Standing Strong for a Woman's Right to a Just and Healthy Life

After two weeks of fierce negotiations at the United Nations’ annual Commission on the Status of Women, on March 15 more than 130 governments committed to ending violence against women and girls, and reached strong agreements to promote gender equality and ensure access to sexual and reproductive health services.

The International Women’s Health Coalition and our amazing partners from around the world came out in force to the UN for the negotiations. Our agenda was clear: push governments to commit to concrete strategies to empower women and girls and end gender-based violence.

We met with instant opposition from conservative governments. Countries such as Iran, Russia, Egypt, and Syria joined with the Vatican in what The New York Times called “an unholy alliance.” IWHC staff and our women’s rights caucus of more than 100 activists worked around the clock to support progressive delegations to stand strong and not to cave in to pressure. We would not let a small but vocal minority use culture and religion as excuses to deny women their rights.

Our efforts prevailed and consensus was finally reached to loud applause from supportive governments such as Argentina, Brazil, Denmark, Mexico, Norway, the Philippines, South Africa, Switzerland, Turkey, United States, Uruguay, and even the small island of Tonga! As the “agreed conclusions” document was adopted, hundreds of women’s rights activists streamed into the negotiating room to join in the cheers.

For the first time at the UN, governments reached consensus that survivors of rape are entitled to emergency contraception to prevent unwanted pregnancy, and to timely and respectful forensic exams to support prosecution. They called for an end to child marriages. They agreed women’s right to control their sexuality is essential to preventing further violence. And they recognized the role that evidence-based sexuality education can play in reducing the harmful gender stereotypes that lead to violence.

In a sign of just how much was at stake, this year’s meeting received an unprecedented amount of media coverage after the Muslim Brotherhood condemned (and mischaracterized) the negotiations. IWHC featured prominently in many news articles, including in The Washington Post, The Guardian, Associated Press, ABC News, The Globe and Mail, Radio Free Europe, O Estado de S. Paulo, and Reuters.

Once again, we women have shown we’re an irresistible force. But our work is far from over. Now we must be vigilant to ensure that the agreements made at the UN are put into practice in local communities worldwide.

For that to happen, we must continue to support women’s groups to hold their own leaders to account.

Best regards,

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In my previous blog post, I noted how universal health insurance schemes often fail to help women and adolescents in need of sexual and reproductive health services. This shortcoming seriously undercuts the aim of universal health coverage to protect against “financial risk” and increase access to health care for low-income populations.

But an equally important weakness of universal health coverage as a concept is that it fails to address the non-economic factors that play a significant role in determining whether women and young people can access and use the health services they need. These factors include:

• Laws and policies that restrict access, such as policies requiring parental or spousal consent or couples treatment, or laws that restrict the provision of and access to certain services, such as safe abortion.
• Social and cultural norms and practices that embody persistent gender inequalities. This can result in, for example, low immunization rates for girls or stigma and discrimination when unmarried women seek sexual health services. These norms and practices can keep women and girls from using services that are otherwise available.
• Lack of individual empowerment, information, and education, which impede women’s and adolescents’ knowledge about health and health-seeking behaviors.
• Weaknesses in health systems that may result in poor quality of care or inaccessible, inadequate, and inappropriate services. These range from resource issues such as the inequitable distribution of services between urban and rural areas and insufficient numbers of trained health care workers to systemic problems like discrimination and abuse of marginalized patients, including women, adolescents, and people who are lesbian, gay, bisexual, and transgender.
• Other social determinants of health, such as food and nutrition, security, water and sanitation, and other environmental and occupational factors that can have specific negative health consequences for women and girls, including for their sexual and reproductive health.

