In August, as the reality of living while trying to survive a pandemic was finally hitting, and the magnitude of challenges to Sexual and Reproductive Health Rights were becoming amplified. Advocates were forced to work with little resources to reach communities of women and girls to ensure some continued access. The pandemic had disrupted the normal health service seeking behaviour with lockdowns and fear of the coronavirus spread. Just as advocates were grappling with these challenges varying from access to maternal health services, contraception, abortion, post-abortion care, sexuality education, protection from sexual abuse, a more potent challenge was being cooked by the Donald Trump administration.
We started hearing about the Geneva Consensus Declaration, a document developed by the US government that sought to suppress and altogether erode hard-won human rights for women and minorities. How it was being developed was also an apparent bastardisation of multilateral bodies responsible for monitoring States’ adherence to the set human rights norms and standards. The declaration targets some of the rights already under attack- sexual reproductive health and rights, including the right to abortion both within the US and beyond. The Declaration was officially launched on 22nd October 2020 at a virtual ceremony officiated by US Secretaries Mike Pompeo and Alex Azar and co-sponsored by five other states including Uganda at the margins of the World Health Assembly in Geneva Switzerland.
This initiative is not an isolated move but part of a strategy to undermine Sexual Reproductive Health Rights (SRHR) already recognised and adopted through international mechanisms and treaty documents that Uganda is party to. Earlier in his presidency, Trump reintroduced the Global Gag Rule that targets organisations that receive US health funding from working on abortion, talking about it or even doing referrals. The rule also means public health organisations cannot advocate for changes in the abortion laws. Funding and operations of thousands of service providers of contraception and abortion services across the world were affected. This declaration was another move to cement the harm already in place. The document falsely claims that there is no international recognition of abortion as a human right.
The onset of the coronavirus pandemic has further illuminated the danger of such decisions on the lives of the most marginalised women and girls. In addition to the devastating effects of the pandemic on the social and economic well being, the impact on the health of women and girls has been direr with high incidences of sexual violence resulting in unplanned/unwanted pregnancies.
A recent media report noted an escalation of teenage pregnancies in northern Uganda with an estimated 8,717 pregnancies recorded between April-June 2020. It’s no surprise that one in four girls aged 14-19 is already a mother or pregnant. This is not unique to Uganda. UNAIDS data shows that 4,500 adolescent girls in sub-Saharan Africa become HIV positive every week with five in six new cases of HIV among adolescents between the ages of 15 and 19 in this region are among girls.
Rates of sexual violence resulting in unplanned and unwanted pregnancies among adolescent girls and young women aged 15-19 years exacerbating a decade-old problem as Uganda has the highest incidence of teenage pregnancy in Sub-Saharan Africa. Populist decisions of government officials in Uganda do have ominous effects on the health and wellbeing of its citizens.
One of the significant ways in which this trend may be mitigated is through the implementation of appropriate legal-policy and programmatic interventions that are backed by science and evidence. Unfortunately, in many cases, the evidence-based approach is often ditched for populism. Another classic example being Uganda’s placing of a reservation on article 14(2) (C) of the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa.
With cultural and structural hurdles are already at play and keeping Uganda’s girls and women from achieving equality with their male counterparts, Trump’s Geneva Consensus Declaration, despite its non-binding nature, has the real effects. It creates unnecessary legal, policy and service delivery hurdles that will obstruct interventions meant to address the persistently high numbers of women and girls dying due to pregnancy-related complications.
The Constitution of Uganda recognises the right to life of all Ugandans. It obliges the state to “protect the rights of women, taking into account their unique status and natural maternal functions in society.” A recent ruling on Constitutional Petition No. 16 of 2011 held that “the government’s omission to adequately provide basic maternal health care services in public health facilities violates the rights of women and is inconsistent and contravenes articles 33(1), (2) and (3) of the constitution.”
As an advocate of sexual reproductive health and rights for all Ugandans, it is my view that the endorsement of the declaration by Uganda’s Minister for Health goes against good practice expected of government representatives of a free and democratic state. Not to mention, it was a poor political calculation as it came a week before Trump’s sinking ship of conservative fundamentalists in the US lost recent election l to President-elect Joe Biden.
Why would Uganda rush to support a declaration that seeks to trample on rights of many African women and girls a week before the American election? At the very least, they should hold consultations with legal and policy experts within the government, academia, Attorney General and the population most likely to be affected by the declaration- Uganda’s women and girls.
No other rights, other than reproductive rights of women to exercise their bodily autonomy and rights to decide, have been the subject of political semantics of state mechanisms as is the case of Uganda.
One scholar put this aptly when he stated that, “in no other context, except pregnancy, are people considered as having a legal obligation to sacrifice anything in order to help others realise their right to life.”
Uganda must focus on developing and implementing its homegrown policies and programs aimed at improving the lives and wellbeing of its citizens rather than chasing whatever foreign powers say. We must remain mindful of the many challenges women and girls face like limited access to information, low social and economic standing, inaccessible health services all of which leave them with unmet reproductive health care needs. Uganda cannot achieve its development goals whilst leaving its female population behind; the pandemic has further exposed most of these divides. As a new US administration takes over this January and Uganda goes to the polls in the same month, may the health of Uganda’s women and girls be treated as the priority that it is.
Joy Asasira is Sexual and Reproductive Health Rights advocate and strategist based in Kampala.