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THE PROGRAMME OF ACTION

Beginning on Wednesday, 6 April 1994 and continuing through Wednesday, 20 April 1994, the focus of attention shifted to the two working groups who were responsible for negotiating the chapters in the draft Programme of Action. Working Group I, under the chairmanship of Lionel Hurst (Antigua and Barbuda), addressed the following chapters: III. Interrelationships between Population, Sustained Economic Growth and Sustainable Development; XI. Population and Development Information, Education and Communication; XII. Technology, Research and Development; XIII. National Action; XIV. International Cooperation; XV. Partnership with the Non-Governmental Sector; and XVI. Follow-up to the Conference. Working Group II, under the chairmanship of Nicolaas Biegman (the Netherlands), addressed the following chapters: IV. Gender Equality, Equity and Empowerment of Women; V. The Family, its Roles, Rights, Composition and Structure; VI. Population Growth and Structure; VII. Reproductive Rights, Sexual and Reproductive Health and Family Planning; VIII. Health, Morbidity and Mortality; IX. Population Distribution, Urbanization and Internal Migration; and X. International Migration. The preamble and principles (Chapters I and II) were discussed by a Committee of the Whole, under the chairmanship of PrepCom Chair Fred Sai.

During the first week of the PrepCom, delegates proposed amendments to the Secretariat's draft final document of the Conference (A/CONF.171/PC/5). During the second and third weeks, the Working Group Chairs produced revised versions of each chapter for the consideration of delegations. During the last three days of the PrepCom, delegates considered each chapter one final time in Plenary. Although the Chair had hoped to remove as many as the remaining brackets as possible, some of the more divisive issues could not be resolved. Thus, the PrepCom adopted the final draft Programme of Action and sent the text, brackets and all, to the Conference in Cairo.

To facilitate understanding of the current status of the Programme of Action, the following report is presented on a chapter-by-chapter basis.

I. PREAMBLE

PrepCom II had mandated the Secretariat to prepare a preamble that would both serve as a chapeau to the substantive chapters and reflect other related international conferences and instruments. During a brief discussion of the preamble by the Committee of the Whole, PrepCom Chair Fred Sai expressed concern that some amendments eliminated references to important themes in the original preamble. Sweden, supported by Norway and New Zealand, proposed that the preamble be drafted as an executive summary. Australia suggested that the preamble should be incorporated as the Cairo Declaration. Delegates were asked to submit their comments to the Secretariat.

During the last week, the Secretariat circulated a revised version of the 21-paragraph preamble. The preamble references a number of topics, including: the socio-economic and political challenges facing the international community; population growth; the demographic future; the relationship between the ICPD and other Conferences; changes in attitudes towards family planning; levels of morbidity and mortality; death rates and maternal mortality; life expectancy; education levels; role and status of women; internal and international migration; population ageing; and a discussion of quantitative and qualitative goals for population and development policies.

When it was time to consider the preamble on the last day, Algeria, on behalf of the Group of 77 (G-77) and China, proposed that further formal discussion be deferred until Cairo. Informal consultations on the preamble are expected to continue up until the Cairo Conference.

II. PRINCIPLES

When the Committee of the Whole considered the principles on Tuesday, 19 April, Dr. Sai reported that he had held consultations aimed at streamlining this chapter. The G-77 called for a principle to address the rights of migrants. Australia, New Zealand and Bolivia suggested stronger reference to the specific problems of indigenous people. Australia also requested stronger language on the participation of women. India insisted that the text take into account sustained economic growth. Morocco supported India and called for reference to the problem of international migration. Nepal requested reference to safe motherhood wherever reproductive health and family planning is mentioned. Canada and the US said that where principles are derived from other instruments, they should be quoted exactly.

Sweden suggested four possible bases for action: relevant UN conferences; other documents on the status of women and children; other basic UN instruments, such as the UN Declaration on Human Rights; and a short chapter summarizing the basis for the ICPD's work. Yemen regretted the lack of commitment from developed countries to assist developing countries and called for principles to address international support. Dr. Sai said that issues related to women's participation, socio-economic development, migrants and indigenous people will be reflected in the revised text.

