The share of Belgium’s total expenditure on international cooperation spent on health and reproductive health has fallen to 11% in 2018, the lowest percentage in 4 years. A downward trend is found over the course of the previous legislative period, from 14% in 2015, 12.7% in 2016 and 12.4% In 2017. The trend is shown in the audit of the 2018 ODA expenditure by DGD, conducted by Sensoa, the Flemish centre of expertise on sexual health, which compared the 2018 expenditure with previous years. 

For World Aids Day, the ‘Parliamentarians for the 2030 Agenda’ invited UNAIDS Brussels Representative Dr. Jantine Jacobi, Burundian youth representative Fabien Ndikuriyo, Stéphanie Drèze of MSF and Dr. Gert Scheerder of Sensoa to discuss the HIV epidemic worldwide, in Belgium and in Belgium’s partner countries. 

Georges Dallemagne, Belgian MP and member of the Parliamentarians for the 2030 Agenda visited the Philippines and learned about the country's outstanding challenges in living up to the needs of its young population. 
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The Philippines counts as many as 104 million people and is the 13th most populated country in the world. The country has seen an unprecedented growth of its population, in part due to the lack of access to family planning. The Philippines’ ultraconservative catholic church forbade access to contraception and while its influence is said to be slowly lessening, it is still having a huge impact on the family planning decisions of citizens. Only 40% of all young women have access to contraceptives and one in 10 girls has their first child before the age of 10.

Belgium’s all-party parliamentary group ‘Parliamentarians for the 2030 Agenda’ hosted a seminar on 25 years ICPD Programme of Action in the Belgian Senate, days after the ICPD Nairobi Summit of 12-14 November. 

Taking stock
UNFPA Brussels Director, Sietske Steneker, introduced the MPs to the successes as well as the unfinished business in realising the ICPD Programme of Action. In the past 25 years, maternal mortality dropped by 40%, adolescent birth rates by one third, early marriages by one fourth and more women had access to family planning. 
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At the same time, progress has been slow and uneven. In Sub-Saharan Africa, maternal mortality remains an enormous challenge. Worldwide, only 50% of all women have the right to decide to use family planning. The barriers are multiple, including the out-of-pocket costs, the mentality of service providers, and, at the core of it all, the persistence of gender inequality. 

On October 10th, at the federal parliament in Brussels, the ‘Parliamentarians for the 2030 Agenda’, Belgium’s APPG on sexual and reproductive health and rights, kicked off for a new legislative period. The group unites parliamentarians from all colours, invested in advancing gender equality, health and rights internationally, as put forward in the ICPD Programme of Action and the SDGs.
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The group, likely to make up around 30 members, will see to Belgium’s international role to achieve the ICPD PoA and the SDGs, and more specifically SDG 3, to achieve health and wellbeing for all, and SDG 5, to achieve gender equality and women’s empowerment. They will do so by convening regularly, informing the public, participating in international delegations, visiting the field, inquiring the government and drafting resolutions. 

More than half of the world’s population currently lives in cities, with one in three living in slums. By 2030, the world is projected to have 43 megacities with more than 10 million inhabitants, most of them in developing regions. While one in eight people currently live in 33 megacities worldwide, close to half of the world’s urban dwellers reside in secondary cities with fewer than 500,000 inhabitants. These secondary cities, particularly in Africa and Asia, are also expected to grow very fast. Reason enough for Be-cause Health, Belgium’s platform on international health, to take the urban turn, and put the spotlight on how to ensure the right to health in cities. In tandem with the Institute of Tropical Medicine, Sensoa organised two panels that took on the challenges of health service delivery in mega-cities and urban slums. 

In the Flemish government agreement for 2019-2023, the government is committed to combating sexual and gender based violence, with particular attention for the prevention of forced marriages, honour-related crimes and female genital mutilation. Sexual health should equally receive the needed attention. In Flanders’ international cooperation the government is also quoted as being committed to projects that improve equality between the sexes, with a special focus on women’s education and the promotion of SRHR.

The promise of 0.7%
The new Flemish government will contribute to the realisation of the SDG Agenda 2030 in developing countries. Belgium currently spends only 0.4% of its GNI on development cooperation, despite the legal obligation of 0.7%. In the coming legislature, the Flemish government promises to make further efforts to finally reach the 0.7% standard at Belgian level.

Flanders' bilateral cooperation plans
The Flemish government is to continue its bilateral cooperation with Malawi and Mozambique, whereas cooperation with South Africa will be reoriented from development to “strong political-economic diplomatic cooperation”. The new Flemish Prime Minister Jambon also expressed the intention to set up a new cooperation with one or more countries in the North and East Africa region. The future partner country is said to be selected based on  its current cooperation with the EU in the fight against human trafficking and illegal migration. The new government is thus joining the trend of using development cooperation funds for the management of migration flows.

Should we be counting on the private sector?
In addition, the new government is looking at the private sector to step in with development cooperation through public-private partnerships. Public funds are only deemed needed where private partners cannot bear the risk (alone), or when they fail to deliver a suitable solution. The call for private sector support for development should not come at the cost of social sectors, including SRHR, as these are traditionally dependent on ODA support. Mechanisms seeking to mobilise private sector resources are primarily focused on non-social sectors such as infrastructural projects. Moving away from traditional ODA support and towards private sector mechanisms thus brings a real risk of reducing donor investments in sectors such as health, education and SRHR.

​Finally, the government sets out to move part of the development cooperation resources towards more Flemish emergency aid. Increasing support for humanitarian aid is welcome, but it should not come at the cost of development cooperation, which could help prevent disasters from happening in the first place. 

Early October Inspire, the European Partnership for Sexual and Reproductive Health and Rights (SRHR) convened European and international SRHR advocates in the ancient city of Athens. The conference focused on the upcoming 25th anniversary of the International Conference for Population and Development (ICPD) in Cairo (1994) and collected best practices as well as European input for the ICPD Nairobi Summit. Participants were invited to share successes by the SRHR community, and to reflect on the ongoing push-backs to SRHR from conservative and populist movements.

Belgium put sexual and reproductive rights in the spotlight during the ‘European Sustainability Week’ in Berlin, June 2019. Sensoa participated in a panel with Moroccan documentary maker Mohammed Nabil and human rights activist Katrin Erlingsen of the NGO Deutsche Stiftung Weltvölkerung (DSW) at the Belgian Embassy in Berlin.

New Lancet Series on Gender Equality, Norms, and Health exposes failures by governments and health institutions to make progress towards gender equality, despite compelling evidence on impact of gender - and the spoken and unspoken rules of societies about acceptable gender behaviours - on health.