Demographics and Development in the 21st Century

The new head of the United Nations Population Fund (UNFPA) should focus on the agency’s core mission—promoting sexual and reproductive health, including universal access to family planning, according to a Center for Global Development (CGD) study released today. UNFPA’s new executive director, Babatunde Osotimehin, a former minister of health in Nigeria, has taken the helm at a time when UNFPA’s mission is receiving greater attention than ever. Yet the agency has been engaged in a broad range of activities that dilute its impact on high-priority Millennium Development Goals (MDGs), which include improving child and maternal health, the report says. UNFPA itself reports that an estimated 215 million women lack access to the modern contraceptives they need to prevent unwanted pregnancies each year. Other studies show that roughly 76 million pregnancies are unplanned and unwanted, and approximately 350,000 maternal deaths occur worldwide annually. “UNFPA should focus on its core mission: expanding access to sexual and reproductive health and reproductive rights for women around the world,” says Rachel Nugent, CGD deputy director of global health and co-chair of the working group that prepared the report. “Executive Director Osotimehin can lead the way in preventing thousands of maternal deaths and millions of unwanted pregnancies worldwide each year.” Access the UNFPA Report Background Papers and Case Studies David Bloom, a working group co-chair and chair of the department of Global Health and Population at the Harvard School of Public Health, adds: “Enabling women to avoid unwanted pregnancies is one of the best investments that the international community can make. UNFPA should position itself to be the global champion on this critical issue.” Jotham Musinguzi, also a working group co-chair and the Africa regional director of Partners in Population and Development, an alliance involving 25 developing countries, says: “Investments in sexual and reproductive health services contribute to economic growth, societal and gender equity, and even democratic governance. Developing countries look to UNFPA for leadership on these issues.”                                                                                                 UNFPA has been squeezed from opposite ends of the political spectrum. From 2002 to 2008, the U.S. administration withheld funding out of concern that the agency supports programs that may include access to abortion.  Conservatives in the U.S. Congress are again threatening to cut UNFPA’s funding as part of the current budget debate underway in Washington. Others have urged UNFPA to widen its remit to include a broad array of programs on the social and economic empowerment of women. In response, UNFPA has worked on initiatives such as establishing safe spaces for sports, art, and socialization for youth or economically empowering women and youth in vocational training and self-employment—issues that promote the goal of women’s empowerment but risk distracting from the agency’s core mission of ensuring reproductive health and rights and access to contraception.  Since UNFPA, like many other agencies, will likely face flat or reduced funding in the near future, it should be selective and concentrate its activities on the core mission, the report says, and work closely with other UN agencies to accomplish broader goals. CGD president Nancy Birdsall says that by focusing on its core mandate, UNFPA will be better able to “navigate and lead from its own strength among the many organizations and interests that comprise the population and development and sexual and reproductive health communities. Now is the time for  UNFPA to make sexual and reproductive health its key mission.” The UNFPA report is the latest in a series of CGD studies that offer recommendations to incoming leaders of international organizations. In addition to Nugent, Bloom, and Musinguzi, sixteen other population and development experts from all regions of the world participated in the group’s deliberations and endorsed the final report. The report offers four recommendations on how to achieve faster progress on UNFPA’s main objective while reducing redundancy and building on the strengths of various UN agencies that work on population, sexuality, health, women’s empowerment, and other issues related to UNFPA’s core mandate. Four Recommendations for Action Establish and pursue a limited set of priorities closely related to UNFPA’s unique mission. Refine goals and transparently measure progress. Align human resources with a focused and renewed mission. Rebrand UNFPA as the lead agency for sexual and reproductive health and reproductive rights. The recommendations coincide with two of the eight MDGs: child health and maternal health. Specific MDG targets within these goals include reducing maternal mortality by three-quarters, and under-five child mortality by two-thirds from 1990 levels by 2015; as well as achieving universal access to reproductive health, including the unmet need for family planning. CGD Working Group on UNFPA’s Leadership Transition CGD organized the group in August 2010 as an independent panel to develop recommendations for UNFPA’s new executive director and associated bodies. Members volunteered their time as individuals, not representing institutions. Recommendations draw upon consultative meetings, one-on-one interviews, expert-panel deliberation, and literature reviews. CGD has previously prepared similar reports on the World Bank (2006), Global Fund to Fight AIDS, Tuberculosis and Malaria (2006), African Development Bank (2006), Inter-American Development Bank (2006), and UNAIDS (2009). Leadership transitions provide an opportunity for the international community to strengthen the institutional mandates, policy focus, resources, and governance of global agencies. The United Nations Population Fund The United Nations Population Fund (UNFPA) was established in 1969 as part of the United Nations to generate resources for family planning and provide global leadership on population issues. The diverse needs of countries and evolving global views of population have placed complex issues on UNFPA’s doorstep. Today UNFPA is engaged in a broad range of activities and UNFPA’s objective of promoting sexual and reproductive health and reproductive rights is shared with other UN agencies and organizations both public and private. The involvement of many actors is positive—however, UNFPA’s role should be prominent and evident. UNFPA’s staff numbers over 2,000 (including special programs and seconded staff), with more than 80 percent located in 129 country offices and in the 10 liaison and regional offices. In 2009, UNFPA worked in 155 countries and territories—almost one-third of them in sub-Saharan Africa.