FOR PARTICIPANTS ONLY REFERENCE DOCUMENT DDR/2 10 September 2009 ORIGINAL: ENGLISH Economic Commission for Latin America and the Caribbean (ECLAC) United Nations Population Fund (UNFPA) Regional Seminar "Key advances and actions for the implementation of the Cairo Programme of Action, 15 years after its adoption" 7 - 8 October 2009 REVIEW AND APPRAISAL OF THE IMPLEMENTATION OF THE CAIRO PROGRAMME OF ACTION IN THE CARIBBEAN (1994-2009) This document was presented at the Caribbean subregional meeting to asses the implementation of the Programme of Action of the International Conference on Population and Development (ICPD) 15 years after its adoption, took place in St John's, Antigua and Barbuda, on the 20 and 21 August 2009. The views expressed in this document, which has been reproduced without formal editing, are those of the authors and do not necessarily reflect the views of the Organization. Table of Contents A. Introduction ...................................................................................................................................................... 3 B. Context and Dimensions of Population and Development............................................................................... 5 1. Population Trends in the Caribbean..................................................................................................... 5 2. Economic Trends in the Caribbean...................................................................................................... 7 3. Social trend in the Caribbean............................................................................................................... 9 4. Environmental concerns and natural disasters ................................................................................... 10 5. Human rights..................................................................................................................................... 11 C. Review of the implementation of the ICPD (1994-2009): Achievements and Constraints............................ 13 1. Population, sustained economic growth and sustainable development.............................................. 13 2. International Migration...................................................................................................................... 14 3. Population Ageing ............................................................................................................................. 16 4. Gender Equality, Equity and Empowerment of Women ................................................................... 18 5. Family, population structure and interdependence between productive and reproductive live/social protection..................................................................................................... 22 6. Sexual and Reproductive Rights........................................................................................................ 24 7. Reproductive Health.......................................................................................................................... 25 8. HIV and AIDS ................................................................................................................................... 30 9. Emerging Issues................................................................................................................................. 33 D. Conclusions .................................................................................................................................................... 37 Annex A .............................................................................................................................................................. 41 Annex B ............................................................................................................................................................ 102 3 REVIEW OF THE IMPLEMENTATION OF THE CAIRO PROGRAMME OF ACTION IN THE CARIBBEAN (1994-2009): ACHIEVEMENTS AND CONSTRAINTS A. Introduction At the International Conference on Population and Development (ICPD) held in 1994 in Cairo, Egypt, industrialized and developing countries alike forged an inspiring and farsighted plan that integrated a wide range of population, development and human rights issues into a blueprint for 20 years of action. Concrete goals of the ICPD centred on providing universal education; reducing infant, child and maternal mortality; and ensuring universal access by 2015 to reproductive health care, including family planning, assisted childbirth and prevention of sexually transmitted infections including HIV and AIDS. This year (2009) marks the 15th anniversary of the ICPD and reminds us of the five years remaining to fulfil the commitments made at Cairo. The first population conference under auspices of the United Nations was organized in 1954 in Rome. Although many relations between population and development were discussed, the paradigm was still the (revived) Malthusian population theory of the competition between fast population growth and insufficiently expanding productivity. By the time of the second conference, in 1965 in Belgrade, fertility had declined in many countries leading to a shift in the focus. These first two conferences had primarily been scientific conferences. In 1974 in Bucharest, the United Nations convened the first global, intergovernmental population conference. Although the groundbreaking World Population Plan of Action was adopted by consensus, the old paradigm still reigned. The urgency of accelerating social and economic development and the need to bring about a new international economic order was stressed. The next intergovernmental population conference, held in Mexico City in 1984, had as major goals to review the World Population and to make recommendations for their further implementations. Although there had been a paradigm shift, “Take care of the people and the population will take care of itself” was still a popular credo. Since then despite a more than doubling of the world population, the false dichotomy between family planning and development has been widely acknowledged. The 1994 ICPD in Cairo had therefore a much broader mandate and the interconnection between population and development was acknowledged, resulting in an integrated treatment. An ambitious Program of Action was adopted at the ICPD. It was the first time that at world level an integrated all encompassing plan was accepted that went way beyond only addressing the direct relation between population and economic as in earlier models. Population and development are now widely recognized as complementary instead of as substitutes. Human beings were placed at the centre of development in the Cairo Consensus. By providing family planning and reproductive health care and the accompanying education services, stabilization of the population would occur without coercion and control. A critical conceptual contribution of the ICPD is the anchoring of reproductive rights within the realm of human rights. The emphasis is on meeting the needs of individual women and men rather than on achieving demographic targets. The ICPD Plan of Action reflects the new approach to population and development. Making the interrelationships between population, sustained economic growth and sustainable development is a key part of the integrated strategy. Gender equality, equity and empowerment of women and male responsibilities in relations to reproductive rights and reproductive health and family planning are stressed. The effects of population growth and changing population structures, for example population ageing, are acknowledged. Special attention is given to the position of vulnerable groups such as children, the elderly, indigenous people, persons with disabilities, and HIV-infected individuals and their families. Development and international migration and the rights of and obligations towards documented and undocumented migrants are given importance. Throughout the plan the position of children, youth and adolescents is targeted. 4 The ICPD Plan of Action precedes another integrated all encompassing attempt of development for all and the eviction of poverty in the world by the United Nations and its member states. In the Millennium Declaration of 2000, eight Millennium Development Goals (MDGs) were formulated and operationalized into 18 targets and 48 indicators. Omitted initially, reproductive health was endorsed and incorporated, together with three other new targets, in the MDG-framework at the 2007 World Summit in New York. By adding this target of universal access to reproductive health, all goals set by the Plan of Action of the ICPD have been incorporated in the MDG exercise. The Programme of Action of the ICPD therefore continues to be highly relevant for international development and, consequently, also for the achievement for the MDGs. UNFPA, the United Nations Population Fund is the lead agency in implementing the ICPD Programme of Action. UNFPA covers twenty-one countries in the English and Dutch Speaking Caribbean operating from the sub-regional office in Kingston, Jamaica with branch offices in Barbados (which covers the OECS), Trinidad and Tobago, Guyana, Suriname, and Belize. The ICPD Programme of Action agreed that the Regional Commissions should play an active role in its implementation through sub-regional and regional initiatives. The Population Division (CELADE) of ECLAC is acting as technical secretariat of the Latin American and Caribbean Regional Plan