a universal declaration of remarkable for its principles and values values human rights applied to population, sexuality, and forged and agreed to by over 180 nations from women's lives. Had the document been cast in the around the world and clearly articulated in chapter narrow terms the Vatican demanded, it would have two of the Programme of Action. divided and splintered the world community. A new language of shared values needed to be formulated, a The principles, the foundation for the language of universal rights and responsibilities. The Programme of Action, are consistent with Catholic agency to speak that language, the United Nations, values - especially as they relate to population and gained the world's confidence more readily than the development - reflecting how much the Catholic respected but sometimes ideological voice of the church has in common with the global community. Vatican. These principles are the legacy of Cairo. Regardless of what happens with regard to proposed actions or The debates at Cairo made it clear that in many financial commitments, the principles are critical to moments, the Vatican and the global community the development of a common language of values. frequently spoke with the same voice. The Vatican, And despite initial appearances to the contrary, the however, often declared its position on the more Vatican and those supporting reproductive rights do controversial issues as definitive, neither inviting nor agree on these values. allowing participation or nuance in order to achieve consensus. The United Nations cannot adopt a PRINCIPLE 1: language of ethics and values that the human family UNIVERSALITY OF HUMAN RIGHTS at large neither understands nor accepts. If people Following the United Nations tradition of support are fundamentally reliable, then open debate, for human rights, the Programme of Action includes accommodation, and global consensus may offer us strong support for individual rights. Catholic our best hope for choices that are moral, profoundly endorsement of the fundamental vocabulary of human, and irresistibly fair. human rights moved forward dramatically as social justice documents and the Declaration on Religious For the purposes of this article and to help Freedom from Vatican II were adopted in the 1960s. clarify the distinction between the official and the Since then, the church has become an international living church, the terms "Holy See," "Vatican," and advocate for human rights, even though, like many "delegation" are used to represent church other political and religious bodies, it has a mixed governance. The terms "church," "church record in this area. teachings," and "church tradition" are used to represent a broader definition of Catholicism, to Catholic support for human rights - such as include the laity, theologians, and the hierarchy. bodily integrity, right to life, and right to health - is linked to the value placed on human dignity by the church, biblically grounded in the creation of human CATHOLICS FOR A FREE CHOICE 4 beings in the image of God (Gn 1:26) and the spirit of resisting development is incalculable and of Christ (In 1). These rights are human, therefore unconscionable. universal, and transcend boundaries of gender, race, religion, and nations. However, while the church The Catholic social justice tradition and upholds the universality of human rights, its record preferential option for the poor provide a basis for on women's rights is varied. the church's teaching on development. The church maintains that industrialized nations should assist, Within the international community there is a through technology transfer and debt forgiveness, debate over the universality of human rights. In this the developing world's ability to use its resources for debate, the Vatican agrees with human rights its own development. In particular, John Paul II has organizations that a core group of human rights are criticized both capitalism and socialism for universal because of our common human dignity neglecting to put human needs and the common and should be freely exercised independent of the good above material profit. current political, cultural, or economic atmosphere of a particular location. The other side of the debate PRINCIPLE 5: POPULATION-RELATED GOALS argues that human rights are not necessarily Although often perceived as unwilling to universal and indeed are culturally conditioned. In acknowledge problems caused by rates of population this way "culture" has often been used to defend growth, the church does consider hunger and other human rights abuses and to prevent the developmental problems to be exacerbated by implementation of development programs. population growth. Indeed, the Second Vatican While the church teaches that preservation of Council insisted that parenthood be exercised culture is an important consideration in any global responsibly. Parents who bring children into the mandate, it insists that culture is not an absolute world recklessly and thoughtlessly are censured. At value that justifies everything from the oppression of issue is not limiting births or determining family size, women to the bondage of children and genocide. which the Vatican accepts, but the means by which The Jewish prophets and Jesus himself exemplified this limitation is achieved. the Christian belief that people of good will often resist aspects of their own cultural heritage. PRINCIPLE 6: SUSTAINABLE DEVELOPMENT Because developing countries were able to voice PRINCIPLE 2: PEOPLE AS CENTRAL their concerns over sustainable development at CONCERN OF DEVELOPMENT Cairo, a larger recognition of the overconsumption The true measure of development, according to both of developed countries was written into the the Programme of Action and the church, is whether Programme of Action. This principle is also seen in it meets people's human needs and aspirations and the church belief that developed countries must whether it does so in accord with their human dignity. eliminate their overconsumption as a way to maintain sustainability and to achieve responsible Development policies have at times been the stewardship. subject of serious criticism by faith-based organizations, including both official and The Catholic church supports consideration of independent Catholic groups. Development policy environmental concerns in development policy. For has often been focused solely on economic rather many centuries, the church, prompted by Scripture, than human development. In contrast, delegates at principally Genesis, believed that domination of the Cairo reaffirmed the emerging global consensus that earth by people was God's will. To its credit, the people's lives, not markets or production, should be church has begun to appreciate the vital the central concern of all development policies. interrelationship among human beings, other forms of life on the planet, and the planet itself. Now the PRINCIPLE 3: RIGHT TO DEVELOPMENT church sees the world itself as a sacrament, namely a The United States President's Council on Sustainable reality endowed with the presence of God and with Development notes that people in developed grace. There remain those in the Catholic countries only 20 percent of the world's community who fear that ecological spirituality may population - consume 85 percent of the world's lead to pantheism. This hesitancy has not prevented resources. In light of this observation, we are made popes from speaking bravely about an ecological aware that we can do better and that the human cost crisis, our common environmental responsibility, CATHOLICS FOR A FREE CHOICE 5 and the need to impose limits on human domination experts prior to Cairo to address this subject: and overconsumption of natural resources. prostitution of children in Bangkok, Thailand (1992); child labor in Manila, Philippines (1993); and street PRINCIPLE 7: ERADICATING POVERTY children in Rio de Janeiro, Brazil (1994). The Programme of Action's focus on eradicating poverty and the special attention it gives to the However, it is important not to overstate the neediest of poor countries is an important aspect of hierarchy's support of children's rights. While the the Cairo consensus for Catholics. Cairo is church often speaks and acts on behalf of the well- consistent with church teachings on the preferential being of children, it defines children's rights as option for the poor and economic justice for all in almost exclusively derivative of parental rights. insisting that "special priority" be given to the least Furthermore, the Vatican is more likely to support developed nations of the world. parental rights over children's rights, as further recognition of the patriarchal family unit. Parents It has been observed that poverty imposes have a primary right to educate and raise their imperatives on the affluent. Jesus makes it quite children, but it is not an absolute or exclusive right, clear that neglect of the poor is neglect of God. The such as prevails in some cultures where children are Catholic tradition resonates with this teaching, from defined as property. Society at large and the church the medieval legends of the poor as saints and of must establish and affirm children's rights when God disguised in poverty to modern proclamations parents violate or neglect them. of a preferential option for the poor. Indeed, the Catholic church is often seen as the church of the PRINCIPLE 12: MIGRANT RIGHTS masses, the poor, and the workers. The Programme of Action acknowledges that migrants often have the least access to resources and There are different ways of addressing poverty; services provided in development plans and calls on sometimes the least effective, but by no means countries to guarantee fundamental human rights to inconsequential, is charity and alms giving. On a all migrants. The church's record here has been deeper level, however, the church calls for the impressive and effective. The church has organized transformation of structures that create poverty. On and spoken on behalf of migrants. It has often the deepest level of all, the poor must be addressed demanded that nations support immigrant and as equal in dignity to those who are affluent. On migrant populations by not only considering them as this, the church and Cairo agree. workers, but also respecting their cultural identity. The church has offered migrants pastoral service, PRINCIPLE 10: RIGHT TO EDUCATION and through the pope and national conferences of In Cairo, education was emphasized as the means to bishops has acted as their advocate before the world the full development of human resources. community. In fact, on the issue of migrant rights, Traditionally, girls and women have not been given the church and United Nations are more in equal access to educational opportunities. agreement with each other than with developed Investment in education is critical to the nations. empowerment of women and the achievement of their human rights. PRINCIPLE 13: RIGHT TO ASYLUM Cairo explicitly calls on nations to grant protection Catholic teachings support the importance of for refugees escaping persecution. This stance is education. From monasteries to universities, the well in line with church tradition, which condemns church has been a pioneer in educating people in political and religious persecution and urges nations their spiritual and social responsibilities. to provide asylum for those in exile as a duty of the common good. In fact, church buildings have PRINCIPLE 11: CHILDREN AS A PRIORITY traditionally been sanctuaries for the persecuted. Cairo maintained children's rights to standards of The church at large, sometimes selectively, has living and adequate health care, as well as the right to offered protection to the vulnerable. be protected from injury and exploitation. The church protects children as innocents. The church PRINCIPLE 14: INDIGENOUS RIGHTS was so concerned with the injustices perpetrated In the past, the church has in many instances against children that the Pontifical Council for the favored evangelization and cultural transformation Family organized three international meetings of over the preservation of indigenous identities. CATHOLICS FOR A FREE CHOICE 6 History tells how colonization of indigenous people proposing language or lending force to the many by Western powers was often accompanied by the other issues discussed at the Cairo Conference and imposition of Christianity. The church, however, important to Catholics. has recently been more sensitive to indigenous traditions. Nonetheless, it is disappointing that In the end the Vatican joined the global national church leaders, speaking on behalf of their consensus on the Programme of Action as a whole, own people, have not been sufficiently heard by the but placed reservations on the following list of Vatican. Indigenous rights are not only the rights of specific phrases: indigenous minorities. The church cannot be truly incarnated in a culture unless it takes on the contraception character of that culture. If the church appears as an couples and individuals alien presence in the culture, it will not reach the family planning people there on a profound level or in an authentic reproductive health way. reproductive rights PRINCIPLE 15: sexual health DEVELOPMENT RESPONSIBILITIES sexual rights The final principle agreed to in Cairo addresses the widest range of family-planning services need for all nations to take responsibility in assisting women's ability to control their own fertility global development while acknowledging that each nation has its own needs, capabilities, and The Holy See also placed general reservations responsibilities. It also states a special obligation of on eight of the sixteen chapters: "Reproductive more developed countries to advance set agendas Rights and Reproductive Health"; "Health, and to maintain sustainable levels of growth. The Morbidity, and Mortality"; "Population, church has historically been sensitive to the diversity Development, and Education"; "Technology, of nations in regard to population and development Research, and Development"; "National Action"; strategy, and it has put pressure on the North to "International Cooperation"; "Partnership with the contribute to the equitable development of the Non-Governmental Sector"; and "Follow-up to the South. Conference." PART 2 Cairo, of course, did not detail ethical values as AREAS OF DEBATE: WOMEN, a religious tradition would detail them. It could not HEALTH, AND FAMILY do this, given the diversity of its constituency. It did, however, search for a common, global ethic based When the United Nations produces an international on human rights and responsibilities. Cairo afforded document such as Cairo's Programme of Action, its an opportunity for the Holy See to make its points goal is to secure the support of as many nations as regarding the importance of human dignity in possible. Thus, it provides an extensive drafting population policy. The Holy See might have done process aimed at achieving consensus, with many this more convincingly by affirming more forcefully versions of a document and numerous preparatory the many positive features in this document and by meetings -- with considerable input by engaging in a constructive dialogue with the world nongovernmental organizations to discuss on the complex issues of reproduction and sexuality. objectives. A government delegation objecting to any part of the document may have a section, The Holy See delegation's concerns over three phrase, or word placed in brackets for further debate principles in the Programme of Action - women's and possible deletion. During the Cairo process the human rights, the right to health, and the definition Holy See and a handful of other nations- including of family - led to reservations on a number of Cairo Argentina, Benin, Guatemala, Honduras, Malta, objectives. Disagreement was over application, as Morocco, and Nicaragua- bracketed most language the church has historically supported all three of referring to reproductive rights, sexuality education, these principles. However, a gap exists between abortion, contraception, the definition of family, and what the Vatican said at Cairo and what Catholic safe motherhood. In fact, the Vatican focused most tradition allowed the Vatican to say. In reality, of its energy at Cairo on objecting to the existing official church statements could have been brought consensus on reproduction and sexuality rather than CATHOLICS FOR A FREE CHOICE 7 to bear to support the United Nations positions on Catholic support for women's rights comes women, health, and family. from the biblical tradition of gender equality. Theologians, men and women, working within the PRINCIPLE 4: WOMEN'S HUMAN RIGHTS Catholic tradition have rediscovered the role of As part of the new development paradigm created at women in Scripture and early tradition and have Cairo, women's human rights were supported as a found it to be more open, creative, and decisive than principal goal. Prior to Cairo, women's lives were current Vatican policy. Scripture begins, in the first not always treated with dignity and respect in chapter of Genesis, with the grand theme of gender population policies; women were often considered equality in the creation account. Not only is there only in terms of their reproductive capacity, and no subordination of women, there is indeed a radical their aspirations and needs were made secondary to gender equality. The Christian Scriptures present to demographic outcomes. us the startling ease that Jesus has in bringing women into a discipleship of equals. The greatest of While the church has a strong record of all messages about Christ, the Easter experience, is speaking in support of human dignity and objecting borne by a woman who becomes the apostle to the to human rights abuses, its record on women's apostles and, indeed, their teacher. Paul readily human rights is ambiguous. It is not that church speaks of the prominent role women play in the teachings do not support gender equity or the dignity creation of the early church: Women are appointed of women, but that the Vatican has shown itself to as deacons, coworkers, and even apostles (Romans hold a limited understanding of women's human 16). rights, and in particular, the ability of women to control their own fertility. This discrepancy between the statements of the Holy See delegation at Cairo and church teachings is The Holy See is careful never to assert illuminated by the delegation's criticism of two areas women's equality with men without a qualifier, of the Programme of Action: empowerment of usually the notion of "women's special dignity." In women and reproductive rights. the Vatican's worldview, men are the normative human beings and women are understood primarily EMPOWERMENT Of Women in terms of their reproductive and mothering Cairo's focus on the empowerment of women is a capacities. What seems to be a laudable principle culmination of decades of progress in the field of women's dignity -- actually circumscribes women's population and development, accelerated as women options and equality. No such assumption is ever entered the international dialogue and research made with regard to men, whose dignity is presumed showed that women's status was a factor in family simply to stem from their humanity.iii size and efficacy of development programs. The Programme of Action was the first United Nations When the Vatican addresses rights for women, document on population that explicitly recognized they are more often rights to be protected through the importance of women's rights as a crucial factor the agency of others. They are not political, social, in development and indeed, as a worthy goal in itself. or economic rights through which women Cairo declared that development policies should not themselves exercise power as autonomous moral center on controlling women's fertility, but on agents. And while the Vatican does support the empowering women to make decisions about their universality of human rights, a division exists own reproduction. This empowerment could be between the Vatican and women's human rights advanced by ensuring access to information and advocates over the question of what a human right resources and providing social, political, and is. In the case of human rights dealing with economic conditions that favor autonomous reproductive health, sexuality, and women's decision making. empowerment, the Vatican holds that Western feminists, among others, are attempting to establish The Vatican and even Pope John Paul II "new" rights. In reality, Cairo sought not so much himself have spoken of women's empowerment and an expansion of human rights but an expansion of call for the support of women in their dual roles as what the global community means when it says mother and part of the labor force. But this very human rights. positive view of women in the public sphere is presented with an emphasis on the woman's role as mother. "The true advancement of women requires CATHOLICS FOR A FREE CHOICE 8 that labour should be structured in such a way that rights as an integral aspect of human rights. women do not have to pay for their advancement by According to the Programme of Action, abandoning what is specific to them and at the reproductive rights are grounded in previously expense of the family, in which women as mothers recognized human rights, such as the right to bodily have an irreplaceable role."iv integrity and nondiscrimination, and specifically the right to decide freely the number and spacing of Vatican support of the economic children and reproductive autonomy a right first empowerment of women demurs when this recognized in 1968 at the International Conference empowerment leads women to a sense of their on Human Rights in Teheran, Iran." sexual and reproductive options. As the Catholic tradition developed, men were made the norm for The Vatican objected at Cairo to the human experience, and women far too readily were Programme of Action's treatment of reproductive defined in church teachings in terms of their rights, choosing this moment to invoke the reproductive and maternal capacities. In this preservation of culture and tradition and proclaiming scenario, little accrues to women simply because they the danger of establishing "new fundamental human are human More often, women are praised when rights."vi However, Catholic teachings supply many they are submissive, when they are mothers, and elements that support reproductive rights, primarily when they serve the needs of men or their children. the church tradition advocating for the universality Within this framework, the Vatican sees the exercise of human rights. The Vatican recognizes that human of women's human rights as threatening the dignity is tied to the ability to exercise free will and traditional family unit. individual conscience. In the contemporary world, religions gain credibility and become persuasive And although the church has spoken of the when they recognize the importance of free will, contributions women can make in the public forum, allow alternatives, and then guide or persuade people this belief does not extend to the role of women in by appealing to their highest motives. the church. Actions speak more clearly than words. No woman is ordained in the Catholic church. The There is something demeaning and morally governing structure of the Holy See includes no offensive about putting burdens on women without women in decision- or policy-making roles and no allowing them a voice and a vote about their own women in the church's pivotal electoral body, the lives and the consequences they may be asked to College of Cardinals. There is no requirement that endure. Women at large must be trusted to be women be consulted regarding the development or concerned about life issues and to make responsible content