Alanna Armitage is the Regional Director of the United Nations Fund for Population Activities (UNFPA) for Eastern Europe and Central Asia. Translation: she advocates for the health and human rights of women and girls around the world. She works closely with government policy makers, parliamentarians, non-governmental organizations and leaders from all sectors to help develop and support women’s health, even in humanitarian and emergency settings. A Canadian, Armitage joined UNFPA in 1992 and has since served in Africa, the Middle East, Eastern Europe and Latin America. ABILITY caught up with her at the Special Olympics in Abu Dhabi, where she elaborated on UNFPA’s mission and her role in advancing its objectives.
ABILITY: What is the UN Population Fund?
Alanna Armitage: The United Nations Population Fund is an agency of the UN that was established in 1969. We are 50 years old, like the Special Olympics. Our major focus is on universal access to sexual and reproductive health and rights. Let me explain what that means. Basically, UNFPA’s mandate or mission is to deliver a world where every pregnancy is wanted, each childbirth is safe, and every young person’s potential is fulfilled. We do that by focusing on three main objectives: One is ending maternal death, because there are so many women in the world who die as a result of complications in childbirth. The second one is ending the unmet need to family planning, making sure that all couples—all women and men—have access to contraception should they wish to have access to it. And the third one is ending violence against women and other harmful practices against women, such as child marriage, female genital mutilation, and gender-biased sex selection. In some countries, we see that families have preferences for boys, and so they are choosing to have boy children over girl children.
ABILITY: Those are big challenges. How do you go into a country, let’s say China, which has a one-child rule, and they typically want a male child, what do you do?
Alanna Armitage: As a UN organization, we work with our member states. We work upon the invitation of the countries in which we’re working. We have offices in 150 countries, and in countries like China, India, we have agreements and programs with the countries to support their own work on issues around sexual and reproductive health. In the case of China, it no longer has a one-child policy.
ABILITY: Is that new?
Armitage: Yes. It’s relatively recent. Basically, we and organizations like UNFPA have always advocated against any kind of coercive policies. We believe in the concept of reproductive rights, which is that all women and men should be able to choose freely the number, timing, and spacing of their children. We advocate that globally. We work with countries all over the world to help them provide family planning services, to help them build their maternal health programs, HIV prevention, and prevention of gender-based violence. We work very closely with governments, the majority of which are very committed to all of these goals. Often the funding is an issue, so for both governments and UNFPA there aren’t enough funds to fund the programs that need to be established. Sometimes it’s also an issue of myths and misperceptions around talking about issues that seem to be sensitive for some people but, in fact, are life-threatening issues.
ABILITY: And that’s where you would need money and resources to teach about health? Are you working primarily with the health administrations?
Armitage: Yes. We work a lot with ministries of health, with ministries of education, and with ministries of women’s empowerment. Sometimes they’re called ministries of gender equality. It depends on the country. We work very much with strengthening health systems to make sure that those health systems include access to contraception and that they have very strong maternal health programs. We work with human rights institutions around laws and policies on child marriage, on female genital mutilation. We work also at the community level, to help support communities in doing that social change that they want to do to make sure that certain harmful practices are no longer practiced in communities.
And we’ve seen great results in the past few decades. While there are certainly many, many challenges remaining, I think we’ve seen some great results in many areas. We’ve seen maternal deaths cut in half in the last 20 years, which is fantastic.
ABILITY: That’s progress.
Armitage: We’ve seen quite a reduction in the number of communities that are practicing female genital mutilation. All in all, I think there’s a great commitment to the agenda we work on, and we’re seeing good progress.
Having said that, many issues still need to be tackled. One of them is the primary reason why I am here on behalf of the United Nations Population Fund at the Special Olympics World Games, and that is the issue of sexual and reproductive health and disability. The whole issue of sexual health, relationships, there’s often the misperception or idea that a woman with an intellectual disability cannot have a relationship, cannot get married, cannot have a pregnancy. These are the kinds of things we need to talk about. We need to make sure that all people have the right to make their own decisions about their bodies and about their lives. This is the aspect that we are bringing into this partnership with the Special Olympics.
ABILITY: With the UN’s Convention on the Rights of Persons with Disabilities, most countries have signed, ratified, and are now trying to implement them. How do you help implement the disability component in these different countries?
