The Future of Sexual and Reproductive Health and Rights

The ICPD Programme of Action offers a universally applicable roadmap to comprehensive sexual and reproductive health (SRH) and reproductive rights that has been further elaborated since 1994, including through follow-up commitments. The global health community has repeatedly reaffirmed that SRHR is fundamental to health and underpins human well-being. SRHR today is widely understood as core to sustainable development and appears prominently in the 2030 Agenda for Sustainable Development adopted in 2015. Implementation of ICPD commitments has moved forward, with impressive achievements in every part of the world, centred on people having services and information to make choices about their families and their own bodies. Much depends on an environment fully conducive to the empowerment of women, girls and young people, where they can live free from discriminatory barriers and have equal opportunities to thrive.

In 2024, the thirtieth anniversary of the ICPD takes place at a moment of multiple crises, driven by climate change as well as conflict and political polarization. Humanitarian emergencies have multiplied and intensified. Record numbers of people are on the move, pushed by armed conflict and natural disasters and propelled by historic rates of urbanization in a process that is reshaping entire societies.
Demographic trends are diverging as never before; some countries and regions are very young, while others are ageing rapidly. The Internet, artificial intelligence (AI) and other technologies have transformed every aspect of life and human interaction but have also fanned frustrations and amplified divisions. While individual choices have grown, inequalities remain deeply rooted in social, economic and political structures. Gender equality is still far away at current rates of progress. Deepening mistrust in institutions has diminished social cohesion while geopolitical tensions have weakened commitment to multilateralism.

The United Nations Secretary-General has highlighted “megatrends” laden with risks for the future of humanity. Yet by thinking ahead, policymakers can steer choices today that mitigate risks, build resilience and realize the ICPD promise of sustainable, people-centred development. Towards that end, this paper looks at where the world has come since the ICPD, what it needs to anticipate in light of the megatrends, and how these might affect SRH service demand and supply in the coming 30 years. In a context of complexity and rapid change, health policies guided by the ICPD vision and values remain essential to realizing commitments to universal and comprehensive SRH care as well as human rights and gender equality, across the course of life.