of Vatican documents and no indication that decisions. Political participation, equality in the such consultation occurs voluntarily except in very workplace, protection from violence all rights limited and rare examples. Official church policies supported by the Vatican cannot be addressed prohibiting important forms of women's without first affirming women's moral capacity and participation in the church make it difficult for integrity. Women cannot be expected to make people to believe that the church is committed to decisions freely outside the home if society or the gender equality. The fact that these policies of church preempts their personal decision making exclusion are difficult, if not impossible, to derive concerning the reproductive activity of their bodies. from Scripture or tradition further weakens the Vatican's position. Church teachings on the common good and justice show us that we cannot achieve moral order We cannot expect an all-too-human church to if individuals are coerced or repressed. Because be centuries ahead of the cultural development of women in the church have been excluded from gender equality. It is unpardonable, however, when defining elements of the common good, the church seems to be behind, or worse, when it reproductive rights have not been adequately resists such development. addressed in the Catholic church. Women, indeed all people, do best in dialogue, not when they are REPRODUCTIVE Rights asked only to take dictation. The Vatican has recently been supportive of rights of women in society, but it continues to try to deny It is telling that the Vatican chose this moment women reproductive rights. Cairo went beyond in the Cairo negotiations to argue for cultural defining reproductive health to affirm reproductive preservation. It argued, for example, that access to CATHOLICS FOR A FREE CHOICE 9 contraception and legal abortion are staunchly and sexual health is noncontroversial, such as opposed in other cultures and that democracy does prenatal, postnatal, and maternal health care and not suit the culture of the Vatican. This may be true, treatment for those affected with HIV. However, but it raises the question of who defines this culture. even this section of the Programme of Action Such "sensitivity" to culture is not evident when the provoked numerous objections on the part of the culture of women, for example, is at issue or when Vatican. cultures that strongly support contraception and legal abortion are denied these options because they In addition to the church's strong support of do not adhere to the Vatican view of acceptable health as a fundamental human right, Catholic health public policy. care is guided by the tradition of treating the whole person, recognizing that separating the body from There is a tendency to criticize Western culture the soul or treating only one aspect is not the best as too feminist and to favor more traditional method of promoting overall health. Yet church alternatives. However, when African and Asian leadership over and again singles out reproductive bishops ask for different attitudes on the position of health and attempts IO limit services and information the Vatican, as they did in recent synods at Rome, available for this aspect of health. For women, they are not heard. When women of the South and reproductive health is central to overall health. At East spoke to delegates on the importance of some point, women are placed in bondage to reproductive rights and health, their positions were reproduction and biology if only periodic abstinence dismissed. Culture has been invoked to silence the ("natural family planning") is tolerated. voices of women in the dialogue on reproductive rights. Surely those who have most at stake in every To tell the world that "natural family planning" pregnancy should be allowed a decisive voice and is the only means by which pregnancies may be choice on their own behalf. avoided - as the Vatican does - is to speak with an ineffective voice. The world knows that such PRINCIPLE 8: RIGHT TO HEALTH teaching is rejected by a virtual unanimity of Catholic The church's support of the right to health has couples and by the vast majority of Catholic biblical grounding in the healing tradition of Christ. theologians. The historical record shows that all the A "right to medical care" is established in the 1963 cardinalatial and episcopal committees formed by encyclical Pacem in Terris, and the Catechism of the the popes to deal with this issue recommended a Catholic Church places the burden of respecting health change in church teaching and the acceptance of on all of society. Pope John Paul II often calls upon artificial contraception as a moral option. The nations to provide health care to all citizens as a prohibition of artificial contraception is not so much basic economic right necessary for human dignity. church teaching as it is papal teaching. By acknowledging the universality of the right to health care, the Catholic church is acknowledging Furthermore, Catholic teaching on responsible the need for health care to be independent of parenthood strongly rejects coercion by any group or geography, language, ethnicity, gender, or religion. individual attempting to restrain couples from making responsible decisions about procreation. While the church asserts the right to health as a Denying access to information about certain options fundamental right, absolutely necessary for human was perceived by many in the global community as dignity, the Vatican does not support health when morally and practically coercive, especially when applied to reproduction and sexuality, as clearly access and information are denied to those who are demonstrated in the Holy See's objections to the not Catholic or those whose consciences tell them sections on reproductive health, safe motherhood, that contraception is a moral choice. In any case, abortion, sexual health, and sexuality education for even according to church teachings, without options adolescents as agreed to at Cairo. At issue was how one cannot act morally. The Vatican remains free to to specify and define health. address and influence the consciences of people by moral suasion. The world community objects, REPRODUCTIVE HEALTH however, to efforts to eliminate access to artificial Cairo's Programme of Action was the first United contraception, sterilization, and abortion completely Nations document to explicitly define reproductive with legal force and punishment. health. Much of the language included in the recommended actions for obtaining reproductive CATHOLICS FOR A FREE CHOICE 10 SAFE MOTHERHOOD contraceptives became more available over a thirty- The Vatican bracketed the term "safe motherhood" year period, abortion rates fell from over 60 per in the Draft Programme of Action and objected to 1,000 women aged 15 to 44 in the 1950s to under 40 its use at the Cairo Conference. Its opposition to per 1,000 in the 1980s.* One of the best ways to the term, the Vatican delegation said, was based on a reduce recourse to abortion is through access to a fear that inclusion of the term would open the door range of effective contraceptive options. for abortion. vii But "safe motherhood," by definition, covers many services and programs that Even taking into account Vatican opposition to the church unequivocally supports, including efforts abortion, we remain puzzled about why the Vatican to improve women's health in pregnancy through objects to abortion being safe where legal. "There is prenatal care and nutrition. no such thing as a 'safe' abortion: Whether legal or not, abortion is lethal for the child and destructive of All women face risks in pregnancy and the mother and society," declared the US cardinals childbearing. Poor women face especially high risks. before the Cairo Conference. This dismissal of safe For example, Bolivia, the poorest country in South abortion by the hierarchy is insensitive to the America, has a maternal mortality rate of 600 per realities women face and to the number of women 100,000 live births,viii compared with 12 per 100,000 who die from unsafe abortions every day. in the United States.ix Because women everywhere resort to abortion, The Vatican delegation's decision to reject the the alternative to safe abortion, of course, is unsafe term "safe motherhood" outright, without any abortion. Again, it is the hierarchy's preoccupation attempt to make a distinction between its acceptance with eliminating abortion from the world that of the components it supports and its resistance to prevents the real issues of justice and health for abortion without exception, led to an inconsistent women from being addressed. Such an absolutist position on motherhood. All women's lives are position fails to acknowledge the ambiguity and defensible, and it is disingenuous for the church to doubt regarding fetal life and ignores the moral claim to defend life while simultaneously opposing complexities surrounding each situation. measures necessary to save women's lives. The Vatican's refusal to support safe motherhood at While the legal status of abortion appears to Cairo gave the impression that a woman's health is have relatively little connection to its overall secondary to her reproductive functions. pervasiveness in a country, it does influence the safety of conditions under which the procedure must ABORTION be performed. Illegal abortion is associated with a Despite much talk about the issue, the Programme high incidence of maternal death and disability. For of Action principally deals with abortion in one example, while Mexico and United States have paragraph, which makes four major statements: similar abortion rates, maternal deaths per 100,000 abortion should not be promoted as a live births are almost ten times higher in Mexico, method of family planning; where abortion is illegal.xi incidence of abortion should be reduced through access to family planning services; In countries where abortion is illegal, it is the abortion should be safe where legal; and poor who are left to face abortions under the worst where illegal, the consequences of types of conditions. And in countries where illegal/unsafe abortions should be addressed. abortion is legal, but safe abortions are costly, it is During Cairo, the Vatican objected to all but again poor women who shoulder the burden. The the first. church tradition of a preferential option for the poor has been interpreted by many Catholics to support Abortion is a complex moral and social issue the safety of abortion and to oppose unsafe potential mothers know this best. However, the abortions when safe options are available. It is Vatican's position on abortion is compromised by its possible to be opposed to abortion without unwillingness to accept contraceptive services and supporting unsafe procedures; concern for public devices even though they reduce abortions by safety is not the same as moral endorsement. diminishing the number of unwanted pregnancies. For example, according to the Alan Guttmacher Despite Vatican disapproval, the Cairo Institute, data from Hungary show that as Conference was right to address the catastrophic CATHOLICS FOR A FREE CHOICE 11 health consequences for women of unsafe abortion. temptresses. Celibacy is protected, admired, and Mercy requires that we eliminate pain whenever rewarded by special privileges in the church. possible; justice demands that we do not abandon Holiness is equated with abstinence. In the Council poor women or women in need of help. of Trent (1545-1563), the church at its highest level of authority condemned and censured anyone who SEXUAL HEALTH dared to say celibacy is not superior to marriage. Cairo acknowledged the link between sexuality and gender relations, affirming that relationships The Vatican's views on sexuality translate into between partners have profound consequences for an isolation in church policy of sexual health from sexual health and behavior. The Vatican, in other forms of mental and physical health, which has response, accused the Programme of Action of real impact on human lives. This impact is most "promoting a self-centered and casual view of conspicuous in the Vatican's treatment of human sexuality, an approach so destructive of HIV/AIDS. Forbidding the use of condoms when family life and the moral fiber of society."xi In one partner is already infected is an irresponsible Catholicism, a long tradition of aversion to sexuality application of church teachings on contraception. is the root of current Vatican conservatism on reproduction and women. Despite recent attempts Realizing the impracticality of the Vatican's to expunge this historical antipathy, church teachings position on condoms, the French bishops in 1996 often continue to reflect its influence. presented a 235-page document on AIDS acknowledging the usefulness of condoms in Until Vatican II, pleasure was rarely, if ever, preventing the spread of HIV. The use of a linked to sex in a positive way by the church. Sex condom, the bishops said, "can be understood in the was often presented as a necessary evil and is termed case of people for whom sexual activity is an such by church teachers such as St. Augustine. The ingrained part of their lifestyle and for whom [that purpose of sex was procreation, not pleasure or even activity] represents a serious risk."xiv relationship. For more than a thousand years, the church taught the superiority of sexless marriages An escalating chorus of voices from recent and urged all married priests to reject sex with their official church teachings, theologians, and laity wives and to refuse to conceive children. supports positive views of human sexuality. Spirituality and sexuality are seen today as linked. Today, the Vatican's suspicion of sexuality The celebration of our bodies and sexuality brings us persists. Part of this mistrust is based on amnesia spiritual awareness and even love itself. Human concerning biblical references to sexual pleasure as a sexuality is seen as committing each person to value in its own right. A preeminent example of this concern for the other or else it forfeits its human tradition is the Song of Songs. In this most frank and virtuous content. Sexuality, like love, should be and erotic of all biblical books, sexual pleasure sensitive, considerate, generous, compassionate, and between lovers and spouses is celebrated. In concerned. Christianity insists that we love our addition, one of the overriding images of God's love neighbors as ourselves. This principle is expected to for the human family in both testaments is the govern our sexual relationships. relationship between the bridegroom and bride. Jesus has been misinterpreted by some as hostile to Furthermore, in the sometimes less-than-ideal pleasure. In reality, Jesus says little about sex but is lives people must live, differing levels of tolerance, deeply troubled by power and authoritarianism. The compassion, and resiliency matter. By denying the church's suspicions of sexual pleasure and its sexual or reproductive realities and needs of people, negative judgment about it do not derive from the the church cannot effectively heal lives. Bible. They emerge from second- and third-century Greco-Roman ideas about pleasure and pain, ideas ADOLESCENTS AND SEXUALITY EDUCATION that the mind needs to control the body and that During the Cairo Conference, the Vatican accused pleasure or emotions are less human or less the Programme of Action of accepting "almost as an acceptable than cognitive life. unrestricted right, that each individual including adolescents from an early age, may be 'sexually Female sexuality, in particular, was and is often active."xv In reality, the Programme of Action viewed negatively by the church. Women are blamed balances the needs of adolescents for access to for men's sexual desires and presented as services and information on sexuality and CATHOLICS FOR A FREE CHOICE 12 reproduction with the rights and duties of parents as a "domestic church," a "privileged community," and other adults to provide needed guidance and and "the original cell of social life."xvii Indeed, direction to maturing young people, calling on society is always most stable when families are secure societies to promote mutually respectful and and when governments invest resources in them. equitable gender relations and to provide education But while both the Vatican and the Programme of and services in order to deal with sexuality positively Action concur that family is important, their and responsibly. definitions of what constitutes a family differ. Instruction in sexuality must, of course, fit with Cairo acknowledged a wide spectrum of the age and condition of the person to be instructed. families, reflecting the global reality of diverse family The intent should not be information only but structures. In contrast, the Vatican objected to the formation of a responsible conscience and sensitivity diverse characterization of families in the to the lives of others. Programme of Action out of fear that this diversity would threaten the patriarchal system that the Paralleling the Vatican's difficulty in affirming church has supported and encouraged throughout women as moral agents, there is only limited support the twentieth century. By using "families" instead of of adolescent sexuality in Catholic teaching. When it "family," the Holy See delegation believed Cairo is mentioned, the duty of educating adolescents on would establish "a formula which would recognize the issue of sexuality rests with the parents. all free unions, homosexual couples, etc. as equiparated with the family."xviii Envisioning a "real The Vatican is concerned that too much family"xix as only a husband, a wife, and children, the knowledge too soon, sexual information offered Vatican lobbied to include language giving special with no value orientation, and contraceptives made protection to this configuration of a family and in too readily available will be seen as tacit the end officially entered a reservation to the use of endorsement for irresponsible sexual behavior. "couples and individuals." These points could be made without discouraging the benefits of sexuality education. Adolescents deal In reality, family diversity has existed with issues of sexuality every day. The church's throughout human and biblical history. In biblical policy of abstinence before marriage does not times, there were several perspectives on the family, address the realities of adolescent lives or respect none of which readily corresponds to the modern their capacity to make meaningful decisions about nuclear family. In the Hebrew Scriptures, patriarchy their sexuality. Abstinence should be encouraged, prevailed as well as polygamy, men were allowed but not without information about alternatives, even concubines, and wives could be dismissed for even if they are less than ideal. trivial reasons. In Matthew 19, Jesus objects strongly to this patriarchal model, especially when it allows a While Cairo was concerned with the possible man to divorce a woman because she is property and and the practical, the Vatican insisted on abstract forbids a woman to divorce a man on the same moral imperatives, which led it once again to grounds. become an obstacle to the global community's consensus. Family structure is not set by nature but reflects the culture and economy in which it is embedded. A PRINCIPLE 9: DEFINING FAMILY male-dominated nuclear family, consisting of a During the Cairo drafting process, John Paul II told working husband, a wife who works in the home, pilgrims in Vatican City that the United Nations was and several completely dependent children, is a attempting to destroy families: "I am going back to relatively recent development in history. Cairo, in the Vatican to combat a project prepared by the suggesting that diversity reflects current realities and United Nations, which want to destroy the aspirations, is making a statement that has always family."xvi Despite the pope's early characterization been true. Out of fear that the Programme of of the Cairo Conference, the Programme of Action Action would be interpreted as endorsing same-sex clearly supports families in significant ways. marriage, the Vatican failed to acknowledge that Catholic tradition supports and affirms diverse Principle 9 names the family as the basic unit of family forms such as extended families, society and calls for its protection on these grounds. multigenerational families, families without children, The Catechism of the Catholic Church refers to the family CATHOLICS FOR A FREE CHOICE 13 and other constructs of family that embody love and We are amazed at how impressive church acceptance. rhetoric is and how often it resonates with the global consensus. There is no reason not to conclude that There are some who observe that the Holy See the rhetoric is genuine and that it springs from a has not always matched its performance on family profound belief in what is being said. life with its rhetoric. Marriages were dissolved in the Nonetheless, the consequences and practice past so that one partner might enter formal religious that the world community expect to flow from such life. Annulments are granted today to one spouse or rhetoric do not follow in the Catholic church. The parent over the staunch objections of the other. strong statements on the equality of women are And although the Holy See speaks beautifully of difficult to reconcile with the marginalization of marriage, it continues to insist that celibacy is a women in decision-making structures in the Catholic superior state of life. It punishes priests who marry church and their absence from key Vatican offices with exclusion from ministry; it does not, as a matter and, of course, from the priesthood. The ringing of course, allow married people to be ordained. words about parents rather than the state determining the number of their children and the REFLECTION: CONSCIENCE AND CONSENSUS appeal that parents should follow their consciences Catholicism, despite appearances to the contrary, in doing so do not fit in easily with the rejection by has a profound sense that rules are not rigid. Some the official church of the overwhelming number of of this sense comes from the New Testament Catholic parents who believe in conscience that resistance to law; some comes from the dynamics of artificial contraception can be a moral choice in canon law, which readily builds exceptions into the structuring their families. The statements about the system; and some comes from a strong investment sacredness and sacramental character of sexual love in forgiveness and reconciliation. All this protects are inconsistent with the denial of sexual love to church teaching and practice from many of the church leaders. rigidities of fundamentalism and biblical literalism. This inconsistency happens, we believe, One of the hallmarks of Catholic moral because the Vatican has been unwilling to admit that teaching has been its capacity for nuance. Catholic it sometimes makes mistakes, that it has sometimes tradition speaks with vigor about principles in the misled, and that substantive change is possible in the public forum but encourages latitude in pastoral system. The Vatican and the Catholic church have practice. To appreciate the full range of Catholic impressive power and resources. An admission of teaching one must take into account not only the errors made in good faith in the past cannot articulation of the principle but also the way the destabilize the credibility of such an institution. A principle is lived out in practice. willingness to state, furthermore, that the world has impressive moral wisdom of its own in no way For Catholics, conscience is always the court of makes the Catholic church a less welcome last appeal in moral decisions. According to the participant in the global dialogue. Catechism of the