A draft discussion paper prepared for next week’s Global Leadership Meeting on Health acknowledges the critical gap of universal health coverage in addressing the social determinants of health and other barriers to health care. Indeed, this gap might even make universal health coverage something of a pipe dream when sexual and reproductive health is on the line. Without concomitant efforts to address these and the economic factors outlined in my previous blog, women and girls will continue to face challenges accessing and using sexual and reproductive and other critical health services and exercising their rights. The government and civil society leaders meeting next week would do well to discuss the full range of factors that can facilitate or impede people’s ability to achieve the highest attainable standard of health.

We at the International Women’s Health Coalition hope that global leaders agree to take a more holistic approach to improving health care by recommending development goals specifically for women and adolescents—two population groups who face the biggest barriers to care and whose health is critical for overall development. Such an approach would allow for focus on the particular health challenges faced by women and young people, the contextual factors that can jeopardize their health and erect barriers to care, and the specific interventions needed for both prevention and treatment of health conditions.

Universal health coverage is important, but it alone is not enough to guarantee access to health services and improve health. We need specific goals that address the diversity of barriers to care faced by women and adolescents, along with a dose of political will and resources adequate to meeting these goals.

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Today’s passage of the Violence Against Women Act (S. 47) is a victory for women and girls both here in the United States and those living abroad. After being stalled in Congress for over a year, the Violence Against Women Act (VAWA) was reauthorized today, with the House of Representatives passing the same bill the Senate passed earlier this month.

Not only does VAWA protect women and girls in the United States from violence, but it also ensures that the U.S. is doing its part to protect girls from being forced into early marriages. Ending early and forced marriage is vital to the goal of ensuring that girls around the world are able to lead healthy, empowered, educated, and safe lives. As Senator Durbin, a champion on this issue, stated just after the vote, the bill’s “new mandate for a multisectoral strategy to end child marriage is an important step forward and now we must focus our efforts on ensuring it is developed without delay and its implementation is fully funded.”

The passage of this bill is a testament to how various communities that care about the health and safety of women and girls can come together to fight for what is necessary and what is right. It is also a testament to the hard work of steadfast leaders in the United States Congress on this issue, such as Senator Durbin (D-IL), Congresswoman McCollum (D-MN), Congressman Aaron Schock (R-IL), and former Senator Olympia Snowe (R-ME). We congratulate them on this accomplishment and thank them for their service to women and girls around the world.

For more reactions from communities and Congress, please see:

• Reps. McCollum and Schock Applaud House Passage of Child Marriage Prevention Strategy in Violence Against Women Act
• Interagency Working Group – “Congress Passes Violence Against Women Act”

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Next week, leaders from governments and civil society will meet in Gaborone, Botswana to discuss how health will feature in the development agenda that will succeed the Millennium Development Goals after 2015. Should it be construed as a “single health goal”? If so, what would that goal be, considering the plethora of health issues that still require urgent action, such as HIV, maternal mortality, tuberculosis, and diabetes?

One proposal on the table would group all these concerns under the objective of “universal health coverage.” In my two-part blog series, I will discuss why this proposal falls short when it comes to women and adolescents.

Universal health coverage is defined in the draft discussion paper for Botswana as “two inter-related components: coverage with needed health services (prevention, promotion, treatment, and rehabilitation) and coverage with financial risk protection, for everyone.” Universal health insurance is considered critical to achieving universal health coverage because of the protection it can provide against catastrophic health costs and its contribution to sustainable financing. But is it enough?

Economic barriers (“financial risk”) certainly pose formidable obstacles to women and adolescents seeking sexual and reproductive health care; universal health insurance can help to address this.  But alone, it is not sufficient. In fact, health insurance schemes may contain their own barriers to care, particularly for marginalized women and adolescents.

For example, core sexual and reproductive health services, such as family planning counseling and contraceptives and maternity care, are often excluded from benefits packages that determine what is and is not covered by insurance schemes.

Abortion services are largely excluded from coverage, despite the fact that abortion is legal (on one or more grounds) in a majority of countries worldwide. Coverage of contraceptives and sexual health services for adolescents may be likewise constrained due to political sensitivities.