Norway suggested adding inter-generational equity to Principle 5 (reduce and eliminate unsustainable patterns of production and consumption). The Russian Federation suggested adding reference to countries with economies in transition to Principle 6 (eradicating poverty). Pakistan noted that Principle 7 (right to liberty and security of person) should provide the basis for unbracketing references to reproductive health and family planning throughout the Programme of Action. On Principle 7, Norway added reference to the basic right to decide freely and responsibly the number and spacing of children. Dr. Sai confirmed that Principles 8 (freedom of choice provided by sexual and reproductive health care programmes) and 10 (family as a basic unit of society) would be held in abeyance pending the completion of negotiations.

The Chair circulated a revised text during the last week. It contains 15 principles primarily derived from other documents, including the Rio Declaration, the Universal Declaration of Human Rights, and the International Covenant on Economic, Social and Cultural Rights. When it was time to consider the principles on the last day, Algeria, on behalf of the G-77 and China, proposed that further formal discussion be deferred until Cairo. In the meantime, informal consultations on the principles will continue.

III. INTERRELATIONSHIPS BETWEEN POPULATION, SUSTAINED ECONOMIC GROWTH AND SUSTAINABLE DEVELOPMENT

This chapter contains three sections: integrating population and development strategies; population, sustained economic growth and poverty; and population and the environment. During the debate in Working Group I, there was considerable disagreement regarding the reference to the importance of eliminating social and economic discrimination against women, who form the majority of the world's poor. There was disagreement between the European Union (EU) and the US and the G-77 regarding the reference to sustained economic growth as essential to poverty eradication. There was also conflict between the G-77 and the Eastern Bloc countries regarding the placement of developing countries and countries with economies in transition on an equal footing. Finally, some delegates, specifically the G-77 and China, wanted to shorten the third section so that it effectively referenced Agenda 21, rather than elaborating a number of action items on population and the environment. The US commented that Agenda 21 did not adequately address population issues and there was a need to elaborate action items here. A compromise was reached where Agenda 21 was referenced and all other action items are to be consistent with Agenda 21.

Some of the issues remaining to be resolved in Cairo include: reference to the right to development and the guarantee of human rights (3.13); all references to sexual and reproductive health and family planning (until these issues are adequately defined in Chapter VII); reference to creating and sustaining democratic institutions, good governance and transparency (3.19); and the international community's responsibility to promote an enabling economic environment (3.20).

IV. GENDER EQUALITY, EQUITY AND EMPOWERMENT OF WOMEN

This chapter contains three sections: empowerment and the status of women; the girl child; and male responsibilities and participation. During the discussion of this chapter in Working Group II, Switzerland and Sweden called for the deletion of target dates for universal education. Indonesia insisted that some forms of discrimination are justifiable. Malaysia and most Muslim delegations objected to equal inheritance rights for women. There was also a debate on the use of the terms "gender equity" and "gender equality." Canada preferred the use of equality, whereas Norway wanted to use both terms.

At the request of the EU, reference to the goal of universal primary education for all by the year 2015 (4.15) remains in brackets pending the discussion on goals. The only other brackets in this chapter are around the terms "reproductive and sexual health," at the request of the Holy See, pending definition.

V. THE FAMILY, ITS ROLES, RIGHTS, COMPOSITION AND STRUCTURE

This chapter contains two sections: diversity of family structures and composition; and socio-economic support to the family. A potential problem with the definition of the "family" was easily resolved since the UN General Assembly adopted a resolution on the International Year of the Family in October 1993. Delegates agreed to use this definition in paragraph 1: "While various concepts of the family exist in different social, cultural and political systems, the family constitutes basic units of social life and as such are entitled to receive comprehensive protection and support." Vanuatu had called for reference to discrimination based on sexual orientation, but it was not acceptable to all delegations.

The only brackets remaining in this chapter are around "reproductive," until the definition of this term is resolved in Chapter VII.