Catholic Church, "a human being must Morality can at times become the tool of a always obey the certain judgement of his political program rather than a principle of rights conscience."x Even though the official church and truth. Sexual norms are sometimes formulated seeks to qualify conscience with such words as not to illuminate the ethical content of the choices "informed" or "right," it nonetheless allows that an people make but to legitimate the denial or objectively wrong action is a virtue if those who restriction of personhood for those who defy a perform it are convinced in conscience they are convention. To sanction torture in the rooting out doing good. One of the most influential church of heresy is to establish the overriding claims of thinkers, St. Thomas Aquinas, said that it would be orthodoxy. To forbid all sexual activity to better to be excommunicated than to act in a way homosexuals is to promote the exclusive claims and that contradicted conscience.xxi value of heterosexuality. To deny all contraception is to insist that pleasure and relationship must always Given this tradition, why does the official be subordinate to reproduction. All these have been church so often become rigid and ideological? More taught by the Vatican. specifically, why were resiliency and consensus so difficult for the Vatican during Cairo? The Vatican declares that access to abortion, contraception, or the use of condoms is never CATHOLICS FOR A FREE CHOICE 14 permissible. These positions are rigidly held and For example, the Universal Declaration of admit no exceptions. Thus abortion is not permitted Human Rights declared, in 1948, that adult men and even in cases of incest, rape, a seriously deformed women had a right to marry and to found a family fetus, or risk to the life of the mother. and, indeed, that they had equal rights in entering Contraception is prohibited even for women who and dissolving a marriage. There was tension have had so many births that another would imperil between the world community and the Catholic their health or lives. Condom use is condemned church on the question of divorce. Yet then, as even to save one's partner from AIDS. Assisted now, there was a basis for dialogue. Article 16 of the reproduction is rejected even if done to correct a Declaration goes on to use language echoing biological defect. At Cairo, such positions dominated Catholic documents that the "family is the natural the Vatican's diplomacy and eclipsed all other and fundamental" basis of society and that it is manner of church teaching and discourse. "entitled to protection by society and the State." The Catholic community at large and indeed In the past fifty years, Catholics and sometimes the pastoral and theological communities take the official church as well have moved closer to the different positions on all these issues. One finds United Nations' position. In 1948, for example, the substantial latitude in the behavior and beliefs of church taught that celibacy was superior to marriage Catholics, in the pastoral practice of priests, and in and asked many of its members to give up their right the teachings and analysis of Catholic theologians. to marry and found a family. In 1948, Catholics responded favorably; now, they do not. Fifty years The Vatican position at Cairo reflected papal ago, virtually no Catholic marriages were officially rather than necessarily Catholic thinking and dissolved; now, annulments are frequent, and many tradition. Its position was narrowly focused rather Catholics divorce and remarry without annulments. than comprehensive, diplomatic rather than magisterial, political rather than morally An openness to sexual and reproductive ethics conscientious. The Holy See delegation sought to and rights is gaining ground in the Catholic church. bring the Cairo document as close as possible to the Despite the vehement opposition of the Vatican, pope's thinking without expecting full concurrence Catholics in many countries favor access to legal from the world community, and yet the Vatican was abortion and contraception and civil rights for at the same time convinced that it would withhold homosexuals -- unthinkable even fifty years ago. endorsement of the document if it did not receive Catholics support legal options even when they are complete concurrence. This stance did not reflect not convinced that people have the moral authority the flexibility that exists in the Catholic tradition. to exercise them well. The Vatican repeatedly expressed its concern at At Cairo, it is relevant to note that, although Cairo that the rest of the world does not affirm an the Vatican was a fully active and engaged impressive ethic on life, reproduction, sexuality, and participant, its sexual and reproductive agenda did family. The global community is aware that it faces not prevail. This fact was instructive for the both life and death decisions regarding abortion, Vatican and the world. In the grand human contraception, HIV/AIDS, and sexuality education. dialogue, the church sometimes teaches the world (as The Vatican, despite being a sovereign state, is the Vatican has done brilliantly on the evils of immune from these concerns because of the coercion and self-indulgence and on the sacred character of its population and the purpose of its character of sexual experience and marital existence. Aware of this dilemma, the Vatican commitments), and sometimes the world teaches the might have been resilient and flexible at Cairo on church (as Cairo and the United Nations may be how its moral principles are applied to the world's doing on human rights, women's human rights, and governments as they confront concrete realities and reproductive and sexual rights) diverse belief and ethical systems. The church is always less than the truth it Yet there is reason for hope. History contains proclaims. It does not control this truth but serves it examples of church flexibility and growth, as well as and searches for it. The church sometimes advances Catholic teachings informed by global values. because of a reflection on its own traditions; very Substantive changes have occurred. often it grows, however, because it hears and learns from the world. The Reformation and the CATHOLICS FOR A FREE CHOICE 15 Enlightenment not only benefited the global community, they also enriched the church. One of the more encouraging results of Cairo is an awareness of how the United Nations heard the church and respected its voice. It is now time for the church to hear the world community as it speaks with responsibility and consensus. When the church possesses truth, it is always a truth the world possesses in some way. The Creator does not love and enlighten only a few and leave all the others to their own devices. And so humility is always in order and hope is always justified. NOTES i Msgr. Diarmuid Martin, Statement at the Beginning of the III Session of the PrepCom, April 4, 1994: para. 7. ii The President's Council on Sustainable Development, Population and Consumption Task Force Report, US GPO, Washington, DC: 1996: p. 33. iii Women-Church Convergence, Equal is as Equal Does: Challenging Vatican Views on Women, Washington, DC: Women-Church Convergence, 1995: p. 2-3. iv Pope John Paul II, Laborem Exercens, 1981: para. 19. The Proclamation of Teheran said the following about reproductive rights: "Parents have a basic human right to determine freely and responsibly the number and the spacing of their children." United Nations International Conference on Human Rights, Proclamation of Teheran (Teheran, Iran), May 13, 1968. vi Statement at the Beginning of the III Session of the PrepCom: para. 12. vii Dennis Poust, "No Consensus," Catholic New York, April 28, 1994. viii United Nations Population Fund, The State of World Population 1997 New York: UNFPA 1996, p. 86. ix Alan Guttmacher Institute, "The Role of Contraception in Reducing Abortion," Issues in Brief, 1997: p. 4. "The Role of Contraception in Reducing Abortion": pp. 2-3. xi US Cardinals Conference, Concerns Expressed to Clinton on Cairo Conference, May 29, 1994. xii "The Role of Contraception in Reducing Abortion": p. 4. xiii US Cardinals Conference, Concerns Expressed to Clinton on Cairo Conference, May 29, 1994. xiv French Bishops Council, AIDS: Society in Question, February 12, 1996. XV Statement at the Beginning of the III Session of the PrepCom: para. 7. xvi Philip William, UPI, April 17, 1994. xvii Catechism of the Catholic Church: 2204-2207. xviii Notes on the Draft Final Document of the ICPD: p. 2. xix Gravissimum Educationis Momentum: para. 3. XX Catechism of the Catholic Church: 1800. xxi As quoted in T. O'Connell, Principles for a Catholic Morality, Crossroad, 1978/1990, chapter 8. CATHOLICS FOR A FREE CHOICE The Rome Declaration On the International Conference On Population and Development January 5, 1999 Religion Counts Religion Counts representatives met in Rome in January 1999 to draft and issue this statement, articulating religious support for ethical approaches to population and development, and specifically demonstrating solidarity with groundbreaking agreements made at the 1994 International Conference on Population and Development. THE ROME DECLARATION ON THE INTERNATIONAL CONFERENCE ON POPULATION AND DEVELOPMENT January 5, 1999 RELIGION COUNTS Religion counts. Religious values and thought have helped to build the foundation for human well-being and they continue to inspire and guide billions of the world's people. Religions have maintained a sense of the sacred and sustained humanity in times of trial. They have nurtured spiritual growth, spurred intellectual inquiry, and provided moral guidance. The world's faiths have developed in different cultures and historical contexts. They nonetheless share common moral sensibilities. The different traditions highlight complimentary values. In many indigenous faiths there is a comprehensive understanding of the relationship of human beings to the earth; in Hinduism a great appreciation of diversity and tolerance; in Buddhism a deep understanding of suffering and compassion; in Confucianism a powerful awareness of reciprocity and duty in human relationships; in Taoism an enduring emphasis on harmony and balance; in Judaism a profound regard for the sanctity of life; in Christianity a rich understanding of charity and mercy; in Islam a boundless devotion to equality and justice. These attributions have not been exclusive but are embraced across religious boundaries. They are religion's shared gifts to the world community. These values are splendidly expressed in the Programme of Action adopted in Cairo in 1994 at the International Conference on Population and Development (ICPD). The conference articulated a new approach to population and development issues in which development policies focus on people rather than markets and population policies treat women not as receptors of family planning but as directors of their own reproductive decisions. The Programme's positioning of health and education as central components of human development replace a prior concentration on fertility regulation and population control. Finally, the ICPD acknowledged over- consumption in the developed world as both socially unjust and ecologically damaging. These developments represent a fundamental transformation in the way the world community and its policy makers address concerns related to population and development. -2- The ICPD's PRINCIPLES The ICPD grounded these advances in a set of principles put forth in the second chapter of its Programme of Action. These principles are consistent with four moral norms that reflect core affirmations of the world's religions: Equality, evidenced in the ICPD's assertions that women and men, whatever their difference, are equal in dignity and rights, and that education and comprehensive physical and mental health services are prerequisites for full participation in human societies. Justice, which the ICPD states is violated in poverty and great disparities of wealth, and which is at the foundation of its assertion that families, in their diverse expression and as a basic unit of society, deserve defense and support. Freedom, embodied in the ICPD's rejection of coercion in reproductive decision-making and its recognition that all women and - men are meant to be free moral agents. Respect, embodied in its call for public policies that are sensitive to cultural identities, and its insistence that nations not marginalize migrants and refugees. RELIGIOUS INSIGHTS INTO THE PROGRAMME OF ACTION People of faith readily recognize many of the values and principles in the concepts and commitments in the Programme of Action because they resonate with moral convictions that are deeply rooted in the heart of religious traditions. These principles provide the foundation in the document for addressing the interrelated issues of population and development, including those that require fundamental social transformation. The Programme of Action establishes the elimination of poverty as a crucial means for achieving full human rights and for meeting the objectives of humane population policies and sustainable development. The recommendations challenge economic systems that cause and perpetuate poverty, exacerbate disparities in wealth among people and nations, and recklessly degrade the environment. These recommendations reflect historic teachings of the world's religions, giving a clear mandate to people of faith to advance the Programme of Action. Religion Counts -3- At the heart of the document is a challenge to patriarchal societies. Male dominance bears significant responsibility for women's illiteracy, sexual and physical violence to women, and women's lack of educational and economic opportunity and inadequate access to health care. Religions through history and even today are complicit in sustaining male domination in the societies of which they are part. In recent decades, religious traditions have begun to recognize that their integrity compels them to advance towards full gender equality, including within the religious communities themselves. Both traditional sources and findings of modern religious scholarship are fully in keeping with the ICPD recommendations on women's rights and political participation, education, reproductive health and rights, and socio- economic opportunity in the public and private spheres. Eradication of male dominance is imperative for the sanctity of all creation. Reciprocity and mutuality in relationships is the appropriate moral and ethical foundation for policies related to sexuality. Prompted by the personal articulation of people's experiences, a reexamination of traditional teaching on sexuality is taking place within most religious communities. Sexual and reproductive health are of significant religious concern as integral components of human well-being. Both women and men must exercise responsibility in their sexual behavior. Most faith communities accept modern forms of contraception and family planning, and even where there is official religious condemnation the evidence suggests that a great many adherents make use of artificial contraception without a sense of being unfaithful to their traditions. Sexual and reproductive health care, including education and access to comprehensive health services, should be available to all women and men. The challenge is to provide reproductive and sexual health services to those women and men for whom it is still inaccessible. Religious communities should be advocates for the recommendations for the Programme of Action in these areas. People with HIV/AIDS have human dignity that must be respected. There is no justification for stigmatizing them. Religious leaders and teachers have a particular duty to dispel the myth that AIDS is a punishment from God. In many countries, this devastating disease is killing millions of people, leaving children orphans, partners bereft, and communities crippled. Those who value life should support access to services that prevent the transmission of HIV. The world's religions are compelled to assert their most fundamental teachings on the sanctity of life by advancing comprehensive sexuality education, assertive positions on the use of condoms, confidential HIV/AIDS testing, and support for those affected by the disease. Religion Counts 4 Abortion continues to be a divisive and complex issue. The Programme of Action addresses the question of abortion in a very limited way. It notes that abortion should not be a method of family planning; that abortion can and should be reduced through access to family planning services; it should be safe wherever it is legal, and, where illegal, the consequences of unsafe abortion should be addressed as a public health issue. Certain realities should be made clear. Where there is a full range of family planning services, the incidence of abortion decreases. In the absence of provisions for safe abortions, even when legal, the rate of maternal death is increased. When abortion is illegal it is poor women who suffer the greatest consequences in the loss of life and health. Children who are the result of unwanted pregnancy can suffer abuse or abandonment. Those who oppose even the modest provisions of the ICPD language on abortion need to be accountable for these realities. Reflection on these hard truths has caused many people of faith, even those personally opposed to abortion, to conclude that provisions for legal, safe, and accessible abortions are defensible on religious and moral grounds. While the religious traditions differ on the issue of abortion, the Programme of Action's limited statements on abortion do not violate the teachings of any of our traditions. Therefore religious leaders and communities can and should support the ICPD on this issue. CALL FOR ACTION As Religion Counts joins with others in the five-year review of the Programme of Action, the following considerations demand our commitment: 1. Principles count. The principles articulated in chapter two of the Programme of Action must serve as the benchmark against which implementation of specific actions laid out at the ICPD are evaluated. For example, a comprehensive review of family planning programs must not only address their efficacy, but also the extent to which they embody the ICPD's principles. 2. Partnerships count. Governments and non-governmental organizations have the opportunity to enlist the support and participation of religions as large and powerful allies for the implementation of the Programme of Action. It would be tragic for both religious communities and advocates of the ICPD consensus if this opportunity for collaboration and cooperation were not realized. Religion Counts 3. Commitments count. As a matter of moral integrity, nations must keep their financial and programmatic commitments as signatories to the Programme of Action. Religious communities and other non-governmental organizations must insist that their governments meet these obligations. 4. Religions count. Religions must commit themselves to the realization of the ICPD's goals and assume an active role in the implementation of the Programme of Action, including empowering women, eliminating poverty, making provisions for comprehensive health care, and promoting a sustainable environment. Religion Counts affirms the powerful message of the Programme of Action. All nations, all peoples, and all religions share this world in relationships of interdependence. The immense challenges taken on in Cairo five years ago by the countries of the United Nations can only be addressed in an environment of mutual respect. Religion counts. This is a moment to make it count for the common good of all humanity and the whole of creation. Religion Counts RELIGION COUNTS Religion Counts is an inter-religious group of religious scholars, experts, and leaders from around the world. An initiative of the Park Ridge Center for Health, Faith, and Ethics and Catholics for a Free Choice, Religion Counts provides a positive, ethically sensitive religious contribution to discourse on issues surrounding population, reproductive health, and development policies. The Park Ridge Center Catholics for a Free Choice 211 East Ontario 1436 U Street, NW Suite 800 Suite 301 Chicago, IL 60611 Washington, DC 20009 Attention: Larry Greenfield Attention: Frances Kissling (p) 312-266-2222 (p) 202-986-6093 (f) 312-266-6086 (f) 202-332-7995 Rev. Carlton Veazey USA Executive Director, Religious Coalition for Reproductive Choice Washington, DC, USA Protestant Isaac Wüst Dutch Member, International Movement We Are Church Amsterdam, the Netherlands Roman Catholic RELIGION COUNTS MEMBERS Rev. Rose Teteki Abbey Rev. Julian Cruzalta Beverly Harrison Ghanaian Mexican USA Pastor Lecturer, Universidad Colonia Professor of Christian Ethics, Presbyterian Church of Ghana Copilco Union Theological Seminary in Accra Mexico City, DF, Mexico New York, New York, USA Accra, Ghana Roman Catholic Protestant Protestant Musa W. Dube Elfriede Harth Denise M. Ackermann Botswanan German, Colombian South African Professor, University of = Coordinator, International Professor of Religion and Botswana Movement We Are Church Theology, University of Western Gaborone, Botswana Member Cape Protestant Versailles, France Belleville, South Africa Roman Catholic Anglican Asghar Ali Engineer Indian Riffat Hassan Michio Araki Director, Institute of Islamic USA Japanese Studies Professor of Religious Studies Professor of Religion, Mumbai, India and Humanities, University of Tsukuba Muslim University of Louisville Tsukuba Ibaraki, Japan Louisville, Kentucky, USA Buddhist Rev. Walter Fauntroy Muslim USA Mehmet Aydin Pastor, New Bethel Baptist Teresia Hinga Turkish Church, Former Member, Kenyan Philosophy Department Head, United State Congress Professor of Religion, DePaul Dokuz Eylul University Washington, DC, USA University Turkey Protestant USA Muslim Roman Catholic Rev. Larry Greenfield Sheila Briggs USA Shamsul Islam USA Research Scholar, The Park Indian Professor, School of Religion, Ridge Center for Health, Faith, Senior Reader, Political Science University of Southern and Ethics Department, University of California Chicago, Illinois, USA New Delhi Claremont, California, USA Protestant Delhi, India Roman Catholic Muslim Sahar Hafez Dina Cormick Egyptian June Jacobs South African General Secretary, Arab British Leadership, Women's Women's Solidarity President, International Ordination of South Association Council of Jewish Women Africa/We Are Church Cairo, Egypt London, England KwaZulu-Natal, Republic of Muslim Jewish South Africa Roman Catholic Sandha Jain Joanna Manning Rev. Gustavo A. Parajon Indian Canadian Nicaraguan Columnist, the Times of India Founder, Coalition of President, Nicaraguan Council and political/religious Concerned Canadian Catholics of Churches commentator Toronto, Ontario, Canada Managua, Nicaragua New Delhi, India Roman Catholic Protestant Hindu Rev. James Martin-Schramm Rosemary Radford Ruether Madhu Khanna USA USA Indian Assistant Professor, Georgia Harkness Professor, Associate Professor, Indira Department of Religion and Garrett-Evangelical Seminary Ghandi National Centre Philosophy, Luther College Evanston, Illinois, USA for the Arts Decorah, Iowa, USA Roman Catholic New Dehli, India Protestant Hindu Arvind Sharma Maria Consuelo Mejia Indian Gabi Kienesberger Mexican Birks Professor of Austrian Director, Catolicas por el Comparative Religion, Theologian, member, Derecho a Decidir McGill University European Women's Synod Mexico D.F., Mexico Montreal, Quebec, Canada Vienna, Austria Roman Catholic Hindu Roman Catholic Rev. Myosei Midorikawa Sheikh Gamal Solaiman Frances Kissling- Japanese British USA Chaplain, Jindai Temple Council Member, Institute of President, Tokyo, Japan Business Ethics Catholics for a Free Choice Buddlrist Ottawa, Ontario, Canada Washington, DC, USA Muslim Roman Catholic