KATHMANDU: The United Nations Population Fund has long had a significant presence in Nepal, supporting government and civil society to reach zero preventable maternal deaths, zero unmet need for family planning and zero gender-based violence and harmful practices including child marriage. This year marks the 25th anniversary of the signing of the landmark Programme of Action of the International Conference on Population and Development. The ICPD Programme of Action was unanimously adopted in Cairo in 1994 by 179 member states including Nepal. Despite significant gains this past quarter-century, for far too many women and girls around the world including in Nepal, the promise of Cairo has yet to be fulfilled. From 12-14 November, UNFPA in collaboration with the governments of Kenya and Denmark are co-convening the Nairobi Summit on ICPD25. Dr Natalia Kanem, the Executive Director of UNFPA, visited Kathmandu on her first official visit to Nepal earlier this week. Dr Kanem, who is also UN Under-Secretary-General, also met with the Prime Minister, Deputy Prime Minister and ministers among other stakeholders recognizing the significant achievements by Nepal in relation to the Cairo vision and the commitment of the government to its full implementation by 2030. Rajan Pokhrel of The Himalayan Times caught up with Dr Kanem for an exclusive interview to talk about the upcoming Nairobi summit, relevance of ICPD and other issues of population and development. Excerpts: Let’s start with the US Global Gag Rule and the rising opposition to sexual and reproductive health and rights from some right-wing populist movements in Europe, the US, and also in a few developing countries. Amid these threats to universal access to sexual and reproductive health and reproductive rights, how are global SRHR advocates and your agency fighting back? There are formidable challenges, but there are also undeniable opportunities that we can and must seize. The so-called Global Gag Rule, as well as the defunding of UNFPA by the current US government, definitely impact the health and wellbeing of women and girls in so many parts of the world – as they prevent essential information and services from benefiting those who need them the most, some of the most vulnerable and marginalised women, girls and young persons, primarily in developing nations where the needs are the highest. Our development partners on the ground are reporting on how essential services have been cut, and how devastating this has been for these populations. We hope the US will look at the evidence and reconsider these restrictions. But this is not just about the US – as you say, there is an escalating pushback on reproductive rights and choices around the world.  What countries do now in terms of the International Conference on Population and Development (ICPD) Programme of Action will determine the health and wellbeing of women and girls for generations to come. Without achieving ICPD, we simply won’t achieve the Sustainable Development Goals. We are gratified at the same time that a coalition of allies and champions of sexual and reproductive health and rights are determined to forge ahead.  Movements like SheDecides, which has a strong presence in Nepal, are finding innovative ways to reach young persons and get them involved, to commit to funding and resources for SRHR, to ensure that women and girls and young persons have rights and choices that they can freely and fully exercise. Indeed, at next month’s ICPD25 Summit in Nairobi, we are calling upon governments and civil society stakeholders to reignite the ICPD movement started in Cairo in 1994 – to renew commitments and take them forward, to show the world why this work is so essential, more than ever. Globally, there are some contentious views on issues like abortion, comprehensive sexuality education, LGBTI rights. This has been the case in some quarters in Asia as well as in Nepal. That your agency works on these issues, how, in your view, can this be tackled? Do you think these issues will be depoliticized one day? Yes, these are contentious issues – they have long been and likely will remain so for a while to come. I can’t predict if they will be depoliticized one day, but I would remind all countries that the ICPD, as well as the landmark frameworks that came before and after it, from the UN Charter and the Declaration of Human Rights to the 2030 Sustainable Development Agenda, incorporate rights and choices, dignity and respect and gender equality. These principles also apply to the most intimate, integral parts of our lives, those aspects that shape and define us, that are central to our health and wellbeing across the life-cycle. We focus on ensuring that all people have full access to sexual and reproductive health and rights. All people means all people, regardless of their sexual orientation, where they were born, how much money they make, or any other characteristic. And, we base our work on clear evidence, data, that shows, for example, that comprehensive sexuality education does not encourage young persons to be sexually active, but instead imbues responsibility and the ability to make the right choices at the right time. We reiterate, once again, that if every woman had the right to choose when or if to get married, when or if to have children and how many – if every young person had access to optimal sexuality education so their foundation for life and love was strong – we would see a very different scenario in country after country than we do today. Even 25 years after the Programme of Action was adopted by 179 governments, with Nepal being one, at the International Conference on Population and Development, many women and girls are still denied their rights and autonomy. What is the best way forward? The quest for genuine gender equality is ongoing, and will remain so for a long while to come; studies and forecasts have indicated that many countries will take years and years, under current circumstances, to achieve this. But that doesn’t mean we have to despair; on the contrary, we need to work harder, and push harder, and create an environment where more and more women and girls are truly empowered to achieve their full potential.For this, it’s essential to involve men and boys. Men and boys are critical to achieving gender equality.  In fact, UNFPA and partners are involved in innovative programmes globally, including in Nepal, that do just that – and we are seeing increasing success as awareness strengthens along with a newfound sense of responsibility. Using robust data as evidence to highlight gaps as well as progress is key to convincing governments and other stakeholders to invest in women and girls – socio-economic arguments are all the stronger when you have reliable data to back them up; which is why we so strongly support countries in conducting accurate censuses and demographic health surveys, for example, because they help map out progress being made, as well as gaps that must be addressed, by governments. Another interesting angle to gender equality is that of population ageing.  