Gains made in preventing mother-to-child transmission of HIV could be reversed, with new HIV infections among children up by as much as 162% and setting the clock on AIDS-related deaths back to 2008, a modelling group convened by the World Health Organization and UNAIDS estimated. If no efforts are made to mitigate and overcome interruptions in health services and supplies during the COVID-19 pandemic, a six-month disruption of antiretroviral therapy could lead to more than 500,000 extra deaths from AIDS-related illnesses in sub-Saharan Africa in 2020–2021.
The crisis affects every country, every individual person, but we still need to guarantee a global approach. More than ever, this crisis demonstrates how our lives are interconnected. In other words, a solidary, joint response will be necessary.
Sensoa International works with other organisations, including umbrella organisation IPPF, Belgian health and development organisations to steer the policy of Belgium, other EU member states and partner countries. We inform policymakers and advocate to safeguard sexual and reproductive rights, also in times of Covid-19.
The weakness of healthcare structures in developing countries will now become painfully clear and be a major threat to the global spread of the virus. Together with its partners, Sensoa International is therefore focusing on the importance of strengthening health systems, ensuring the continuity of care, and the promotion of universal healthcare coverage, which should include sexual and reproductive health services and family planning.
Sensoa International advocates to keep up and increase the necessary financial support. Existing official development assistance (ODA) should not be diverted to tackle the current crisis, as this creates new problems. Instead, new funds should be set up to counter the spread of Covid-19 and to address the large-scale side effects of the approach in a spirit of solidarity.
Measures to deal with the pandemic should not result in restrictions of human rights, democracy and the critical role of civil society and media. Jointly with our civil society partners in Belgium and abroad, we are watching and alerting policy makers when human rights, and particularly sexual and reproductive rights are at risk.
Quarantine affects the access to contraceptives for women worldwide:
Contraceptives are threatening to become scarcer and scarcer. This is due to different factors. For example, large NGOs as well as contraceptive manufacturers warn that the supply chains of various contraceptive products are severely disrupted. China, the world's second-largest exporter of pharmaceuticals, has closed several drug production plants, which in turn has caused delays in Indian plants producing generic drugs, including anticonception.
The demand for long-term contraceptives (such as the coil or the implant) will increase. For example, after Trump took office as president of the US, the demand for coils increased as women feared that access to other contraception would become more difficult.
As governments around the world are severely restricting the mobility of their citizens, the use of contraceptives will also decline. Particularly women who depend on public transport to travel, or who are currently without income, may find it difficult to get anticonception prescriptions and buy anticonception. What's more, family planning clinics might be temporarily closed.
The reduced access to contraceptives comes on top of the already existing needs of women. 214 million women in the Global South who want to use contraceptives already had no access to it before the crisis. Their numbers are increasing.
Audit shows decreasing Belgian support for health and reproductive health in its international cooperation
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.
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.
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.
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.
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.