Message from Director SRH/HRP 29 October

Portrait photo of director

Ian Askew, Director, Department of Sexual and Reproductive Health and Research including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction

Gender equality is fundamental to fulfill everyone’s right to the highest attainable standard of health. At the 76th United Nations General Assembly last month, HRP was proud to contribute to an official WHO side event: Women, Health and Gender equality: Commit, accelerate, scale up!

Sexual and reproductive health and rights (SRHR) were front and centre of this inspiring session, carrying forward the momentum from the Generation Equality Forum. The full recording is well-worth your time, as is this 2-minute video animating WHO’s commitments to drive change for gender equality and the empowerment of women and girls in all their diversity.

Recent international awareness days have shown some of these commitments in action.

On World Contraception Day, WHO highlighted both general public information and useful tools for healthcare workers, such as the medical eligibility for contraceptive use (MEC) digital app. The app helps providers ensure a contraceptive method is safe, effective and acceptable for each client. At HRP we also celebrated some of the research activities, achievements and partnerships of the past year which are addressing barriers contraception services and information around the world.

On International Safe Abortion Day WHO and HRP celebrated global efforts to protect ongoing provision of quality comprehensive abortion care, even as the pandemic continues to challenge health systems capacity for delivering essential services. We also shared results from a multi-country research study with partners in 17 countries, shedding light on the severity and clinical management of abortion-related complications. With so much to learn from each other, I would urge you to consider joining the new community of practice on comprehensive abortion care, hosted by HRP and the IBP Network.

Sexual health and wellbeing is a critical aspect of SRHR, and a growing area of leadership and partnership for WHO and HRP. On World Sexual Health Day, and at the 25th Congress of the World Association for Sexual Health, I was proud to affirm that a positive and respectful approach to sexuality and sexual relationships is fundamental to WHO’s working definition of sexual health. You can read about our current range of activities, including education, counselling and care related to sexuality, sexual identity, and sexual relationships, here.

Good sexual health is about much more than the absence of disease; but prevention and management of diseases, should they arise, is an important part of the continuum of sexual health and well-being. Cervical cancer is one particularly pernicious disease associated with sexual activity, and it is important news that a further update to WHO’s guidance for screening and treatment of cervical pre-cancer lesions is expected in November.

Cervical cancer is also a profound reflection of global inequities: nearly 90% of deaths from cervical cancer in 2018 occurred in low- and middle-income countries. Persistent failures of equity, justice and accountability, in cervical cancer and across global health, were confronted at a recent WHO event honoring Mrs. Henrietta Lacks. Mrs. Lacks, a Black American woman who died from cervical cancer in 1951, paved the way for medical advancements including the HPV vaccine, when a sample of her cells was taken without consent, commercialized and distributed across the globe after her death. This thought-provoking and emotional conversation with Mrs. Lacks’ family is essential viewing.

A recent milestone for WHO and HRP was the launch of the 6th edition of the laboratory manual for the examination and processing of human semen. Over the past 40 years, this manual has become a vital guide for laboratory examinations, widely translated and used extensively by clinical and research laboratories throughout the world. The 6th edition was published following extensive expert and public review, and you can catch up on the dynamic launch event here. In related – and equally anticipated – news, the infertility Guideline Development Group has been meeting online over the past couple of months, and WHO guidance is expected next year.

Indeed, digital tools have been a crucial means of connecting across so much of our work this year. Last week we welcomed online our expert Guideline Development Group meeting on recommendations for Induction of Labour. The IBP Network and HRP Alliance also held their recent partners meetings online. It was wonderful to see so many faces and feel so much support “in the room” for improving SRHR globally, through research and implementation.

The accelerated use of digital health interventions during the pandemic presents a particular opportunity for children and adolescents under 18, who account for an estimated 1 in 3 internet users worldwide. On International Day of the Girl Child, we shared some of the ways in which digital health solutions are playing a role in promoting girls’ empowerment and fulfilment of their human rights. Please do make use of the data presented, including these excellent country profiles on adolescent sexual and reproductive health.

Last month on World Sepsis Day we highlighted ground-breaking research, collaboration and advocacy from WHO and HRP to prevent and address maternal sepsis, which has a much larger impact on global maternal mortality and morbidity than previously thought. New research also showed the significant impact on infants born to women with infection during pregnancy.

For these and many other reasons, we were delighted to join with many departments across WHO in support of this year’s World Patient Safety Day, focusing on safe maternal and newborn care. I spoke at the launch event with a key message to convey: good quality care is safe and respectful care.

This is a message we have repeated throughout the pandemic, and will continue to affirm as the new era for safe and respectful childbirth. Engaging women and accounting for their experiences in health systems is the first order of respect in a human rights approach to maternal and newborn care. Beyond clinical service delivery, strategies to promote respectful care must also account for gender, racial and power dynamics.

As WHO Director General Dr Tedros Adhanom Ghebreyesus says: when it comes to gender equality, we can, and must, do better.

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