Michelle Bachelet gives Dame Jillian Sackler Distinguished Lecture on Global Health
05 November 2012
Remarks by UN Women Executive Director Michelle Bachelet at the Dame Jillian Sackler Distinguished Lecture on Global Health. Hunter College, New York, 25 October.
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Good evening to all of you. I thank you Noel (Lateef) for your kind introduction. I also thank the Foreign Policy Association for inviting me to deliver this lecture.
I would also like to thank President Jennifer Raab and Hunter College for hosting us tonight. I congratulate both of you on your leadership of extraordinary institutions—we need institutions like yours that foster global understanding and citizenship. My very special thanks go to you, Dame Jillian Sackler, for your vision and leadership.
Tonight, allow me to speak about a topic that I care deeply about. To me, this is a matter, which is fundamental to our progress and shared prosperity as human beings, and vital to democracy, and peace and security. I am speaking about the health and rights of women and girls.
For two years now, as the Executive Director of UN Women, I've had the privilege of reaching out around the world, advocating for the rights of women and girls, being a global spokesperson for gender equality. I have pushed for, and I witness, rising global attention to women's rights and ending violence and discrimination against women.
We are making progress. In all regions, countries have expanded women's legal entitlements. More women are exercising leadership in politics and business, more girls are going to school, and more women survive childbirth and can plan their families. There is now global awareness that improving the status of women should be a political priority.
Yet despite progress, tremendous gaps remain and we need to transform awareness into stronger action. Action to tackle persistent wage gaps and unequal opportunities, action to increase women's leadership and decision-making, action to end child marriage and stop shocking levels of violence against girls and women. We need stronger action to advance the health and rights of women.
I say this because whether we are talking about the political arena, the parliament, during peace or during conflict, women's bodies continue to be a battleground. Rape continues to be used as a tactic of war, millions of women are missing due to gender discrimination, and reproductive rights continue to be hotly debated.
You may be surprised to learn that within the United Nations, the topic of reproductive health and rights is followed just as closely by some delegates as nuclear disarmament. Yet all too often the voices that should be heard, the voices of women, are not an equal part of the debate at both the international and the national levels. This is why I am a strong proponent of expanding women's leadership in politics and parliaments, in peace talks and in the private sector.
It is time for women's voices to be heard. This is especially important when it comes to improving women's health and advancing women's rights. Today far too many women are denied a voice, denied choices and denied control of their own bodies.
Guiding us forward is the UN Convention on the Elimination of All Forms of Discrimination against Women, the action programmes from the 1994 International Conference on Population and Development and the 1995 Fourth World Conference on Women, and the UN Security Council resolutions on women, peace and security.
Thanks to the international women's rights treaty, and advocacy by many, reproductive rights are increasingly protected in national legislation and advanced through policies and programmes. This is important because reproductive rights are fundamental to gender equality and women's empowerment, to peace and security, and to economic development. And thanks to the Security Council resolutions, action is being taken to involve more women in peace and security and to prevent and punish sexual violence during conflict.
I travel worldwide and in preparing for my visits to countries and going over their different characteristics, their development path, and national indicators, I have found a consistent pattern. The health and well-being of women and girls is an indicator of the health of a country.
Now I am not saying that this is exact science. But I am saying that one can tell a lot about a country, and its current status and future prospects, by examining certain indicators, such as the lifetime risk of maternal death, the percentage of women using modern contraception, women's literacy rate and their participation in national government, and girls' enrollment in school.
If you look at the countries with the highest rates of maternal death and disability, the countries where it is the worst place in the world to be a mother or an infant or growing up, you find countries in deep distress, such as Afghanistan, Chad and Somalia.
The reverse is also true. The countries with the highest levels of gender equality, Nordic countries such as Norway, Finland, Iceland and Sweden, the countries where women have the best health and education standards, economic opportunities and political participation are the countries that are performing well and rank the highest in human development.
The healthiest and most vibrant societies have women and men who are healthy and can exercise their human rights.
And this is true not only for countries, it is also true for companies. Nations and corporations perform better when women enjoy equal opportunity and can play their full and equal role.
Now this is not just my own personal opinion or the ideology of a group of feminists, this is the finding of an ever-growing number of studies and reports from governments, universities, think tanks, organizations, and the private sector.
