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The continued commitment to achieving comprehensive healthcare, education, and gender equality played a crucial role in making the ICPD programme a success.

Thirty years after the Cairo Conference: Assessing the ICPD Programme of Action 1994

This is part of the essay series: World Population Day 2024


This year’s World Population Day (WPD), celebrated on 11 July, centres around the theme of precise and detailed data collection, underlining its importance for understanding complex problems and driving effective action. This article revisits the pivotal 1994 International Conference on Population and Development (ICPD) in Cairo, Egypt, which shifted global policy from demographic targets to a rights-based approach to development. Thirty years following the Cairo Declaration, it is evident that accurate data in monitoring the effectiveness of the ICPD Programme of Action (PoA) and recalibrating efforts toward sustainable development, gender equality, and health improvements globally plays a crucial role.

Shifting the narrative

The narrative of the “population bomb,” popularised by Paul R. Ehrlich in the late 1960s, has driven fears of resource depletion and ecological collapse. Echoing Malthusian concerns, these views often oversimplify and raise false alarms. Many dire predictions did not materialise due to advances in agricultural technology, improved healthcare, and family planning. Rather, global population growth slowed down considerably across socio-economic groups, with regions facing ageing populations instead. Contemporary policy concerns lie in socio-economic inequalities, unequal resource distribution, poor governance, and unsustainable consumption.

The narrative of the “population bomb,” popularised by Paul R. Ehrlich in the late 1960s, has driven fears of resource depletion and ecological collapse.

The 1994 ICPD in Cairo marked a shift from demographic targets to a human-centred approach, presenting reproductive health and rights, gender equality, and sustainable development as fundamental and setting goals regarding mortality rates, education, and access to reproductive health services. 

Health and mortality reduction

The ICPD aimed to reduce infant, child, and maternal mortality by emphasising comprehensive healthcare services, including prenatal and postnatal care, skilled birth attendance, and child health interventions. As shown in Figure 1 and Figure 2, global under-5 mortality had declined by 58.41 percent between 1994 and 2022 and maternal mortality was estimated to have dropped by 34.22 percent between 2000 and 2020 due to improved healthcare, vaccination programmes, and better nutrition. However, prevailing inequities in Sub-Saharan Africa, East Asia and Pacific, and South Asia demand stronger healthcare systems.

 

The inclusion of reproductive health services in emergency response plans also stressed upon recognising that conflicts, natural disasters, and other emergencies often disrupt access to essential health services. Organisations like the United Nations Population Fund (UNFPA) developed guidelines for these services in humanitarian responses. Still, challenges remain, including funding shortages and logistical constraints.

The inclusion of reproductive health services in emergency response plans also stressed upon recognising that conflicts, natural disasters, and other emergencies often disrupt access to essential health services.

Additional emphasis was placed on comprehensive strategies to combat HIV/AIDS, including public education, access to testing and treatment, and support for affected individuals and communities. Since 1994, global efforts have reduced new HIV infections by an estimated 59.38 percent by improving access to antiretroviral therapy (ART) as demonstrated in Figure 3. Prevention initiatives like condom distribution and education campaigns have been effective. Sustained efforts to improve access to prevention, treatment, and care services, along with addressing stigma and discrimination, are crucial for ending the epidemic by 2030.

Reproductive health and rights

The ICPD advocated for universal access to reproductive health services as a fundamental human right, including family planning, safe pregnancy and childbirth services, and the prevention and treatment of sexually transmitted infections (STIs), aiming for the integration of reproductive health into primary healthcare systems as well as the surety of accessibility, affordability, and cultural sensitivity. Post 1994, the availability of family planning and maternal health services has increased. Yet, gaps remain, particularly in rural and low-income areas. Figure 4 displays regional disparities in access to contraception, with Sub-Saharan Africa lagging behind.

 

The ICPD also addressed adolescent sexual and reproductive health, urging comprehensive sexuality education and youth-friendly health services. Following the Cairo conference, many countries have integrated related programmes and policies, increasing awareness and healthier behaviours among adolescents. Nevertheless, cultural resistance remains and access to confidential services are limited, thus continued advocacy and investment in education and health services are required.

