This is what the Guttmacher-Lancet Commission “Accelerate progress – sexual and reproductive health and rights for all” states in no uncertain terms. The report documents the magnitude of the SRHR needs, provides a comprehensive definition of SRHR and a roadmap on how to advance universal access to SRHR.
The commission underlines that the improvement of people’s health depends on individuals’ ability to make decisions about their own sexual and reproductive lives and respecting the decisions of others. The commission’s report is the result of two years of joint collaboration of 16 respected SRHR experts from different parts of the world. Belgian Prof. Dr. Marleen Temmerman was one of them.
The Commission’s report finds that almost all 4.3 billion people of reproductive age worldwide will have inadequate reproductive health services over the course of their reproductive years. This includes more than 200 million women in developing regions who want to avoid pregnancy but are not using modern contraception, 350 million men and women a year who need STI treatment and the nearly 2 million people who are newly infected with HIV.
A new, integrated definition of SRHR
The report sets out the integrated definition of sexual and reproductive health and rights which includes not only reproductive but also sexual rights:
Sexual and reproductive health is a state of physical, emotional, mental and social wellbeing in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction or infirmity. Therefore, a positive approach to sexuality and reproduction should recognise the part played by pleasurable sexual relationships, trust and communication in promoting self-esteem and overall wellbeing. All individuals have a right to make decisions concerning their bodies and to access services that support that right.
Achieving sexual and reproductive health relies on realising sexual and reproductive rights which are based on the human rights of all individuals to:
- have their bodily integrity, privacy and personal autonomy respected
- freely define their own sexuality, including sexual orientation and gender identity and expression
- decide whether and when to be sexually active
- choose their sexual partners
- have safe and pleasurable sexual experiences
- decide whether, when and whom to marry
- decide whether, when and by what means to have a child or children, and how many children to have
- have access over their lifetimes to the information, resources, services and support necessary to achieve all the above, free from discrimination, coercion, exploitation and violence
An essential package of SRH interventions
The Guttmacher-Lancet Commission also recommends an essential package of sexual and reproductive health interventions that aligns with this comprehensive definition of SRHR. The package includes the commonly recognised components of sexual and reproductive health, including contraceptive services, maternal and newborn care, and prevention and treatment of HIV/AIDS. It also includes less commonly provided interventions that are necessary for a holistic approach to addressing SRHR: care for STIs other than HIV; comprehensive sexuality education; safe abortion care; prevention, detection and counselling for gender-based violence; prevention, detection and treatment of infertility and cervical cancer; and counselling and care for sexual health and wellbeing. Attention for STIs other than HIV and infertility is often overlooked, yet much needed. About 180 million couples worldwide suffer from infertility problems.
The road ahead
The report provides a roadmap towards the universal coverage to the full range of SRHR information and services. A must to advance the realisation of SDG 3 and 5 and the overall 2030 Agenda.
The cost of providing universal access to contraception, maternal health and safe abortion care – as a first step towards universal coverage of all services – is estimated to be as low as $9 per person, per year.