Philomena Mwaura Kenyan Rev. Gordon Sommers Manfred Kulessa Lecturer, Department of USA German Religious Studies, Kenyatta Former President, National Leadership, University Council of Churches Association of Churches' Nairobi, Kenya Bethlehem, Pennsylvania, USA Development Service Roman Catholic Protestant Bonn, Germany Protestant Maria Jose Rosado Nunes Ven. Haeju Sunim Brazilian Korean Chung Hyun Kyung Coordinator, Catolicas pelo el Professor of Philosophy, Korean Direito de Decidir, Brazil, Dongguk University Professor, Professor, Catholic University Seoul, Republic of Korea Union Theological Seminary of Sao Paulo Buddhist New York, New York, USA Sao Paulo, Brazil Protestant Roman Catholic Ven. Karma Lekshe Tsomo USA Rabbi Amy Levin Anthony Padovano Secretary, Sakyadhita: Israeli USA International Association of Treasurer, Rabbinical Assembly Director, CORPUS, a national Buddhist Women of Israel association for married priests Honolulu, Hawaii, USA Jerusalem, Israel Morris Plains, New Jersey, Buddhist Jewish USA Roman Catholic CATHOLIC VOICES WITH THE ATROICONSENSUS Catholic Voices: Reflections from the Paseo de la Reforma Mexico City, December, 1998 INTRODUCTION formal meetings sponsored by the United Nations, The Hague Forum in February, 1999. The Hague Over the past decade, the United Nations has, Forum will evaluate the progress in implementation through a series of international conferences and of agreements made at the International Conference plans of action, addressed a number of serious on Population and Development held in the Cairo problems facing the world and its people: human Programme of Action since its completion in rights, the environment, population and September 1994. One of the remarkable aspects of development, social development, housing, and the Cairo conference was the partnership forged women's rights. Few areas have been more between governments and civil society in the crafting contentious or difficult than the question of of international policies. In the spirit of that population and development, which embody partnership and with an eye toward the five-year differing deeply embedded political and religious review, the United Nations invited non- views of women's rights, gender, sexuality, and governmental organizations to share their reproduction. perspectives with the UN on the themes and actions outlined in the Cairo Programme of Action. At the UN International Conference on Catholic Voices has taken up this invitation with Population and Development, held in Cairo in 1994, enthusiasm, and thus we gathered in Mexico to these different perspectives collided. The Vatican reflect upon the issues of population and and its Holy See delegation occupied substantial development. public space, serving as an obstacle to a growing international consensus on population. This We are not experts in service delivery or consensus resulted in a remarkable, socially program evaluators. Rather, we review the transformative document called the Programme of Programme of Action from the perspective of values Action, which was adopted by the world's and principles enlightened by the Catholic social governments. The past five years have marked the justice tradition. The agreements reached at the beginning of realizing the world view represented in Cairo conference represented what has been called that document and implementing its outlined by many a "paradigm shift" in the world's approach actions. These matters were the basis for discussion to population and development. In this shift, an of Catholic Voices, a forum of Catholic leaders, emphasis on demographic targets gives way to an theologians, activists, and scholars who came emphasis on human needs and the common good. together in Mexico City in December 1998. In the new paradigm, we see hope, a reverence for life, health, and well being, and an impulse toward With Catholic Voices' work for women's rights, respect for human dignity, social justice, and equality human development, and church reform, it was among all people. Especially evident in the fitting that the meeting took place on Mexico City's Programme of Action is a new-found respect for the Paseo de la Reforma, the Reform Promenade. This moral agency of women. wide, grand boulevard with its stirring name became a symbol of our hopes for the human community's Particularly because the views of many progress toward justice and the common good. Catholics were not represented by the Holy See at the Cairo Conference, we present this report of our The gathering on the Paseo de la Reforma reflections on issues related to population and came just two months before the first of a series of development. CATHOLICS FOR A FREE CHOICE 2 Reflection: Eradicating Poverty enable people to "seek to do more, know more and We are rooted in the principle of the preferential have more in order to be more," as Pope Paul VI's option for the poor and economic justice for all in 1967 encyclical Populonon Progressio (On the insisting that special priority be given to the least Development of Peoples) put it. developed nations of the world and to the poorest individuals everywhere. Profound concern for the As part of development, Cairo specifically poor is a refrain throughout the Hebrew Scriptures, emphasized the right to education and noted that where the community is urged time and again to care investment in education is critical to the for the widow, the orphan, and the stranger. In the empowerment of women and the achievement of Christian Scriptures, neglect of the poor leads to their human rights. Cairo also underscored exclusion from the Reign of God (Mt. 25), which everyone's right to "the enjoyment of the highest embraces not just life after death, but also the here attainable standard of physical and mental health." and now, indeed, the totality of human experience. Cairo recognized development as an integral part of fundamental human rights and said it must be Poverty imposes imperatives on the affluent. fulfilled so as to equitably meet the needs of present Neglect of the poor is neglect of God. We support and future generations. ways of helping the poor such as charity, but we also call for the transformation of domestic and world Reflection: Human Rights and the Poor and the structures that create and maintain poverty. On the Marginalized deepest level, it must be recognized that the poor Our Catholic tradition calls us to stand with the poor and the affluent are equal in dignity and rights. and the marginalized. Marginalization of the "other" Furthermore, the privileged must acknowledge and leads to corruptions such as racism and nationalism. reform their habits of over consumption. The Common human dignity argues for the free exercise world's resources belong to all of us, rich and poor of rights by those who are marginalized, including alike. - the impoverished, migrants, threatened indigenous populations, the disabled, the elderly, the persecuted, As population and development policies are homosexuals, and other disempowered groups. created and implemented, it is important to note that World history reveals an often repeated record of poverty cannot be blamed on population growth. maltreatment of these groups. It also shows us that Poverty arises from injustice, and slowing fertility women and children are the world's poorest and rates is not a single or simple solution to poverty. most marginalized. We applaud Cairo's call for nations to cooperate to eradicate poverty "in order to decrease the disparities Cairo calls on countries to do better. For in standards of living and better meet the needs of example, the Programme of Action acknowledges the majority of the people of the world." that migrants often have the least access to resources provided in development plans. It entreats countries Reflection: People-Centered Development to guarantee fundamental human rights to all People's lives, not markets or production, should be migrants. It also explicitly calls on nations to grant the central concern of development policies. The protection for refugees escaping persecution and to true measure of development is whether it meets recognize and support the identity, culture and people's human needs and aspirations and whether it interests of indigenous peoples, and to enable them does this in accord with their human dignity. In the to participate fully in the nation's life. past, the Catholic church as a whole has seriously criticized development policies for focusing solely Reflection: Women's Human Rights on economic rather than human development. To put it concisely: women's rights are human rights. Ethical population and development policies must Women and men are entitled to the same rights and be focused on people, not numbers; on rights, not privileges; both also share the same responsibilities demographics; on serving human needs, not denying and duties. Universal acceptance of women's human human desires. rights remain unsettled. However, throughout the last several decades, women's rights have been Every person has the right to development. increasingly recognized in the world, in both the The cost of the world community's failure to secular and religious fields. Unfortunately, the support development is incalculable and Vatican's actions at Cairo did not reflect the richness unconscionable. Development policies should CATHOLICS FOR A FREE CHOICE 3 3 of the Catholic tradition in support of women's reproductive health services. Cairo called for human rights. adolescents to have information and services "to help them understand their sexuality and protect Cairo's Programme of Action was the first them from unwanted pregnancies, sexually United Nations document on population that transmitted diseases and subsequent risk of explicitly recognized the importance of women's infertility." Cairo also correctly called on rights as a worthy goal in itself and as a crucial factor governments to safeguard the rights of adolescents in development. Prior to Cairo, women's lives were to privacy, confidentiality, respect and informed not always treated with dignity and respect in consent. It said countries should remove legal, population policies; women were often considered regulatory and social barriers to reproductive health only in terms of their reproductive capacity, and information and care for adolescents. The their aspirations and needs were made secondary to Programme of Action also acknowledged that demographic outcomes. Cairo noted the exceptional adolescents must be fully involved in the planning importance of the "empowerment and autonomy of and implementation of these educational women and the improvement of their political, programmes. social, economic and health status." Reflection: Sexuality We stand with Cairo's groundbreaking calls for Sexuality is a gift of God and is integral to our gender equality, the empowerment of women, and humanity. The celebration of our bodies through the recognition of women's moral agency. We sexuality brings us spiritual awareness. Human endorse its outlined actions aimed at advancing sexuality commits each person to concern for the women's status, including promoting education for other or else it forfeits its human and virtuous women, eliminating economic and other content. Sexuality, like love, should be sensitive, discrimination against women, enhancing women's considerate, generous, compassionate, and employment opportunities, and ending violence concerned. The same standards apply to men and against women. women equally. The principle that insists that we love our neighbors as ourselves is expected to Reflection: Adolescents' Human Rights govern our sexual relationships. Ethical expressions Adolescence is a passage in the human journey of sexuality based on equality, mutual respect, and toward maturity. It is an age in which people concern are found in many kinds of relationships appropriately begin to explore and discover and unions. experiences related to adult life, including social, spiritual, and personal growth. Given this search, These perspectives reflect a broader adolescents must have adequate reliable information understanding of sexuality than the ones put forth by to light their way. Adolescents must also be the Vatican at Cairo. Indeed, a persistent tradition recognized as more than recipients of adult of aversion to sexuality within Catholicism is the knowledge and advice. They have much to draw root of current Vatican conservatism on from and to offer as a result of their own insights reproduction and women. Sex has often been and experience. presented as a necessary evil by churchmen, reflecting a kind of amnesia concerning biblical The intent of sexuality education for references to sexual pleasure as a value in its own adolescents should not be information only; it right. should rather be aimed toward the formation of a Sexual expression is multi-facted and serves responsible conscience and sensitivity to the lives of many good purposes. It is a way of communicating others. The responsibility for these kinds of intimately with another, of giving and receiving messages are shared by many, including parents, pleasure, and of creating new life. It is morally schools, the media, and other social institutions. separable from its reproductive function. To its Sexuality education must respond to the expressed credit, Cairo addressed "sexual health" in the context and unexpressed needs of young persons of "enhancement of life and personal relations, and themselves. not merely counseling and care related to reproduction and sexually transmitted diseases." One of Cairo's achievements was its recognition The Cairo agenda should be informed by agreements that the reproductive health needs of adolescents as made by nations at the 1995 Fourth World a group have been largely ignored by existing Conference on Women, which declared that "the CATHOLICS FOR A FREE CHOICE 4 human rights of women include their right to have responsible procreation more possible, it also allows control over and decide freely and responsibly on for a satisfying, pleasurable sexual life with matters related to their sexuality free of coercion, diminished fear of unintended pregnancy. discrimination and violence." Furthermore, the control over fertility that contraception offers has allowed women to develop Reflection: Reproductive Health and Rights aspects of their lives beyond motherhood. Reproduction is one of the most important and profound aspects of human life and relationships. The Vatican supports, in fact encourages, the Through reproduction, we express our hope in the practice of family planning, for it recognizes the future of the human family. Reproduction is both moral imperative of responsible parenthood. private and public. It has undeniable consequences However, only "natural family planning," a set of for the community and society at large. It is also a methods that involve periodic abstinence, is allowed. matter of public health, religious teachings, and Making only one method available - and one that government policy. It is an area in which women are does nothing to protect against sexually transmitted the central protagonists, for it is women who bear diseases - cruelly ignores the reality of people's lives. the risks and consequences of childbearing and the Women and men must freely decide not only greater responsibility for child rearing. In the just whether they wish to use contraception, but which world we work toward, these risks and method is best for them. responsibilities will be equally shared by men and better supported by society. Couples worldwide have indicated that they need and want to use contraception. We endorse An ethically based approach to reproductive Cairo's commitment to voluntary family planning health and rights has several underlying principles. programs that include a full range of safe, effective, First, it must be voluntary rather than coercive. and affordable contraceptive choices. Imposition of external limits on family size are unacceptable. Couples must have the right to decide Reflection: HIV/AIDS when, whether, and how to bring new life into the Society's and individuals' responses to AIDS must world. Second, it must be comprehensive rather be rooted in compassion, responsibility, and a than focused on family planning alone. Women's commitment to life. These principles require that reproductive health cannot be extricated from their efforts to prevent the spread of HIV must include health, and programs must provide a wide range of condoms and condom instruction. Couples should services. Third, it must be seen as an integral aspect be encouraged to use them to prevent transmission of human rights. Reproductive rights are grounded of HIV. We reject the Vatican's opposition to in previously recognized human rights. This right condom use, and we stand with Cairo's approach to was first recognized in 1968 at the International treating and preventing this tragic disease. Conference on Human Rights in Teheran, Iran. Fourth, it must be tied irrevocably to respect for the Reflection: Safe Abortion rights of conscience and free will. Couples consider Abortion is a complex moral and social issue a range of concerns in making the decision whether potential mothers know this best. The Vatican's to have a child. The community, family, religious position on abortion is compromised by its teachings, social conventions will play a role in unwillingness to accept contraceptive services and reproductive decisions, but in each decision, the devices even though they reduce the need for individual conscience has the ultimate say. abortion. Even taking into account Vatican opposition to abortion, we remain puzzled by Cairo's approach to reproductive health and Vatican objections to abortion being safe where rights is grounded in these principles. Its rejection legal. This dismissal of safe abortion by the church of coercion and its support of comprehensive safe hierarchy is insensitive to the realities women face motherhood programs are to be commended. and to the number of women who die from unsafe abortions every day. Because women everywhere Reflection: Contraception resort to abortion, the alternative to safe abortion is, Catholics around the world have come to believe of course, unsafe abortion. Again, it is the that contraception is a moral option. Bringing hierarchy's preoccupation with eliminating abortion children into the world is a sacred responsibility. from the world that prevents the real issues of justice Safe and effective contraception not only makes and health for women being addressed. Such an CATHOLICS FOR A FREE CHOICE 5 absolutist position fails to acknowledge the Cairo honored families in the Programme of ambiguity and doubt regarding fetal life and ignores Action, saying, "The family is the basic unit of the range of moral complexities surrounding each society and as such should be strengthened." And it situation. recognized diversity. "In different cultural, political and social systems, various forms of the family Despite charges that it did, Cairo did not call exist." for universal legal abortion. In fact, it based a large measure of its support for comprehensive family Reflection: The Role of Religion planning programs on the imperative to reduce the Religious thought has an important role to play need for abortion. It did call for abortions to be safe within the civil society and its cultures. The values where legal and for the public health issues of unsafe and principles at the core of all the major religious abortion to be addressed. The Holy See opposed traditions - respect for human dignity, care for the even these points. poor and marginalized, a striving for the common good are important touchstones for civil society. In countries where abortion is illegal, it is the Where religion is rooted in community and poor who are left to face abortions under the worst experience, religious stories and traditions serve as types of conditions. And in countries where important teaching tools. Religious insights often abortion is legal, but safe abortions are costly, it is form the framework for the most fundamental and again poor women who shoulder the burden. The profound human inquiries. church tradition of a preferential option for the poor has been interpreted by many Catholics to support Many of the issues at the heart of population the safety of abortion and to oppose unsafe and development concerns- not least among them abortions. Within the Cairo context, concern for issues of sexuality and reproduction, women's rights, public safety is not the same as moral endorsement. gender roles and responsibilities- call for massive social change. They center on transforming Despite Vatican disapproval, Cairo was right to relationships, between men and women, between address the catastrophic health consequences for government and citizens, and between and among women of unsafe abortion. Justice demands that we family members. This kind of social reform and do not abandon poor women or women in need of reorganization will be difficult and will take a long help. time. Participation by religious institutions, organizations, and individuals can promote, enhance, Reflection: Families and accelerate this transformation. A broad, fluid vision of families is reflected by Jesus himself in the Gospel of Mark As his mother and However, there is not one religious model that brothers one day approached Jesus and a group applies to the whole world. There must be constant encircled around him, Jesus asked, "Who is my dialogue among religious and spiritual movements so mother, or my brothers?" He gestured toward the that we can become more aware of how to circle and said, "Here are my mother and my accommodate difference as well as reach shared brothers!" (Mk. 3:31-35) values. As Catholics, we are called by the Second Vatican Council to "recognize the legitimacy of We do not agree with the parsimonious view of differing points of view," and show respect for our family espoused by the Vatican. fellow citizens. (Gaudium et Spes, 75). Moreover, while religions have a place at the policy table, it is In the fragile world in which we live, it seems not a privileged place. Rather, they are equal voices to us that we do better as a human community to among many. embrace extended and varied definitions of families. Why decry people's bonds of solidarity and EPILOGUE willingness to take responsibility for another? As Catholics who support the ethical approach However, whatever structure the family has to population and development articulated in the taken, it has often been the site of violence against Cairo Programme of Action, we call on nations to women and children. As we look to a more strengthen their commitment to the principles and generous vision of families, violence has no place. actions outlined therein. We further call on people who gather themselves in religious communities to CATHOLICS FOR A FREE CHOICE 6 dedicate themselves to addressing the challenges and problems related to these issues. We look forward with hope to a future in which poverty and its roots are eliminated, men and women enjoy equal rights, children have what they need to grow and develop, and the rights of conscience are protected. CATHOLICS FOR A FREE CHOICE CATHOLIC VOICES IONE WITH THE AIROCONSENSUS Acting Against the Grain A Chronology of Church Action to Block Cairo's Implementation At the September 1994 International Conference on informed choice. In fact, the agreement says that Population and Development held in Cairo, Egypt, governments should remove "unnecessary legal, the overwhelming majority of nations agreed to a medical, clinical and regulatory barriers to Programme of Action - a set of actions and information and to access to family-planning policies intended to address "the critical challenges services and methods." But church officials around and interrelationships