Pretoria, South Africa – Sweden today announced a further investment of $42 million for sexual and reproductive health and rights (SRHR), in an effort to transform the lives of millions of people in East and Southern Africa. The funding is being made available through Sweden’s Strategy for SRHR in Africa 2022-2026.

The investment will bolster existing efforts by four United Nations agencies – UNAIDS, UNFPA, UNICEF and WHO – to support countries and regional entities in East and Southern Africa to reduce maternal mortality including from unsafe abortion, HIV and sexually transmitted infections (STIs), unmet need for contraceptives, and gender-based violence (GBV). The investment brings to $99 million the total amount committed by Sweden since 2018.

“We are proud that, as four UN agencies working together, we have created a regional movement of government, civil society and development partners committed to improving the sexual and reproductive health and rights of all people in East and Southern Africa, using an integrated approach. This investment by Sweden will enable this partnership to conclude the unfinished business and to fast track the realization of the SRHR targets of the Sustainable Development Goals,” said UNAIDS Regional Director Anne Githuku-Shongwe,UNFPA Regional Director Lydia Zigomo, UNICEF Regional Director Mohamed Fall and WHO Regional Director Dr Matshidiso Moeti.

Despite progress made to date, the region is unlikely to ensure universal access to SRHR by 2030, without a concerted effort. Across the region, too many pregnant women die from preventable causes. One in five women in the region who need to use modern contraceptives are not using them, with adolescents and young women having the highest unmet need, resulting in high levels of early and unintended pregnancies.

HIV remains the single biggest threat to people’s sexual and reproductive health, with close to 670,000 new HIV infections occurring in the region in 2021, of which one quarter were among adolescents and young women. And one in six adolescents and young women will have experienced GBV by the age of 19.

UNAIDS data underscore the urgent need for immediate action to address the devastating impact of AIDS among adolescent girls in Sub-Saharan Africa. As of 2021, an astonishing 4,900 young girls are newly infected with HIV every week, highlighting a crisis of monumental proportions.

In a region already burdened by the challenges of HIV/AIDS, the frequency at which our girls are acquiring the virus is deeply troubling. The figures speak for themselves: 82% of the newly infected adolescent girls and young women in 2021 hail from sub-Saharan Africa, including two thirds in East and Southern Africa

Progress continues to be challenged by structural, social and health system barriers. Restrictive laws, policies and traditional and cultural practices give rise to stigma and discrimination, which limit people’s ability to exercise their sexual and reproductive rights.

Health systems challenges – including inadequate domestic investments in health, poor infrastructure, stock-outs of essential commodities and supplies, and limited skilled personnel – continue to undermine the health outcomes of people across the region. Many countries are becoming increasingly vulnerable to humanitarian, climate change, socio-economic and geo-political shocks, with health systems inadequately prepared to respond to such shocks and crises.

“Sweden is committed to working together with our partners to ensure no person is left behind. The realisation of sexual and reproductive health and rights is a priority for us and for the greater Team Europe group. We are excited that this impressive investment in the 2gether 4 SRHR Programme aligns with the AU Agenda 2063 and the Sustainable Development Goals. This project is proof that through collaboration, we have the ability to change our future for the better,” said H.E. Ambassador Håkan Juholt.

The continued support from Sweden will enable the 2gether 4 SRHR Programme to fast track efforts to achieve universal access to SRHR. This will be done by supporting laws and policies that empower people to exercise their sexual and reproductive rights, and ensuring that they can access quality, integrated and people-centred SRHR services that meet their needs, including in times of crisis. With a comprehensive approach to SRHR, the social and cultural norms that give rise to the stigma and discrimination that impede people’s rights, health and well-being will be identified and tackled.

Note to the Editor

Over the past four years, Sweden has invested $56 million in the 2gether 4 SRHR Programme. This investment has supported regional and national partners to develop laws, policies and strategies, and advocated for greater domestic investments in SRHR. If realised, these investments will enable the 633 million people living in the region - the majority of whom are young people - to exercise their rights to bodily autonomy, to decide freely when and whether to have children, to realise their full potential, and to contribute towards the socio-economic development of the region.

Twelve countries were supported to provide quality, integrated SRH services, with results showing an increased uptake in SRHR services. In five countries, women accessing gender-based violence services were more likely to receive ART to prevent HIV, and to receive emergency contraception to prevent unintended pregnancies. 

In six countries, women accessing comprehensive abortion-care services in accordance with the laws of their country were more likely to be tested for HIV, screened for STIs and receive information, counselling and contraceptives to prevent unintended pregnancies. Five countries reported an increase in the number of women accessing contraceptive services being screened for HIV and STIs. Most countries successfully contributed towards the 90-90-90 HIV targets through ensuring that 90% of pregnant women were tested for HIV and screened for STIs.

The programme harnessed the effectiveness of community-based approaches, such as mentor mothers and community health-care workers, to minimize the disruption to essential SRHR services, in particular the use of contraceptives, and ensure that people living with HIV were able to receive services.

Lessons showed that providing an integrated package of services for people not only improves the uptake of services but reduces transport costs, waiting times and congestion, and improves client retention.