VI. POPULATION GROWTH AND STRUCTURE

This chapter contains the following sections: fertility, mortality and population growth rates; children and youth; elderly people; indigenous people[s]; and persons with disabilities. The last section, persons with disabilities, was not included in the original text, but was added at the request of Sweden and Madagascar. Reference to the elderly originally used the term "ageing populations," however, New Zealand and Switzerland proposed using the terms "elderly" or "older people" instead. During the discussion, Honduras insisted that "access to reproductive health" by youth should not compromise parental rights' to information. The Plenary reached agreement on compromise language, which is also used in Chapter VII, that reads: "with the support and guidance of their parents and in line with the Convention on the Rights of the Child."

There was also disagreement about the reference to "indigenous people." Australia requested the pluralized term, "peoples." Canada and others argued that "people" is accepted UN language. The Secretariat mentioned that there is a UN working group addressing this issue and that they would consult with this group and transmit the group's recommendations to the ICPD in Cairo. Thus, the "s" remains bracketed throughout the text.

In addition to the usual brackets around "reproductive health and family planning services" and "reproductive rights," the phrase "international migration" with regard to the disabled was bracketed. The Philippines and Cameroon argued that limiting the movement of people with disabilities is discriminatory. Switzerland argued that its laws require immigrants to work. The Chair pointed out that this issue is also addressed in Chapter X (International Migration) and should be discussed there.

VII. REPRODUCTIVE RIGHTS, SEXUAL AND REPRODUCTIVE HEALTH AND FAMILY PLANNING

This chapter covered some of the most controversial issues to be addressed by the ICPD and brought the Holy See and a handful of other Catholic countries head-to-head with those countries who advocate or do not object to sexual and reproductive health programmes, including family planning, that may include abortion and contraception. Although delegates attempted to reach agreement on definitions of these terms that would be acceptable to all, it was not to be.

During the lengthy debate on this chapter, Bolivia, Mexico and Peru called for the expansion of reproductive health to include sexual health. The definition of reproductive health was vehemently opposed by the Holy See and others who objected to the phrase "fertility regulation." The EU and Bolivia called for the right to confidentiality, but Nicaragua objected, stressing that adolescents' right to confidentiality jeopardizes parental rights to information about their children. The Holy See and a few others disagreed with the rest of the Working Group regarding the reference to "individuals and couples." They preferred "men and women," since it could not be implied to include adolescents. Likewise, Honduras and Morocco objected to reference to providing reproductive health care to individuals "of all ages," since this would include adolescents.

There was also disagreement on the provision of the "full range" of family planning services. Malaysia preferred the "widest possible range" since some countries may be unable to provide the "full range." Governments could not agree on the enumerated list of barriers to informed choice. Malta and others made continual charges of cultural imperialism and insisted that they would never submit to international pressure on family planning and related matters. While the US and the Philippines wanted reference to high-quality condoms, the Holy See insisted on brackets around condoms, advocating voluntary abstinence as the only reliable method of combatting AIDS and other STDs.

When this chapter was considered by the Plenary on the final day of the PrepCom, it appeared as though precious time would be wasted as delegates restated their well-known positions. Costa Rica, Argentina, Malta, Venezuela, Morocco and Ecuador argued passionately that they would not agree to any term that was not defined in such a way that it could not be interpreted as to include abortion. Dr. Sai noted that 173 countries have abortion permitted in some form or another, usually to safeguard the health of the mother, and, thus, the majority of mankind has accepted abortion. Delegates agreed to hold further consultations on the definitions of these controversial terms and until then, the chapter remains heavily bracketed. Phrases or terms in brackets include: "fertility regulation;" "reproductive and sexual health;" reference to confidentiality of family planning services; the principle of voluntary choice in family planning; reference to "abortion" in 7.18 bis and 7.37; sexual education "at an early age;" and all of paragraph 7.38, which refers to removing barriers to sexual and reproductive health information and care for adolescents. The Holy See agreed to remove the brackets from "contraceptives" and "couples and individuals," but expressed its reservations for the record.

