Foreign Affairs Committee on March 9th, 2023

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

How do you respond to these specific allegations, though?

[Dr. Natalia Kanem]

In particular, because I wish to be precise—

[The Chair, Liberal, Ali Ehsassi]

Mr. Genuis, you're out of time.

[Dr. Natalia Kanem]

Certain things that you mentioned I am not in a position to comment on. It is our member states, for example, that decide who receives the population award. This is not something that the agency decides. It is, in fact, the countries of the United Nations.

Nevertheless, I do wish to assert very clearly that in China, and in every country, UNFPA works in ways that uphold and address issues of rights founded in the 1994 Cairo mandate, which is how we operate now. I will mention that some of the cases you alluded to may have preceded the 1994 Cairo mandate. That platform of action is exceedingly clear that UNFPA is to focus on people-centred development, women-centred development specifically. The allegations against UNFPA, where investigated, have always been found to be unfounded. That includes in China as well.

The primary focus of what we do is to reduce inequality, reduce inequity and in fact reject coercion. We believe that rights-based, gender-sensitive and comprehensive sexual and reproductive health programming is protective for women, who may or may not be able to express in certain circumstances because of government rules and regulations, which UNFPA is obliged to operate under.... Even in Afghanistan, we have been able to maintain life-saving care by working very carefully with midwives on the ground, with women and civil society—

[The Chair, Liberal, Ali Ehsassi]

Madam Under-Secretary, I'm terribly sorry to do this. Please conclude your remarks, if you could.

[Dr. Natalia Kanem]

Just to emphasize that we stand for the rights and the choices—

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

You say it's rights-based, but you can't make rights-based determinations.

[The Chair, Liberal, Ali Ehsassi]

Mr. Genuis, I have already warned you—

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

I don't know how you can say it's right-based but it's not—

[The Chair, Liberal, Ali Ehsassi]

Mr. Genuis, you're out of time.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Either I have time or I don't, Mr. Chair.

[The Chair, Liberal, Ali Ehsassi]

How many times do you need me to warn you, Mr. Genuis? You are out of time.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

The witness was still talking, so either it's my time or it isn't, Mr. Chair.

[The Chair, Liberal, Ali Ehsassi]

Mr. Genuis, you're out of time.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Okay, but if the witness is talking, it's either her time or mine.

[The Chair, Liberal, Ali Ehsassi]

Mr. Genuis, please.

We now go to Mr. Sorbara.

Mr. Sorbara, you have two minutes.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Thank you, Chair.

Welcome to the witnesses.

If I could just address two aspects that are connected, one being maternal health, and the second one.... Dr. Francoeur, you said that women's sexual and reproductive rights need to be respected. I want to start off with those two.

The reason I touch upon maternal health to the three witnesses is that I am blessed with three daughters. The first one was born in a hospital under the circumstances of code pink. I know you would both understand what code pink means. She's very healthy, and she's one of the loves of my life. Not everyone throughout the world has the ability to call code pink.

May I ask about the importance of maternal health for women, not only here in Canada, and the benefits of investing monies for maternal health, whether it's here in Canada or across the world, please?

If I could, I would go to Dr. Kanem first and then to Dr. Francoeur, for 30 seconds each, please.

[Dr. Natalia Kanem]

Thank you so much.

You underscored that maternal mortality can be a tragedy, but it can also be averted. Preventable maternal death is what we focus on. Maternal mortality reduction progress has been considerable, yet over 280,000 women globally still die yearly since 2020 from preventable causes. I hasten to say that approximately 70% of global maternal deaths occur in sub-Saharan Africa alone, followed by central and southern Asia, which account for almost 17%.

Midwives are part of the answer to that conundrum. A midwife is capable of calling the local code pink, if you will, even in a small clinic, and she does this very well. That's why it's a focus of our training.

Thank you.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

I would say that all three of our daughters were born via the midwifery system.

[The Chair, Liberal, Ali Ehsassi]

You're out of time, sorry. Thank you.

We go to Mr. Bergeron next.

Mr. Bergeron, you have one minute.

[Stéphane Bergeron, Bloc, Montarville, QC]

Thank you, Mr. Chair.

I thank the witnesses for being here.

Ms. Kanem, you are an under-secretary-general of the United Nations and executive director of the United Nations Population Fund, UNFPA. According to UNFPA, Afghanistan is one of the most dangerous places to give birth in the world. On average, a woman dies there every two hours from pregnancy and childbirth.

What can be done? What can Canada do to try to reverse this trend?

[Dr. Natalia Kanem]

Thank you.

UNFPA stands in solidarity with the women of Afghanistan. We remain deeply concerned about the de facto authority's decision to ban female aid workers from working in humanitarian NGOs. In Afghanistan, UNFPA's work includes the provision of maternal reproductive health and psychosocial support services. To date, we have been able to keep over 1,400 female service providers, as the health sector has been exempted from that recent decree banning female aid workers.

Our delivery points are functional; however, the overarching issue of the insistence on equal treatment and equality for women is the fundamental issue there. We also work through microsystems of clinics, which may be small, household-based clinics, and also mobile clinics because the terrain is so challenging. Ultimately, the women and girls of Afghanistan need tremendous amounts of support during a season of hunger and cold. Protection during childbirth is one of the aims that we do share.

Thank you.

[The Chair, Liberal, Ali Ehsassi]

Thank you.

For the last question, we go to MP McPherson.

You have one minute.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

I'm going to pass it back to our guests in the room and ask if they could share any more information on access, in Canada and around the world, to abortion and SRHR.

[Dr. Jocelynn Cook]

I was just writing notes to put into your notes, which we'll send later.

We've partnered with UNFPA on a number of global health projects. Because we are a health professional organization with high standards of clinical practice, there's also educating health care providers across different professions. We do have a lot of international projects. We work with countries—sometimes the governments, sometimes the leadership of their own organizations—to figure out what they want. How can we work together to bring our clinical expertise so that we can develop curricula and basically build capacity to train the trainer? We have a great system, and I'm a really good helper there in terms of doing that.

Again, it's creating WhatsApp groups, so they can come back and ask questions of our volunteers who have that technical expertise. There's that piece, in terms of delivery of the care and working directly with the folks on the ground. There's also working with the health professional organizations and sometimes the CEOs of hospitals to figure out how they can foster an environment that's supportive of women and their reproductive rights. Sometimes it's just putting screens around the beds, for example.

I'm happy to elaborate, but I know I don't have any time.