Adolescents: 50% of the population of the AWR is under 25 years old. Yet young people lack reproductive health information and services. Existing national and local studies in the region do not address all aspects of the sexual and reproductive health of young people. There is a lack of reliable statistics but available data on maternal mortality and morbidity show that adolescent girls in the region bear the highest burden of death from pregnancy-related causes. Female genital mutilation remains a persistent threat in a number of AWR countries, particularly Egypt, Sudan, Djibouti, and Mauritania. IPPF/AWR responds to this    challenge, seeking to bring information and services to youth in ways that are sensitive to cultural circumstances and conditions.

Combating Unsafe Abortion: The absence of access to safe abortion poses major health risks for women seeking to avoid or manage an unintended pregnancy. Hundreds of thousands of preventable deaths of women occur every year because of unsafe abortion. Apart from in Tunisia, abortion remains illegal in most AWR countries except when the mother’s life is in danger. In 1995-2000, there were 59 million pregnancies in the AWR, of which 14 million were unintended. During the same period, 7.1 million abortions were performed and abortion-related complications accounted for nearly five percent of all maternal deaths. This shows that, despite the prevailing legal and religious culture, women in the AWR are having abortions and too often under unsafe conditions.

Access to services: Much more work is needed to ensure that all people, particularly the poor, marginalized, the socially-excluded and under-served have access to sexual and reproductive health information, sexuality education and high quality services. IPPF AWR is working to realize the ICPD-endorsed goal of universal access to reproductive health care services throughout the region. There are variations among countries, but the overall fertility rate in the AWR remains high; and half of AWR countries have a maternal mortality rate exceeding 200 per 100,000 live births. Modern method contraceptive prevalence rates vary but are relatively low; half of all AWR countries have a rate of less than 40%. Specific strategies are needed, particularly for rural populations, who continue to be greatly underserved.

AIDS/HIV: Young people, both men and women, are the most seriously affected by STIs, including most tragically HIV/AIDS. Overall HIV infection rates are still relatively low. However, scant surveillance data in several countries may mean that serious outbreaks are being missed in vulnerable populations such as sex workers, users of controlled substances and men who have sex with men, where social stigma prevents an accurate assessment of the problem. Effective prevention targeted at vulnerable groups is urgently needed. The current low prevalence does not mean that this is a low priority. A failure to take the appropriate measures will have devastating consequences.

Advocacy: Despite general agreement on the ICPD Program of Action, national implementation of comprehensive reproductive health programs has been slow. IPPF Arab World Region works at all levels, from Parliamentary to community groups, to ensure a greater level of understanding of sexual and reproductive health and rights, and the linkages between these issues, the elimination of poverty, and the achievement of the Millennium Development Goals.

Within the Region’s strategic plan, strategic interventions have been incorporated within each of the five A’s that relate to capacity-building, resource mobilization, governance and policy and evaluation. Similarly, interventions related to gender and rights, which are an important cross-cutting issue for the Region and for all MAs, have been incorporated within the overall portfolio of interventions to address adolescents and young people, HIV/AIDS, access to services, abortion, and advocacy.