Many countries in Asia-Pacific – including Nepal – are either grappling with, or will be grappling with, the demographic shift of ageing populations, stemming from people living longer – which is a mark of development – as well as lower fertility, as women exercise their rights and choices and decide to have fewer children so as to maximise their potential and invest better in their families. Not to over-simplify, but if countries want to genuinely turn the challenge of population ageing into opportunity, gender equality is key – because a woman who has had optimal health and wellbeing and opportunities across her entire life cycle is more likely to enjoy a secure old age, and we know that women are outliving men in general.  Thus, gender equality and equity are key to addressing population ageing. Thus you have moral arguments for gender equality – it is enshrined in all key global development frameworks that all UN Member States have agreed upon – as well as economic arguments.  We have to use all of these to continue to push the gender equality envelope, and demonstrate the beneficial impact that gender equality has on everyone – not just women. Holding a senior position at the UN and working at the headquarters gives you an opportunity to see whether countries are moving in the right direction. How do you see Nepal from New York and also while travelling to other countries? From what I have seen and read, I believe Nepal is on the right track, despite the considerable challenges the country has emerged from and the challenges it still faces. The 2015 Constitution of Nepal is a remarkable achievement. Clearly, there is strong political commitment to addressing the disparities across the country and to prioritizing the needs of those who are furthest behind. For this, a genuine partnership between government and civil society is key. The Right to Safe Motherhood and Reproductive Health Act 2018 has been endorsed by the Government of Nepal as a fundamental human right – this provides a very strong basis for expanding access to quality sexual and reproductive health services to those who most need them. As in every country, of course, the challenge is to move from policy to reality – to ensure that the vision contained in the Act is underpinned by concrete actions on the ground, and that progress is monitored carefully to ensure that gaps are identified and addressed as the work is strengthened. The clause under the Act on non-discrimination based on ethnicity, religion, age, marital status and disability is particularly important as it will ensure that marginalized groups, including young people regardless of their age, marital status, sexual orientation and gender identity, can access sexual and reproductive health information, counselling and services. It is important to acknowledge the remarkable achievements in Nepal since the Cairo Conference 25 years ago, in relation to poverty reduction and reduction in maternal and neo-natal deaths. However, we also recognize that there is a long road ahead before Nepal can claim to have fully met the ICPD vision, which will also determine the achievement of the SDGs. Maternal mortality remains high, at 239 per 100,000 live births – this is the second highest rate in the region after Afghanistan; the rate of child marriage is also one of the highest in the world, with 40% of women married before the age of 18 (legal age 20); adolescent birth rate is increasing; and almost one-fourth of women and girls aged 15 years and above will experience physical or sexual violence. These are startling figures, but I believe Nepal has all the building blocks to address these key development challenges, including high-level political commitment and an enabling policy and legislative environment. Change takes time and from what I understand the federal structure is still taking shape; if implemented as per the Constitution, it will offer incredible opportunities to align development efforts with the local realities and context in a very diverse country, and may serve as a model globally. I am happy to note that there are many good programme initiatives led by the government at different levels that are showing promising results. This includes the efforts of the Ministry of Health and Population to reach those people who live in remote and hard-to-reach parts of the country with family planning services through Visiting Health Providers; the efforts under way to offer and improve the quality of youth-friendly health services; the integration of Comprehensive Sexuality Education in the school curriculum by the Ministry of Education, Science and Technology; and an effective and well-functioning model for providing multi-sectoral support services to the survivors of gender-based violence. Nepal aspires to become a middle income country by 2030 and also meet the Sustainable Development Goals. How do you view this aspiration? Given the current circumstances, how do you think this dream will come true in 2030? I commend the government for the vision of “Prosperous Nepal, Happy Nepali” (under the 15th Plan) and the adoption of the national SDGs and its goal to reach middle income status by 2030. Looking ahead it is important to understand the inter-relationship between economic and human development, social and environmental challenges and projected demographic trends – and these inter-relationships should be captured in the population and migration policy that is due to be updated. UNFPA stands ready to support the government in this effort. According to Nepal’s Needs Assessment, Costing and Financing Strategy for SDGs, $18 billion will be required annually to achieve the SDG targets by 2030. With the percentage of working age population (60%) significantly higher than the dependent population, a window of opportunity of a demographic dividend has opened (1992 to 2047), provided adequate investments are made to build the human capital of young people. This will also create conditions that will allow young people to take full advantage of opportunities at home rather than migrating overseas. Nepal's GDP grew by 6.3 percent in 2018 despite the impact of the monsoon – this is impressive. As a country that is highly vulnerable to natural disasters and climate change, it is important that the capacities for disaster preparedness and response continue to be improved, including for addressing the specific needs of women and girls in emergencies. I believe Nepal has tremendous potential but will certainly need to accelerate implementation of its development agenda to achieve the growth and prosperity it aspires to. This includes ensuring the empowerment of women and girls – which is at the heart of the ICPD Programme of Action and Beijing Platform for Action. The outcome of the 2017 elections is remarkable, with women now holding one-third representation in federal and provincial assemblies and 41 per cent of all local government positions. This is a historic moment for women’s political inclusion. But there is still a need to ensure that these female elected officials can exercise their leadership and functions in what has traditionally been a largely male-dominated space. There is also a need to look at the underlying factors that are holding women and girls back and find ways to evolve the practices and social norms that continue to present challenges, such as the practice of chhaupadi (where women are banished to a hut or a room outside the home during their cycle) and menstrual restrictions, dowry, son preference, child marriage and of course the prevalence of physical and sexual violence against women and girls. In all of these vital areas, UNFPA stands ready to support the government in fulfilling its aspirations.