Reverse the Backsliding on Sexual and Reproductive Health and Rights: A Wake-up Call from Independent Scientists and Advisors
reproductive health
Sister Percilda Manhica, a nurse at the Manica Health Center in Mozambique, discusses contraceptive options with Clara Obadias Matavele.

Amid a huge global push against sexual and reproductive health and rights, some of the foremost global experts in the field are calling on the World Health Assembly to protect these hard-won rights. All the authors are listed below.

Progress on comprehensive sexual and reproductive health and rights (SRHR) and its connected goals of gender equality are fundamental for human rights and dignity, national economies, sustainable development, and a healthier planet. 

While SRHR are often thought of in terms of the services needed to prevent unwanted pregnancies, unsafe births and avoidable sexual or reproductive illness, injury or dysfunction, it is much broader. 

Vitally, it includes the positive enjoyment of consensual sexual intimacy and pleasure, the development of mutually respectful and loving relationships, as well as the affirmation of individuals and families in all their diversity. 

It is core to human dignity, autonomy, creativity and security. Sexual and reproductive health and rights flourish only where its emotional, mental, and social dimensions are also enabled, free of coercion, discrimination, and violence.

Upholding this holistic understanding of sexual and reproductive health and rights is essential now more than ever. The costs of failure of inaction or purposefully undermining sexual and reproductive health and rights have devastating consequences for the health, wellbeing and survival for 4.3 billion people (See text box at end).

Ensuring well-being

In contrast, investing in and ensuring access to effective sexual and reproductive health services ensures better health, well-being and life. 

Comprehensive sexual education gives life skills to young people and contraceptives enable girls and women to plan their destinies. 

Maternal mortality is largely avoidable and has declined by 34% from 2000 to 2020. When carried out using a method appropriate to the pregnancy duration, and by someone with the necessary skills, abortion is a safe health care intervention. Legislative action broadening access to abortion has led to declines in maternal mortality.  

Antiretroviral therapy has changed the course of the HIV epidemic. Effective primary (Human papillomavirus  vaccination) and secondary prevention approaches (screening for, and treating precancerous lesions) will prevent most cervical cancer cases.

Beyond health and social benefits, investing in SRHR has economic payoffs. For example, every dollar invested in meeting the need for contraceptives accrues $120 of benefits, in the form of reduced infant and maternal mortality and long-term benefits from greater economic prosperity

The financial return generated by income and consumption taxes paid by people born through assisted reproduction far exceeds public funding for assisted reproductive technology, not counting other contributions to society.

Today, there are shining examples of progress towards the full realisation of sexual and reproductive health and rights, with impact on broader peace and well-being. At the same time, sexual and reproductive health and rights are being challenged on multiple fronts in today’s increasingly polarised and unequal world.

Ultra-right groups are undermining gains

Girls and women protest outside Gambia’s parliament earlier this year in protest against attempts to reintroduce female genital mutilation.

Ultra-right-wing gender ideologies and religious fundamentalism continue to consolidate political influence. Further threats arise when governments collude with commercial interests to profit from war economies that undermine the basis for sexual and reproductive health rights

Some war-makers go further and weaponise sexual and reproductive rights. Similarly, progress made on democratic rights, accountability and equitable development are undermined with trade agreements cleaving global inequalities that corrode the universality of sexual and reproductive health and rights.

Seeking electoral success, ultra-right-wing leaders and movements propagate hate speech, misinformation, and the promotion of retrograde policies and laws that roll back sexual and reproductive services and our rights to them. 

Specifically, these ultra-right-wing activists seek to reverse legal protections against gender-based violence and harmful practices such as female genital mutilation; ban sexuality education; prohibit sex outside of marriage; criminalise LGBTIQ+ populations; implement bans or broad restrictions on safe abortion, and even deny access to modern contraceptive methods

They are also rolling back funding for sexual rights and well-being; and last but not least, they target, denounce and outright threaten sexual and reproductive health and rights care providers and advocates.

