Guttmacher-Lancet Commission Proposes a Bold, New Agenda for Sexual and Reproductive Health and Rights

To achieve global health and development goals, experts recommend increased investments and comprehensive interventions

Johannesburg, South Africa—Today, the Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights—a collaboration of global health, development and human rights experts from around the world—called on national governments, international agencies, donors, civil society groups and other key stakeholders to commit to a new, bold agenda to achieve universal access to sexual and reproductive health and rights. This agenda, presented in a new report published today in The Lancet, puts forth an evidence-based, forward-looking vision that is affordable, attainable and essential to the achievement of health, equitable development and human rights for all. It encompasses the right of all individuals to make decisions about their bodies and lives—free of stigma, discrimination and coercion—and to have access to essential sexual and reproductive health interventions.  

The report was launched today in Johannesburg at an event featuring Justice Edwin Cameron, Constitutional Court of South Africa; Richard Horton, Editor-in-Chief of The Lancet; and Julitta Onabanjo, Director for East and Southern Africa of the ‎United Nations Population Fund.

"Gaps in sexual and reproductive health and rights worldwide take an enormous toll on individuals, communities and economies. We must not continue to tolerate this problem," said Dr. Alex Ezeh, Commission Co-Chair and former Executive Director of the African Population and Health Research Center. "It’s time to eliminate these inequities with a comprehensive approach that doesn’t overlook critical components like access to safe and legal abortion, prevention of reproductive cancers, or treatment for infertility."

The Commission’s report details the magnitude of sexual and reproductive health needs. Each year in developing regions:

  • more than 200 million women want to avoid pregnancy but are not using modern contraception
  • more than 45 million women receive inadequate antenatal care, or none at all
  • more than 30 million women deliver their babies outside of a health facility

Worldwide, each year:

  • 25 million unsafe abortions take place
  • as many as 180 million couples may be affected by infertility
  • nearly two million people become infected with HIV
  • approximately 266,000 women die from cervical cancer

And at some point in their lives, about one in three women worldwide experience gender-based violence, most often from an intimate partner.

"For too long the world has accepted these stark realities as inevitable. Our report shows how they can be overcome, laying out a roadmap that countries can use to put essential services and interventions in place," said Ann M. Starrs, Commission Co-Chair and President and CEO of the Guttmacher Institute. "We have the means and the knowledge to achieve universal sexual and reproductive health and rights. Meaningful progress is possible, it is affordable and it is vital."

The Commission reports that meeting the need for modern contraception, safe abortion, and maternal and newborn health care in developing regions would cost just US$9 per person per year. This is an affordable investment, especially considering that half of this amount is already being spent to cover the cost of current levels of care, and it will yield enormous returns. Access to sexual and reproductive health services saves lives, improves health and well-being, promotes gender equality, and increases productivity and household income.

The Commission stresses that improving health depends not only on implementing effective programs, but also on advancing rights—including those frequently neglected in global discussions, such as the right to freely choose one’s sexual partners and the right to safe and legal abortion care. Commissioners call on countries to tackle restrictive social norms, laws and policies, and to hold governments accountable to their commitments.

"It’s appropriate to launch the Guttmacher-Lancet Commission report here in South Africa, where we are proud to have enshrined sexual and reproductive health and rights in our Constitution," said Dr. Aaron Motsoaledi, Minister of Health of South Africa. "We know that, around the world, investments in sexual and reproductive health and rights yield great returns for individuals, communities and governments."

The Commission also underscores the importance of gathering more evidence on the sexual and reproductive health needs of distinct populations that are often marginalized and vulnerable, including adolescents, people with diverse sexual orientations and gender identities, displaced people and refugees, and people living with disabilities.

The report is accompanied by two commentaries welcoming this new agenda for sexual and reproductive health and rights—a joint comment from two Ministers of Health, Professor Isaac Adewole of Nigeria and Dr. Alejandro Gaviria Uribe of Colombia, as well as a joint comment from the Director-General of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, and the Executive Director of the United Nations Population Fund, Dr. Natalia Kanem.


About the Commission

The Guttmacher-Lancet Commission consists of 16 commissioners from Africa, Asia, Europe, the Middle East, North America and Latin America, with multidisciplinary expertise and experience in a broad range of sexual and reproductive health and rights issues. From 2016 to 2018, the Commission held numerous consultations and synthesized available evidence with the support of researchers at the Guttmacher Institute, the African Population and Health Research Center and other organizations affiliated with several of the commissioners. The Advisory Group for the Commission consists of 23 representatives from sexual and reproductive health and rights, global health, and funding organizations who provided valuable feedback on the report and its recommendations.


About the Guttmacher Institute

The Guttmacher Institute is a leading research and policy organization committed to advancing sexual and reproductive health and rights in the United States and globally.

About The Lancet

The Lancet is one of the world’s leading medical journals, published weekly since 1823.