The world has made genuine progress towards achieving the ambitious programme outlined at the 1994 Cairo population conference, a United Nations review released today finds, but a serious funding shortfall is obstructing efforts to provide universal access to reproductive health care, combat HIV/AIDS and improve maternal health.
The State of World Population 2004, issued by the UN Population Fund (UNFPA) a decade after the landmark conference in Cairo and nearly halfway into the 21-year timetable for achieving its goals, shows that donors have given only half of what they promised.
In Cairo, international donors pledged to give $6.1 billion a year by 2005 for population and reproductive health programmes, but in 2002 - the most recent year with available figures - donors were giving only $3.1 billion.
The report indicates that the huge funding gap is having a negative ripple effect, retarding progress in health, education and other fields, especially for women and girls.
More than 350 million couples worldwide, for example, do not have access to a full range of family planning services; at least 500,000 women die each year from problems caused by pregnancy or childbirth, and most of those deaths are preventable; countless girls are unable to attend school; and five million people were infected with HIV last year.
In sub-Saharan Africa, the HIV/AIDS picture is especially grim: 25 per cent of the workforce there is HIV-positive, reducing economic productivity and strangling opportunities for economic development.
Adolescent health care also remains a problem, with early marriage and childbearing the norm for girls in many countries, and women aged below 24 disproportionately represented in statistics for sexually transmitted diseases.
But the UNFPA review finds there have been many advances since 179 governments agreed in 1994 that poverty could be reduced and economic growth sustained if women were given greater rights and access to reproductive health services was made universal.
The percentage of couples using modern contraception has risen from 55 per cent to 61 per cent; laws and policies to protect the rights of women, especially against violence, have been put in place; and population issues have become integrated into the heart of poverty-reduction strategies.
Many nations are also much more aware of the need to tackle the scourge of HIV/AIDS, improve adolescent reproductive health and expand training schemes for health care, according to the report.
UNFPA Director of Information and External Relations Safiye Cagar told a press briefing at UN Headquarters that "we have much to celebrate," but she said increased donations are essential if the world is to achieve the reforms sought at the Cairo conference.