The level of financial protection provided by health insurance can also vary and may not be sufficient to insulate women against economic hardship.  Women consistently experience a higher burden of out-of-pocket costs for health care services than men who have similar levels of insurance coverage, largely due to non-coverage or limits on coverage for sexual and reproductive health services. Even nominal co-pays, common in many insurance programs, may pose a significant barrier if women do not have access to or control over cash.

Concerns about confidentiality and privacy may also impede access for adolescents and women when their own insurance coverage is tied to their parents’ or spouse’s coverage.  In the United States, adolescents and young women and men enrolled as dependents under their parents’ health insurance policies often choose not to use their insurance coverage to pay for sexual and reproductive health services, for fear that their parents will receive notification that they sought such care. Women covered as dependents under their husbands’ insurance policies may likewise be hesitant to seek much-needed care, such as contraceptives or treatment for violence.

Finally, the most marginalized women often fall through the cracks of so-called “universal” health insurance schemes for a number of reasons including lack of autonomy and decision-making power, or lack of information.  Women who are employed in the informal sector, women living in poverty, adolescent girls, and older women are often those least able to obtain good quality health insurance.

How do we make sure what is recommended at the Botswana meeting addresses these concerns?

I suggest a way forward in my next post.

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Leading up to the year 2015, the United Nations and civil society groups are organizing a series of consultations to help shape the post-2015 development agenda. Part of this process is a Global Online Discussion, which provides a platform for people worldwide to share their visions for building a just and sustainable world free from poverty. IWHC made the following contribution to the online discussion on “The Unfinished HIV Agenda.” Click here to read our contribution to the thematic consultation on Inequalities, specifically within the sub-discussion on “Inequalities faced by girls”.

Despite the highly gendered nature of the HIV/AIDS pandemic (women represent well over half of all people living with HIV worldwide), most prevention and treatment programming fails to account for the social determinants—violence against women, limited access to sexual and reproductive health (SRH) services, early and forced marriage, etc.—which make women and girls particularly vulnerable to the virus.

The International Women’s Health Coalition believes that effectively curbing the spread of HIV/AIDS relies fundamentally on the integration of sexual and reproductive health and rights (SRHR) with HIV/AIDS programming. The post-2015 development agenda must address the particular susceptibility of women and girls to HIV as well as the fundamental role that gender inequality plays in the spread of the virus.

Integrating SRH and HIV/AIDS services is a proven strategy for reducing new infections.   When men and women have access to HIV testing and treatment in the same spaces they seek out family planning and maternal health services, they are more likely to find out their status, learn about prevention methods, and explore treatment options.

Research has also shown that the availability of HIV services alongside other SRH services can reduce the stigma typically associated with HIV-specific programs.  Because the availability of treatment services for other STIs has been proven to reduce new HIV infections, expanding access to all forms of contraception and sexual health services through voluntary, rights-based, client-centered, and cost-effective programming is imperative.

Comprehensive Sexuality Education (CSE) should equip young people with protective sexual behaviors, the skills to effectively use condoms and other contraceptive methods, and should address gender and power, human rights and healthy relationships.  While male and female condom use is proven to reduce new HIV infections, the distribution of condoms alone is not a sufficient prevention method.  CSE should ensure that young people know how to use condoms correctly and should equip girls in particular with the tools to negotiate condom use and refuse unwanted sex.

In addition to equipping young people with scientifically sound and culturally appropriate information about sexuality, health, and rights, CSE should introduce empowering life skills to help young people navigate healthy and rewarding relationships, influence leaders in their community, and exercise their rights.

It is critical to invest in prevention efforts that target the most at-risk and overlooked populations of women and girls—adolescent girls, married girls and women, sex workers and women who use drugs. We must also ensure that treatment options are available and accessible to those living with HIV/AIDS, and that prevention and treatment efforts do not infringe on the rights of women living with the virus.