Let me give you some examples:
The World Bank finds that greater gender equality enhances productivity, improves development outcomes for the next generation, and makes institutions more representative.
The United Nations Development Programme finds that women's empowerment is catalytic and central to economic growth, social development and environmental sustainability.
The World Economic Forum in its Global Gender Gap report finds that gender equality correlates positively with economic growth across 134 countries.
Goldman Sachs finds that reducing barriers to female labor force participation would increase America's GDP by 9 percent, the Eurozone's by 13 percent -and Japan's by 16 percent. Unlocking the potential of women could lead to a 14 percent rise in per capita incomes by the year 2020 in several economies, including China, Russia, Indonesia, Vietnam, and Korea.
The United Nations Food and Agriculture Organization finds that providing women farmers with the same access as men to land, credit, fertilizer and other inputs could increase national crop yields by up to 4 percent, advance food security and reduce hunger.
And the management consultants McKinsey & Company finds that companies with a higher proportion of women on their management committees have the best performance.
This evidence leads us to conclude that maintaining inequality between women and men can no longer be considered an option. In our complex world and given unprecedented economic, demographic, environmental and political challenges, we simply can no longer afford to waste the potential of half the world's population.
The struggle for gender equality and women's rights is the greatest cause of the 21st century.
Now, we have known for a long time that the health status of women and the disparities in health between the sexes are often critical indicators of inequity in society. Countries with high rates of fertility and high rates of maternal and child mortality are countries characterized as least developed.
And, of course, the reverse is also true. As nations grow richer, people enjoy better health and living standards.
However, economic growth alone does not guarantee progress for women and their health. While higher income levels mean countries have more money to improve women's health, ultimately it comes down to how governments decide to spend the money.
We know that if governments spend the money to improve the health and legal status of women, this improves social conditions and advances economic performance.
By providing equal opportunities, empowering girls and women with health and education, and leveraging their talent and leadership in the economy, politics and society, countries succeed and stay competitive in today's globalized, fast-changing and inter-connected environment.
Investing in women and girls is especially important at this juncture. Looking forward, we see emerging trends that demand a health response across sectors with a special focus on women. I am talking about population dynamics, climate change, the rise of middle-income countries, and the growing burden of non-communicable diseases.
Today non-communicable diseases—cancers, cardio-vascular disease and diabetes are taking a rising toll on women and are responsible for more than 60 percent of all deaths globally. Nearly 80 percent of these deaths occur in low and middle-income countries. By 2030, it is projected that non-communicable disease in low-income countries will surpass communicable, maternal, perinatal and nutritional diseases combined. This is a rising threat that can push households into poverty and adversely affect national economies. So urgent efforts are needed to deliver integrated health services that meet women's needs and to promote healthy lifestyles.
We must also pay greater attention to population dynamics. Today you are I are one of 7 billion people on Earth. While people are living longer and healthier lives, huge inequities persist that need to be tackled. The current pace of growth is adding about 78 million more people every year -and almost all growth is occurring in urban areas in less developed countries, some of which already struggle to meet their people's needs. At the same time, many rich and middle-income countries are concerned about low fertility, declining populations and ageing.
As the global population grows from the current 7 billion to almost 9 billion by 2040, and the number of middle-class consumers increases by 3 billion over the next 20 years, the demand for resources will rise exponentially. By 2030, the world will need at least 50 per cent more food, 45 per cent more energy and 30 per cent more water — all at a time when environmental boundaries are throwing up new limits to supply.
I believe that our ability to live together on a healthy planet will depend on ethical leadership that addresses inequality, disparities and discrimination in society. We need inclusive leadership that promotes and protects equal opportunities, human dignity and human rights.
We see this so clearly when we examine the health of women. Perhaps the most shocking statistic regarding women's health is the fact that nearly 4 million women are missing in our world from infanticide, neglect and other unnatural causes.
Of these missing women, two-fifths were never born, one-fifth died in infancy and childhood, and the remaining two-fifths died between the ages of 15 and 59. The causes range from overt discrimination, a preference for boys over girls, a total lack of resources in the household for children, and maternal mortality and HIV/AIDS for women of reproductive age.
Due to gender discrimination and violence, women are more likely to contract HIV. HIV infection rates of young women aged 15-24 are twice as high as those of men. In many cases, women simply do not have the means to protect themselves. In sub-Saharan Africa, home to the majority of people living with HIV, there is only one female condom available for every 36 women.
