Putting People First: Why SRHR Must Be Central to Health and Development Agendas

By Richarlls Martins and Rajat Khosla
GENEVA / RIO DE JANEIRO, Apr 4 2025 – As global leaders prepare to convene for the Commission on Population and Development (CPD) in New York, April 7-11, the world finds itself at a critical crossroads. We can either recommit to human dignity, equality, and justice—or risk unraveling decades of progress in global health.

Central to this choice is the urgent need to prioritize sexual and reproductive health and rights (SRHR) as the bedrock of sustainable development. This is not just a health agenda—it is a human rights imperative.

Globally, over 164 million women still have an unmet need for modern contraception.¹ Every day, more than 800 women die from preventable causes related to pregnancy and childbirth² , and over 73 million induced abortions occur annually, of which 45% are unsafe,³ the vast majority in low- and middle-income countries.

The UN sexual and reproductive health agency, UNFPA, has appealed for $1.4 billion to safeguard the rights and well-being of women, girls and youth in 57 crisis-affected countries in the coming year. Credit: UNFPA/Ralph Tedy Erol

In many countries, young people—especially girls—continue to face systemic barriers to accessing comprehensive sexuality education and adolescent-friendly health services, undermining their autonomy and well-being.

In Brazil, we have made significant strides over the past decades. The country’s Unified Health System (SUS) has played a critical role in expanding access to maternal and reproductive health services, including free family planning, prenatal care, and safe delivery services.

Brazil’s National Policy for Comprehensive Women’s Health Care and the Stork Network (Rede Cegonha), launched in 2011, have aimed to ensure a continuum of care for women before, during, and after pregnancy.⁴ These initiatives represent the kind of people-centered, rights-based approaches we need more of globally.

Yet the work is far from over.

Despite improvements in access to care, Brazil continues to face deep inequalities. Maternal mortality remains disproportionately high among Black, Indigenous, and low-income women. Unsafe abortions persist as a major public health issue, particularly in regions where access to legal services is limited or stigmatized.

Adolescents—especially in rural areas and marginalized communities—often encounter barriers to sexual and reproductive health information, including fear, judgment, and lack of confidentiality.

In 2024, the Brazilian government launched the Alyne Network, a restructuring strategy for the former Rede Cegonha, whose goal is to reduce maternal mortality by 25% in the country. In addition to expanding actions focused on maternal and child health, with an investment of R$400 million in 2024 and R$1 billion in 2025, the new program seeks to reduce maternal mortality among black women by 50% by 2027.

The initiative pays tribute to the young black woman Alyne Pimentel, who died at the age of 28, while pregnant and the victim of medical negligence. The young woman’s case led Brazil to become the first country condemned for maternal death by the Global Human Rights System worldwide.

The CPD offers a pivotal opportunity to galvanize political will and place SRHR at the center of health and development agendas—not just in Brazil, but globally. As governments assess progress on the Programme of Action of the International Conference on Population and Development (ICPD), it is essential that they reaffirm the full spectrum of SRHR as non-negotiable and indivisible from broader development goals.

Investing in SRHR yields powerful dividends. For every dollar spent on modern contraceptive methods, governments can save up to $3 in maternal and newborn health care costs.⁵ Women and girls who can make decisions about their bodies and reproductive lives are more likely to finish school, participate in the workforce, and contribute to economic growth.

In fact, evidence shows that fulfilling the unmet need for contraception alone could prevent 70,000 maternal deaths annually and reduce unintended pregnancies by over 70%.⁶

Moreover, SRHR is a gateway to gender equality, resilience, and social inclusion. It is also a matter of justice. For populations pushed to the margins—people of color, Indigenous peoples, LGBTQIA+ communities, people with disabilities—SRHR is too often the frontline of discrimination.

In Brazil, we have seen how the lack of culturally sensitive care and structural racism in health services deepen health disparities. Addressing these inequities demands intersectional policies and intentional investments in inclusive systems of care.

Brazil has the tools—and the responsibility—to lead. Through its National Commission on Population and Development, Brazil is working to align national priorities of population issues with the Sustainable Development Goals, including SDG 3 on health and well-being and SDG 5 on gender equality. But this leadership must be mirrored and matched globally.

At this year’s CPD, we call on all countries to:

● Reaffirm SRHR as a core component of universal health coverage and the right to health;
● Expand funding for integrated, rights-based sexual and reproductive health services;
● Ensure youth-led participation and accountability in policy-making processes;
● Protect human rights defenders and health providers from discrimination and violence.

The Partnership for Maternal, Newborn & Child Health (PMNCH) and National Commission on Population and Development of Brazil stand united in this call. SRHR is not a siloed issue—it is central to health, equity, and the full realization of human potential.

In a world shaped by crisis—whether conflict, climate change, or pandemics—we must not lose sight of the simple truth: When people, especially women and girls, have control over their own bodies, they build stronger communities, healthier economies, and a more just world.

Let CPD 2025 be remembered as the moment we put people first—by putting SRHR at the heart of our global commitments.

¹ World Family Planning 2022 Meeting the changing needs for family planning: Contraceptive use by age and method. UNDESA. 2022. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2023/Feb/undesa_pd_2022_world-family-planning.pdf

⁶ ibid

Dr. Richarlls Martins is President of National Commission on Population and Development of Brazil (CNPD). Rajat Khosla is the Executive Director of the Partnership for Maternal, Newborn & Child Health (PMNCH).

IPS UN Bureau

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