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In 2002, the leaders of 189 countries came together at the Millennium Summit and pledged to: eliminate poverty; create a climate for sustainable development; and ensure human rights, peace, and security for the entire world's people. To measure progress towards this vision, the Millennium Development Goals (MDGs) were created. While many of the MDGs come from previously agreed upon declarations, none explicitly references youth's reproductive health, even though its relationship is integrally linked to poverty and to meeting the vision of the summit. Investments made by governments to improve youth's reproductive health can have a positive long-term impact on the productivity of a nation's workforce, per capita income, health care expenditures, and social capital.

The State of Youth's Reproductive Health

People under the age of 25 represent nearly half of the world's population,[1] giving them a powerful role in the world's health and future. Despite youth's diversity in culture, background, language, and socioeconomic status, their lives reflect similar, intersecting issues and events. For youth ages 15 through 24, life can be overshadowed by reproductive health issues, including unintended pregnancy as well as HIV and other sexually transmitted infections (STIs).

• Worldwide, about 6,000 youth ages 15 to 24 are infected with HIV each day.[2]
• Young people experience over 100 million new cases of STIs each year.[2]
• Young women experience high rates of unintended pregnancy. Each year, about 15 million young women ages 15 to 19 give birth.[3] In Latin America and the Caribbean, about 40 percent of teenage pregnancies are unintended while in sub-Saharan Africa the percent varies widely from 11 to 77 percent.[4]

Youth's decisions about their sexual and reproductive health affect not only their lives, but also the health of the global community. Addressing the sexual and reproductive health needs of young people ages 15 to 24 is essential to meeting the vision laid out at the Millennium Summit.

Poverty and Youth's Reproductive Health

Poverty and youth's reproductive health are integrally linked. Most notable is the impact of the HIV and AIDS epidemic on the economies and labor forces of the hardest hit nations. Young people worldwide now account for half of all new HIV infections.[1,2] Research further indicates that half of 15-year-old youth in the worst affected countries may die of AIDS,[5] leaving behind depleted work forces and little hope for sustainable development.

Early marriage and childbearing are also linked to poverty. Young women from poor families are less likely to be allowed to finish school and more likely to be forced to marry early than are teens from wealthier families.[5] Poor young women also are three times more likely to give birth than are wealthier young women of the same age.[6] Maternal mortality is twice as high for women ages 15 to 19 as for those ages 20 to 34.[5,6] Children born to mothers under the age of 20 are significantly more likely to die than those born to mothers ages 20 to 29.[5] Further, children born into poverty tend to remain poor as they grow into adulthood. They then raise their own children in a state of economic disadvantage, perpetuating a cycle of poverty that is the central objective of the MDGs.[5]

Governmental investments to improve youth's reproductive health will have long-term impact on both individual families and a nation's economic development. Investments in youth's reproductive health can yield greater productivity in a nation's workforce, increase per capita income, lower national health costs, and improve a country's social capital. Further, these investments will result in improved productivity and well-being in the generations that follow.[5]

Incorporating Youth's Reproductive Health into the Millennium Declaration

The General Assembly of the United Nations has the opportunity to acknowledge the meaningful part that youth's reproductive health will play in meeting the Millennium Development Goals. The MDGs cannot be met without focused and strategic attention on improving the reproductive health of the world's two billion young people. As such, United Nations members should advocate for and support incorporating targets and indicators of youth's reproductive health into the Millennium Declaration. Specifically, members should advocate at regional forums and at the Millennium Project +5 in September 2005 for the inclusion of a goal from the International Conference on Population and Development (ICPD) to "ensure universal access to reproductive health by 2015." The Millennium Project's Task Force on Maternal/Child Health and Gender Equity recommends including this goal as a target to MDG no. 5. Additionally, the Task Force has recommended the addition of two indicators that are critical to tracking youth's reproductive health: HIV prevalence among 15- to 24-year-old women (to be added as an indicator of progress towards MDG no. 6) and adolescent fertility rates (to be added as an indicator of progress towards MDGs no. 3 and no. 5).

Youth's Involvement in the MDGs

Youth's reproductive health and, in fact, young people themselves are the key to meeting and sustaining the goals of the Millennium Summit. By including targets and indicators related to youth's reproductive health in the MDGs, the summit will encourage governments to move successfully towards creating a healthy and economically secure populace. Further, young people have much to say about what will best assist them to meet these targets. As such, governments should include young people in developing and implementing their country-level strategies as well as in country delegations to General Assembly meetings regarding the MDGs. The reproductive choices of the world's two billion young people will largely determine the quality of life on this planet for decades to come. Youth's reproductive health must be targeted in the MDGs to assist nations in meeting the vision of the Millennium Summit.

References

1. UNAIDS. 2004 Report on the Global AIDS Epidemic. [4th Global Report] Geneva, Switzerland: Author, 2004.
2. UNAIDS. Young People and HIV/AIDS: Opportunity in Crisis. Geneva, Switzerland: Author, 2002.
3. Boyd A et al. The World's Youth 2000. Washington, DC: Population Reference Bureau, 2000.
4. Mahler K, Rosoff JL. Into a New World: Young Women's Sexual and Reproductive Lives. New York: Alan Guttmacher Institute, 1998.
5. Zwicker C et al. Commitments: Youth Reproductive Health, the World Bank, and the Millennium Development Goals. Washington, DC: Global Health Council, 2004.
6. Mathur S et al. Too Young to Wed. Washington, DC: International Center for Research on Women, 2003.

Special thanks to the Global Health Council for its informative publication, Commitments: Youth Reproductive Health, the World Bank, and the Millennium Development Goals.

May 2005 © Advocates for Youth