Armitage: Specifically, I would say two areas. One is through education and services. We are working with ministries of education to include family life education. It depends on the country and what they call it. Sometimes it’s called sexual health education, family life education, or healthy lifestyles—
ABILITY: Is this at the school level?
Armitage: Right. This would be with ministries of education, and that’s what we do in general. But with respect to disability, we have special programs for people with disabilities to bring in this issue of sexual health. In some countries, we’re working with the Special Olympics on this issue. We are also involved with other partners, like the World Health Organization and UNICEF to train healthcare providers so that they themselves can discuss these issues with their own patients with disabilities.
And then the other issue is awareness-raising. We do a lot of work around talking about these issues publicly. We have a campaign called “Let’s Talk.” In this campaign, we have a lot of different organizations coming together, private sector, Special Olympics, UN agencies, and government, to raise issues that people don’t like to talk about, because we do need to talk about them. That’s something else we do.
ABILITY: Do you bring in people who have disabilities—
ABILITY: —and who have gone through pregnancy—
Armitage: That we haven’t gotten to yet. That is what I would like to see going forward with the partnership.
I think UNFPA has a fair amount of experience working on health issues with persons with disabilities but not so much on the intellectual disability side. I think we need to go further on that issue. That’s why we look forward to working even more with Special Olympics.
ABILITY: Do you think about over-population?
Armitage: The United Nations Population Fund was established 50 years ago to address those types of questions. One thing the international community has learned in the last 50 years is that we—and we did move the discussion from population numbers to rights, from human numbers to human rights. We realize that most of the time, women are having, in some cases, more children—in many cases when families or when women have access to contraception or family planning, they will tend to have fewer children than they were having before. In other words, the family size is often different than what would be the desired size. The problem is that women don’t always have access to contraception.
You have seen all over the world fertility rates dropping everywhere, across the board. That is thanks to the availability of modern contraception, thanks to education, because generally, in some cases where women were having eight children, for example, maybe they only wanted five or four, but they had more because they didn’t have access to contraception. Interestingly, what’s happening in other parts of the world now, in Europe, and particularly in Eastern Europe, women are not having as many children as they would like to have. If you do studies and collect data on this issue, they will say families would like to have two children, and yet they will only have one because perhaps there are issues around work-life balance and financial issues.
Our role as the UNFPA is to help at the individual level, to make sure that individuals are able to realize their own intentions. It’s not about controlling population growth, it’s about giving people the ability and the access to what they need so that they can realize what we call their own fertility intention. It sounds very technical, but they can have the number of children they would like to have.
Fifty years ago people were concerned about the macro level, about population numbers, population growth, population bombs, population explosion, as they used to talk about it, and they didn’t look at the individual rights of the person. What the population movement or what UNFPA is focusing on is implementing something called the Program of Action of the International Conference on Population and Development, which was endorsed by 179 member states in 1994 in Cairo. It brought these issues together.
So yes, it is very important for countries to understand their population dynamics, their demography, because of course those numbers make a big difference in how they can plan for development, education, health needs, etc. But at the same time, it’s all about individual women, men, and families’ needs in terms of access to modern contraception to be able to make their own choices in the number of children they would like to have. Governments cannot dictate to families how many children they should be having, whether more or less. When you meet those individual needs, we see that fertility tends to decline, and it has been declining across the board.
Of course, we do have a very large population in the world, which will continue to grow. We have to continue working together.
ABILITY: We were talking earlier about Peru and how they’ve changed their civil codes, where it was illegal for people with intellectual disabilities to marry or to have children, and now it’s reversed. Do you work in that realm?
Armitage: Yes. When it comes to reproductive rights issues, we have been doing that kind of work, in general, on the legal side. We work with civil societies on that, with governments, and we advocate for governments to change discriminatory laws and policies in that area. This is the area now that when it comes to intellectual disabilities that UNFPA will be working hand in hand with. For example, the Security General’s special envoy on disability, with the human rights independent expert on disability. These are exactly the kind of laws and policies that we look into to support governments to make those changes based on human rights standards.
ABILITY: Did you pick up any Arabic?
Armitage: Unfortunately, not much. I know a few basic terms, but no—I would love to be able to learn Arabic, and I’d love to learn Russian as well, hopefully. I basically learned a language every decade.
And I’m hoping that I still have enough decades left to fit in a few more. (laughs) They’re getting shorter and shorter!