Women living with HIV/AIDS have a number of unique needs, and are particularly vulnerable to coercive sterilization practices, violence and discrimination.  They still often provide the bulk of care and support for their families, they face unmet need for contraception, and they need support to prevent vertical transmission.

Prevention of Mother to Child Transmission efforts play an important role in reducing new HIV infections, but these programs tend to focus far more attention on the infant than the mother.  The rights of HIV positive mothers must be fully protected and realized, including the right to informed consent and to choose the treatment regimens that best meet their needs.

The post-2015 development agenda must commit to addressing HIV/AIDS through targeted evidence-based prevention and treatment methods that account for the unique needs of women and girls.  Curbing the spread of HIV hinges on the transformation of discriminatory gender norms and practices, and the expansion of SRHR programming and policies. When women are able to refuse sex, live free from violence, insist on condom use, and avoid early marriage, they are able to reduce their risk of HIV infection (not to mention attend school, participate in civic affairs, and engage in healthy and respectful relationships).

Like so many of our development priorities, addressing the HIV/AIDS pandemic is inherently linked to issues of gender equality.  We must focus not only on the direct determinants of HIV infection, but also the profound gender inequalities and resulting discriminatory practices which make women more vulnerable to the virus and which stand squarely in the way of addressing its spread.

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Leading up to the year 2015, the United Nations and Civil Society are organizing a series of consultations to help shape the post-2015 development agenda. Part of this process is a Global Online Conversation, which provides a platform for people all over the world to share their visions for building a just and sustainable world free from poverty.  The following contribution was made by IWHC to the online thematic consultation on Inequalities, specifically within the sub-discussion on “Inequalities faced by girls”.

Young people all over the world face a range of unique challenges to exercising their rights.  Barriers to age-appropriate health services, meaningful education, and viable livelihoods opportunities are among the most pressing impediments to youth empowerment.

The International Women’s Health Coalition is centrally concerned with the sexual and reproductive health and rights of young people.  We believe that working with both young men and women is critical to ensuring that the rights of all young people, particularly girls, are universally protected and realized. The following contribution focuses specifically on the challenges facing girls, who continue to experience systematic social, economic and political marginalization in every part of the world.

Given the global persistence of gender inequality, many of the issues disproportionately affecting young people also tend to disproportionately affect girls. In 1997, UNAIDS reported that 60% of new HIV infections in sub-Saharan Africa were among young people (aged 15-24), with a 2:1 ratio of infected girls to infected boys.  This ratio continues to grow increasingly lopsided, with girls representing 74% of new infections among young people in 2009.

Additionally, girls face extraordinarily high rates of violence.  The experience of violence, the perceived threat of violence, or the stigma associated with being a victim of violence hinder access to entitlements, opportunities for social participation, and employment.

In developing countries, 40% of girls have their first child before the age of twenty, many before the age of 18. Not only does this mean that more girls are dropping out of school, but girls are also more likely than adults to die, experience complications, or suffer chronic injuries related to childbirth. Because they have less access to contraceptives and are less sexually experienced, adolescents are more likely than adults to seek out unsafe (often late-term) abortions.  Each year, it is estimated that 2 million to 4.4 million adolescents in developing countries have abortions, 70,000 unsafe abortions are carried out, and 13% of all maternal deaths occur as a result of unsafe abortion.

Early pregnancy is often associated with child marriage, a practice which also puts girls at increased risk of HIV infection.  Female genital mutilation, infanticide, nutritional bias—these and other harmful traditional practices disproportionately affect girls, infringing on their fundamental rights and opportunities for development.

The short answer to why these inequalities exist is that girls, especially the most vulnerable girls, continue to remain invisible. Despite the aforementioned figures, policymakers have consistently masked the specific needs of girls within “male-focused and male-dominated community-based activities and generic ‘youth’ prevention initiatives, all of which widely miss the mark” (Bruce, Temin, & Hallman, 2012).  This generic youth programming disproportionately benefits boys over girls overall, but it also favors unmarried to married girls, well-connected to socially marginalized girls, urban to rural girls, girls belonging to an ethnic majority to migrant or indigenous girls, and so on.