between population and the globe have acted as barriers themselves, taking sustained economic growth in the context of steps to restrict access to any method of family sustainable development." The Holy See joined the planning officially banned by the church. (Official consensus on all of the principles articulated in the teaching forbids the use of any method except conference Programme of Action, while expressing periodic abstinence.) reservations on most of the document's other chapters, including those dealing with sexual and Since Cairo, church officials have obstructed reproductive health and rights. efforts to implement many other Cairo agreements, including efforts to broaden sexuality education The Vatican's opposition to agreements programs, to improve and expand prevention reached in these areas did not end with the programs on HIV/AIDS and other sexually conference's conclusion. In the ensuing four and a transmitted diseases, and even to end discrimination half years, church officials, from the Vatican to of disabled persons with regard to reproductive bishops' conferences and beyond, have conducted a rights and family formation. campaign of obstruction to implementation of these parts of the Cairo agenda. Many of these instances The following chronology enumerates incidents have taken the form of direct incursions into the in this campaign of obstruction. It is by no means formation of public policy; some are more oblique comprehensive, and in fact presents only a portion efforts to vilify those implementing the Cairo of what is likely a high number of such actions. The agreement, as when the pope maintained that entries in this chronology have been gleaned international institutions providing voluntary principally from church documents that have been contraceptives to couples who want them are made public and from news reports of public actions involved in a "conspiracy against life." All of their by church officials. There is no way to identify or efforts, however, affect not only Catholics, but quantify nonpublic efforts of the Roman Catholic citizens of all faiths and no faith all across the world. church as an institution in the crafting of public policy and the shaping of individual behavior. The Cairo Programme of Action stresses the Appearing at the end of each chronology entry is a "right of all couples and individuals to decide freely citation of the relevant section from the Cairo and responsibly the number, spacing and timing of Programme of Action. their children, and to have the information and means to do so," and it called for expanded access to In chapter 11 of the Programme of Action, primary and reproductive health care. Cairo called delegations at Cairo agreed that those in "influential for family planning programs to "ensure that women positions," including religious leaders, should and men have information and access to the widest "mobilize public opinion in support of the actions possible range of safe and effective family planning proposed" (11.17). Sadly, officials of the Roman methods in order to enable them to exercise free and Catholic church have tried to do just the opposite. CATHOLICS FOR A FREE CHOICE 2 Chapter 11 was among those on which the Holy See insist that the only reliable remedy to the spread of did not join the consensus, and indeed, church AIDS is fidelity within marriage and chastity outside representatives have worked, often in the public marriage." In their statement, the bishops also insist policy arena, to make it harder for the Cairo vision that periodic abstinence is the only acceptable to be realized. method of family planning. 5 PROGRAMME OF ACTION 7.2, 7.3, 7.6, 7.15, 7.23, 8.31, 8.35 December 1994 The US bishops approve updates and revisions to August 1995 the Ethical and Religious Directives for Catholic Health The Peruvian bishops' conference issues a news Care Services. The Directives bar Catholic health care release upholding the pope's new encyclical, facilities from providing or condoning contraceptive Evangelium Vitae, which condemns contraception and practices, from providing condoms or condom criticizes family planning programs. The bishops counseling, even for disease protection, and from assert that the church's ban on contraception is not performing voluntary sterilizations for men and just an opinion, but is a truth, taught by the church, women.¹ PROGRAMME OF ACTION 7.2, 7.3, 7.6, "in the name of God."Moreover, they assert, this 7.15, 7.23, 8.17 church doctrine is not only directed at Catholics, but is directed to all people of good will.6 PROGRAMME December 1994 OF ACTION 7.2, 7.3, 7.6, 7.15, 7.23, 8.31, 8.35 US Archbishop Francis Schulte of New Orleans, Louisiana, issues a pastoral letter entitled "Pastoral September 1995 Action for Families," in which he denounces the use Brazilian Roman Catholic officials publicly criticize of contraceptives. "To many," he writes, "the ability the government's new AIDS prevention campaign. to control conception seems to be accompanied by The campaign advocates the use of condoms to the right to separate the procreative and unitive prevent the spread of HIV and AIDS. Bishop functions of marriage."2 PROGRAMME OF ACTION Dadeus Grings states that "a sickness isn't fought by 7.2, 7.3, 7.6, 7.15, 7.23, 8.17 degrading morals and hurling people to hell. The church preaches chastity and is opposed to the use March 1995 of prophylactics The church is highly concerned Pope John Paul II issues his encyclical letter, about preserving human dignity and can't agree with Evangelium Vitae (The Gospel of Life), in which he the methods adopted to fight AIDS." condemns, among other things, contraception and PROGRAMME OF ACTION 7.23(b), 8.31, 8.35 treatment of infertility. The pope claims that international institutions are involved in a September 1995 "conspiracy against life" because they are engaged in In its reservations and statements of interpretation campaigns to make contraception available.³ of the UN World Conference on Women in Beijing, PROGRAMME OF ACTION 7.2, 7.3, 7.6, 7.15, 7.23, the Vatican says, "The Holy See in no way endorses 8.17 contraception or the use of condoms, either as a family planning measure or in HIV/AIDS June 1995 prevention programs."8 The Vatican also criticizes The Catholic church in Kenya vows to fight a new the platform of the Conference for the document's program of Family Life Education in schools. The focus on sexual and reproductive health, and wants new program would give young people access to that all references to sexuality in the document be information to equip them with the ability to say interpreted to mean sex within marriage. Joined by "no" to sex and to help them avoid unwanted Latin American, Islamic countries, and conservative pregnancies and sexually transmitted diseases, nongovernmental organizations (NGOs), the including HIV/AIDS.4 PROGRAMME OF ACTION Vatican opposes language that it claims denigrates 7.46, 8.31, 8.35, 11.9 the two-parent (mother and father) family, belittles motherhood and diminishes the rights of parents to June 1995 decide if their children should receive sex education Fifteen bishops from the Middle East and Asia meet and reproductive health care, including contraceptive at the Vatican to discuss goals in the pastoral care of services.⁹ PROGRAMME OF ACTION 7.2, 7.3, 7.6, families. In their statement, "Serving the Needs of 7.15, 7.23, 7.37, 7.46, 8.31, 8.35, 11.9 the Family," the bishops call upon all men and women to reject "safe sex" programs, saying, "We CATHOLICS FOR A FREE CHOICE 3 September 1995 March 1996 Catholic groups oppose Ireland's move to institute A Brazilian Roman Catholic bishop rejects the sex education programs in schools, accusing the Stay marriage application of a Brazilian couple because Safe program of "confusing moral judgments and the man is "paraplegic and therefore impotent," personal feeling." Although there persists a debate according to the bishops' letter to the couple. The among Catholics in Ireland over the sex education man had applied to the Catholic church to marry a program, Stay Safe continues - but it is closely widow who had two children from a previous monitored by the church. 10 PROGRAMME OF marriage. A couple "needs to be in perfect physical ACTION 7.23(b), 7.37, 7.46, 8.31, 8.35, 11.9 condition to be married," the bishop says.¹⁵ PROGRAMME OF ACTION 6.30 January 1996 Church leaders and Catholic conservatives fight August 1996 against a New York City AIDS education curriculum As 250 people watch, Kenya's top Catholic bishop, that includes condom distribution and textbooks Cardinal Maurice Otunga, ceremoniously burns that teach respect and tolerance for diverse sexual several boxes of condoms and one hundred copies orientations. Consequently, the Board of Education of pamphlets promoting safe sex. According to the adopts a revised curriculum on AIDS education that World Health Organization, one million of Kenya's no longer includes classroom demonstrations of twenty-six million people are infected with the virus condom use.¹¹ PROGRAMME OF ACTION 7.23(b), that causes AIDS. 16 PROGRAMME OF ACTION 7.6, 7.37, 7.46, 8.31, 8.35, 11.9 7.23, 7.37, 8.31, 8.35 February 1996 August 1996 The Vatican advises parents to "reject the promotion Experiencing pressure from Catholic and other of 'safe sex' or 'safer sex,' a dangerous and immoral religious groups, Kenya's President Daniel Arap Moi policy based on the deluded theory that the condom rules out sex education in primary schools. Moi can provide adequate protection against AIDS."12 states that, "Our religions are against such PROGRAMME OF ACTION 7.3, 7.23(b), 7.37, 7.46, immorality [sex education] and my government will 8.31, 8.35, 11.9 reject calls for it to be debated in parliament." The Catholic church has persistently opposed the February 1996 teaching of sex education because the proposed The Peruvian bishops' conference releases a letter, curriculum included information about "Building a Culture of Life," that criticizes the contraception." PROGRAMME OF ACTION 7.23(b), government's promotion of a sex education program 7.46, 8.31, 8.35, 11.9 geared toward adolescents. They claim the program is devoid of moral values and social responsibility. August 1996 They assert that the program is limited to education The Catholic bishops of Nicaragua release a on prophylactics and condoms, and thus encourages statement saying the country is suffering under a recreational sex that does not take into account campaign of "antireproductive colonialism." The responsibility for consequences.¹³ PROGRAMME OF bishops call for Catholics to not be confused by ACTION 7.23(b), 7.37, 7.46, 8.31, 8.35, 11.9 those who speak of "reproductive rights," "reproductive health," and "safe sex," arguing that March 1996 these terms disguise "abortionists, promiscuity, and The Vatican orders Scottish Archbishop Keith the arbitrary use of sex."18 PROGRAMME OF ACTION O'Brien to remove his imprimatur (official 7.2, 7.3, 7.6, 7.23, 8.25 permission to print) from an AIDS education package that includes information and advice on November 1996 using condoms. The most important inadequacy of The Holy See announces at the Pledging Conference the package, according to one churchman involved, for Development Activities, held at the United is the attitude towards condoms, "that if you have Nations in New York, that it will not offer its usual got HIV and you are having pre-marital sex, or sex symbolic contribution to United Nations Children's in any situation, you should use a condom." Fund (UNICEF) for 1997 and calls on others, PROGRAMME OF ACTION 7.23(b), 7.37, 7.46, 8.31, especially Catholic institutions and individuals, to 8.35, 11.9 reconsider their support for the agency. The attack is based on charges-unequivocally denied by CATHOLICS FOR A FREE CHOICE 4 UNICEF - that the agency is engaged in contraception. The pope asks that the bishops distributing contraception and promoting abortion, "support the teaching of natural methods of and on UNICEF's endorsement of a UN manual regulating fertility."2 PROGRAMME OF ACTION 7.6, dealing with women's needs in emergency situations 7.15, 7.23(b), 8.31, 8.35 and in refugee camps. Produced at the height of the Bosnian conflict, the manual states that women - February 1997 including the victims of rape as an instrument of war The US National Conference of Catholic Bishops - "have the same rights as others to have access, on decries the congressional approval of a bill providing the basis of free and voluntary choice, to additional international family planning assistance. comprehensive information and services for The bishops claim that the money would support reproductive health," including emergency post- abortion activities, even though US law prohibits the coital contraception for raped women.¹⁹ use of US funds for any abortion-related activities PROGRAMME OF ACTION 4.17, 4.18, 4.19, 7.46, overseas.24 PROGRAMME OF ACTION 7.2, 7.3, 7.6, 11.8, 11.9 7.15, 7.23, 8.17, 8.25, 8.31 November 1996 March 1997 The Roman Catholic church in Honduras uses its The Pontifical Council for the Family issues a influence to prevent the distribution of condoms at reference document entitled, "Vade Месит for polling stations during primary elections. The Confessors Concerning Some Aspects of Morality of Honduran Ministry of Health had planned to Conjugal Life," in which contraception is referred to distribute more than one million condoms at polling as an "evil." The document states, "The church has places where voters from the country's two major always taught the intrinsic evil of contraception, that parties were choosing candidates for the presidency is, of every marital act intentionally rendered and other offices. Government officials say they unfruitful. This teaching is to be held definitive and cancelled the plans largely because of church irreformable. Contraception is gravely opposed to objections.² PROGRAMME OF ACTION 7.2, 7.3, 7.6, marital chastity; it is contrary to the good of 7.15, 7.23, 8.31, 8.35 transmission of life ; it harms true love "25 PROGRAMME OF ACTION 7.2, 7.3, 7.6, 7.15, 7.23, December 1996 8.35 Addressing participants in a course to prepare teachers of natural family planning, the pope April 1997 reiterates that natural family planning is the only The Catholic bishops of the United States urge the method permitted by the church for married couples US Congress to vote against aid for family planning to use to space pregnancies. A month prior to his programs overseas.²⁶ PROGRAMME OF ACTION 7.2, statement, the pope urged doctors to adhere to the 7.3, 7.6, 7.15, 7.23, 8.17, 8.25, 8.31 church's sanctioned method of family planning, and he condemned contraceptives as a form of June 1997 "hedonism."21 PROGRAMME OF ACTION 7.2, 7.3, In a letter to US Bishop John McCarthy of Austin, 7.6, 7.15, 7.23, 8.35 Texas, the Vatican's Congregation for the Doctrine of the Faith instructs the bishop to terminate all January 1997 access to contraception and sterilization at In a letter to the US Congress, Cardinal Bernard Law Brackenridge Hospital. The letter is part of a series of Boston, Massachusetts urges members of of correspondence regarding the leasing arrangement Congress to vote against the US Administration's between Seton (a Catholic health care system) and proposal to spend an additional $123 million for Brackenridge Hospital (a public medical facility) in international family planning assistance.² Austin, Texas. "This Congregation," the letter reads, PROGRAMME OF ACTION 7.2, 7.3, 7.6, 7.15, 7.23, "directs Your Excellency to ensure that direct 8.17, 8.25, 8.31 sterilizations, as well as any other contraceptive programs, immediately and permanently cease at February 1997 Brackenridge Hospital." PROGRAMME OF ACTION In an address to members of the Philippine bishops' 7.2, 7.3, 7.6, 7.15, 7.23 conference during their ad limina visit to Rome, Pope John Paul II instructs the bishops to defend the family by publicly opposing sterilization and CATHOLICS FOR A FREE CHOICE 5 July 1997 November 1997 L Osservatore Romano, the Vatican newspaper, gives its The Vatican nuncio to the United Nations protests support to a report which calls on people with medical aid in refugee camps, saying it is "sometimes mental and physical disabilities to abstain from sex. almost exclusively in the form of reproductive health Dr. Maria Cristina Baldacci, a surgeon and measures."³ PROGRAMME OF ACTION 7.2, 7.3, 7.6, consultant in bioethics, wrote an article for Medical 7.15, 7.23, 10.25 Morality ,saying the disabled should "collaborate with God to avoid creating further pain and sorrow" by January 1998 expressing their sexual urges as "friendship or The German bishops' conference concedes to Pope something more transcendental."28 PROGRAMME OF John Paul II's "urgent request" that Catholic church- ACTION 6.30 sponsored counseling centers stop issuing counseling certificates to pregnant women who need July 1997 abortions. The bishops agree to withhold counseling Catholic and Muslim groups form Citizens for a certificates that are key in Germany's legal Healthier Kenya to campaign against the procedures for abortion.34 PROGRAMME OF government's sex education programs and ACTION 7.6, 7.24, 8.19, 8.25 distribution of contraceptives. The group seeks to gain support for "traditional family life" and in its January 1998 literature states that the planned sex education will The local Catholic church in Zambia opposes a be dangerous "killing all sense of morality, opening proposed regulation that would allow unmarried the way to free sex, to contraception and pregnant girls to continue in school, claiming the abortion."29 PROGRAMME OF ACTION 5.9, 5.13, regulation sanctions immorality. The church says 7.15, 7.23, 8.31, 8.25, 8.35, 11.9 that only students with potential should have the opportunity to continue their education, and argues August 1997 that pregnant unmarried girls do not have The archbishop of Mexico, Norberto Rivera Carrera, potential.35 PROGRAMME OF ACTION 4.17, 4.18, demands that all condoms distributed through 4.19, 11.8 Mexico's AIDS prevention program carry warning labels that state, "Use of this product is harmful to February 1998 health." In his homily in Mexico City's cathedral, the On the thirtieth anniversary of Humanae Vitae the archbishop praises the Mexican government officials 1968 encyclical letter issued by Paul VI that reiterates for placing warning labels on alcoholic beverages the church ban on the use of artificial contraception that say, "this product is harmful to your health," - Pope John Paul II tells Catholics that the and laments how the government does not do the church's ban on contraception is the law. In his same for contraceptives. PROGRAMME OF ACTION letter addressed to Anna Cappella, director of the 7.6, 7.15, 7.23, 8.31, 8.35 Center for Research and Study on the Natural Regulation of Fertility at Rome's Catholic University September 1997 of the Sacred Heart, Pope John Paul states that "in With the support of PROVIDA, a conservative the act that expresses their love, spouses are called to prolife group in Mexico, Mexico's Archbishop make a reciprocal gift to themselves to each other in Norberto Rivera Carrera rejects the use of the totality of their person. This is the reason for contraceptives in marriage. In his homily, Rivera the intrinsic unlawfulness of contraception: It Carrera instructs parishioners not to use intrauterine introduces a substantial limitation into this reciprocal devices and condoms, arguing that they are methods giving "36 PROGRAMME OF ACTION 7.2, 7.3, that destroy the sexual unity between spouses.3 7.6, 7.15, 7.23, 7.24 PROGRAMME OF ACTION 7.2, 7.3, 7.6, 715, 7.23, 8.17 April 1998 The New York State Catholic Conference and the October 1997 Connecticut Catholic Conference lobby against US Fr. Jacque Suaudeau, a medical doctor who is a legislation that would require health insurance member of the Vatican Council for the Family policies to provide prescription drug coverage for claims that using condoms during sexual intercourse contraceptive drugs and devices. Women of low- will not protect against transmission of the HIV virus.³² PROGRAMME OF ACTION 7.23(b), 8.31, 8.35 CATHOLICS FOR A FREE CHOICE 6 incomes would especially benefit from the sponsored insurance plans.⁴² PROGRAMME OF legislation.37 PROGRAMME OF ACTION 7.2, 7.3, 7.15, ACTION 7.2, 7.3, 7.15, 7.23, 7.24 7.23, 7.24 April 1998 NOTES The archbishop of Lima, Peru, Cardinal Augusto Vargas Alzamora, protests sex education for eleven- 1 US Bishops, "Ethical and Religious Directives for Catholic and twelve-year-olds in secondary school, calling it a Health Care Services," Origins 24:27 (December 15, 1994), 450-460. sacrilege and a crime. He criticizes the program for 2 Archbishop Francis Schulte, "Pastoral Action for Families," teaching students to prevent pregnancies by using Origins 24:30 (January 12, 1995), 506. artificial contraception. The minister of education, 3 Pope John Paul II, The Gospel of Life Evangelium Vitae Domingo Palermo, explains the program addresses (New York: Random House, 1995), 23-30. the country's problem of teen pregnancy and the aim 4 Open File, June 1995. 5 Asian, Middle Eastern Bishops, "Serving the Needs of the is to bring information not only to the students, but Family," Origins 25:6 (June 22, 1995), 100. also to parents and teachers.³⁸ PROGRAMME OF 6 "Al Servicio del Evangelio de la Vida," comunicado de los ACTION 7.23(b), 7.37, 7.46, 8.31, 8.35, 11.9 Obispos de Perú, 4 de agosto de 1995. 7 UPI wire service, September 19, 1995. May 1998 8 Mary Ann Glendon, "Vatican Stance: Women's Conference Final Document," Origins 25:15 (September 28, 1995), 235. Cardinal Augusto Vargas Alzamora of Lima, Peru, 9 "Vatican Criticizes Women's Platform," UPI, September 15, calls upon parishioners to boycott artificial methods 1995. of contraception. The archbishop states that, "the 10 The Catholic World Report, August-September 1995. church condemns these methods because they 11 "Best for Kids," Catholic New York, January 4, 1996. compromise and affect health, dignity and the 12 Pontifical Council for the Family, "The Truth and Meaning of Human Sexuality," Origins 25:32 (February 1, 1996). economy of families."3 PROGRAMME OF ACTION 13 Carta de los Obispos de Perú a los fieles creyentes, 7.2, 7.3, 7.6, 715, 7.23, 8.17 "Construyamos una Cultura de Fe," 2 de febrero de 1996; The Catholic World Report, March 1996. June 1998 14 The Catholic World Report, March 1996; PA News wire In the process of instituting the International service, November 11, 1995. 15 "Brazil Bishop Bans Marriage Because of Impotence," Criminal Court, the Vatican opposes the inclusion of Reuter wire service, March 26, 1996. "forced" or "enforced" pregnancy among the court's 16 AP wire service, August 31, 1996. list of war crimes, in fear of women being able to use 17 The Catholic World Report, August-September 1996. the ICC to obtain abortions in countries where 18 "Obispos Católicos condenan 'Colonialismo abortions are illegal.40 PROGRAMME OF ACTION anticonceptivo'," La Tribuna, August 15, 1996. 19 "Vatican Shelves UNICEF Support," AP wire service, 7.35, 7.39 November 5, 1996; "The Holy See Suspends Its Annual Symbolic Contribution to UNICEF," Holy See press release, July 1998 November 4, 1996. US residents of Enid, Oklahoma, face the loss of 20 "Honduran Church Blasted For Halting Condom Giveaway," Reuter wire service, November 28, 1996. tubal ligation services. The city's two hospitals, one 21 "Pope-Birth Control," AP wire service, December 7, 1996. Catholic and the other Baptist, plan to build a 22 Cardinal Law, letter to Members of Congress, January 30, Medical Plaza for Women and Infants. The new 1997. See www.nccbuscc.org. facility will not offer the choice of tubal ligations at 23 "Filipino Families Are Seeking Sound Doctrine, Grace and delivery for women because it will operate under the Human Empathy," L 'Osservatore Romano, February 19, 1997. 