Sexual and Reproductive Health and Rights: Overseas Aid

My Committee has heard from several organisations about the importance of UK overseas aid to delivering comprehensive SRHR services and achieving universal access for every woman and girl. UK aid can and does make a real difference to the lives of women and girls around the world, but we must continue and expand our support in a sustainable way.

It is important to look at this issue through an intersectional lens. The Committee has heard that the most marginalised face additional barriers to accessing sexual and reproductive health services. They are often not delivered in a way that is accessible to women with disabilities. That could be as simple as a lack of a wheelchair ramp into the clinic or a lack of sign language interpretation. LGBTQ+ people can also find it difficult to access services due to the stigma, discrimination and even criminalisation of same-sex relationships and gender expression. We must do all we can to change that. I am very proud that our embassies around the world stand up for those rights.

Not only is investing in SRHR the right thing to do, but it makes financial sense. United Nations Population Fund research shows that for every $1 invested in family planning and maternal health in low-income countries, over $8 is accrued by averting unintended pregnancies and reducing the demand for, and cost of, maternal and other health services. Organisations such as the UNFPA are vital actors in the SRHR space, which is why it was so disheartening to hear it tell the Committee recently of the devastating impact of UK Government cuts on its services. In 2021, UK aid to UNPFA’s supplies partnership was cut by 85% with very little warning. Its only clue as to what was coming was from media reports about the UK’s reduction in official development assistance spending from 0.7% to 0.5%.

UNFPA provides 40% of the world’s contraceptive supply, reaching approximately 20 million women and young people every year. It told the Committee that because of the lack of funding, it had to immediately cut the commodities it provides—contraception—by 30% and has since had to make sweeping cuts across the board. While there has been a path to the restoration of funding for UNFPA supplies, the UK Government ultimately remain off track to meet their 2019 commitment of £425 million, with support for the UNFPA’s core operating fund remaining significantly reduced. Will the Minister make a commitment today that the UK Government will restore support to the UNFPA’s core operating fund alongside their existing commitments to their supplies partnership?

Supporting women and girls to take control of their reproductive health is essential in achieving the UK’s international development objectives, in particular its ambitions for gender equality. Government investment must reflect that. I understand that the Minister knows this, but action, not just empty promises, is desperately needed. Women and girls being able to access their reproductive health rights also underpins the success of all three of the ambitions of the Foreign, Commonwealth and Development Office’s women and girls strategy. Girls with access to education, safe and sensitive contraception and abortion services are less likely to drop out of school. Enabling women and girls to choose if and when they have children frees them to pursue employment and participate more fully in social and political life. Empowering women to make decisions about their SRHR is essential in tackling gender-based violence.

In its new report, the RCOG makes the case that if the UK Government are to be successful in achieving their key aims in the women and girls strategy, those aims must be matched with dedicated and sufficient long-term funding. Otherwise, it simply will not work.

Countries with the greatest need for SRHR funding and programmes have been hit the hardest by the cuts, and within those countries, the most marginalised are often the most affected. Professor Friday Okonofua, an obstetrician and gynaecologist based in Benin City, Nigeria, said in RCOG report that it is the most marginalised people who are reliant on donor-funded services. In Nigeria, where nearly 80% of health payments are out of pocket, the loss of funding from the UK Government has only widened this dire gap in services.

Making donations towards SRHR in humanitarian crises is welcome, but not enough. UK support must be in the form of sustained programming that delivers against the UK’s commitments to the UN sustainable development goals, and promoting the health of women and girls must be the backbone of international development. As RCOG recommends, will the Minister commit to restoring funding for SRHR, and spend £500 million each year for the next three years on SRHR programming and supplies?

RCOG is calling on the Government not only to restore investment in SRHR, but to strengthen their global advocacy on SRHR by investing in new and existing global partnerships and collaborations. The UK’s financial commitment to the Family Planning 2020 initiative had a significant impact on the global funding landscape for SRHR. It contributed to enabling an additional 24 million women and girls to access family planning services. I ask the Minister again to make a financial commitment to the Family Planning 2030 initiative, so that we can continue the programme’s success.