Girls also remain invisible because of how we measure progress.  Primary education enrollment figures, for example, are based on one day of the school year; even if there were genuine parity on this particular day, these figures fail to account for the reality that girls often miss multiple days of school each week because their domestic and reproductive responsibilities take priority.  Moreover, data on young people is rarely disaggregated, resulting in measures of participation which fail to report gender, age, marital status, and other critical factors.

The disproportionate burden that girls share for maternal morbidity and mortality, the time burdens that girls shoulder, the staggering inequalities in girls’ educational outcomes—these are all reversible realities. To tackle these disparities, we need to begin by making girls visible.  We must call for the post-2015 agenda to pay particular attention to girls and the challenges that they face.  The risks facing girls are well documented and the next step is to match the research with the necessary resources.

We need to make girls visible.

Making girls visible begins with how we count them.  By properly counting girls and disaggregating data by age and gender, we can target youth programming at specific subsets of youth—like adolescent girls.  We can also measure whether programs are actually reaching the girls who are most at risk.

We need to invest in girls.

We must invest in programming aimed specifically at girls, with an emphasis on the most at-risk populations of girls—those who engage in transactional sex, those who are forced into early marriage, those who fluently speak their native language but cannot communicate in their national language, and so on.  These programs must include the following features.

• Comprehensive Sexuality Education (CSE) must be thorough, scientifically sound, and culturally appropriate.  It should take place in a safe and healthy learning environment and it should explicitly address gender norms and gender equality.  When young people are educated about human rights, gender equality, and the role of power in relationships, they are not only equipped with the tools to negotiate their own health relationships, but they are also able to educate and influence power-brokers in their communities.
• Comprehensive services must be universally available and accessible.  This means, access to high quality sexual and reproductive health care, all forms of safe and effective contraception, safe abortion and post abortion care, maternity care, and prevention and treatment of sexually transmitted infections including HIV.
• Education is foundational to girls’ empowerment. We must ensure that all girls, no matter how poor, isolated or disadvantaged, are able to attend school regularly and without the interruption of early pregnancy, forced marriage, etc.  Education—for both girls and boys—must go beyond academics and equip young people with life skills so that they are prepared to think critically and challenge discriminatory and repressive policies and practices.
• Empowering spaces ensure girls have the opportunity to feel secure, be themselves, and plan for their safety and development.  Even if only for a few hours a week, accessing safe spaces allows girls to frame their own agendas, receive training on sexual and reproductive health and rights, and develop their social and economic capital. These participatory social spaces also foster opportunities for community-building and networking, mitigating the isolation that many girls experience.

We need to support young leaders.

We must continue to support both young women and young men to be advocates for change. Ensuring that reproductive rights are protected and promoted rests in the hands of young women and men, particularly young people throughout the global South.  Young people should be involved in all types of decision making on sexual and reproductive health and rights.  Seasoned advocates must be willing to pass the torch, share best practices, and work alongside—sometimes even be led by—a new generation of SRHR leaders.

As advocates, we can listen to one another and work in tandem to repeal legislation that legitimizes discrimination against girls and press for new protections that ensure equality of access to health services, jobs and earnings, education, property and all the rest.  Addressing the profoundly complex root causes of gender inequality (and accordingly the inequalities experienced by girls) is not a simple challenge.

As we begin to develop a tangible action plan for the post-2015 development framework, we must remain mindful that shifting the social and cultural norms that permit and promote discrimination against girls is not a simple box-ticking task. We cannot continue to view gender equality as a singular aim, but rather as both an explicit goal and an issue that needs to be mainstreamed throughout the post-2015 development agenda.

