The report sponsored by the International Planned Parenthood Federation, titled ”Sex and the Hemisphere: The Millennium Development Goals (MDGs) and Sexual and Reproductive Health in Latin America and the Caribbean”, is based on two meetings held in New York and Rio de Janeiro last fall.

The MDGs include a 50 percent reduction in poverty and hunger; universal primary education; reduction of child mortality by two-thirds; cutbacks in maternal mortality by three-quarters; the promotion of gender equality; and the reversal of the spread of HIV/AIDS, malaria and other diseases, by 2015.

However, the goals have disappointed some in the reproductive health community because of the incomplete attention they give to sexual and reproductive health and rights, the report says.

”None of the eight MDGs included universal access to reproductive health care, which they should if they are a summary of big conferences of the 1990s,” said Carmen Barroso, western hemisphere director of the International Planned Parenthood Federation, who participated in both the New York and Rio symposia.

”Women are not completely neglected -- the goals do talk about HIV, maternal health and gender equality -- but the core of universal access was not there,” she told IPS. ”It seems like a mechanistic approach to a complex problem.”

Many activists see a need to continue to use the agendas approved at population conferences in Cairo and Beijing in 1994 and 1995 for advocacy and policy-making -- and to make it clear that this is not an ”either/or” scenario.

”Cairo took a very holistic approach to population issues,” Barroso said. ”It addressed reproductive health and rights in the context of their social, economic and politic dimensions.”

The report warns that governments in the Western hemisphere are also unlikely to pay much attention to the MDGs because they are not relevant to the reality of middle-income and even lower middle-income countries.

In Latin America and the Caribbean, for example, only a few governments have been engaged in the process of drawing up the poverty reduction strategy papers that will become the blueprints for achieving the goals.

One answer is to make the MDGs much more region-specific. In Latin America, which is comparatively much wealthier than sub-Saharan Africa, for example, this means reassessing indicators that may be too low.

The report notes that some progressives have also shied away from discussing the effects of religion -- namely the Catholic Church -- and culture on women's development in Latin America, to their detriment.

”The question is very complicated for the Vatican because it is on the side of the angels when it comes to poverty and some human rights issues, but is adamant in its unwillingness to even look at family planning as an important element of human rights,” said Frances Kissling, president of Catholics for a Free Choice, who attended the Rio meeting.

”This intransigence holds to the minute,” she said in an interview. ”In general, ordinary Catholics are not listening to the Vatican on these issues, although it does have power in many ministries of health and attempts to block access to services.”

Kissling also condemned ongoing efforts by the United States to impose a more conservative view of women's rights on the international community.

In the latest flap, earlier this week the U.S. delegation attending a women's conference at the United Nations attempted to force consensus on an amendment to the Beijing Platform that specifically says the reproductive rights enshrined in the document ”do not include the right to abortion.”

”At the U.N., the glass is always half-empty or half-full,” Kissling said dryly. ”I would say the glass is half-full, but you can't expect much more when the issue (of women's reproductive rights) is so controversial to the one of the major members.”

”The mobilisation of high-level commitments through the MDG process is an important tool, and the signs are hopeful. But the intransigence of the U.S. is leading to polarisation and essentially, a culture war. It's a distraction -- but a very effective distraction.”

Barroso agrees. ”I find it very sad and ironic that the country that should be leading is pushing in the other direction,” she said. ”It's shocking that the American public is allowing this to happen; a small vocal minority has hijacked the agenda.”

”However, there is a great mobilisation here to oppose the U.S., and they have been defeated again and again at regional meetings.”

Other women activists, like Mariama Williams of the Jamaica-based DAWN network, place blame for the lack of progress on women's equality squarely on the shoulders of international financial institutions like the World Bank and International Monetary Fund, which influence governments to set goals like cutting taxes, dismantling tariff barriers and paying off debts that ”have little or nothing to do with building social capital.”

The pursuit of these priorities not only fails to produce government investment in health and education, but in fact leads to de-investment in these sectors, she says in the report.

”We have a trade policy that actually is anti-poverty-reduction and anti-human-development. We have a lack of coherence between the MDG agenda and the trade and macro-economic and finance agendas.”

”We are integrating trade and finance by linking the World Bank, the IMF (International Monetary Fund) and the WTO (World Trade Organisation) -- they are now linked formally into a coherence process to make sure that their workings do not conflict with the trade agenda,” Williams noted.

”There is no such linkage for human development and for rights. For me, that is the biggest obstacle for why this will not work, even with sufficient funding.”

Regional experts cite the potentially disastrous fallout from wide-ranging pacts like the Free Trade Agreement of the Americas, currently being negotiated by many countries of Latin America and the Caribbean with the United States.

They note that on the issue of HIV/AIDS drugs, the U.S. has been systematically going through four or five flexibilities in a global patent agreement called the ”Trade-Related Aspects of Intellectual Property Rights” to ensure that through these free trade deals, governments give up their ability to guarantee the availability of cheap generic drugs.

These problems are magnified in the Caribbean, which has the second highest prevalence rate in the world after sub-Saharan Africa.

But women activists are not discouraged.

”The MDGs do present an important opportunity for making progress on reproductive health issues,” Kissling said. ”And Latin America has high development of the NGO sector and women's rights movements.”

”More progressive governments are being elected,” she noted. ”The level of anti-imperialist thought is high, and the unwillingness to bow to the United States is very strong.” (END)