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6THURSDAY11OCTOBER2012GIRLSx19RIGHTSGAZETTEispossibletotakeeectivepracticalactionthatenablesgirlstotacklegenderinequalityandill-healthandtoulx1ltheirpotential.TheinitiativeGirlsDecideandtheprojectIlovebeingagirlbothromtheInternationalPlannedParenthoodFed-erationIPPFareasteptowardthis.Thex1rstoneaimstoensurethatgirlshaveaccessasahumanrightimperativetolie-savingSRHservicesandinor-mation.ThelatterrecentlywinneroaWorldSummitYouthAwardpromotesapositiveapproachtothesexualityoyoungwomenthroughonlinetools.IPPFalsoinvestsinservicesandprogrammestargetinggirls.CIESIPPFx19smemberassociationinBoliviaoersmedicalpsy-chologicalandsocialcarewhileensuringconx1dentialandqualitySRHservicestoyoungpeople.In2011over101270con-sultationswereundertaken.Sustainedleadershipisrequiredtoensurethatgirlsarerecognisedrights-holders.Europeanpolicymakerscanhelptransormlivesogirlsbysupportingevidence-basedresearchthatrefectreali-tiesogirlsx19sexualandreproductivelivesinvestinginyouth-riendlyservicesandprogrammesandguaranteeingaccesstocomprehensivesexualityeducationcre-atingsupportivelegalandpolicyrame-worksandsocialnorms.Thebenex1tsoinvestingingirlsaretransormationalx13ortheirownlivesandortheiramiliescommunitiessocieties.EmpoweringgirlssotheycanmakehealthychoicesnotonlyboostseconomicgrowthbutarealsoessentialtoachievetheMillen-niumDevelopmentGoals.Letx19sgivethemgreaterchoiceandcontroloverdecisionsthataecttheirsexualandreproductivelivesandhelpbreakthecycleopovertyandinequalityorthenextgeneration.UHCincludesaccesstoyouth-riendlyservicesespeciallyintheHIVAidsandsexualandreproductivehealthandrightssectorsduetotheirsensitivenature.Atthesametimeinvestinginqualityeducationisalsocrucialedu-cationandgoodhealthareintimatelyconnected.Whengirlsareeducatedtheyaremorelikelytobehealthyandsurviveintoadulthoodconverselywhengirlsarehealthytheyaremorelikelytobeeducated.Educatedgirlsarelesslikelytomarryorhavechildrenearlyandwouldbemorepreparedtoacetheirroleasamotheraswellasobeingempoweredmembersosociety.Addressingthecausesogirlsx19dis-criminationaswellastheirspecix1chealthneedswouldbeawiseinvest-mentpreventingandtreatingsexu-ally-transmittedinectionstreatingtheconsequencesoandpreventingFGMishappeningpartlysparkedbynewunderstandingsothedynamicsosocialnorms.Overthelast10yearssome8000communitiesinsub-Saha-ranAricahavepubliclycomeoutagainstthepracticeusuallyollow-ingprotractedcommunitydiscussionstouchingonhealthandhumanrightsissues.Engagingtheentirecommunity-includingtraditionalandreligiousleadersyounggirlsthemselveswomenandmen-inthediscussionscanleadtoalastingchangeinattitudes-andactions.Traditionalandreligiousleadersinparticularhavetheabilitytoinfuencedecisionswithinamiliesandtobuildensuringaccesstosexualandrepro-ductivehealthservicespromotingthecompletiononineyearsoeducationandthereoredelayingmarriageandchildbirthwouldreducesocialstigmaandhelpyoungwomenremainingoodhealthcareortheirchildrenbeabletoprovideorthemselvesandcontrib-utetosocietyasawhole.TheEUhasakeyroleinensur-ingthatgirlsandwomenrealisetheirhumanrighttohealthcare.NotonlyshouldtheEUensurethatthereisadequatex1nancingorhealthandbasiceducationinthe2014-2020budgetandinthe11thEuropeanDevelopmentFunditshouldalsobeakeyplayerinensuringthatthecross-cuttingissueogirlsx19healththerighttohealthorallanduniversalhealthcoveragearepartotheuturedevelopmentrameworkbeyond2015.consensuswithincommunities.Mediacampaignsandnationallegislationrein-orcetheunderstandingthatFGMCisaviolationobodilyintegrityandthusaviolationohumanrights.IntroducingnationallegislationthatprohibitsthepracticeoFGMCisimportantparticularlywhenaprocessosocietalchangesisalreadyunderwayandcitizensaresensitisedtotheissues.Butitaloneisrarelyeective.Legisla-tionshouldthereoretakeintoaccountthedegreeosocialacceptanceothepracticeandshouldbepartoabroaderinitiativethatempowerspracticingcommunitiestoabandonFGMC.HealthQualityeducationimprovesbothmaternalandchildhealthAUNFPAUNICEFJointProgrammeonFemaleGenitalMutilationCuttingencouragescommunitiestoabandonthisharmfulpracticeandaimstoseeitendwithinagenerationTheEUmustshowleadershipinpromotinggirlsx19sexualandreproductivehealthEUmustensuregirlsrealisetheirhumanrighttohealthPromotingsexualandreproductivehealthandrightsbeneftseveryoneAbandoningharmx9ultraditionalpracticesFIONASALTERANDELENADx19uRZOIPPFandIPPFENThereisconsensusthatgirlsarecentraltodevelopment.Yetgirlscontinuetobearthebruntopovertyandill-healthincludingmaternalmortalityunsaeabortionandHIV.Issuesrelatingtogirlsx19sexualityandtheirsexualandreproduc-tiverightsremainlargelyneglected.Some14milliongirlsbetween15and19givebirtheachyear.Forthemcom-plicationsopregnancyandchildbirtharealeadingcauseodeath.Some82mil-liongirlsindevelopingcountrieswillbemarriedbeoretheir18thbirthday.Thiswilldisrupttheireducationeventhoughwomenwithmoreyearsoschoolinghavebettermaternalhealthewerandhealthierchildrenandgreatereconomicopportunities.Biologicallygirlsx19healthcanbemorevulnerablethanmenx19s.OparticularconcernarethedramaticincreasesinHIVinectionamongyoungwomenwhonowmakeup60percentothe15to24yearoldslivingwithHIV.Girlsarealsoexposedtovariousormsoviolenceromharmultraditionalpracticessuchasemalegenitalmutilationandthegrow-ingproblemosextrax1ckingtoearlyandorcedmarriage.Disparitiesinthewaygirlsandboysareraisedandtreatedareattherootosexualandreproductiveill-healthSRHanddevelopmentchallenges.Forboysadolescencecanmeannewreedomsandgreaterparticipationincommunitylie.Girlshowevermayacetheoppositerestrictionsintheiraccesstochoicesedu-cationservicesandsupport.Traditionalgenderrolesgivegirlslittlesayabouttheirownhopesanddreams.YetweknowitELISABALDINIActionforGlobalHealthHealthisahumanrightandallhumanrightsshouldapplytopeopleevery-where.Howeverthisisnotarealityorvulnerablegroupslikewomenandchildren.Foryounggirlsbeingbothachildandaemalecanprovetobeadoubledisadvantage.Girlsacepar-ticularhealthchallenges.Duringearlychildhoodtheneglectoyounggirlsx19healthcareandnutritionleadstohighgirl-childmortality.Laterinliegirlsmaybeorcedintomarriagewhichotenresultsinearlypregnancyandpreventedromgoingtoschool.Notreceivinganeducationmakesgirlsmorevulnerabletophysicalandsexualviolenceandtosexuallytransmittedinectionsastheyarenotempoweredtoknowtheirrightsandinmanycasesareunabletoprovideorthemselves.In2009girlsaccountedornearlytwo-thirdsonewHIVinectionsamongyoungpeopleaged15to24globally.Inadditiongirlswhogivebirthbeoretheageo15arex1vetimesmorelikelytodieinchildbirththenwomenintheirtwentiesastheirbodiesarenotullydevelopedwhichmeanstheyarealsoatparticularriskoget-tingobstetricx1stulawhengivingbirth.Theprobabilityocomplicationsdur-ingchildbirthincreaseswhenagirlhasundergoneemalegenitalmutilationFGM.Allotheseactorsleadtohighinantandchildhoodmortality.Thesespecix1chealthchallengesrequirededicatedattention.Despitethisgirlsareotenattheendothehealthcarequeue.UniversalhealthcoverageUHCwhichisreeatthepointouseorthosewhocannotaordtopaywouldbeacriticalsteptoovercomingthisbarrier.TomeetthespecialneedsogirlsitiscrucialthatGRETCHENKAILANDNAFISSATOuDIOPUnitedNationsPopulationFundInacelebrationattheendo2011ahugecrowdgatheredintheKoldaregionosoutheasternSenegaltoormallyannouncethedecisiono69communitiestostopthelongstandingtraditionoemalegenitalmutilationorcuttingFGMC.Aspartoapub-licdeclarationrenouncingthepracticemothersintheregionsaidx1cWehavebeencutandhavecutourdaughtersbutourgranddaughterswillneverknowthepainoexcision.x1dInSenegalgenitalcuttingistypicallyperormedongirlsbetweentheagesotwoandx1ve.Thecollectivenatureothedec-larationamongintermarryingcommu-nitiesinKoldameansthatuncutgirlsandtheiramilieswillnolongeracesocialostracismorx1ndthemselvesunmarriageable.Studieshaveshownthenegativeimpactothepracticeonmaternalandneonataloutcomes.Comparedwithwomenwhohavenotbeencutthosewhohaveundergonegenitalcuttingrunasignix1cantlygreaterriskorequiringaCaesareansectionanepisiotomyandanextendedstayinhospitalandalsoosueringpostpartumhaemorrhage.DeathratesamongbabiesduringandimmediatelyaterbirtharealsohigherorthoseborntomotherswhohaveundergoneFGMC.Itisestimatedthatanadditionalonetotwobabiesper100deliveriesdieasaresult.Fordecadesreormershavebeentryingtoendthisharmulpracticewithlimitedsuccess.ButnowchangePhotoActionforGlobalHealthThomasWilliamsPhotoPlanJennyMatthewsPhotoPlanClaudiaLorenaAmx1cTheMillenniumDevelopmentGoalshavegivenpolicy-makersaunifyingframeworkforglobaldevelopmentaclearagendawithmeasurablegoalsandtargetsandacommoninspiringvision.Aswelookbeyond2015wemustdothesame.Weneedanagendathatisconcreteaction-orientedandfocusedonpovertyeradicationinclusiveeconomicandsocialdevelopmentenvironmentalsustainabilityandpeaceandsecurityforall.x1duNSECRETARYGENERALBANKI-mOON