On 25th April, JOICFP in conjunction with Nihon University Population Research Institute (NUPRI) and the Japan Family Planning Association organized a special lecture "Sexual and reproductive health (SRH) - Today's global challenges and WHO's response," attended by over 30 invited RH specialists, and representatives of RH organizations, the medical profession and NGOs.

The seminar was facilitated by Hirofumi Ando, Professor, Nihon University, and the special lecture was delivered by Dr. Paul Van Look, Director, Department of Reproductive Health and Research, WHO Geneva.

Dr. Van Look said that it was now 12 years since the concepts and needs of RH had been adopted by the 179 national signatories of the Cairo ICPD Program of Action. Based on a ten-year review of that in 2004, WHO was now reporting on the progress made.

Dr. Van Look delivers his speech as Ando looks on

Showing figures for how reproductive ill-health accounts for a substantial portion of the global burden of disease in 'disability-adjusted life-years' (DALYs), Dr. Van Look explained that HIV/AIDS, STIs, RH-related cancers, and perinatal problems accounted for over 13% of DALYs among men, and nearly 20% among women. Unsafe sex and lack of contraception accounted for 2.9 million and 149,000 deaths, respectively, he said.

He showed how these figures were worse than in 1990, and emphasized that these were all preventable problems, and that lack of services and education were the real issue.

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MDGs

Out of the eight Millennium Development Goals (MDGs) agreed to at the 2000 World Summit, three of them, numbers 4,5, and 6 are directly related to RH. However, there is no mention of RH anywhere in the MDGs so proactive attention to RH services in health planning is lacking. Dr. Van Look said that in the case of HIV/AIDS, for example, a curative and drug-based approach was being taken, but that there was no integration with RH in a preventative approach.

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As a result, he said, mother to child transmission (MTCT) was rising, as was the number of 'AIDS orphans', both of which are preventable.

WHO strategy

The 2004 WHO Global RH Strategy, adopted by 192 states, including Japan, emphasizes the needs of RH services in order to "...achieve universal access to RH by 2015, as set out at the (Cairo) ICPD, integrating this goal in strategies to attain the internationally agreed development goals, including those contained in the Millennium Declaration..."

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Dr. Van Look highlighted sections of the strategy, showing that 529,000 women die each year during pregnancy, childbirth and postpartum, and that in Africa the lifetime risk of maternal death is 1 in 16.

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Another critical issue, he said, was that of abortion; out of the 46 million abortions in 2000, 19 million were unsafe, and out of all abortions in Africa, nearly 60% were unsafe.

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While abstinence plays a role in sexual health, it is not the only solution to meet the unmet needs of adolescents and youth, stressed Dr. Van Look. What is also needed is comprehensive sexuality education at all ages in preparation for informed choice making.

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STIs

Dr. Van Look also spoke about the damage caused by STIs, saying that there were 340 million new curable cases a year; that 4.9 million people became newly infected with HIV in 2005; and that there were 500,000 deaths due to syphilis alone.

Research

Speaking on the need to 'get research into practice' (GRIP) and the weakness of funding for research, Dr. Van Look said that Japan's contribution to RH research was invaluable for strategic implementation and that Japan could act as a center for excellence in the field as it had rich experience and knowledge, especially with regard to aging.

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Dr. Van Look finished by quoting Mary Lasker; " If you think research is expensive, try disease."