The pace of change towards advancing sexual and reproductive health and rights is piecemeal and far too slow, said Dr. Natalia Kanem, Executive Director of the United Nations Population Fund (UNFPA), at a recent panel hosted by The Columbia University Global Health Justice & Governance Program (GHJG), in partnership with UNFPA, Columbia World Projects, and the Ford Foundation. The event launched the November 2022 report, Sexual and reproductive justice as the vehicle to deliver the Nairobi Summit commitments, published by the High-Level Commission on the Nairobi Summit on ICPD25 Follow-up.

The sixth International Conference on Family Planning (ICFP) held in Pattaya, Thailand in November 2022 offered an important reason for celebration: tens of millions more people are using a modern method of family planning now than were doing so when the first ICFP was held in London ten years ago. How has this happened? One key reason is that governments, corporations, non-governmental organizations, and donors globally are taking steps to advance reproductive freedom through providing voluntary family planning.

We have all the tools we need for the elimination of cervical cancer, a largely preventable cancer that annually kills more than 300,000 women worldwide—the vast majority in low- and middle-income countries.

Under the narrow shade of our umbrellas, a community health worker from a local NGO and I walked along a dirt path to the edge of some paddy fields in a village in Tamil Nadu, South India in the summer of 2015. There we met a group of Dalit (oppressed-caste) women who were squeezed together under a clump of trees on a small strip of raised land between two fields.

The summer of 2015 was one of the hottest on record in South India at that time, with temperatures consistently above 40ºC (104ºF) every day. Rains which should have begun to arrive had not come by mid-July. These women were hoping to be called for daily agricultural wage labor in the fields, and they had taken refuge under the shade while they waited. They had been waiting all morning with no work available; it had been the same for several days because there was a drought and the crops were failing.

In 2022, the Dot-Mom column published several pieces from expert guest authors from the greater maternal and reproductive health community. In our top read guest contributor piece of the year, Susie Jolly examined the role of colonialism in sexuality education globally. Jolly highlighted examples where sexual health knowledge is built on unethical medical research carried out on racialized people, such as the study of untreated syphilis among Black men in the United States. Sexuality educators, especially those placed in the Global North, have a responsibility to work to decolonize their work. Jolly suggests supporting resources led by marginalized people, critically examining colonialism’s influence in the understanding of sexuality, and shifting the dynamics of who decides on content to lend more weight to non-Western expertise and young people learning from their own experiences.

Abortion restrictions may create obstacles for legal access, but they do nothing to eliminate the need for life-saving reproductive healthcare. And when there is a lack of licit opportunities to obtain that care, patients find pathways to get it through alternative networks.

For instance, after the U.S. Supreme Court’s Dobbs v. Jackson decision in June 2022 reversed a decades-long precedent protecting the constitutional right to an abortion, social media and online forums were filled with reactions and resources alike. Among these interventions were viral posts circulated offering to host anyone going on a “camping” trip in a state with legally protected reproductive rights. These “camping trip” posts alluded to a willingness to aid and abet individuals traveling for abortions in states with legally-protected access—and they captured the complications and conflicts embedded in these responses to the ruling.

“COVID-19 and the backlash against women’s sexual and reproductive health and rights are further diminishing the outlook for gender equality,” states a recent report on the current progress toward gender equality across all 17 Sustainable Development Goals (SDGs) from the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women) and the Department of Economic and Social Affairs. Yet the new report also zeroes in on another factor that is diminish progress on gender equality: violence. The authors observe that “violence against women remains high, global health, climate and humanitarian crises have further increased risks of violence, especially for the most vulnerable women and girls, and women feel more unsafe than they did before the pandemic.”