VIII. HEALTH, MORBIDITY AND MORTALITY

This chapter contains the following sections: primary health care and the health-care sector; child survival and health; women's health and safe motherhood; and human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). During the discussion of this chapter in Working Group II, the Holy See objected to any reference to contraception, insisting instead that single individuals should practice abstinence. There was disagreement regarding the inclusion of life expectancy targets. There was also disagreement regarding the term "unwanted" pregnancy with the Holy See insisting that it devalued the fetus. The Holy See called for deletion to the reference to family planning. C“te d'Ivoire insisted that high-risk sexual behavior is not the domain of men. The Holy See and others called into question the reliability of the condom and questioned the reference to condoms as the only method of AIDS protection. These same countries argued that "safe motherhood" could be construed as including safe abortion, and insisted on bracketing the term.

During the final discussion of the chapter in Plenary, delegates retained the brackets around statements of goals for life expectancy, reduction of infant and child mortality, and reduction of maternal mortality. Further informal consultations will be held to address the issues of goals throughout the text. Honduras, supported by Malta, insisted on bracketing reference to "safe motherhood" programmes, since these may include abortion. Dr. Sadik said that safe motherhood is to protect the health of mothers and if we cannot protect the health of women, we might as well give up. India and Nepal made passionate pleas for the removal of the brackets. The Holy See called for written assurance in the document that safe motherhood programmes do not include abortion. Brackets also remain around "unsafe abortion" and "reproductive health services."

IX. POPULATION DISTRIBUTION, URBANIZATION AND INTERNAL MIGRATION

This chapter contains three parts: population distribution and sustainable development; population growth in large urban agglomerations; and internally displaced persons. The US wanted to include environmental degradation as one of the push factors as they relate to migration flows. India, Malaysia and the Philippines disagreed. Other issues include: ethnic cleansing, mechanisms for compensation to and the rights of internally displaced people, and the need for population distribution policies to be consistent with other international instruments.

During the final plenary session, delegates accepted new language on the issue of consistency with other international instruments in paragraph 9.7 bis: "Population distribution policies should be consistent with such international instruments as, when applicable, the Fourth Geneva Convention Relative to the Protection of Civilian Persons in Time of War (1949), including Article 49." All other brackets were removed, with the exception of 9.18 (solutions to the problem of internally displaced persons). India emphasized that international measures to find solutions to questions relating to internally displaced persons may jeopardize national sovereignty. The US, supported by Croatia, Turkey, the Holy See, Guatemala, Pakistan, Egypt, the EU and Switzerland, disagreed. It was agreed to bracket reference to national and international measures instead of the entire paragraph.

X. INTERNATIONAL MIGRATION

This chapter contains four sections: international migration and development; documented migrants; undocumented migrants; and refugees, asylum seekers and displaced persons. During the discussion in Working Group II, Cuba objected to reference to the creation of market- oriented economies in all countries in the paragraph on measures to keep people in their home countries. The EU opposed reference to the equitable sharing of responsibilities in the context of ensuring international protection of refugees.

There was disagreement on the right of family reunification, since it was not clear what constituted "the family." Cameroon, Guinea and Niger disagreed with the concept of refugee resettlement at borders close to their home. Brazil proposed compromise language that would take the issue of safety into consideration, while giving preference to resettlement close to their homelands.

After the Plenary's consideration, brackets remained around respect for the "[human] rights of [individuals belonging to] minorities, indigenous people[s] and [political opponents]." The G-77, China, the Holy See, Hungary and Canada wanted "human" and "individuals" deleted. The US and the EU supported their retention. Uganda, Hungary and Canada wanted "political opponents" retained. The US and Mali disagreed. Brackets also remain around the right of family reunification. The US was concerned that there was no definition of the family and family reunification could, in effect, include cousins and in-laws. Turkey ardently supported retaining "right." Paragraph 10.23 on rights of refugees and displaced persons arising from forced migration, was resolved at the last moment with the word "repatriation" replacing reference to their homes and properties.

