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WORKING GROUP II

VIII: HEALTH, MORBIDITY AND MORTALITY

C. Maternal Health and Safe Motherhood: In 8.16(a) (objective), the EU, supported by Hungary, the Dominican Republic, Brazil, Poland, Finland, Cuba, Bolivia and Tunisia, requested a statement on reducing unsafe abortions. The Holy See requested reference to the commitment to women's health to reduce the number of abortions. Ecuador remarked that maternal mortality is not limited to unsafe abortion. Malaysia, the US, Botswana, Peru and Bolivia agreed and said although abortion may be illegal, it does occur and should be dealt with as a public health issue. C“te d'Ivoire said that abortion may be allowed only within a limited legal framework, and any reference to unsafe abortion should be replaced with "abortion with its complications." Pakistan said that prohibiting abortion to save the mother's life endangers the life of the unborn. The Holy See and Malta referred to the lack of a clear definition of safe motherhood.

In 8.16(b) (objective), delegates agreed to add breast- feeding as a factor in promoting the health and nutrition of pregnant women. In 8.17 (target date to reduce maternal mortality), delegates agreed that each country should set its own goals according to its resources. In 8.18 (primary health care), some delegations continued to question the definition of safe motherhood. Malaysia and the Philippines called for a glossary of terms. The Chair accepted Malaysia's request to include post-natal care. In 8.19 (government roles in managing maternal mortality), Mexico proposed language identifying high risks for future pregnancies. The Holy See, Malta and Honduras agreed with Mexico, but requested replacement of "unwanted" with "unplanned" pregnancies. The Chair reminded that in 4.24 agreement was reached on the term "unwanted pregnancies." The Chair asked to delete "unsafe, harmful abortions" in light of the considerable discussion on this issue. He added the importance of "late parity" as a pregnancy risk. In 8.20 (delaying first pregnancy), Bangladesh, supported by Iran, suggested replacing the last sentence with "Young adults should be provided with information to help them decide responsibly about the timing of their first child."

Discussion of 8.21 (abortion) was carried out on a sentence-by-sentence basis. In the first sentence, brackets were left around "unsafe." India supported the present formulation. Pakistan urged its retention, since it reflects the reality that some pregnancies are simply not wanted. Sweden, opposed by Hungary, suggested deletion of "eliminate the causes of abortion" with "reduce the need for." The Chair supported Bolivia's suggestion to refer to the causes of abortion. Norway proposed "counseling to reduce the rate of abortion." In the fourth sentence, which calls on governments to assess the impacts of abortion, Nicaragua, Venezuela and Guatemala requested its deletion, arguing that it was an intrusion on sovereign jurisdiction. Canada, Botswana, Bangladesh, El Salvador, Chile, the US, Japan, Mexico, Brazil, India, Norway, Turkey and Bolivia supported its retention. The Chair reminded delegates that the sentence was actually taken from a Holy See formulation. In the fifth sentence, Ecuador deleted the reference to women's well-being and added reference to the moral, cultural and religious context of each country. Peru, supported by Malaysia, Bolivia, Mexico and Iran suggested "governments should consider within their laws and policies related to abortion, humane conditions oriented towards the protection of women's health and well-being." The US, supported by Bangladesh, proposed "governments are urged to frame laws and policies on the basis of a commitment to women's health and well-being." C“te d'Ivoire insisted that where the mother's health is in danger, national laws should regulate conditions for access to abortion. In the sixth sentence, Sweden added the criterion of "affordable." Peru, supported by Uganda, Mexico and others, suggested language to provide all women with the same options for abortion counseling and services. Honduras insisted that her government prohibits her from even talking about abortion in this forum. Canada and Finland called for deletion of the sentence because it is repetitive. In the eighth sentence, delegates agreed to add reference to counseling and education. The Holy See and Indonesia called for deletion of "family planning." The EU tabled new text for 8.21.

In 8.22 (maternal mortality programmes), delegates agreed to the reference to contribution of the parity, spacing and timing of births on maternal mortality. Some delegates affirmed the importance of the right of couples to decide the number of children. Delegates agreed to replace reference to pre-and post-marital counseling with a term that was not tied to marital status. In 8.23 (male responsibility in reproductive health), the Holy See deleted "reproductive health including contraception" since they are not central to male responsibility. C“te d'Ivoire said that "high risk sexual behavior" is not the domain of men. Bolivia, supported by China and the US, added reference to AIDS and to sexual health. The Holy See agreed to the paragraph if "contraception" is replaced with "family planning."

D. Human Immunodeficiency Virus (HIV) Infection and Acquired Immune Deficiency Syndrome (AIDS): In 8.25(a) (objective), Brazil mentioned the lack of emphasis on the individual. The US addressed the socio-economic, gender and racial factors that increase vulnerability to the disease. Norway added the importance of AIDS-associated diseases, particularly tuberculosis. In 8.27 (programmes to reduce AIDS), the Holy See, supported by Guatemala and El Salvador, referred to studies that question the reliability of the condom, and supported abstinence as the only method of prevention. Brazil disagreed. Bolivia and El Salvador requested retention of "condom" and "safe sex" and added "voluntary" before "abstinence." In 28 bis (governments' role in the fight against AIDS), Thailand emphasized research and Malaysia mentioned the financial inability of some countries to conduct research. The US requested development of anti-virus agents for women. In 8.29 (prevention and protection), the Holy See objected to the reference of condoms as the only method of protection. Botswana and Colombia stated that although the use of condoms may not be totally reliable, it should be included. Bolivia, supported by a large number of delegates, asked to include voluntary abstinence as a protection method.

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