24 "Official Expresses Dismay on Vote for Funds for Abortion Ethical and Religious Directives for Catholic Health Care Groups," National Conference of Catholic Bishops news Services, the Catholic church's national guidelines release, February 13, 1997. barring most reproductive services.⁴¹ PROGRAMME 25 Pontifical Council for the Family, "Vade Mecum for OF ACTION 7.2, 7.3, 7.6, 7.15, 7.23 Confessors Concerning Some Aspects of Conjugal Life," Origins 26:38 (March 13, 1997), 621. 26 Most Reverend Theodore E. McCarrick and Most Reverend August 1998 John Ricard, letter to Senator/Representative, April 22, 1997. The US Catholic bishops lobby against the US 27 Congregation of the Doctrine of Faith, letter to the Most Congress bill that would require federal employees' Reverend John McCarthy, June 9, 1997. health insurance to cover prescription 28 "Disabled Protest to Vatican on 'Avoid Sex' Call," Irish contraceptives. The bill passes, but the bishops Times, July 2, 1997. 29 The Wanderer, July 17, 1997. succeed in securing exemptions for Catholic- 30 "El condón no es totalmente seguro, dice el arzobispo Rivera Carrera," Crónica, 25 de agosto de 1997. CATHOLICS FOR A FREE CHOICE 7 31 "Rivera Carrera rechaza los métodos anticonceptivos dentro del matrimonio," Crónica, 1 de septiembre de 1997. 32 The Tablet, October 18, 1997. 33 Catholic New York, November 13, 1997. 34 "Obeying Pope, German Bishops End Role in Abortion System," New York Times, January 28, 1998; "German Catholics to end abortion certificates," Reuter wire service, January 27, 1998. 35 Von Zarina Geloo, "Zambia's Young Mothers Should be Allowed to go to School Again," DPA wire service, January 12, 1998. ⁶Pope John Paul II, "Why Natural Family Planning Differs from Contraception," Origins 27:40 (March 26, 1998), 680- 681; "Pope Reminds Catholics Contraception Not Allowed," Reuter wire service, March 2, 1998. 37 New York State Catholic Conference, letter to New York State Assembly, 3 April 1998; Connecticut Catholic Conference, letter to state legislators, 30 April 1998. 38 "Cardenal Vargas Alzamora critica contenido de educación sexual," El Comercio, 10 de abril de 1998; "Ministerio de Educación no imparte planificación familiar a adolescentes," El Comercio, 15 de abril de 1998. 39 "Cardenal pide a los feligreses boicotear métodos artificiales para control natal," Expreso, 12 de mayo de 1998. 40 "New Struggle for Life," The Catholic World Report, August-September 1998; "The Holy See's Statement on Criminal Court," L Osservatore Romano, July 22, 1998; "Semantics Stalls Pact Labeling Rape a War Crime," New York Times, July 9, 1998. 41 "Religion, Medicine, Collide on Birth Care," Chicago Tribune, July 7, 1998. 42 "Political and health issues dominate 'pill bill' debate," Our Sunday Visitor, August 30, 1998; "Women's Groups Eye Insurance Bill," AP wire service, August 31, 1998; "Federal Coverage for Birth Control Gives Pro-Abortion Forces a Boost," National Catholic Register, August 16-22, 1998. CÁTHOLICS FOR A FREE CHOICE TOLIC VOICES WITH THE INSENSUS The Holy See and Cairo The 1994 International Conference on Population family," John Paul said. It is the "snare of the devil," and Development gave rise to unprecedented promulgates a "culture of death," and represents a attention by the Vatican to a United Nations "serious setback for- humanity." On one visit to a meeting. "No issue has affected John Paul II in a neighborhood church in Rome, the pope told more profound way throughout his fifteen-year parishioners, "I am going back to the Vatican to papacy than the Cairo conference," observed combat a project prepared by the United Nations, Raymond Flynn, then US ambassador to the which want to destroy the family. I say simply no, Vatican. Five months before the ICPD convened, no. Think again. Convert your hearts. If you are Reuters reported that the pope had "pulled out all the United Nations, you must not destroy." the stops in an attempt to influence the conference." Other senior church officials joined in. Throughout the year leading up to the Cardinal Alfonso Lopez Trujillo, president of the conference, Pope John Paul II and other top Roman Pontifical Council for the Family, said the ICPD Catholic church officials campaigned with a could cause "the most disastrous massacre in vengeance against the consensus taking shape history." Trujillo accused the United States and around the UN conference. John Paul met in March other Western countries of "biological colonialism" 1994 with Nafis Sadik, executive director of the for advocating family planning methods the Vatican United Nations Population fund and secretary opposes- that is, any methods other than those general of the ICPD. Face to face, he upbraided relying on periodic abstinence, or "natural family Sadik and criticized the draft Programme of Action planning." as formulating "population issues in terms of individual and 'sexual and reproductive rights,' or A gathering of 114 of the church's 139 even in terms of 'women's rights'." cardinals in June endorsed the Vatican's fight with a statement charging that the Cairo document would Then came his letter to every head of state, legitimize "abortion on demand, sexual promiscuity claiming that the document promotes a "lifestyle" and distorted notions of the family." that is "totally individualistic, to such an extent that marriage now appears as something outmoded." At the final preparatory meeting in April in This lifestyle, the pope wrote, is "typical of certain New York, Holy See Delegate Diarmuid Martin fringes within developed societies, societies which infuriated participants when he accused conference are materially rich and secularized." leaders of flouting the "cultural, ethical, spiritual, and religious values" of people in developing nations and In late March, John Paul summoned all of indulging in "reticence towards a coherent moral ambassadors assigned to the Vatican for a papal vision." NGO representatives jeered his remarks, lesson on population. A month later, he spoke by and in a curt response, the chairman of the session, telephone and in person with President Clinton on Fred Sai of Ghana, turned the charge of ethical the matter. shortcomings back against the Holy See. Through the spring and summer, the pope took Unbowed, the Vatican attempted to secure every opportunity in general audiences and other allies for its crusade, but months of diplomatic public appearances to attack the conference with efforts netted few recruits. After one staunch fiery rhetoric. The conference aims to "destroy the soldier, President Carlos Menem of Argentina, failed CATHOLICS FOR A FREE CHOICE 2 to rally Latin American heads of state to adopt a Indeed, the Vatican's vision of civilization did joint "right to life" platform for the Cairo seem to be at stake. The conference became a conference, it seemed that the pope began turning debate "between modernity and tradition, between over stones to find comrades. In August the Vatican dogma and reason," the Italian daily La Repubblica reached out to Islamic fundamentalists, paying calls observed. What the Vatican decried, others on repressive regimes such as Libya. A Libyan news acclaimed. The overwhelming majority of world agency reported that, in return for Libya's support in governments, religious leaders, and a broad array of condemning the Cairo conference, Vatican public interest organizations with historically diverse diplomats were supporting Libyan efforts to resolve views on population issues had come to a consensus differences with Western governments around the on humane population policies and sustainable 1988 bombing of a Pan Am jet over Lockerbie, development; the Vatican dug in its heels, crying that Scotland the new views of sexuality, reproduction, and families meant the end of civilization. During their campaign against the conference, Roman Catholic church leaders were especially With the preponderance of governments in critical of the US government and its positions on strong support of the plan- a sign that it was no issues related to the Cairo conference. The US manifesto of radical liberalism- the Vatican made bishops issued a statement calling on the US efforts to cloak its disapproval in acceptable terms. government to "reverse its efforts" on the But, crowded with straw men, Vatican criticisms conference. often had a ring of absurdity: "The conference's themes," Navarro-Valls asserted in his op-ed, Higher up the hierarchy, the US cardinals wrote "include coerced family planning, abortion, a letter to President Clinton that distorted the homosexuality and versions of women's rights that emerging Programme of Action in order to attack it. are harmful to women." Readers would have to do They claimed, for example, that the document their own research to learn that the document clearly advocated increased use of sterilization, even though and repeatedly condemned coercive measures, did neither the draft document nor its final articulation not mention homosexuality, and enjoyed the support promoted particular methods of regulating fertility of women's advocates the world over. and never used the words "sterilization," "ligation," "vasectomy," or "surgical contraception." When the conference began on September 5, Vatican diplomats were undeterred by their lack of Meanwhile, the US administration, in the success to date. As soon as delegates set to work on person of Vice President Al Gore, made the document, of which 10 percent had been marked extraordinary efforts not to offend the Vatican while for continued debate at Cairo, the Holy See seized defending the conference agenda. For Gore's upon the paragraph on abortion and, for five days, trouble, a top Vatican official, papal spokesman would not let go. To some extent, the Holy See held Joaquin Navarro-Valls, publicly insulted him by the conference hostage to the high value the UN name, suggesting that the Vice President was lying placed on achieving consensus. The Vatican also about US intentions. took advantage of its own vestigial aura of authority in international circles; with as little support as the The Vatican also courted US opinion with an Vatican had mustered, few countries would have op-ed article written by Navarro-Valls and published been able to win such a long hearing for their by the Wall Street Journal a few days before the ICPD particular agendas. opened. The conference, Navarro-Valls wrote, would be "a crucial challenge to Christianity's most Even after delegates had reworded sections to fundamental doctrine on the sanctity of life as it has appease the Holy See, the pope's envoys forced to come to be and exist in the family. The Holy delay. So exasperated were delegates that at one Father is not merely defending a sort of odd session they booed a Holy See representative. Catholic view about life and family. He is in fact pointing to the key issue on which future humanity "Does the Vatican rule the world?" asked must make a choice. This issue of human life and Egyptian population minister Maher Mahran. "If population undergirds all others. A false step here they are not going to negotiate, why did they come?" leads to a general disorder of civilization itself." CATHOLICS FOR A FREE CHOICE 3 Delegates and NGO representatives grumbled Cairo. But in reality, Cairo's statements about about the Holy See's obstructionist behavior, and at abortion account for only a tiny portion of its least two petitions circulated calling for a change in remarkable 20-year plan for the world's future. To the Vatican's status at the United Nations. While the be sure, Cairo explicitly addressed the public health movement to repeal the Holy See's status was problem of unsafe abortion for the first time in a limited, frustration with the delegation ran deep. It UN document. But the document also says "in no was exacerbated by the widespread understanding case should abortion be promoted as a method of that the Pope's positions on reproductive matters do family planning." not reflect the attitudes and practices of Catholics around the world. "The bottom line is the credibility As evidenced by the Vatican's statements of the papacy," one government delegate told decrying the broad themes of the conference, the Reuters. "If no one follows him, for whom does he Holy See's conflicts centered not only on abortion, speak?" but on the notion that couples and individuals should have access to a range of contraception, The Holy See had refused to endorse the two including but not limited to natural family planning, previous UN population conference documents, in on the prominence of women's rights and women's 1974 and 1984, and no one expected anything equality, and on the recognition of the centrality of different in Cairo. But in the end, the Holy See reproductive and sexual health in ethical population surprised most observers by joining the consensus policies. The Vatican's differences with the world on about half the Programme of Action. consensus on these issues has not changed, and can be expected to arise again during the five-year review From news reports of the ICPD, many might of the implementation of the ICPD. have been led to believe that the single issue of abortion accounted for the conflict between the Holy See and the majority of the delegations in CATHOLICS FOR A FREE CHOICE MOLIC VOICES THE ONSENSUS The Church at the United Nations Through an entity called the Holy See, the Roman the adherents as well- "it exists and operates within Catholic church enjoys unique governmental status the international community as the juridical at the United Nations, where the Holy See is a Non- personification of the Church."⁴ Member State Permanent Observer. While there are numerous UN observers (intergovernmental Legally, the Holy See and Vatican City are organizations, liberation movements, and specialized distinct entities with a relationship unique in agencies of the UN system), the Holy See and international law. The Vatican city-state exists to Switzerland are the only two currently holding that administer the properties belonging to the Holy See status as "states." and to insure the ecclesial independence of the Holy See. The Holy See holds sovereign authority over THE HOLY SEE, VATICAN CITY, THE Vatican City and carries out international relations ROMAN CATHOLIC CHURCH-ARE on the city-state's behalf as well as on behalf of the THERE DIFFERENCES AMONG THEM? Roman Catholic church.⁵ While Vatican City does not enter into diplomatic relations, the Holy See is The Roman Catholic church is a religious society active in the United Nations and maintains full without a political identity under the law. Vatican diplomatic relations with 157 countries.⁶ City is an independent city-state within Rome that serves as the site of the church's government and is IS THE HOLY SEE CONSIDERED A itself governed by the head of the church, the pope. STATE? The Holy See is "the supreme organ [of government] of both the Catholic church and the No, despite its designation as a non-member "state" Vatican City State," according to the authoritative permanent observer, "the Holy See is not a state," work on the Holy See's international relations, according to Cardinale.⁷ It is a religious entity written by Archbishop Hyginus Eugene Cardinale, without defined temporal territory.⁸ Diplomatically, who was a Vatican diplomat.¹ Vatican City is however, many countries treat the Holy See "as temporal and territorial; the Holy See, a more being on the same footing as a state" because of the nebulous construct, is religious. influence of the pope, as leader of Catholics worldwide.⁹ According to its Permanent Observer The term Holy See has multiple meanings. In Mission, the Holy See can enter into treaties as the one sense it is simply the pope's "see," or diocese "juridical equal of a state."10 (the authority and jurisdiction of a bishop), including not just Vatican City but also Rome. In another In international law, statehood traditionally sense, as the "central government" of the church, it rests on four criteria: a permanent population; a refers to the pope, the Roman Curia, and the College defined territory; a government; and the capacity to of Cardinals together.² Also called the Apostolic See, enter into relations with other states. 11 The United the Holy See refers to the pope's "authority, Nations Charter, while requiring statehood for jurisdiction, and sovereignty" in both the "spiritual membership, does not define a "state." and temporal governance and guidance" of the church, including Vatican City.3 Unlike the Holy See, Vatican City is considered a state. At less than half a square kilometer and with Although the Holy See is not the same thing as fewer than 1000 residents- only about half of those the Roman Catholic church-which encompasses being citizens- it is the smallest entity in the world CATHOLICS FOR A FREE CHOICE 2 claiming statehood.¹² In order to administer and must apply to the UN secretary general for the safeguard the property of the Holy See, the State of status.¹⁷ Vatican City was established by the 1929 Lateran Treaty, between the papacy and Italy, which had Permanent Observers cannot vote in the seized the Papal States during the Italian unification. General Assembly, but as a matter of custom they have full access to meetings and documents. WHY IS THE HOLY SEE, A RELIGIOUS Permanent Observers may address the General NON-STATE-AND NOT VATICAN CITY- Assembly and participate in its debates. 18 (The ACTIVE IN THE UNITED NATIONS? Vatican's observer status in the World Health Organization is similar- a voice but no vote.) There was confusion over Vatican/Holy See terminology at the United Nations during the 1950s. Observers can take part in UN conferences, Official UN documents referred to UN relations such as the Fourth World Conference on Women. with the "State of the Vatican City," but in an The UN agency organizing each meeting decides exchange of letters with the UN secretary-general in what level of participation to allow observers, and 1957, the church sought and secured the agreement non-member states typically are granted the full that it was the Holy See that maintained relations status enjoyed by UN member states, including a with the United Nations."13 vote on any question that is put to a vote. The United Nations works hard, especially in The decision, according to Cardinale, was conferences, to avoid relying upon votes, preferring based on the church's desire to stress the pope's to operate by consensus in adopting documents such spiritual leadership rather than his temporal as the programs of action by which UN conferences sovereignty.14 "This opportune classification address global issues. The practice of operating by immensely broadened the perimeter of the papacy's consensus gives states with minority views- even interest" in the United Nations' many activities. lone dissenters- a stronger voice in proceedings than they would have otherwise. At the same time, the Permanent Observer Mission sees to the interests of Vatican City as well Additionally, recent General Assembly as those of the Holy See. "It is up to the Holy See to resolutions have called for all "states" participating decide whether, in actual fact, the representatives in conferences to be accorded "full voting rights."19 it sends to international Organisations and meetings are to act in its own name, or in that of the State of Taken together, these factors have enabled the the Vatican City, or even in both at once, according Holy See to exercise a presence equal to that of any to the subject matter. In any event the sending UN member state- including some power to block authority is the Holy See and not the Vatican City consensus- at recent conferences such as the 1992 State."15 Conference on the Environment and Development, in Rio de Janeiro; the 1994 International Conference WHAT DOES PERMANENT OBSERVER on Population and Development, in Cairo; and the STATUS MEAN? 1995 World Summit for Social Development, in Copenhagen. The same will be the case at the 1995 Permanent Observer status is a matter of custom; Fourth World Conference on Women, in Beijing. there is no provision for it in the United Nations Charter. The custom originated in 1946, when HOW DID THE VATICAN GET INVOLVED Switzerland named a "permanent observer" to the IN THE UNITED NATIONS? United Nations and the UN secretary-general accepted the designation.¹⁶ To become a Permanent The Holy See owes its participation in the United Observer, a state must be a member of at least one Nations to the membership of Vatican City in the specialized agency of the UN system (such as the Universal Postal Union (UPU) and the International International Atomic Energy Agency), must be Telecommunication Union (ITU), which the city- "generally recognized" by UN member states, and state joined because of its operation of postal and radio services. The United Nations, soon after its CATHOLICS FOR A FREE CHOICE 3 formation, invited these organizations and their extends over one billion persons scattered throughout members to attend UN sessions on an ad hoc the world and belonging to the most diverse ethnic basis.20 The Holy See began attending the General groups and geographic regions. Its strength Assembly, the World Health Organization, and the consists in the respect that its words, its teaching, UN Educational, Scientific, and Cultural and its policies enjoy in the conscience of the Organization in 1951 as an ad hoc observer.²¹ In Catholic world-a respect that is widely shared by 1956, the Holy See was elected a member of the UN many people who do not belong to the Church. The Economic and Social Council and also became a full real and only realm of the Holy See is the realm of member of the International Atomic Energy conscience.²⁷ Agency.22 When Pope Paul VI arrived in New York in HOW DID THE VATICAN BECOME A 1965 to address the United Nations, he told the NON-MEMBER STATE PERMANENT crowd at Kennedy Airport that he offered "to your OBSERVER? terrestrial city of peace the greetings and good wishes of our spiritual city of peace." Addressing the While the Holy See was an ad hoc observer, the General Assembly, he presented the church as an pope's representative at UN meetings was an "expert in humanity," and in asking nations to work auxiliary bishop of New York, who also carried out together as equals, he referred to himself "as a other duties in the archdiocese. The relationship representative of a religion that believes salvation is between the Vatican and the United Nations was achieved through the humility of its divine one of "mutual experimentation," a Catholic Founder."28 periodical said-at the time.23 Pope John XXIII moved toward closer relations in 1963 when he In a papal address to the General Assembly in endorsed the United Nations in his encyclical Pacem 1979, John Paul II also claimed a special role. "The in Terris (Peace on Earth) and, as he was dying, sent nature and aims of the spiritual mission of the Cardinal Leon-Joseph Suenens to summarize the Apostolic See and the church make their encyclical in an address to the General Assembly. participation" in UN activities "very different from that of the states, which are communities in the In 1964, Pope Paul VI named a permanent political and temporal sense," he said.29 observer, following Switzerland's precedent. UN Secretary-General U Thant accepted the designation Monsignor Diarmuid Martin, a leader of the and announced it within three weeks.