Rise of disinformation

The growing systematic distribution of disinformation is of particular concern. Sexual and reproductive health and rights issues are purposefully conflated with false claims that these issues deny nature, erase gender, and impose colonial  ideologies or alien agendas

The truth is that upholding sexual and reproductive health and rights enhances life and saves lives: enhances women’s agency over their own bodies and destinies; supports respect for gender identities in all their diversity; and transforms gender power relations for greater equality. 

Lastly, not only are elements of sexual and reproductive health and rights found historically across all cultures, but advancing sexual and reproductive health and rights is a means to counter past legacies of coloniality.

By feeding and instrumentalizing fear, prejudice, and misinformation via national and international platforms, politicians, advocates and community leaders supporting these backward steps are wilfully endangering the lives, health, and well-being of others. 

They behave as if their personal morality claims take precedence over their public duties to reduce preventable mortality and morbidity. The results are disastrous, with longstanding consequences for health and development. Even for maternal health, despite the progress made, more recently maternal mortality ratios have stagnated or even worsened across countries of all income levels.

A mother and her new born baby at the Maternal and Child Health Training Institute in Dhaka, Bangladesh. Maternal mortality remains a very serious concern in Asia.

Our call: Protect SRHR

More than 30 years on from the international commitments made to sexual and reproductive health and rights in Cairo, and to fulfil the commitments made to the Sustainable Development Goals, the pressing work to protect lives, well-being and dignity in sexual and reproductive health is far from finished.

In light of this, and the clear current threats to sexual and reproductive health and rights, we call on all delegates to the 2024 World Health Assembly to protect and promote sexual and reproductive rights, which are human rights, without discrimination. 

Anti-health, anti-rights, anti-evidence dynamics should have no place on the negotiating floors of the UN and WHO

Instead, the substantial progress that has and must be made should be recognised and applauded, while those who evidently failed in their responsibility for the safety and wellbeing of others should be held accountable. At a bare minimum, countries must fully respect the principle of non-regression.

With more people and nations going to the polls this year, 2024 is a decisive year for the future of sexual and reproductive health rights. 

We call on citizens and communities to mobilise, stand up for, demand and vote for leaders who will defend fact over fear and evidence and science over ideology; who will honour their human rights obligations for all in their totality, including our rights to sexual and reproductive health. Investments to advance, not regress, sexual and reproductive health and rights are essential for broader health, equitable development, sustained peace and planetary survival.

The authors are independent scientists and members of the following independent advisory groups for sexual and reproductive health:

Scientific and Technical Advisory Group for the UN’s Special Programme on Human Reproduction (alphabetical order): Abdifatah Abdullahi, Ivonne Diaz, Ana Flavia D’Oliviera, Silke Dyer, Alison Edelman, Fatu Forna, Asha S. George (chair), James Hargreaves, Caroline Homer, Elin C. Larsson, Dorothy Shaw, Tari Turner (co-chair)

Gender and Rights Advisory Panel for the UN’s Special Program on Human Reproduction: Alessandra Aresu, Kate Gilmore (chair), Anuj Kapilashrami (co-chair), Renu Khanna, Allan Maleche, Brian Mutebi, Mindy Roseman, Marion Stevens, Imani Tafari-Ama,

Strategic and Technical Advisory Group of Experts on Maternal, Newborn, Child and Adolescent Health and Nutrition: Amanuel Abajobir, Narendra Arora, Richmond Aryeetey, Per Ashorn, Peter Azzopardi, Oliva Bazirete, Jay Berkley, Cristina Bisson, Gary L. Darmstadt, Kathryn Dewey, Faysal El Kak, Caroline Homer (chair), Caroline Kabiru, Nuray Kanbur, Betty Kirkwood, Jonathan D Klein, Daniel Martinez Garcia, Sjoerd Postma, Linda Richter, Jane Sandall, Dilys Walker, Stanley Zlotkin


Image Credits: Dominic Chavez/World Bank, UN Photo/Kibae Park/Flickr.

Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.