Only by linking our national actions to global goals and commitments can we hope to achieve truly universal access to SRHR for every woman and girl. As well as being one of the largest donors of support for SRHR supplies, the UK has been one of the most progressive in its advocacy. RCOG is calling on the Government to strengthen their global advocacy on SRHR by championing stigmatised issues such as abortion care. That is something I care about deeply, particularly as abortion rights are being rolled back around the world. I was proud that the UK co-led a statement at the UN General Assembly last year on the importance of respecting the bodily autonomy and SRHR of women and girls. It has also been reassuring to see the UK Government commit to prioritising safe abortion care as part of their commitment to supporting SRHR in the women and girls strategy.

Mainstreaming safe abortion services and post-abortion care is essential to reduce maternal morbidity and mortality. Unsafe abortion remains one of the world’s leading causes of maternal mortality. The risk of dying from an unsafe abortion is highest for women in Africa, where nearly half of all abortions happen in potentially dangerous circumstances. In his response, will the Minister say how the Government plan to champion safe abortion care in their programming, and in nations’ universal healthcare plans, as part of an effort to strengthen health systems?

We have seen the success of telemedicine in early abortion care in the UK. Guidance from RCOG, the World Health Organisation and other authorities on clinical standards affirms that telemedicine is a safe and effective delivery model for expanding access to abortion care. RCOG has encouraged the FCDO to invest in telemedicine and in self-management of abortion in settings where that can offer safe additional pathways to increased access. As RCOG has suggested, I would like the UK Government to champion the prioritisation of women’s and girls’ gynaecological health needs on the global health agenda.

The new report from RCOG is an important reminder to us all—and to the Minister—of our responsibility to women and girls around the world, who rely on our Government’s support for their essential healthcare. It should also serve as a call to action, so that we resume the progress that is needed to achieve universal access to SRHR. I urge the Minister to seriously consider the report’s recommendations for investment, as well as the points that I have raised today. We must stand together, alongside women and girls everywhere, and continue to advocate for their health, empowerment, and equality.

We face many challenges in achieving our aims. Global progress on reducing maternal death rates had stagnated between 2016 and 2020, even before the impact of the covid-19 pandemic. That is why I am championing our efforts to help end the preventable deaths of mothers, babies and children by 2030. The campaign joins up efforts right across the system, on issues including water, sanitation and hygiene, good nutrition, clean air, access to new health technologies, and a supportive environment for sexual and reproductive health and rights, which the hon. Member for Rotherham spoke about so clearly.

Let me turn to the worrying trends that are putting at risk the progress we have made on sexual and reproductive health and gender equality. Attempts to roll back the rights of women, girls and members of the LGBT+ community are increasingly well funded and well organised, and we are determined to confront them. Britain is a proud champion of these hard-won rights. We continue to promote and protect them around the world by working closely with our allies, including in the multilateral sphere. We must challenge the lies, polarisation and division that are undermining that progress. That is why the UK led a landmark joint statement at the UN Third Committee last October. Along with 71 global partners, we committed to working tirelessly to advance gender equality, and to supporting the rights of all women and girls. At this year’s Women Deliver conference in Kigali, the UK will help to catalyse united action against the roll-back of women and girls’ rights, and action to further gender equality. There is much to do, but there is cause for hope and the UK has a key role to play.

I turn to another challenge that we face, which is the reduced domestic Government funding for sexual and reproductive health and rights across the world, which was prompted by the covid pandemic and crises around the world. The UK’s official development assistance has also reduced. It remains the Government’s policy that we will get overseas spending back to 0.7% when the economy allows, but meanwhile we are doing as much as we can to find multipliers that can enhance and augment our taxpayers’ money. We have set out a strong pathway towards that through our strategies on women and girls and on ending preventable deaths.

We remain a key supporter of sexual and reproductive health and rights, and we have a significant portfolio of programmes and policies. For example, through FP2030—the global family planning partnership—the UK is helping partners around the world to advocate for better access to family planning. The global financing facility supports stronger, more sustainable access to health systems. The women’s integrated sexual health programme has enabled more than 9.5 million women and girls in Africa and Asia to use modern methods of contraception, and the UK remains a world leader in efforts to end the AIDS epidemic, including through our health system strengthening work, our work to end preventable deaths, and support for the World Health Organisation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. We are pushing for equitable access to comprehensive sexual and reproductive health services, dismantling barriers to access, targeting underserved groups and championing SRHR for all.