XI. POPULATION AND DEVELOPMENT INFORMATION, EDUCATION AND COMMUNICATION

This chapter does not contain any sub-sections. During the discussion in Working Group I, Sweden proposed encouraging gender and racial sensitivity. India thought there was no need to mention the latter. The US, supported by Sweden, Norway, Burundi and Malaysia, proposed a new objective to enhance the ability of couples and individuals to make informed reproductive choices. The Holy See bracketed the need to reference "couples and individuals" and "reproductive choices." The EU disagreed with the Holy See, Honduras, Morocco and Guatemala regarding the need to reference ethical values. There was also a protracted discussion on the role of soap operas as a means of encouraging public discussion of important but sometimes sensitive topics relating to the implementation of this Programme of Action. Some delegates did not think "soap operas" was a serious term, but the Secretariat said that this term is now commonly used in the relevant literature. The Holy See and the EU also disagreed on the reference to the rights, responsibilities and values of parents.

Brackets remain around all references to "sexual and reproductive health" and "family planning." Although 11.7 (role of leaders in mobilizing public opinion) was not bracketed, the US questioned the phrase "specialists of recognized morality." Brazil and Colombia implored Honduras, who had proposed this phrase, to reconsider it. The phrase was changed to "qualified specialists."

XII. TECHNOLOGY, RESEARCH AND DEVELOPMENT

This chapter contains three sections: basic data collection, analysis and dissemination; [sexual and reproductive] health research; and social and economic research. The section on sexual and reproductive health research caused the most difficulties. The Holy See opposed reference to "modern methods of fertility regulation" and "contraceptive methods," preferring, instead, "safe and responsible methods for the planning of family size." India requested deletion of the need for research on the reproductive and sexual health needs of adolescents. Ghana argued that the reality of adolescent sex must be addressed. Argentina, Peru and Honduras called for research on abortion and the related risks. Honduras also proposed research on contraceptive and IUD-related deaths.

In 12.7 (basis for action), the Holy See expressed reservations on the term "contraceptives," and retained brackets around "fertility regulation," until it is defined in Chapter VII. Delegates accepted the EU's proposal to delete the brackets around "barrier methods." In 12.9 (government support for research), brackets were removed from the reference to barrier methods against diseases. In 12.11 (involvement of the private sector), the term "fertility regulation commodities" was changed to "contraceptive commodities," with the Holy See's reservation. In 12.15(c) (objectives), the Holy See agreed to unbracket "sexual and reproductive behavior."

XIII. NATIONAL ACTION

This chapter contains three sections: national policies and plans of action; programme management and human resource development; and resource mobilization and allocation. The latter proved to be the most contentious section. During the first reading, governments questioned and challenged the Secretariat on the methodology used to derive the cost figures in this section. The Secretariat conducted an informal briefing on this and then rewrote the section based on comments received. During the second reading, the EU bracketed the entire section until it had time to discuss the revised figures. The new version of the section reflected the concept of "core national population programmes" with three components: family planning services; basic reproductive health services; and STD/HIV/AIDS prevention programmes. A new sub-section on basic research, data and population and development policy analysis was added at the request of delegates. In general, delegates expressed concern about the focus on family planning to the exclusion of other population-related programmes. Many developing countries expressed their difficulties in meeting two-thirds of the costs related to population programmes. Guatemala and Honduras opposed reference to condom distribution for AIDS prevention.

The only brackets that remain in the first two sections are around the usual phrases "family planning" and "sexual and reproductive health." There are numerous brackets around the two phrases mentioned above as well as "condom distribution," "couples and individuals," "with due respect for parental rights and responsibilities," and all the estimates of financial resource needs.

