“A girl in South Sudan will more likely die in childbirth than finish school”: IDC reports on “devastating impact” of slashed UK aid “failing women and girls and marginalised people the world over”

In 2020, nearly 300,000 women died from pregnancy and childbirth globally, almost 95% of them in low and lower middle-income countries; around 70% in Sub-Saharan Africa alone. 2.4 million babies died in their first month of life: 43% in Sub-Saharan Africa and 36% in central and southern Asia. Last year, the secretary general of the UN warned that global progress on women and girls' rights, to which SRHR are integral, is “vanishing before our eyes”, with further criminalisation of LGBT+ people also. The World Health Organization said maternal health has declined in many parts of the world since 2016, halting 15 years of progress. Overall, so-called ‘benign’ gynaecological conditions kill more women and girls in low- and middle-income countries than than malaria, tuberculosis and HIV/AIDS combined.   

But as the IDC reports today, since 2020 the UK has slashed aid spending on sexual and reproductive health and rights (SRHR), with a devastating impact on women and girls. Existing project budgets were cut or cancelled entirely, often with little to no notice. FCDO funding to multilateral organisations working on sexual and reproductive health was cut, with the deepest impact on the most marginalised, particularly women and girls and people with disabilities. This damaged both relationships with aid partners and recipients and the UK's reputation as a credible and serious partner in advancing SRHR globally.  

Sarah Champion MP, Chair of the International Development Committee, said: “Last year the UN declared that the world is failing girls and women, half our global population, with markers of equality and women’s rights backsliding and decades of progress being lost. For any women or girl in the world today, where she lives will determine how likely it is that she and her baby can survive beyond a pregnancy. A girl in South Sudan is more likely to die in childbirth than to finish secondary school.  Even here in the UK maternal deaths are at their highest level in 20 years, but almost 95% of maternal deaths globally are in poorer countries. 70% of these women and girls die in Sub-Saharan Africa.   

“The UK has had a long proud history of diplomatic and aid programming support of SRHR, but last year’s Equalities Impact Assessment from the FCDO showed the horrifying numbers of women and girls, thousands upon thousands, who will once again face unsafe abortions and who will die in pregnancy or childbirth as a direct result of the UK’s slashed aid spending.  

“It is no good the new Foreign Secretary coming into Parliament and declaring that the UK is still a global aid superpower when we are failing on funding commitments; failing to set or achieve meaningful targets on sexual and reproductive health and rights - failing women, girls and marginalised groups the world over.  

“It is time for the UK to make a new, meaningful commitment to women and girls and particularly the sexual and reproductive health and rights issues that so unequally impact them. It is time to put the money back coupled with impact and progress measured against meaningful targets. Our shared global Sustainable Development Goals are stalled or going into reverse: we will not progress until the rights of women, girls and marginalised groups are prioritised and funded.” 

The report states that in light of the acknowledged damage of the cuts, FCDO must change its approach. The Government should set new, real targets on ending preventable deaths of mothers, babies and children by 2030 and report regularly on its progress toward them. It should calculate a minimum percentage of bilateral Official Development Assistance to be spent on sexual and reproductive health and rights, and make funding commitments on a multiyear basis: a basic requirement to maximise the effect and impact of aid spending that the UK has been failing on for too long.  

Original multilateral funding commitments should be honoured, particularly to the UN Population Fund, and discretionary funding should be restored to pre-pandemic levels.  This should include restoring funding to end the ongoing horror of female genital mutilation, and renewed diplomatic and cross-border efforts to end the practice wherever it occurs. 

The Committee says that going forward the FCDO must:  

·         Ensure all SRHR programmes are accessible to all, under the principle of Leave No One Behind, including for programmes working on HIV and AIDS; and include marginalised and hard-to-reach people in the planning, development and delivery of SRHR aid programming. 

·         Ensure that these programmes reach people with disabilities by having a dedicated budget, baselines, targets and key performance indicators. 

·         Commit to defined spending levels on the development of health personnel in low-and-middle-income countries, as well as prioritising the development of health infrastructure, with a focus on water, sanitation and hygiene facilities (WASH).  

·         Integrate programming and care for female genital schistosomiasis – a little known but painful and debilitating disease affecting up to 56 million women and girls – into broader SRHR programming.  

·         Provide age-appropriate sex education on topics like menstruation, female genital schistosomiasis and WASH to empower local populations, increase the value of aid spending and improve outcomes. 

UK aid programming needs a more integrated and complementary approach between different but overlapping aspects of sexual and reproductive health. Integrating services aimed at treating and preventing HIV and AIDS with those aimed at treating and preventing female genital schistosomiasis offers benefits for women’s health and wellbeing, as well as accessibility, time and cost savings.  

Notes:  

This wide-ranging report on sexual and reproductive health and rights in the global development context includes analysis and recommendations on: 

FCDO spending and programming on SHRH globally 

Eg Para 91: The merger of the Foreign and Commonwealth Office with the Department for International Development offers an opportunity for the FCDO to better use its diplomatic position to obtain its development goals on sexual and reproductive health and rights, such as by supporting access to these rights by women and girls and other marginalised groups. 

& eg Para 83: People from marginalised groups, such as people with disabilities and LGBT+ people, may face additional and unique challenges in accessing SRHR services. The FCDO should ensure its commitment to the principle of ‘Leave No One Behind’ in all its SRHR aid programmes. 

Family Planning 

Eg Para 27: The Committee is pleased to see the FCDO's continuing commitment to family planning as a core part of its work on sexual and reproductive health, including the provision of safe and legal abortion services. However, the FCDO's abrupt and sudden cuts to SRHR programmes directly led to the reduction in vital services for women and girls and damaged the UK’s work and reputation in this area 

Ending preventable deaths, WASH, Menstruation 

Eg Para 33: The FCDO’s approach papers on ending preventable deaths of mothers, babies and children by 2030 (EPD) and health systems strengthening (HSS) show a positive step in the right direction. However, in the absence of key targets for progress or regular updates, it has proved difficult to assess the effectiveness of the UK’s work in this area. 

Gynaecological disease, HIV & AIDS 

Eg Para 46: The FCDO has not sufficiently addressed the threat of gynaecological disease in its SRHR programming, despite the risk it poses to the SRH of women and girls. The prevalence of cervical cancer among women and girls in lower-income countries is also concerning, especially as adequate provision of the HPV vaccine could greatly reduce the threat of cervical cancer to women and girls. 

& Para 50: The UK should integrate female genital schistosomiasis (FGS) care into its SRHR programming. This should include (a) improving access to adequate water, sanitation and hygiene facilities, (b) increasing girls' enrolment in education and supporting distribution of FGS medicine in schools, (c) distributing educational materials on WASH, and (d) considering integrating FGS and HIV and AIDS programming[...]  

Female Genital Mutilation 

Eg Para 55: The UK Government should renew its commitment to preventing female genital mutilation through funding multilateral and bilateral programmes, including those tackling the medicalisation of FGM and 'cross-border cutting', which involves moving women and girls across national borders to undergo FGM or cutters across national borders to perform the practice.