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妇女身体的用词战争

纽约—本月,联合国大会将举办一场高规格会议确保成员国承诺实现全民健康覆盖,包括金融风险保护以及基本医疗服务、医药和疫苗的全民普及。但有多少国家会致力于满足女童和妇女的独特需要,并作为它们落实全民健康覆盖计划的一部分,仍然有待讨论。

各国做出全民健康覆盖的政治宣言意味着同意从国民预算中配置资金用于建立一个世界各地的糖尿病患者都能获得胰岛素,艾滋病毒携带者不会被滞留在破败社区,所有儿童都能得到基本疫苗的未来。在这个未来中,即便是最脆弱社区,也能够可靠而廉价地获得所需服务,整个社会将变得更健康,生产力更高。

但女童和妇女的独特健康需要——不仅仅是性和生殖健康需要——仍是一个政治争议话题,长期以来,这导致女童和妇女医疗问题被低估,得不到足够的资源解决。比如,在人道主义设定中,就很少有性和生殖医疗普及的内容。在许多地方,年轻人很难伸张自己的生殖权利。

进一步影响妇女健康的是,妇女常常无法足够地参与医学实验,导致疾病诊断和治疗不充分。即便是专门为少女服务的计划,也常常缺少有意义的年轻人参与;结果是,它们常常无法满足目标用户的需要,有时甚至会加深伤害性羞辱。

但欲使全民健康覆盖真正做到全民性和革命性,就必须全面实现性别平等——这也意味着提供明确的性和生殖健康和权利(SRHR)保证。这包括现代避孕手段、产前产后看护、不孕症治疗、安全堕胎,以及性传播疾病和生殖器官癌症的防治。这也包括同意性行为和免遭亲密伴侣暴力的权利。

这些健康服务能起到救命的作用。如果发展中地区的现代避孕手段需要得到满足,妇女和新生儿能够得到基本看护,那么意外怀孕将减少75%,产妇死亡将下降73%,新生儿死亡将减少 80%。女童接种人乳头状瘤病毒(HPV)疫苗能够避免th72个中低收入国家的三百万人在未来十年死于子宫颈癌。当然,更健康的母亲能够拥有更健康的孩子

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保护妇女健康,保证他们拥有自己身体、性事和生育的自主权是性别平等的基石。SRHT让妇女能够充分实现潜力,参与到经济、政治和社会事务中去。这将提高家庭和社区的福祉,进而推动总体经济增长和可持续发展。

尽管好处如此巨大,但经验表明,除非SRHR在联合国宣言中得到明确保护,否则很有可能无法纳入政策意见和预算中。确保这些保护是一场逆风之战,因为保守的联合国成员国总是在各种国际宣言中推动免用“性别”、“性和生殖健康和权利”,有时甚至还包括“人权”等用词。

多边体系中正在开展一场用词战争,战场便是妇女的身体。因此,性别平等和全民健康覆盖联盟(Alliance for Gender Equality and UHC)——由来自46个国家的100多家公民社会组织组成——一直在要求联合国成员绝不允许寻求破坏妇女健康和权利的人取得胜利。这些用词被删除将带来真真切切的后果。

 “全民医疗”包括性和生殖健康,而“全民”包括每一个人,不管种族、民族、年龄、能力、移民地位、性别身份或言论、是否原住民、健康条件、阶级或种姓。要想赢得实现这一目标的机会,SRHR就必须得到承认,获得拨款,并进入全世界每个国家和社区的宣言之中。

如今,战斗从纸面上的用词转向了行动。如果政府认真对待全民健康覆盖,就必须致力于构建服务于全民、包括女童和妇女在内的全面医疗体系,并给与资金支持。结果将是一个更健康、更富于、更平等的世界。

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