If we examine all health indicators, maternal mortality represents the greatest inequality between rich and poor. Every day 800 women die from complications of pregnancy and childbirth, two women every minute. Every year such complications leave more than 10 million women with physical and mental disabilities.
We know that globally, maternal mortality is due to a lack of access to quality health services. The high rate of maternal mortality, with the vast majority of deaths occurring in sub-Saharan Africa and South Asia, also has root causes in poverty and gender inequality—in low access to education, especially for girls, in early marriage, adolescent pregnancy, and low access to sexual and reproductive health information and services, including for adolescents.
We know that the more that women's rights are respected, including the right to sexual and reproductive health, the lower the rates of mothers dying during pregnancy and childbirth, the lower the rates of HIV infection, the lower the rates of teenage girls getting pregnant, and the lower the rates of abortion.
We also know from analyzing macroeconomic data that improvements in reproductive health reduce fertility rates, lead to better nutrition, health and education of children; and increase the number of women participating in the labor market, which fuels economic growth.
Between 1960 and 1995, the rapid economic growth of the so-called Asian tigers (Hong Kong, Singapore, South Korea, Taiwan), was fuelled by increases in people of working age, increase in female labor force participation, and increases in education.
Research shows that countries that have expanded opportunities for women and girls in education and work have largely achieved greater prosperity and social progress.
One example is Bangladesh, which has registered significant gains since the 1970s. Bangladesh has reduced child and maternal mortality, increased life expectancy, increased the number of girls in school, and reduced fertility from an average of 7 children to 2 children on average per woman today.
This example shows the tremendous benefits of empowering women. Lives have improved and the Bangladeshi economy has managed to grow more than 6 percent a year during the past decade.
My friends, today and every day, individuals like you and institutions like the Foreign Policy Association and Hunter College are coming together to advance the rights of women, and to advance public health.
This year UN Women joined UNAIDS, and we joined other UN agencies and organizations in a global partnership to advance the health of Every Woman and Every Child.
Since the partnership was launched in 2010, over 200 partners have made policy, service delivery and financial commitments to advance the Global Strategy for Women's and Children's Health, totaling over $40 billion dollars.
These commitments are paying off. HIV/AIDS is coming under control, slowly but steadily. In every country men, women, and young people are mobilizing to end violence and discrimination against girls and women. The health of women and children is improving.
Progress is being made in all regions. Yet accelerated action is needed.
Access to family planning could cut maternal deaths by an estimated 20 to 35 percent. Yet today some 222 million women, who would like to plan and space their births, still lack access to effective contraception.
Global partners, including the United Nations Population Fund, are expanding access to family planning and I applaud and support this effort.
This is especially important for young women. Today pregnancy and maternal conditions are the number one killers of 15-19 year old adolescent girls worldwide. These girls are twice as likely as women are in their 20s to die during pregnancy or childbirth. For those under 15, the risks are 5 times higher.
Despite these risks, one in seven girls in the developing world marries before the age of 15. This is why UN agencies joined together this year for the first International Day of the Girl Child, to call for an end to child marriage, so girls can be girls, not brides.
The Every Woman Every Child campaign aims to save the lives of 16 million women and children, prevent 33 million unwanted pregnancies, end stunting in 88 million children, and protect 120 million children from pneumonia by 2015.
This is an enormous and unprecedented undertaking. But it is achievable through partnership and concerted action across sectors that strengthen health systems and address the social determinants of health.
A vaccine or AIDS treatment works so much better if a person has food, safe water and sanitation. Contraception works better if a woman can take her own decisions about her body and her life. Public health improves when efforts are also take to fight poverty, violence and discrimination.
And if there's one thing I would like you to remember from my talk today, it is this: All over the world, in every country, women and girls are standing up for their rights. They are standing up for equal rights, equal opportunity and equal participation. And their fathers, grandfathers, brothers, uncles, husbands and partners are increasingly standing beside them.
At this time in history, in the second decade of the 21st century, we are in a new phase of understanding as humanity. We realize that reaching our potential as communities, countries and human civilization requires unleashing the full potential of girls and women. I thank you for all that you are doing. The arc of history is bending and it is bending toward's women and equality.
I thank you.