Evidence of meeting #51 for Foreign Affairs and International Development in the 44th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was srhr.
A recording is available from Parliament.
NDP
Heather McPherson NDP Edmonton Strathcona, AB
Of course, knowing that SDG 5 is all about gender equality and very much fits in with the goals of the government, how will you be ensuring that it is being reported at the high-level forum?
Director General, Health and Nutrition, Department of Foreign Affairs, Trade and Development
The report, I believe, will primarily concern itself with Canada's domestic implementation, but there will be an opportunity to flag where there has also been international engagement on these issues. It might not be the main story, but we do hope it will be there. I've seen some of the draft work, as we think about that report.
Again, we're always happy to follow up with more detail.
NDP
Heather McPherson NDP Edmonton Strathcona, AB
Thank you very much.
Speaking of following up with more detail, as I mentioned, the numbers that I received during my Order Paper question request are different from the numbers that you've brought to the committee. If you could provide us with those numbers, including the numbers for 2021-22 when those are available, that would be great. Thank you.
Mr. Chair, those are all my questions for today.
Director General, Health and Nutrition, Department of Foreign Affairs, Trade and Development
Thank you. That's understood. We'll take note.
The annual report that I made reference to before should lay out relatively clearly the numbers for 2021, and we think the next iteration of that report will be ready in the fall. But some time between March and the fall, we'd be happy to come back and provide clarity on what the 2022 numbers show us.
Liberal
The Chair Liberal Ali Ehsassi
Thank you very much. That concludes the questions.
At this point, allow me to thank Mr. Tabah and Ms. Trevors for their expert testimony. I have every confidence that this will be very useful and helpful for the purposes of concluding our study. Thank you very much.
Members, we have approximately four or five minutes, so I will suspend briefly. For all those members who are virtual, we will remain on the same link.
Liberal
The Chair Liberal Ali Ehsassi
Welcome back, everyone.
As you know, we will be proceeding with the second panel. Before we turn to the witness, I was wondering whether all the members would agree to set aside the last 20 minutes of this hour to discuss the details of the trip that will be happening in the next couple of weeks. Of course, that segment would be in camera.
Is that okay with everyone?
Liberal
Hedy Fry Liberal Vancouver Centre, BC
I have one question, Chair.
Is this only for the people who are on the trip or for the whole committee?
Liberal
The Chair Liberal Ali Ehsassi
Well, since it is in camera, if anyone would like to leave and has other things to tend to, that would be perfectly fine. It is in camera.
Liberal
Rachel Bendayan Liberal Outremont, QC
Mr. Chair, to the extent that you're requesting unanimous consent, I am withholding it. It is now 12:10, and you are seeking 20 minutes out of this panel. That would leave us very little time to ask questions.
Liberal
The Chair Liberal Ali Ehsassi
Okay. My apologies to the members who requested this.
Now, pursuant to Standing Order 108(2) and the motion adopted by the committee on Monday, June 20, 2022, the committee resumes its study of the sexual and reproductive health and rights of women globally.
It is now my great pleasure to welcome before this committee Ms. Kelly Bowden, a representative from Action Canada for Sexual Health and Rights.
We are very grateful that you took the time to be with us today. You will be provided five minutes for your opening remarks, after which we will proceed with questions from the members. Again, just as with the previous speaker, when you have 30 seconds remaining, I will put this sign up. Kindly wrap things up as expeditiously as possible.
That having been said, Ms. Bowden, the floor is now yours. You have five minutes.
Kelly Bowden Director, Policy, Action Canada for Sexual Health and Rights
Thank you, Mr. Chairperson.
Action Canada for Sexual Health and Rights is a national organization committed to advancing and upholding sexual and reproductive health and rights in Canada and globally.
Through our frontline programming in Canada managing a toll-free sexual health information line for Canadians and through our work with partners around the world advocating for the advancement of SRHR, our analysis is grounded in the experience of the most vulnerable people who are seeking access and facing barriers when it comes to SRH services.