²⁴ Vatican delegations to Cairo and Copenhagen, referred to "the social teaching of the church" as Paul VI did not pursue full membership. Under "the principal inspiration of the positions taken by the UN Charter, membership entails a state's the Holy See at the conferences."30 acceptance that it may be required to commit military power in collective measures to suppress Archbishop Renato R. Martino, the Vatican's acts of aggression "or other breaches of the "Permanent Observer" to the United Nations-as peace."25 By Lateran Treaty and by choice, the Holy the ambassador for a Permanent Observer state is See and Vatican City are committed to neutrality.26 called- also speaks of a religious mission. Asked about the Vatican role in the United Nations, when FOR WHOM DOES THE VATICAN SPEAK there is no "voice" for Protestant religion, Islam, or AT THE UNITED NATIONS? Judaism, Martino quoted a Moslem supporter. "The Vatican has a right to be present" partly because, 'if Church officials describe their role in the United you would ask the Moslem to come forward and Nations as being unique: speak, we would not know who would be the one to speak," whereas there is "one voice" for the As a full member of the international community, Catholic church. Martino added that the Catholic the Holy See finds itself in a very particular church's "one voice is a message of salvation, found situation, because it is spiritual in nature. Its in the Scriptures and lived in the tradition of the authority-which is religious and not political- Church over the centuries. It is an objective truth CATHOLICS FOR A FREE CHOICE 4 that remains changeless. During the month 11. Cardinale, p. 81; CRLP, citing Restatement (Third) of the preceding the Cairo Conference, Pope John Paul II Foreign Relations Law of the United States, $201 (1986). and the world episcopate have applied these eternal 12. Schabas; Cardinale, P. 104. 13. Cardinale, PP. 256-57. truths to the topics addressed by the conference."31 14. Cardinale, P. 256. 15. Cardinale, P. 257. What place does a religious body- claiming to 16. UN Public Inquiries Unit, "Information on the Status of Permanent Observer Missions to the United possess the universal "objective truth" and to speak Nations, "Oct. 1994. infallibly on moral matters-have in an 17. "Legal Opinions of the Secretariat of the United Nations," intergovernmental institution like the United United Nations Juridical Yearbook, 1962, PP- 236-37; United Nations? Nations Public Inquiries Unit "Image and Reality," April 1993. 18. United Nations Public Inquiries Unit, Image & Reality: NOTES Questions and Answers about the United Nations, How It Works, 1. Hyginus Eugene Cardinale, The Holy See and the International and Who Pays for It, Apr. 30, 1993. Order (Gerrards Cross, England: Colin Smythe, 1976), 19. CRLP (above, note 8). PP. 257-59. 20. Cardinale, P. 256. 2. The Official Catholic Directory, 1995 (New Providence, NJ: 21. Schabas. P.J. Kenedy & Sons with R.R. Bowker, 1995), p.xix. 22. Cardinale, p. 233. 3. The Catholic Encydopedia, (New York: Thomas Nelson 23. "Vatican UN Observer," America, Apr. 25, 1964, PP- Publishers, 1987), p. 268; Cardinale. 560-61. 4. Cardinale, PP 81-83. 24. Tablet (London), Apr, 18, 1964, P. 447; New York Times, 5. Cardinale, PP. 82-85; Tryanjana Maluwa, "The Holy See Apr. 7, 1964; Cardinale, p.232. and the concept of international legal personality: some 25. United Nations Charter, Articles 1, 4, 43, 45 & 49. reflections," Comparative and International Law Journal of 26. Schabas; Cardinale, PP. 259-60; Permanent Observer Southern Africa, Mar. 1986, pp.24-25. Mission of the Holy See (above, note 6). 6. Permanent Observer Mission of the Holy See, "The Holy 27. Permanent Observer Mission of the Holy See See and the United Nations," undated article, in (above, note 6). distribution, June 1995. 28. Peter Hebblethwaite, Paul VI: The First Modern Pope (New 7. Cardinale, p. 259. York: Paulist Press, 1993), P. 437-39. 8. Cardinale, PP. 256-59, William Schabas, "Notes on the 29. Origins, vol. 9 (1979-80), PP. 257-259. Legal Status of the Varican City and the Holy See," 1994; 30. Msgr. Diarmuid Martin, "What the Church Tries to Do at diplomatic sources; Center for Reproductive Law and International Conferences," Origins, vol. 25, no 6 (June 22, Policy (CRLP) (New York), "Church or State? The Holy 1995), PP- 94-98. See at the United Nations," July 3, 1994. 31. Dialogue, National Catholic Register, Feb. 5, 1995. 9. Cardinale, P. 259. 10. Permanent Observer Mission of the Holy See (above, note 6). CATHOLICS FOR A FREE CHOICE CAMHOLIC VOICES WITH THE INSENSUS Catholics and Contraception: A Struggle for Control "If anyone says that it is not better and more godly to live in virginity or in the unmarried state than to marry, let him be anathema « (From a declaration of the church, Council of Trent, 1545-1563) Sincere people worldwide are baffled by the Roman procreation; contraception was implicitly evil. Catholic prohibition of all contraceptives from Augustine strongly opposed periodic abstinence, the condoms to pills. The hierarchy's vehement and method today's Vatican extols. absolute opposition to abortion would seemingly lead it to champion contraception to reduce the need Medieval Years: Monks Put for abortion. The church also accepts that Their Stamp On Sexuality population pressures exacerbate poverty and From Augustine's death to the twelfth century, contribute to human suffering; contraceptives could writings on sexuality were codified by monks and help alleviate those pressures as well. Instead, some monk-bishops. They gave the prohibition of church leaders, especially Pope John Paul II, have contraception more of a "corporate stamp. "1 intensified the opposition to contraception. Popes and bishops, in turn, promoted monasticism and clerical celibacy to prevent the clergy from The above quote exalting chastity points to the having heirs with claims to church property. reason: in a church in which all officials are male and celibate, power and control is maintained when the 1140: First Code Says Contraception a Sin sexual and reproductive functions are resisted. Gratian, a monk, compiled the first collection of Throughout church history, fear of women and canon law that was accepted as authoritative within sexuality runs deep. Sexual intercourse, Catholics are the church. It declared contraception a sin, but not a told, is not a good if engaged in for pleasure or love grave one. alone- it must carry an openness to pregnancy and childbearing. These "goals" redeem sexuality from 1230-34: A Pope Calls Contraception Murder time honored notions of evil. More importantly, The first papal injunction against birth control came these limits serve to keep distance between the when Pope Gregory IX, the creator of the priestly elite and the ordinary Catholic. They serve as Inquisition, compiled existing authoritative decrees a form of control over the lives of all, but most into the universally binding Decretals. The Decretals tragically of women, who bear the brunt of avoidable condemned contraception as murder. mortality and morbidity. 1588: Pope Sixtus V Adopts a Population Policy St. Augustine (354-430): Sexual Pleasure = Sin Pope Sixtus V issued the bull Effraenatam (Without A zealous convert after a lustful youth, Augustine Restraint), which used the rhetoric of birth control dominated moral theology for more than a as murder; the bull applied to contraception the millennium and has recently re-emerged as a penalties designated for homicide. The bull was principal influence on ultraconservative theology. directed partly against the sexual activity of the Augustine linked original sin, hust, and sex: he clergy and served Sixtus's crusade to eradicate asserted that sexual pleasure was the path by which adultery and prostitution in Rome. Rome had also original sin was transmitted from generation to endured the plague in 1581 and famine in 1578 and generation. Sexual intercourse, inherently tainted, 1583, providing additional reason for Sixtus's needed always to be salvaged by the pure motive of CATHOLICS FOR A FREE CHOICE 2 condemnation of behavior that would restrain Nineteenth Century: population growth. The Birth Control Movement 1853: The human ovum had been discovered, and Renaissance and the Counter-Reformation: with it, scientific support of the belief that women Fresh Thinking must be infertile on some days during their The Renaissance and Counter-Reformation brought menstrual cycles. In this year, the Roman fresh thinking and new influences to bear on Penitentiary said couples who had sex only on days Catholic ideas about marriage and sexuality. The they believed the wife was infertile did not need to theology of Thomas Aquinas was dominant. He had be disturbed by confessors, if the couple had sound asserted that contraception violates nature's order reasons for abstaining from sex. because sex is clearly nature's way of propagating species. But he set the stage for moderate reform by The birth control movement grew through the saying that marital intercourse is good and therefore early twentieth century. The idea that overpopulation so is the pleasure in it. Theologians defended sex as causes famine and war gained currency. But legitimate when one used sex to pay the "marriage declining birthrates threatened to weaken the church, debt"- that is, to meet the sexual demands of one's as well as individual nations, and nationalism became partner. an instrument of propaganda in the churches fight against the birth control movement. Council of Trent (1545-1563): Religious Rivalry Rules the Day Bastille Day, 1872: Contraception and War Catholic-Protestant rivalry fueled competition for Catholic moralists blamed France's military defeat by strength in numbers and, therefore, support for the Prussia on waning fertility and predicted the decline prohibition of contraception. Similarly, in reaction and fall of an underpopulated France. In a Bastille against the Protestant rejection of clerical celibacy, Day speech in 1872, a Swiss cardinal told a French Catholicism insisted that celibacy is better than audience. "You have rejected God, and God has sexual marriage. The bishops declared at the Council struck you. You have, by hideous calculation, made of Trent: "If anyone says that it is not better and tombs instead of filling cradles with children; more godly to live in virginity or in the unmarried therefore you have wanted for soldiers."³ World War state than to marry, let him be anathema." I aggravated population related fears, and an alliance of churchmen and politicians enacted laws against Yet the church's posture toward contraception contraception in many countries. eased in two ways during the Counter-Reformation Confessors were told to respect penitents' good faith Late 1800s through 1940s: and not interrogate them so vigorously as to Feminism First Seen as a Threat "disturb" those who were ignorant of the "natural The birth control movement was seen as part of a law" and unlikely to mend their ways. Also, it was broader threat to the church: feminism. Many deemed lawful for a wife to go along with a husband Catholic bishops and priests tried to exert influence who practiced coitus interruptus. against women's suffrage. In 1944, the chairman of the US bishops' conference lamented "a new wave Seventeenth Century: of perverted feminism that is obviously bent on Reasons to Limit Births turning women still more away from the home and In 1679, Innocent XI renewed the condemnation of towards extradomestic occupation." Contraception sex for pleasure, but the condemnation was not was integral to the problem; the conference severe. Restricting intercourse to avoid having too considered planned parenthood a threat to the many children won theological approval. Poverty "integrity" of the home.4 and the need to provide for the education of existing children were accepted as grounds to limit sexual 1930: Pope Attacks "Wicked Childless Parents" activity, marking new approval for the idea that Pope Pius XI's 1930 encyclical Casti Connubii "economic and educational reasons were valid moral denounced "those wicked parents, who seek to reasons for not wanting more children."² remain childless"⁵ or who avoid childbearing "not through virtuous continence. but by frustrating the marriage act."6 "Since. the conjugal act is destined primarily by nature for the begetting of children, those who in exercising it deliberately CATHOLICS FOR A FREE CHOICE 3 frustrate its natural power and purpose sin against Human Life), while glorifying the exception made nature and commit a deed which is shameful and for rhythm (or periodic abstinence). intrinsically vicious," the document said.⁷ Dissent loudly greeted the encyclical and 1951: The Church Gets Rhythm continues more quietly to this day. Theologians note In 1951, Pope Pius XII declared the rhythm method that the principle of probabilism gives Catholics the was available to all couples who for serious motives right to dissent from doctrine on a moral matter if - including economic and social ones- wish to there is a "solid probability" in favor of the avoid procreation "for a long time, perhaps even for dissenting opinion. "If after appropriate study, the duration of the marriage." The overriding reflection, and prayer, a person is convinced that his restriction on which Pius insisted (as does John Paul or her conscience is correct, in spite of a conflict II) was that rhythm not be used "habitually" for less with the moral teachings of the Church, the person than "grave" reasons; in fact, if a woman's health not only may but must follow the dictates of demands that she not become pregnant, she must conscience rather than the teachings of the Church," abstain, not simply use rhythm. Abstinence is theologian Richard McBrien explains.⁸ possible, Pius XII said; otherwise God would not require it. 1970s: Elements of Dissent Scholars criticize Humanae Vitae because it reduces Earlier fears of inadequate population had been sexuality to biological or physical facts. Theologians translated into directives against contraception; now point out that Humanae Vitae fails to see individual population pressure seems to have contributed to a sexual acts in the context of the marriage as a whole reserved acceptance of a contraceptive practice that and assesses marriage "exclusively in physical St. Augustine had damned. terms"- the production of children— without regard to its other results or products.9 Theologians criticize 1953: The Appearance of the Pill as hypocritical the assertion that one can enjoy sex It fell to Pius XII to respond to "the pill," which during the infertile period, while fully intending to emerged in 1953. In 1958, he forbade the use of the avoid conception by remaining abstinent on fertile pill if the aim is contraception. But he confirmed days. that the pill can be used for therapeutic, noncontraceptive purposes-despite its 1980s: Eruptions and Reaffirmations contraceptive side-effect-under the principle of In large part, Catholics in the pews went their own double effect. The pill was licit to clear up menstrual way while priests looked the other way. In 1980, a pain, but not prevent a pregnancy expected to kill synod of bishops spoke urgently of the prohibition's the mother: to cure illness, but not to save lives. non-reception among the laity and called for new exploration of the issue. Bishop Patrick Iteka of 1963-1966: The Papal Birth Control Commission Mahenge, Tanzania, said that for socioeconomic In 1963, Pope John XXIII convened a commission reasons, African families had to be planned. on population and birth control, handing the Indonesian bishop Sudartanto Hadisumatra said the question to a panel that ultimately included bishops, church should help couples reduce the number of theologians, physicians, demographers, and married children they bore. Archbishop Angelo Fernandes of couples. New Delhi asked for a pastoral statement on contraception that would respond to his people's July 29, 1968: Pope Paul VI situation.¹⁰ Reaffirms Prohibition, Inspires Dissent In 1966, the birth control commission created by But the synod's closing statement reaffirmed John XXIII and continued by his successor, Paul VI, Humanae Vitae, saying that "the transmission of life issued a majority report in favor of permitting the is inseparable from the conjugal union."¹¹ John use of contraception. A minority dissented, arguing Paul's closing sermon was even more severe. He said that to change the teaching- admitting error- immediate compliance is expected.¹² would undermine the authority and credibility of the Vatican. After two years of pondering, Paul Ever since the 1960s: categorically reaffirmed the prohibition of The Challenge of Modern Feminism contraception in his encyclical Humanae Vitae (Of Feminism has presented an enormous challenge for the church in the areas of sexual and marital ethics CATHOLICS FOR A FREE CHOICE 4 and the exclusively male priesthood. Throughout supreme interpreter of natural law, his fiat is final in this century, the church has linked contraception and expressing the Church's moral viewpoint.¹⁴ feminism as intertwined evils. Members of the hierarchy continue to make statements that indicate Journalist Robert Kaiser, who wrote the that one root of the contraception prohibition is a authoritative chronicle of the birth control restrictive view of women. commission and the aftermath of Humanae Vitae, makes the point compellingly that the issue is power. "I want to remind young women that Referring to Jesuit John Ford, one of the four motherhood is the vocation of women. It is theologians behind the minority report of the birth women's eternal vocation," Pope John Paul II said in control commission, Kaiser wrote this: his weekly general audience in January 1979. Unwittingly, Father Ford gave the "However, a radical feminism which seeks the game away when he said the rights of women by attacking and denying encyclical reaffirmed "the power of fundamental, clear and constant moral teaching does the magisterium to bind not reflect or promote the full reality and true dignity consciences." For Ford, the point of women," the pope explained in a 1989 letter to was not truth. It was power. The US bishops. point was not to teach, but to rule.¹⁵ 1988: Motherhood First and Foremost In his apostolic letter Mulieris Dignitatem (On the NOTES Dignity and Vocation of Women), John Paul again focused on maternity and virginity. Because men 1. John T. Noonan, Jr., Contraception: A History of Its Treatment neither bear nor nurse children, "parenthood is by the Catholic Theologians and Canonists, enlarged edition (Cambridge, MA: Belknap Press/Harvard University realized much more fully in the woman," the pope Press, 1986; original edition, 1965), pp. 145 and 143. wrote. "In many ways [a man] has to learn his own 2. Noonan, P. 336. 'fatherhood' from the mother." 3. Noonan, P. 414, quoting Cardinal Gaspar Mermillod, via B. Deppe, "Théologie pastorale," Nouvelle reven théologique 31 (1899), 455- 456. The 1990s: Recent Dissent 4. Quoted in Earl Boyea, The National Catholic Welfare A few brave souls continue to question and even Conference: An Experience in Episcopal Leadership, 1935-1945, disagree with Humanae Vitae. At a meeting of the US doctoral dissertation, Catholic University of America, 1987 National Conference of Catholic Bishops, Bishop PP. 359-65. 5. Casti Connubii, 65. Kenneth Untener of Saginaw, Michigan, told the 6. Casti Comubii, 53. assembly that the logic of the birth control position 7. Casti Connubii, 54. is "not compelling" to Catholics, even priests and 8. Richard P. McBrien, Catholicism, Study Edition some bishops. If the church's positions were put to a (Minneapolis, MN: Winston Press, 1981), p. 1004. 9. Thomas Shannon, Ethical Dilemmas in Population blind vote, he speculated in a 1991 interview, most Policy," Conscience, vol. VII, no. 2 (March/April 1986): 1-6, US bishops would opt to change it. p.4. 10. Francis X. Murphy, "Of Sex and the Catholic Church," A statement on AIDS by France's bishops in Atlantic Monthly, Feb. 1981, P. 44 ff. 1989 suggested that using a condom may be better 11. Origins 10:323. 12. Francis X. Murphy, "Catholic Perspectives on Population than death. "The whole population and especially Issues II," Population Bulletin, Population Reference Bureau, the young should be informed of the risks," they Vol. 35, No. 6 (Feb. 1981). said. "Prophylactic measures exist." And Cardinal 13. Peter Hebblethwaite, "What the French are not saying Jean-Marie Lustiger, Archbishop of Paris, told a about condoms," National Catholic Reporter, Feb. 3, 1989, television audience, "Chastity is possible," but if and Origins 18:446. 14. Murphy, Population Bulletin, p. 25. AIDS-virus carriers fail to abstain from sex, they 15. Robert Blair Kaiser, The Politics of Sex and Religion (Kansas "should use all known means" to protect others City, MO: Leaven Press, 1985), P. 219. from the disease.¹ 13 That contraception is an issue of power can be seen in Humanae Vitae. Historian Francis X. Murphy, C.SS.R., writes, "Actually, what the document amounts to is an assertion by the Pope that, as the CATHOLICS FOR A FREE CHOICE CATHOLIC VOICES WITH THE AFROICONSENSUS Abortion and Catholic Thought Through History Most people believe that the Catholic church's on abortion within the Catholic church in a historical position on abortion has remained unchanged for perspective and show the importance of continued 2000 years. Not true. Church teaching on abortion debate and open hearts and minds. has varied continually over the course of its history. There has been no unanimous opinion on abortion at THE FIRST SIX CHRISTIAN CENTURIES: any one time. While there has been constant and BEFORE 600 AD general agreement that abortion is almost always evil and sinful, the church has had difficulty in defining Early Christianity: the nature of that evil. Church hierarchy has Moving Away from Paganism consistently opposed abortion as evidence of sexual Pagan religions had a calm acceptance of sin, but they have not always seen early abortion as contraception and abortion, including the use of an act of homicide. Though not commonly known, barrier methods, coitus interruptus, and various the "right to life" argument is a relatively recent medicines that prevented conception or caused development in church teachings. The debate abortion. continues today. Early Christian leaders, to distinguish Also contrary to popular belief, the prohibition Christianity from Pagan beliefs, developed ideas of abortion is not governed by claims of papal about contraception and abortion, marriage for infallibility. This fact leaves much more room for procreation and the unity of body and soul. They discussion on abortion than is usually thought, with taught that even sex for reproduction was bad and opinion among theologians and the laity differing sex for pleasure was heinous. Chastity became a widely. In any case, Catholics may follow their own virtue in its own right. conscience on moral matters even when it is in conflict with hierarchical views. The current pope's 100 AD: The Debate Begins attempt to make his position on abortion the One of the earliest church documents, the Didache, defining one at the ICPD in Cairo is only one stop condemns abortion, but asks two key questions: 1) Is on a long journey of shifting majority and minority abortion being used to conceal the sins of views within the Catholic church. fornication and adultery? and 2) Does the fetus have a rational soul from the moment of conception or In 400 AD, St. Augustine expressed the does it become an "ensouled human" at a later mainstream view that early abortion required point? This idea of "hominization"- the point at penance only for the sexual aspect of the sin. Eight which a developing embryo becomes a human being hundred years later, St. Thomas Aquinas agreed, -would become one of the cornerstones of the saying abortion was not homicide unless the fetus debate about abortion and remains unsolved even was "ensouled," which he was sure took place well today. after conception. Church teaching that abortion is a serious sin and grounds for excommunication only Early 400s: St. Augustine became established 150 years ago. Says Abortion is Not Homicide St. Augustine (354-430) condemns abortion because The following brief chronology cannot do full it breaks the connection between the conjugal act justice to the twists and turns of theological thinking and procreation. However, in the Enchiridion he says, over the centuries. However, it can put the debate "But who is not rather disposed to think that CATHOLICS FOR A FREE CHOICE 2 unformed fetuses perish like seeds which have not While St. Thomas Aquinas opposed abortion as fructified," clearly seeing actual human life beginning a form of contraception and a sin against marriage, at some point after the fetus has begun to grow. He he maintained that abortion was not a sin of held that abortion was not an act of homicide. Most homicide unless the fetus is ensouled, and thus, a theologians of his era agreed with him.