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As I reported previously, the ICPD Global Youth Forum in Bali earlier this month brought passionate engagement by young people committed to securing a healthy and just life for youth worldwide. The Forum closed on December 6 with a celebratory reading of the key recommendations from the various multi-stakeholder consultations that took place related to five themes: Staying Healthy, Education, Decent Work, Youth Leadership and Participation, and Families, Rights, and Sexuality.

The key recommendations are included in a public declaration. Please take a look and share your thoughts with us. We here at the International Women’s Health Coalition are thrilled that young people and adult allies from governments, civil society, the private sector, multilateral agencies, and other stakeholders from around the world spoke out in support of a bold and progressive vision for what the global community must do in partnership with youth to achieve the largest generation ever of educated, empowered, safe, and healthy young people.

Only by working together as a global community and as individuals can we realize this bold and achievable vision of what young people want, need, and deserve. UNFPA Executive Director Dr. Babatunde Osotimehin rightly described the process of meeting the sexual and reproductive health and human rights of young people as “a journey of 1,000 miles [that] starts with the first step.”

We look forward to working with and on behalf of young people to realize the key recommendations contained in the Bali Declaration, including with UNFPA which did an exemplary job ensuring that the process remained youth-led and youth-driven. We simply cannot progress as communities and nations without continuing to make these important leaps forward on our collective journey of 1,000 miles to secure an educated, empowered, safe, and healthy future for all.

Will you join us?

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Peru, while famous for its modern culinary delights and ancient civilizations, also has a far less flattering distinction: it has more reported cases of rape and sexual violence than any other country in South America. Eight in ten of these victims are minors.

Researchers estimate that 35,000 pregnancies occur every year in Peru as a result of rape. Women and girls in this situation are faced with two options: seek an illegal abortion and risk going to jail or carry the pregnancy to term and suffer the psychological and physical trauma that go along with giving birth to your rapist’s child. Women who can prove that a pregnancy is the result of rape receive a “reduced” sentence of three months in jail (the standard prison sentence for illegal abortions in Peru is two years). Perversely, this reduced sentence does not apply to married women who are raped by their husbands, even though marital rape is a crime under Peruvian law. Doctors who perform abortions in cases of rape face up to six years in prison.

On September 28, 2012, a coalition of women’s rights groups launched a campaign to challenge this cruel violation of human rights. The campaign, Dejala Decidir (“Let her decide”), seeks to introduce a new law that decriminalizes abortion in cases of rape (currently, abortion is only permitted when the woman’s life or health is at risk). The groups, led by partners of the International Women’s Health Coalition—PROMSEX, Demus, Catholics for the Right to Decide-Peru, Manuela Ramos, CLADEM-Peru, and Flora Tristán—need to collect 60,000 valid signatures to petition Congress to consider the bill.

Photo courtesy of PROMSEX

This is no small challenge. The requirement for valid signatures means that people must be willing to provide their government ID numbers to verify their identities. This may be intimidating to many people in a country where the Catholic Church exerts a great deal of influence in the government and within communities. Consider also that many people in rural and indigenous communities—especially poor women who are disproportionately impacted by the abortion ban—do not have government IDs. Even if the campaign succeeds in obtaining 60,000 valid signatures, there is no guarantee that Congress members will risk controversy or the ire of the Catholic Church and support a change in the law.

The groups see the Dejala Decidir campaign as an opportunity to build a powerful and active movement on two important but neglected issues: abortion and rape. Every signature represents at least one more person informed about the harsh realities faced by rape victims in Peru, and mobilized to change the current abortion law.

George Liendo, Director of PROMSEX, says the time is ripe for a national dialogue. “It’s not always easy to build a coalition in Peru, but there is real energy for this campaign. People across the country want to put this on the political agenda.”

Peru is not the only country in the region rethinking its draconian approach to abortion. In October 2012, the Uruguayan congress voted to decriminalize abortion in the first twelve weeks of pregnancy.