Investing in and advocating for the promotion of sexual and reproductive health and rights—specifically the underfunded and neglected areas of access to safe abortion services, contraception, comprehensive sexual health education and advocacy for sexual health—play a fundamental role in advancing global development and human rights. Support for SRHR, and the neglected areas specifically, saves lives, reduces overall health care systems costs, advances gender equality and promotes economic participation.
Every year, about half of pregnancies in low- and middle-income countries are unintended. About 218 million women have an unmet need for contraception. There are currently an estimated 35 million unsafe abortions each year, with almost four million of these among girls 15 to 19 years old.
The consequences of unsafe abortions are dire. They result in mortality, morbidity and lasting health problems. Almost every abortion death and disability could be prevented through a combination of sexuality education, effective contraception, provision of safe abortion care and timely care for complications. Providing safe abortion care also reduces health care cost burdens from the fallout of unsafe procedures. World Health Organization estimates from 2006 show that complications from unsafe abortions cost health systems in developing countries $553 million per year for postabortion treatments.
When young women have unintended pregnancies, it makes them more likely to stop their education and less likely to participate economically later in life. Comprehensive sexuality education plays an important role in providing information that allows young people to understand their bodies and their rights and to make the decisions that are best for them.
I understand that this committee was just looking at the situation in Turkey and Syria. In humanitarian situations like this, the need for these services is exponentially higher. Unless SRHR is fully integrated into health systems as a foundational aspect of health care, it is easily deprioritized when the system comes under stress or strain. We see this in fragile states and humanitarian settings, and we saw this around the world throughout the COVID-19 pandemic. Maternal mortality and gender-based violence increased and rollbacks to contraception and other SRH services occurred.
When we think about the experience of the pandemic, the importance of investing in advocacy for SRHR is also clear. It was women's rights organizations in this time that raised the alarm on service disruptions, helping to ensure that provision returned. It was local youth organizations that created ways to ensure that important sexual health information continued to be disseminated through new and virtual means.
Investing in advocacy plays a critical role, to both open up civic space and navigate appropriately within constraints to make sure that the delivery of programming for SRHR is both possible and effective.
Canada’s work on the neglected areas is critical, because there are very few donors working in this space globally. There is thus a tremendous need for leadership in terms of service provision and global advocacy.
Focusing Canada's investments in the four neglected areas can concentrate financial and political efforts in a way that maximizes impact. Canada's 10-year commitment to women and children's health can show that Canada is stepping up where the world is falling short—by emphasizing the fundamental importance of a rights-based approach to sexual health and investing where the need is greatest.
Canada's investment in SRHR is unique precisely because of this focus. Yet, in the last reported spending from 2020-21, Canada has invested only $104 million of its SRHR spending in the neglected areas. Canada needs to aggressively scale up spending here if we are going to garner the political effort that is needed from partners around the world to make progress and transform the lives of millions of women and girls.
Broadly, I would like to leave the committee with four key recommendations.
The first recommendation is for Canada to scale up spending in the neglected areas of SRHR to ensure that we meet the ambition of delivering $500 million per year to the neglected areas by the end of 2023.
The second recommendation is that, as a country, we double down on our engagement with the G7 and with other allies around the world to catalyze further global investment and support for the neglected areas of SRHR.
The third recommendation is that we continue the important work of investing in grassroots women's organizations and taking a localized approach to implementing SRHR programming.
Lastly, we recommend that we ensure that sexual and reproductive rights are not relegated only to a conversation about development assistance, but also integrated into a more fulsome approach through a feminist foreign policy.
I thank you for your time and attention.
Liberal
The Chair Liberal Ali Ehsassi
Thank you very much, Ms. Bowden.
We now go to the first questioner, Mr. Chong.
Mr. Chong, you have six minutes.
February 16th, 2023 / 12:15 p.m.
Conservative
Michael Chong Conservative Wellington—Halton Hills, ON
Thank you, Mr. Chair.
Thank you, Ms. Bowden, for coming to our committee.
My first question is about something you referenced towards the end of your opening remarks. Where does Canada rank among donor governments in relation to funding for global health writ large, and for sexual and reproductive health and rights specifically?
