People's rights to bodily autonomy and choice: a new definition

By Divya Bajpai

Divya Bajpai, director of programmes at the Alliance

As movements for people's rights to bodily autonomy and choice gather momentum, a new report calling on leaders at all levels worldwide to commit to advancing sexual and reproductive health and rights (SRHR) for everyone is launched by the Guttmacher-Lancet Commission on SRHR.

<p>Women at maternal health clinic</p>Women at a maternal health clinic at Bwafwano Integrated Service Organisation, Chikanga, Lusaka, Zambia. © The Alliance

The report sets out a new comprehensive definition of SRHR which emphasises sexual and reproductive rights for all, including: lesbian, gay, bisexual and transgender (LGBT) people, adolescents, sex workers, and people who use drugs.

If the definition and its push to "accelerate progress" is taken on board in its entirety by national governments as they develop programmes for universal health coverage, this could have a major positive impact on the experiences of individuals in attaining good sexual and reproductive health, free from discrimination and coercion.

The world needs a new SRHR agenda

It’s been nearly 25 years since the International Conference on Population and Development set out its Programme of Action. A new SRHR agenda is needed to respond to the current attack from conservative forces on progressive agendas in relation to gender, sexuality and health. Each year there are nearly two million new HIV infections, 25 million unsafe abortions, over 200 million unintended pregnancies and one in three women globally experience violence by an intimate partner or sexual violence by a non-partner. If we are to meet global health development goals, such as the sustainable development goals (SDGs), we must be stronger and bolder with our responses to advance SRHR.

Global momentum to support people's rights to bodily autonomy and choice, particularly for women and girls is bold and current. The SheDecides campaign, sparked by the introduction of the expanded Mexico City Policy (Global Gag Rule), demands that women and girls have agency over their bodies, lives and futures. The #MeToo campaign has resulted in greater scrutiny on sexual harassment in different sectors of society, starting with Hollywood – and leading to knock-on effects for parliament, the charity sector, and the UN.

During this turbulent time, the Guttmacher-Lancet Commission on SRHR has been working to lay the foundation for a new global sexual and reproductive health and rights definition and agenda, backed by evidence and grounded in human rights. As a member of the expert review group, I, along with stakeholders from across, civil society, academia policymakers and donor governments have had a chance to review and input into this new definition.

Going beyond the SDGs

The report proposes a minimum package of services and information to meet and go beyond the indicators of the SRHR targets under the sustainable development goals (SDGs) alongside the broader target of universal health coverage. This includes HIV prevention and treatment, contraceptive services and maternal new-born child health. In addition, it includes other sexually transmitted infections (STIs), comprehensive sexuality education, safe abortion, gender-based violence (GBV) prevention and care, prevention, testing and care for infertility and cervical cancer and counselling support for people’s sexual health and wellbeing.

SRHR needs are universal regardless of age, gender identity, sexual orientation or socio-economic status. It is critical that governments now act on upholding people’s rights to make decisions that govern their bodies, free of stigma, discrimination and coercion. Governments and societies must change laws, policies and attitudes and explicitly link sexual rights and reproductive rights to human rights, such as by: prohibiting the discrimination against LGBT groups; supporting the rights of all people to make free, informed and voluntary decisions related to their sexuality, sexual orientation and gender identity; ensuring comprehensive, evidence-based sexuality education; liberalising abortion laws, and promoting mutually respectful and equitable gender relations.

What’s exciting about this new definition is that it reinforces - and moves the world closer to - the Alliance’s work of person-centred integrated programming and advocacy with, for, and by some of the most marginalised people, including adolescents and young people, LGBT people, sex workers and people who use drugs.

What does this mean for the Alliance?

This definition validates our existing programmes such as READY, PITCH and our developing work to address gender-based violence in the Middle East and North Africa, which embrace an integrated and comprehensive SRHR approach. It means that we can advance this definition in our person-centred programming with key populations and adolescents in all their diversity, and use key recommendations raised in this report to hold national governments to account, as they invest domestic resources into universal health coverage.

At the Alliance we are passionate advocates for integrated HIV and SRHR responses for key populations, adolescents and young people. I believe we must seize this opportunity of a renewed SRHR agenda to claim the space for community-led responses to issues such as sexual rights, HIV prevention, and safe abortion, as well as communities often neglected by mainstream SRHR programmes.