Activists in Peru have until October 2013 to collect enough signatures to ask their own Congress to act. In the meantime, we can expect a rich and lively dialogue on rape and abortion. It’s about time.

This blog was cross-posted on RH Reality Check at http://www.rhrealitycheck.org/article/2012/12/19/double-jeopardy-rape-victims-in-peru.

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The last couple of days of the ICPD Global Youth Forum in Bali, Indonesia, have seen a flurry of around-the-clock activity by nearly 1,000 young people, adult allies, NGO representatives, academics, government officials, and other stakeholders from around the world. Their hard work is already paying off.

Yesterday, forum participants developed a number of “Staying Healthy” recommendations to ensure that governments prioritize programs that empower vulnerable young populations, including young women and adolescent girls, LGBTQI individuals, persons with disabilities, and young people living with HIV and AIDS. These recommendations are progressive, measurable, and based on evidence.

The journey has not always been easy. A small, but vocal, opposition made up of non-youth participants have attempted to intimidate and censor young people during this forum. Many people could easily have been intimidated into silence by this group, but thankfully the youth at the Global Forum refused to back down. There is too much at stake.

The “Staying Healthy” recommendations were developed as part of a consultative process following a lively plenary. In his speech, UNFPA Executive Director Dr. Babatunde Osotimehin encouraged young people to continue questioning the status quo, stating that young people are not only the present but the future. He discussed a number of issues impacting the sexual and reproductive health and rights of young people, including meaningful participation, gender equality, ending early and forced marriage, unintended pregnancy, maternal mortality, and the needs of both married and unmarried adolescents. Osotimehin described the process of meeting the sexual and reproductive health and human rights of young people as “A journey of 1,000 miles [that] starts with the first step.”

Indonesian Health Minister Nafsiah Mboi also spoke at the plenary and was met with rousing applause when she stated that, “We have the responsibility to fulfill and promote the health and human rights of young people,” that, “Young people need to be empowered in all aspects of their life,” and that, “It is a fundamental human right of adolescents and youth to access comprehensive sexual and reproductive health education and services.” In Indonesia, there are more than 65 million young people aged between 15 and 24 years old and only 21 percent of them have comprehensive knowledge regarding HIV/AIDS. Sexual transmission of HIV accounts for the vast proportion of new HIV infections among young people and unmarried girls cannot access contraception. Despite these facts, Mboi stated she believes that “The government has an obligation to provide education and services on sexual and reproductive health that are equitable, affordable, and accessible.” For the tens of millions of Indonesian young people in need of information, services, and protection of their human rights, we are optimistic when she says that “You can count on me, I won’t let you down.”

I am thrilled that the final consolidated “Staying Healthy” recommendations articulate a clear, comprehensive, and human-rights based vision as to where the global community needs to focus attention and resources to secure the health and human rights of all young people, and in particular the most marginalized and vulnerable which include adolescent girls and LGBTQI individuals.

These young forum participants deserve our applause for remaining steadfast that this must remain a youth-led and youth-driven process. They stood strong as did UNFPA, which made it clear in various ways that this is indeed intended to be a youth-led and youth-driven process. Displeased with the final consensus recommendations consolidated from the 15 Staying Healthy breakout sessions, the vocal minority of non-youth unconstructively confronted forum participants, after the recommendations were presented during the plenary. During my own breakout session, this same minority consistently opposed suggestions concerning individual rights, and access to safe abortion and contraception.

In contrast to this small group, many other government and non-youth forum participants from around the world stood out as great allies to the youth participants in support of this set of recommendations. The final “Staying Healthy” recommendations will be released as part of a consolidated set of recommendations including the other forum themes: “Decent Work,” “Sexuality, Family and Rights,” “Education,” and “Leadership and Meaningful Participation.” We at the International Women’s Health Coalition look forward to sharing the final recommendations with you when they are released. Stay tuned!

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