Education and empowerment

In Cairo, the importance of empowering individuals through universal access to education, particularly for girls and women was endorsed. The PoA called for eliminating gender disparities in education and ensuring all children, especially girls, have access to quality primary education. Over the last 30 years, significant strides have been made towards increased access to primary education, with many countries eliminating school fees and providing incentives for attendance. Figure 5 shows that gross enrolment ratios for primary education among females have improved globally. Nonetheless, poor infrastructure and socio-cultural barriers necessitate continued investments in educational infrastructure and teacher training.

 

The ICPD framed gender equality and women's empowerment as vital to sustainable development, calling for legal reform to protect women’s rights by eliminating discrimination and ensuring their full participation in social, economic, and political life, promoting equal opportunities, and addressing gender-based violence. Over the past 30 years, women have seen increased access to education, healthcare, and economic opportunities. Yet, as exhibited in Figure 6, gender-based imbalances in the Middle East, North Africa, and South Asia regarding labour force participation accompany global concerns around gender-based violence and discrimination, mandating further efforts to enforce legal protections and challenge societal norms.

Integrated development and sustainability

The ICPD stressed the need to integrate population concerns into development strategies for sustainable development, highlighting. the interrelationships between population dynamics, economic growth, and environmental sustainability. It called for incorporating population factors into all aspects of development planning, including health, education, employment, and resource management. Over the years, many countries have recognised this need, implementing policies promoting sustainable resource management and environmental protection. However, as showcased in Figure 7, poverty rates still remain significantly high in Sub-Saharan Africa. Obstacles including rapid urbanisation and socio-economic inequalities provide compelling arguments for continuous adaptation and commitment to these strategies. 

 

Additionally, the ICPD called for increased financial commitments from governments, international organisations, and private sectors to support population and development programmes while ensuring the successful implementation of the PoA. It advocated for efficient allocation and resource utilisation, transparency in funding mechanisms, and accountability when using financial resources towards sustainable development outcomes. Since 1994, funding for population and development programmes has increased, as illustrated in Figure 8, especially in Sub-Saharan Africa and Middle East and North Africa, but still falls short of required levels. Innovative financing mechanisms are needed to bridge funding gaps and ensure transparent and efficient resource use.

Additionally, the ICPD called for increased financial commitments from governments, international organisations, and private sectors to support population and development programmes while ensuring the successful implementation of the PoA.

The ICPD proposed a five-year review process to evaluate the implementation of the PoA, monitor progress, identify challenges, and adapt strategies as needed, stressing the involvement of governments, international organisations, and civil society to ensure comprehensive and inclusive assessments. Since 1994, regular reviews have been conducted, highlighting significant achievements as well as areas requiring further attention. The involvement of multiple stakeholders has been crucial for ensuring comprehensive evaluations and informing policy adjustments. Continued commitment to regular monitoring and adaptation is essential for addressing emerging challenges and ensuring the sustained success of the ICPD PoA.

Conclusion

Looking forward, the continued success of the ICPD PoA hinges on several critical factors: Firstly, continued commitment at the national and international levels to invest in comprehensive healthcare, education, and gender equality initiatives while addressing socio-economic and cultural barriers and promoting inclusivity is crucial to strengthen systems, especially in crisis-affected and rural areas. Secondly, the incorporation of population dynamics into development policies and increased financial commitment to address rapid urbanisation is important for sustainable development. Finally, aligned with the theme of WPD 2024, quality data is the cornerstone of these efforts. Monitoring and evaluation heighten transparency, accountability and the effectiveness of policies through appropriate and targeted interventions. By reaffirming these commitments, it can be ensured that the vision set 30 years ago continues to advance.


Oommen C Kurian is a Senior Fellow at the Observer Research Foundation.

Nimisha Chadha is a Research Intern at the Observer Research Foundation.

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Authors

Oommen C. Kurian

Oommen C. Kurian

Oommen C. Kurian is Senior Fellow and Head of Health Initiative at ORF. He studies Indias health sector reforms within the broad context of the ...

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Nimisha Chadha

Nimisha Chadha

Nimisha Chadha is a Research Intern at the Observer Research Foundation. ...

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