There are powerful signs that many people throughout the region aren’t yet under the umbrella of protective information, behaviour and services. Rates of early sexual initiation and child sexual abuse remain high. HIV-related knowledge is moderate to low. Teen pregnancy is prevalent. People continue to have a great number of high risk sexual encounters. Condom-use is merely moderate. And for the Caribbean as a whole the unmet family planning need is a high 20 percent.
Geeta Sethi, Director of the United Nations Population Fund (UNFPA) Sub-regional Office for the Caribbean, says that there is an increasing understanding of how and why people are left off the development train.
“There are layers and layers of who we leave out,” she explained. “Sometimes it’s linked to religion, ethnicity, socio-economics, class, education and, surprisingly here, even age.” She noted that there has been a shift in the global approach to targets surrounding HIV and family planning. Governments, development agencies and other stakeholders now aim for Universal Access.
“That means each and every person is included. Health and rights should be for everybody,” Sethi said, “irrespective of who they are.”
The 1994 United Nations International Conference on Population and Development (ICPD) was underpinned by belief in the inherent worth of each person. At that meeting 179 countries agreed to a 20 year Plan of Action meant to improve the lives of people by putting their concerns at the centre of development. It includes the promotion of human rights, sexual and reproductive health and rights and gender equality; supporting family planning; and eliminating violence against women. “ICPD Beyond 2014” is a programme through which countries will reaffirm these commitments and review their progress.
Even after 19 years of working in HIV and reproductive health with agencies including UNAIDS and in places ranging from Bangkok to Bangladesh, the petite Sethi isn’t jaded about politicians and their sincerity in signing on to international commitments.
“I might be naïve but I think that governments genuinely believe in these values. I don’t think you make these commitments lightly. I don’t think you say before the community of nations that you are going to do something and intend not to do it. But you go back home and you’re not sure how. There might be contradictory laws or you mightn’t have the capacity to engage your citizenry, so what happens is that you don’t do it.”
Sethi noted that the time countries take to come to terms with issues deemed "taboo" like sex work or sexual minorities, varies. An important factor is the willingness of affected communities to speak out.
“You also have to have strong partners that are open about the fact that they support these communities. People continue to advocate on these issues at the highest levels of the global agenda. National programs driven by partners and advocates need to connect to that,” she explained. “A lot of times people feel everything is okay as long as it’s hidden. This happened in the early years of the AIDS response. Very articulate, strong people from the community had to stand up and say ‘This is who I am and I deserve to be treated like everybody else’.”
Almost two decades on, there isn’t any part of the ICPD agenda that she considers a done deal.
“It is always going to be a struggle and even after you’ve covered some ground you’ve got to keep fighting. There are those with a different point of view and that’s all right,” Sethi said with a smile. “But those who believe have to advocate.”
Photo caption: Geeta Sethi, Director of the United Nations Population Fund (UNFPA) Sub-regional Office for the Caribbean (Credit: UNFPA)