Director, Policy, Action Canada for Sexual Health and Rights
I don't have the statistics differentiating between Canada's investment in health as compared to other OECD countries.
One thing I will say is that a step that Canada has taken with this new commitment is to introduce tracking codes so we can see what our investment is as a country in these neglected areas of safe abortion access, contraception access, CSE and advocacy. This is a first among OECD DAC countries, and in fact it is an important step in being able to push other countries to trace and understand where that financing is going.
Overall, Canada is one of the top donors and in the top 10 with investments in multilaterals like the UNFPA, which is the global multilateral leader on investing in SRHR.
While I don't have the numbers on health specifically, I think we're in a good position as a country to be able to push others to be clear on how they are investing and how we continue to invest in these areas.
Conservative
Michael Chong Conservative Wellington—Halton Hills, ON
Thank you for that answer.
What percentage of Canada's overall official development assistance is devoted to women's, children's and adolescents' health? Do you have a sense of what percentage women's, children's and adolescents' health makes up of the overall ODA envelope?
The second part to that question is, what percentage do sexual and reproductive health and rights make up as a percentage of the overall ODA envelope, just roughly? I don't need an exact figure. I just want to get a sense of that.
Director, Policy, Action Canada for Sexual Health and Rights
I wouldn't wager to do the math myself at the moment, but we have the commitment of $1.4 billion a year from the government to global women's and children's health. Half of that, $700 million per year, should be dedicated to SRHR funding. That's the scale-up goal that is to be met by the end of 2023.
It would be your colleagues from the department who would be best placed to give numbers around the breakdown in relation to other financing that Canada has.
Conservative
Michael Chong Conservative Wellington—Halton Hills, ON
Yes, I think the overall envelope is headed roughly towards $7 billion, so that gives us a sense. Thank you for that.
The other question I have concerns the UN's health goal, SDG 3. The goal that was set was to reduce global maternal mortality to less than 70 maternal deaths per 100,000. It's presently at roughly 220 maternal deaths per 100,000 live births.
Can you tell us where that was a decade ago or two decades ago and how much progress has been made on that goal in the last decade or two? How much progress is currently being made on reducing those maternal deaths?
Director, Policy, Action Canada for Sexual Health and Rights
I don't have specific numbers in front of me, though I'd be happy to follow up and provide those.
What I can say confidently is that we have seen gains in the reduction of maternal mortality over that time. Obviously, the COVID-19 pandemic created a number of setbacks around issues of maternal mortality, gender-based violence and access to a wide range of SRHR services. We're currently in a time period when there are losses to be regained on that front, but overall there has certainly been progress made. I am happy to follow up with the statistics around it.
Conservative
Michael Chong Conservative Wellington—Halton Hills, ON
I was talking to our analyst during the suspension, and she mentioned to me that in Canada we have roughly eight maternal deaths per 100,000 live births, compared to 218 on average globally, which means that, in some countries, it's going to be a lot higher than that. Obviously there's a lot of work that needs to be done in that area to meet the SDG 3 that has been set.
The other question I have concerns the SDG as well. One of the key goals of the SDG, when it was first agreed to several years ago, was to better collect data on what exactly is going on. At the conclusion of the MDG initiative, the progress report highlighted that only 51% of countries maintained some data on maternal causes of death.
Can you tell us what progress has been made globally in terms of data collection so that we can make informed decisions about where to allocate resources for the SRHR goals?
Director, Policy, Action Canada for Sexual Health and Rights
There are two elements to this. There is progress at the national, country level around health systems data collection, and then there is the increase or analysis of research being done by multilateral institutions, research initiatives, to try to document changes in this progress.
I can't comment on the progress of individual countries and their health systems data collection. I will say that this is why continued investment in institutions like the UNFPA, which are continuing to collect and monitor these types of health indicators, is an important investment for Canada to make.
Conservative
Liberal
The Chair Liberal Ali Ehsassi
I'm afraid you're out of time, Mr. Chong. You're considerably over time. Thank you.
We now go to Dr. Fry.
Dr. Fry, you have six minutes.