¹ human being.⁵ The general legislative agreement at this time PRE-MODERN PERIOD: 1500-1750 said abortion was a sin requiring penance if it was intended to conceal fornication and adultery. 1588: Making the Penalty for Abortion Excommunication THE MIDDLE PERIOD: 600-1500 Concerned about prostitution in Rome, Pope Sixtus V issued the bull Effraenatum (Without ca. 675: Illicit Intercourse is the Greater Sin Restraint) and applied to contraception and abortion, The Irish Canons place the penance for "destruction at any stage of pregnancy, the penalties designated of the embryo of a child in the mother's womb [at] for a homicide. The prescribed penance was now three and one half years" while the "penance of one excommunication. There were no exceptions for who has intercourse with a woman, seven years on therapeutic abortion.6 bread and water."2 1591: Quickly Relaxing the Rules ca. 8th Century: Recognizing Only three years after Pope Sixtus V issued his Women's Circumstances Effraenatum, he died and Gregory XIV succeeded In the Penitential Ascribed by Albers to Bede, the ideal of him. Gregory felt Sixtus's stand was too harsh and in delayed hominization is again supported, as well as conflict with penitential practices and theological acknowledgment of women's circumstances: "A views on ensoulment. He issued Sedes apostolica mother who kills her child before the fortieth day recommending that, "where no homicide or no shall do penance for one year. If it is after the child animated fetus is involved, not to punish more has become alive, [she shall do penance] as a strictly than the sacred canons or civil legislation murderess. But it makes a great difference whether a does." This papal pronouncement lasted until 1869.7 poor woman does it on account of the difficulty of supporting [the child] or a harlot for the sake of 1679: Denying Abortion to Pregnant Girls concealing her wickedness."³ Facing Murder by Their Families Abortion had consistently been considered wrong if 1140: Gratian Code Holds Abortion Not used to conceal sexual sins. Pope Innocent XI Homicide when Fetus Unformed attempted to define the "outer limits of permissible In 1140, Gratian compiled the first collection of teaching" when he rejected the idea that abortion is canon law- the Gratian code- that was accepted as permissible even in situations in which the parents of authoritative within the church. In the canon a girl would murder her for becoming pregnant. The Aliquando, Gratian concluded that, "abortion was church was still teaching delayed hominization, but homicide only when the fetus was formed.4 If the said hominization occurred some time before the fetus was not yet a formed human being, abortion moment of birth. was not homicide. THE MODERN ERA: 1750-PRESENT 1312: Council of Vienne Confirms Aquinas On "Delayed Hominization" 1869: Requiring Excommunication for The position of this council, still very influential in All Abortions Catholic hierarchical teaching, confirmed the Pope Pius IX's Apostolicae sedis completely ignores conception of man put forth by St. Thomas the question of hominization and requires Aquinas. He said that the fetus is first endowed with excommunication for abortion at any stage of a vegetative soul, then an animal soul, and then pregnancy.9 He said all abortion was homicide. His when the body is developed, a rational soul. This statement was the first implicit endorsement of theory of "delayed hominization" is the most immediate hominization by the church. consistent thread throughout church history on abortion. CATHOLICS FOR A FREE CHOICE 3 1917: Excommunicating Doctors and Nurses NOTES Performing Abortions 1. St. Augustine, De muptis et concupiscentia, 15. 17. In the Code of Canon Law, the first new edition of (CSEL 42.229-230). canon law since Gratian's in 1140, excommunication 2. John T. McNeill and Helena M. Garner, Medieval was required for both the woman and any others, Handbooks of Penance (New York: Octagon books, 1974), PP. 119-120. such as doctors and nurses, who take part in an 3. McNeil and Garner, Medieval Handbooks of Penance, P. 225. abortion.¹⁰ 4. John Noonan, ed., The Morality of Abortion: Legal and Historical Perspectives, (Cambridge, Mass.: Harvard 1930: Condemning University Press, 1970), P. 20. 5. Joseph F. Donceel, S.J. "Immediate Animation and Therapeutic Abortions Delayed Hominization," Theological Studies, Vols. 1 and 2, Pope Pius XI issued the encyclical Casti Connubii (Of (New York and London: Columbia University Press, Chaste Spouses), condemning abortion in general, 1970), P. 86. 6. and specifically in three instances: in the case of Codicis iuris fontes, ed. P. Gasparri, vol. 1, (Rome, 1927), P. 308. therapeutic abortion, which it is killing an innocent; 7. Codicis iuris fontes, ed. P. Gasparri, PP. 330-331. in marriage to prevent offspring; and on social and 8. Actae Sanctae Sedis,5. 298. eugenic grounds as practiced by some 9. Codex iuris canonici, C. 2350. governments. 11 Pius's stance on abortion continues 10. (AAS 22.539-92). as the hierarchical view. This document did not purport to be infallible teaching, but as an address by the pope to the bishops it carried great moral authority. 1965: Protecting the Embryo From the Moment of Conception Vatican II, Gandium et Spes, section 51 declared: "Life must be protected with the utmost care from the moment of conception; abortion and infanticide are abominable crimes." Here, abortion is now condemned on the basis of protecting life, not as a concealment of sexual sin. 1974: Arguing for the "Right to Life" The Sacred Congregation for the Doctrine of Faith issued the "Declaration on Abortion," which argues against abortion on the grounds that "one can never claim freedom of opinion as a pretext for attacking the rights of others, most especially the right to life." The key to this position is that the fetus is human life from the moment of conception, if not necessarily a full human being. The church has now fully changed the terms of argument. Today: Abortion Ban is Absolute The Catholic church hierarchy of today does not permit abortion in any instance, not even in the case of rape or to save the life of a pregnant woman. CATHOLICS FOR A FREE CHOICE #CATHOLIC VOICES WITH THE ONSENSUS Catholics For A Free Choice An Organizational Summary Catholics for a Free Choice is the voice of International Conference on Population and Catholics worldwide who hold progressive Development. In partnership with the Park views on women, reproduction and sexuality. Ridge Center for Health, Faith and Ethics, CFFC's work deals with some of today's most CFFC is also co-sponsor of Religion Counts, an debated cultural and moral issues in some of the inter-religious group of scholars, experts, and most significant forums, including the United leaders providing a positive, ethically sensitive Nations conferences on women, the religious contribution to discourse on issues environment, and population and development. surrounding population, reproductive health, With a skillful and accomplished staff of and development policies. Its Women, Religion, researchers, writers, and analysts, CFFC has and Public Policy project is an effort to extend become an important source of information and outreach across faith lines and across national analysis worldwide on a range of subjects, borders to examine religion's influence on including reproductive health and ethics, public policies related to women. religious fundamentalism, population policy, and Catholic church reform. CFFC carries out its The organization has ECOSOC status at the work through policy analysis, outreach and United Nations, and was a prominent NGO advocacy, and education and communications. participant in the activities surrounding the 1994 CFFC was established in 1973 and has ICPD and the 1995 Fourth World Conference headquarters in Washington, DC, four partner on Women. organizations in Latin America, and a US staff of twenty. CFFC's positions and activities are backed by original, accurate research and study of CFFC articulates sound ethical arguments - myriad resources, including church documents based on Catholic teachings - that support the and references. Publications feature a quarterly right to follow an informed conscience in magazine, Conscience, A Newsjounal of Prochoice making moral decisions about sexual and Catholic Opinion, and a number of titles including reproductive matters. CFFC counters the Catholics and Reproduction: A World View, an efforts of the Roman Catholic hierarchy to see unprecedented collection of opinion and that public policies reflect Vatican positions. In behavior surveys from around the world; When one recent campaign, Catholics for Catholic and Non-Catholic Hospitals Merge: Contraception, CFFC organized a leadership Reproductive Health Care Compromised, a committee of more than 1,000 Catholics in the groundbreaking study of the loss of United States to voice support for international reproductive health services in the United States family planning assistance. as a result of consolidations in the health care industry; Evolution of an Earthly Code, a history of CFFC creates room in the dialogue on the changing church position on family planning reproductive rights for progressive religious and population; and Catholic Options in the voices to present their views on an equal footing Abortion Debate: Reforming Irish Law, a with religious institutions. A CFFC initiative, submission to the Irish government's Catholic Voices, is aimed at lifting up Catholic Interdepartmental Working Group. support for the plan of action adopted by the CATHOLICS FOR A FREE CHOICE 2 CFFC works nationally in the United States CFFC has been led since 1982 by Frances and internationally, particularly in Latin America Kissling, a leader in both the church reform and and Europe, to provide materials to Catholics, the women's rights and health movements policy makers, and the media. We work in internationally. CFFC's board of directors close collaboration with four partner includes theologians, public health experts, and organizations in Latin America: Católicas por el women's' rights leaders. The organization's Derecho a Decidir (Catholics for the Right to funding comes from some of the world's most Decide) in Mexico, Argentina, and Bolivia, and respected philanthropic foundations, such as the Católicas pelo Direito de Decidir (Catholics for Ford Foundation and the MacArthur the Right to Decide) in Brazil. CFFC is a Foundation, as well as from individual respected member of the international reform Catholics. and renewal movement in the Catholic church. CATHOLICS FOR A FREE CHOICE CATHOLIC VOICES AT ONE WITH THE INSENSUS Catholic Voices Catholic Voices, an initiative of Catholics for a Free Christianity, nineteenth and twentieth century Choice, is an international forum on issues of theology, and modern liberation movements. population and development. The forum provides She has been a consultant to the Lily Foundation a space for progressive Catholic leaders to reflect, project "What's Left" on the Roman Catholic research, and participate in national and left in America. Prof. Briggs is a member of the international discourse on women's human rights, steering committee of the Feminist Theology sexuality, and reproductive health. With special and Theory Group of the American Academy of attention to the values and ethics of the Catholic Religion. tradition, Catholic Voices supports public policies and agreements on these issues that promote social Dina Cormick justice, respect human dignity, and honor the rights South Africa of individual conscience. Born in Nkana, Zambia, Dina Cormick is an artist, feminist, and Begun in 1998, Catholics Voices is in political activist. She earned a formation. Membership is in the initial stages; Masters degree in Feminist to date, seventeen Catholic leaders, theologians, Theological Ethics from the University of South and activists from twelve countries have formed Africa in 1993. An active participant in the reform a leadership circle. In December, 1998, Catholic movement in the Catholic church, Ms. Cormick Voices issued its first declaration, "Catholic is a member of the international steering Voices: Reflections from the Paseo de la Reforma," committee of Women's Ordination Worldwide, a from Mexico City. The declaration examines the co-founder of Women's Ordination South Africa, Programme of Action of the International and a member of the Circle of Concerned African Conference on Population and Development Women Theologians. through a Catholic lens. Elfriede Harth Following are brief biographies of the France leadership members of Catholic Voices. Each can Elfriede Harth is a leader in the be contacted through Catholics for a Free Choice Roman Catholic church reform in Washington, DC, at (country movement. She is spokesperson code 01) 202/986-6093, or for the International Movement email, [email protected]. We Are Church, member of the steering committee of Women's Ordination Worldwide, Sheila Briggs and member of Maria von Magdala, an association United States working for women's equal rights in the Catholic Sheila Briggs is Associate church. Ms. Harth is currently working on her Professor in the School of doctoral dissertation on women, Catholicism, and Religion at the University of Southern California. fertility from the Ecoles des Hautes Etudes en Her feminist theology research interests are early Sciences Sociales in Paris. CATHOLICS FOR A FREE CHOICE 2 Teresia Hinga Anthony Padovano Kenya United States Teresia Mbari Hinga is Assistant Professor in A well known theologian, author, the Department of Religious Studies at DePaul activist, and commentator on University in Chicago, Illinois. She has written Catholic church issues, Anthony extensively on issues surrounding women and Padovano holds an S.T.D. from the religion in Africa. Book chapters have included Gregorian University in Rome and a Ph.D. from "Christianity and Female Puberty Rites in Africa: Fordham University. He was president of The Agikuyu Case," "Between Colonization and CORPUS, National Association for Married Inculturation: Feminist Theologies in Africa," Priesthood from 1988 to 1998. He is vice-president and "Gikuyu Theology of Land and of the International Federation of Married Catholic Environmental Justice." Under a research grant Priests, which has members in thirty countries. Dr. from the Rockefeller Foundation, Dr. Hinga Padovano is Professor of American Literature and produced a research report, The Role of Religious Religious Studies at Ramapo College of New Jersey. Networks in the Provision of Education to Women He has been a summer visiting professor at twenty- in Africa. four American universities and has lectured throughout the Americas and in Asia, Europe, Joanna Manning Australia, and New Zealand. Canada Joanna Manning is an acclaimed Rosemary Radford Ruether teacher and writer; in the 1990s she United States won the Canadian Church Press One of the world's leading award for theological reflection. Catholic feminist theologians, Her book, Is the Pope Catholic? will be published Rosemary Radford Ruether by Malcolm Lester Books in March 1999. An teaches courses on the relationship activist for justice, peace, and women's equality, of Christian theology and social justice issues at Ms. Manning started the Rigoberta Menchu Garrett Theological Seminary and Northwestern Centre for Justice, Peace, and Creation, and founded University. The author or editor of twenty-five the Coalition of Concerned Canadian Catholics. She books, among them, Contemporary Catholicism: has a Masters in Theology from Regis College, Crises and Challenges (1987) and Gaia and God: University of Toronto. An Ecofeminist Theology of Earth Healing, she has also contributed to eighty-five book symposia. She Philomena Mwaura writes regularly for the National Catholic Reporter, Kenya Christianity and Crisis, and the Religion News Philomena N. Mwaura is a lecturer in the Service. Dr. Ruether is a frequent lecturer at Department of Religious Studies at Kenyatta conferences and universities; she has lectured University in Nairobi, Kenya. She has a Masters throughout the Americas and Europe, as well as degree in Religious Studies from the University of Israel, Egypt, Japan, Korea, India, the Philippines Nairobi and is currently a Ph.D. candidate. She and South Africa. has taught courses on the church in Africa; women in religion and culture, and development of Valerie Stroud Christian doctrine. United Kingdom Valerie Stroud has served as a Mrs. Mwaura is deeply involved in the ongoing catechist and has been employed in constitutional review process through the Kenya parish administration and pastoral Women Political Caucus. She has organized and care. She served for several years as facilitated workshops and conferences for the Secretary to the Deanery Pastoral Council, a worker Ecumenical Association of Third World for the Diocesan Liturgy Commission and is Theologians and the Circle of Concerned African currently a member of the Diocesan Christian Unity Women Theologians. 3 Commission. Mrs. Stroud represented her diocese in philosophy and letters from the Universidad at the 1996 Council of Churches of Britain and Central de Barcelona. She has been involved for Ireland Assembly. A commissioned Eucharistic several years in a collective, Mujeres y Teologia Minister, Mrs. Stroud now works full time in the (Women and Theology), and in 1997 joined with reform/renewal movement in the Catholic church. four other women to form the group Católicas por She is the UK liaison for the International Movement el Derecho a Decidir (Catholics for the Right to We Are Church. Decide) in Spain. Both groups collaborate on projects with Somos Iglesia de España (We Are Isaac Wüst Church in Spain). For the past two decades, Ms. The Netherlands Alfonso has taught children and adults, and Isaac Wüst works full time in the currently works in a literacy program with women renewal/reform movement in the gitanas (gypsies) in Madrid. Catholic church. He became a priest in 1956 in Amsterdam, where Frances Kissling he was born. He studied Latin American political United States and social sciences at the Catholic University of Writer, advocate, and policy Louvain, and subsequently lived and worked in analyst, Frances Kissling has been Latin America for many years. Mr. Wüst was President of Catholics for a Free executive secretary of the education department of Choice since 1982. An CELAM, the Latin American bishops' conference, internationally recognized non-governmental for five years before leaving the priesthood. In the organization, CFFC works to advance reproductive mid-1970s, he worked as an advisor to a UN project health, women's rights and the strengthening of that introduced new methods for health education, civil society through research, education, and mother and child care, and family planning in remote policy analysis. Ms. Kissling is a highly regarded areas. During the next decade, he was involved in speaker and thinker on issues of religion, many development and education projects throughout reproductive health, women's rights, and Colombia. Since returning to The Netherlands in population policy. Ms. Kissling's views on 1986, Mr. Wüst has worked at the service of parishes reproductive health issues combine a deep respect in Amstelveen and Amsterdam. for the spiritual aspect of life-giving with a passionate commitment to the moral agency of women. Ms. REPRESENTATIVES OF CATHOLICS FOR A FREE CHOICE Kissling has briefed parliamentarians and AND CATHOLICS FOR THE RIGHT TO DECIDE IN THE development professionals in a number of countries, LEADERSHIP CIRCLE OF CATHOLIC VOICES: including Brazil, the United Kingdom, Mexico, the Philippines, Germany, Ireland, Poland, and Marta Alanís throughout the United States. A leading voice Argentina promoting international public policy that advances Marta Alanís is coordinator of Católicas por el Derecho women's health and rights, Ms. Kissling was a a Decidir (Catholics for the Right to Decide) in prominent participant in the United Nations Córdoba, Argentina. Since 1989, Ms. Alanís has conferences on Population and Development (Cairo, worked as a teacher in the Archdiocesan Charities of 1994) and on Women (Beijing, 1995). Córdoba. She has worked in human rights communities in Bolivia, France, and Nicaragua, Teresa Lanza Monje focusing particularly on indigenous women's literacy. Bolivia Committed to both liberation and feminist theologies, Teresa Lanza is coordinator of Católicas por el Ms. Alanís has studied with liberation theologian Derecho a Decidir (Catholics for the Right to Leonardo Boff and feminist theologian Ivone Gebara. Decide) in Brazil. A lawyer, Ms. Lanza graduated from the Universidad Mayor de San Andres in Paloma Alfonso La Paz, where she conducted research for her Spain thesis on sexual and reproductive rights and the Angeles Paloma Alfonso Aguirre earned her degree problem of abortion in Bolivia. She is a founder 4 of Género Y Teología (Gender and Theology), an ecumenical collective of pastors and Marysa Navarro-Aranguren theologians. She has written several opinion United States columns on women's rights for major daily Marysa Navarro is Charles Collis newspapers. Currently, Ms. Lanza is involved Professor of History and Chair of in providing information to legislators, opinion the Latin American, Latino and leaders, health providers, and the news media Caribbean Studies Program of on the positions of CDD. Dartmouth College, where she has taught for thirty years. She is an academic and also an activist. She María Consuelo Mejía has been a member of the board of directors of the Mexico Ms. Foundation for Women, the Global Fund for An anthropologist, feminist, and Women and Catholics for a Free Choice, which Catholic activist, María she presently chairs. Consuelo Mejía directs Católicas por el Derecho a Decidir Maria José Rosado Nunes (Catholics for the Right to Decide) in Mexico. Brazil Ms. Mejía was named to Mexico's country Maria José Nunes is coordinator of delegation to the International Conference on Católicas pelo Direito de Decidir Population and Development in 1994 and (Catholics for the Right to Decide) participated in the 1995 Fourth World in Brazil. She is a graduate Professor Conference on Women. Born in Bogotá, in Religious Studies at the Pontifical Catholic Colombia, she became a naturalized Mexican University in São Paulo and at the Methodist citizen in 1984. She received her Masters degree University of São Paulo. Ms. Nunes is a director and in Latin American Studies from the National past vice-president of the Institute for Religious Autonomous University of Mexico (UNAM) in Studies in Rio de Janeiro. With a grant from the 1986. Since 1990, she has worked as a researcher MacArthur Foundation, she managed a research in the Interdisciplinary Humanities Research project on the Catholic position on abortion. Ms. Center and as a consultant for the University Nunes is an award winning author and frequent Program on Gender Studies at UNAM. contributor to national and international magazines.