XIV. INTERNATIONAL COOPERATION

This chapter contains two sections: responsibilities of partners in development; and towards a new commitment to funding population and development. There was disagreement between developed and developing countries on the responsibility of developed countries to adopt favorable macro-economic policies to promote sustained economic growth and development in developing countries. India, supported by China, proposed this language during the discussion in Working Group I. The EU, Canada and Australia said that this Conference cannot solve all development programmes. The US, supported by Sweden, Australia and the EU, added a new objective on human rights standards. However, India said that unless its new objective was accepted, it could not accept the US proposal. Tuvalu, Estonia and Honduras wanted to delete reference to local production of contraceptives. There was heated discussion regarding the level of resources needed by the year 2000. As well, there was disagreement on the issue of increasing ODA from 2% to 4% for population programmes as well as the 20-20 proposal -- donor agencies and recipient Governments devoting at least 20% of ODA funds to the social sectors along with 20% of domestic expenditure.

Brackets remain around the objectives on favorable macroeconomic policies and human rights standards. In numerous paragraphs the reference to countries with economies in transition remains bracketed. Delegates suggested different alternative methods for dealing with this problem, including a separate paragraph on the needs of these countries, making the phrasing more general so that these countries are included (i.e., deleting reference to developing countries) or removing all references to these countries. All proposals were rejected. The proposal to increase ODA from 2% to 4%, all figures on resource flows from donor countries, and a new paragraph proposed by Tunisia on innovative financing for population and development programmes remain in square brackets.

XV. PARTNERSHIP WITH THE NON-GOVERNMENTAL SECTOR

This chapter contains two sections -- local, national and international non-governmental organizations; and the private sector -- although some delegates originally did not think that these two groups should be separated. Several countries, including Brazil and Benin, felt that the relationship between governments and the non- governmental sector should be a "working relationship" rather than a "partnership," which implies equal sharing of responsibilities. Brazil also emphasized that the design, implementation and evaluation of population activities fall within the sovereign jurisdiction of each country. Brazil, Venezuela, Indonesia and Iran also called for deletion of the reference to the official status of NGOs in national and international development processes. Morocco and Liberia objected to the political independence of NGOs.

During the Plenary's consideration of this chapter, the Holy See once again called for brackets around "sexual and reproductive health" throughout the text. Reference to "contraceptives" was retained, with the reservations of the Holy See, Guatemala and Honduras. Benin once again raised the issue of partnership with NGOs and proposed replacing "partnership" with "cooperation." Working Group I Chair Lionel Hurst reminded delegates that the Working Group had agreed to retain "partnership" and the Chair noted that Chapter 27 of Agenda 21 refers to NGOs as partners and urged Benin to reconsider. After a tedious debate, both "partnership" and "cooperation" were bracketed.

XVI. FOLLOW-UP TO THE CONFERENCE

This chapter originally contained only two sections: national-level activity and activity at the international level. During the first reading, however, delegates raised general concerns about the content and organization of the chapter. Other issues raised during this reading were the importance of government accountability, the need for consistency with national policies, difficulties in preparing annual reports, and coordination of follow-up activities within the UN system. Delegates agreed to hold informal consultations on this chapter aimed at arriving at a consensus text. An informal group met under the chairmanship of Canada for nearly two weeks. The resulting text contained only two sets of brackets and a new section on subregional and regional activities.

The text submitted to the Plenary on the last day states that the Economic and Social Council will assist the General Assembly in promoting an integrated approach and system- wide coordination and guidance in the monitoring of the implementation of the Programme of Action. The General Assembly at its forty-ninth session is also invited to give further consideration to the establishment of a separate Executive Board of the UN Population Fund.

The first set of brackets were around two alternatives for implementation, monitoring and evaluation of the Programme of Action. The first option mentions "qualitative and quantitative indicators consistent with human rights and ethical principles recognized by the international community." The second option notes that implementation, monitoring and evaluation of the Programme of Action requires appropriate indicators. The G-77 supported the first option, while the EU preferred the second. A compromise proposed by Canada, "implementation, monitoring and evaluation of the programme of action at all levels should be conducted in a manner consistent with its principles and objectives;" and the other two options remain bracketed. In paragraph 16.18 (new and additional financial resources), language referring to the burden on the "already difficult economic situation of developing countries" was deleted. Language on the need for additional resources "including on concessional and grant terms, according to sound and equitable indicators" was retained.

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