KEEPING A PLACE AT THE TABLE: PARTNERSHIP AND
ACCOUNTABILITY AFTER CAIRO AND BEIJING

By Joan Dunlop and Rachel Kyte

Successful development initiatives often demand a combination of consciousness-raising and practical synthesis of ideas. The recent United Nations conferences on population and women went a long way to heighten awareness of problems involving fertility, women's economic empowerment, and reproductive health. EDI held a conference for South Asian policymakers on practical ways to provide higher quality reproductive health care. With an estimated 500,000 women dying each year from causes related to pregnancy and childbirth, much remains to be done to translate awareness into better health care. Joan Dunlop and Rachel Kyte of the International Women's Health Coalition look at the road ahead from the Cairo and Beijing conferences.

The International Conference on Population and Development in Cairo in September 1994 and the Fourth World Conference on Women in Beijing a year later attracted news media around the world. Part of the attraction was thousands of articulate women activists who translated arcane diplomatic language into the realities of women's lives and put faces on the figures of poverty, violence and discrimination. More than agents who could focus attention on critical development issues, women were full participants in an unprecedented experiment in international democracy and decision making.

The conferences changed the way the world considers development. They demonstrated that women's issues are the world's issues and that solutions can result only from women's full involvement. The main messages are unequivocal and compelling:

The Cairo Programme of Action represents a shift away from demographic targets and population control policies to the protection of individual rights and better match of human needs and aspirations. Beijing extended the Cairo consensus by recognizing a women's right to control her own fertility and by calling on governments to review laws that penalize women seeking illegal abortion.

Progress is occurring. IN India, Health Watch has brought women's health advocates and other non-governmental organizations to talk with the federal government and with international agencies including the World Bank. Urged on by the Bank's new policy on reproductive health and the coalition of NGOs, the government is looking to implement some family planning programs in all states without contraceptive targets or incentives, building them instead around women's reproductive health needs.

In South Africa, new, non-racial, non-coercive population and development policies have been devised with the involvement of women activists, based on conclusions reached in Cairo. Consultative workshops have been held, along with national advertising campaigns.

In Peru, feminist organizations will work for the first time with funds from USAID to explore what women want from reproductive health services and how these services can be provided.

The U.N. conferences had their controversies. Besides the reluctance of much of the development establishment to discard their shibboleths, those that worked for the Beijing and Cairo agreements faced concerted, organized opposition from conservative and fundamentalist forces. Despite the Beijing conference's strong support for the core principals of the Cairo Programme of Action, opposition has continued.

Another less visible obstacle is that in the year between the two meetings, some northern countries expected to contribute one-third of the cost of implementing the Cairo Programme lost the certitude they had demonstrated. Arguments persisted about how realistic the Cairo agreements were. Political opposition was often masked by calls for more research into just what is entailed in a reproductive health approach. However, in Cairo the consensus had been that we know enough to make some changes now and that we must make them. At Beijing the international community again was clear.

We know enough to improve the quality of family planning programs. We know enough to counsel and inform people on sexually transmitted diseases and HIV/AIDS and to invest in maternal and child health, integrating screening and treatment in family planning, and other public health programs. We know enough to reallocate financial resources to the Cairo agenda while we search for the political will to produce new funding sources. We also know enough to start educating professionals in health services and development about the rights of women.

Successful implementation of policies demands greater transparency and accountability. The involvement of women at every level of the crafting of the Cairo and Beijing agreements in the field, Cairo and Beijing have a solid constituency.

International agencies such as the World Bank can draw women into all stages of program development. The Bank should protect the political space for women's involvement by working with women from the Bank's client countries. This means involving women on review teams and in policy design at headquarters and in country, in implementation and evaluation. The Bank's face must change in the countries in which it works as well as in Washington. Steps in the same direction are being made by the United Nations Fund for Population, UNFPA has formed an NGO advisory committee to seek advice and invest in women's health networks.

Countering the backlash, vocal and inert, and multiplying positive changes means that women must be at the table at every level including at the international financial meetings that set the parameters for health and population related development.

In his plenary address in Beijing, World Bank President James Wolfensohn said he was there to listen and to learn. Institutionalizing that process of learning at the program, department and agency level, and working closely with women, will mean that much of our knowledge about improving women's lives can be put in place today. And it will speed development of what can and should be done tomorrow.


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