A trained economist and feminist scholar, Gita Sen is director of The Ramalingaswami Centre on Equity and Social Determinants, Public Health Foundation of India, and adjunct professor at Harvard University. She was the only Indian among 10 global leaders awarded by UNFPA for their work on population and development at the recently-concluded International Conference on Population and Development (ICPD+25) Summit in Nairobi. Sen was also one of the movers at ICPD-Cairo in 1994, which put womens rights and gender equality in the spotlight for the first time. Last month, she won the prestigious Dan David Prize for her pioneering work in advancing gender equality, population policies, reproductive and sexual health, and womens human rights. Excerpts from an interview:

The biggest gain which could never have happened without ICPD is the change in how we think about population, family planning, contraception and child bearing. It may be hard to imagine but prior to the Cairo ICPD, whenever population conferences took place, there would be no mention of sex or reproduction.

This changed after Cairo. Earlier, the thrust was on fertility control. So, even if women and girls were talked about, it was mainly around how to control their fertility to reduce the population. The change came about by putting women at the centre of population and development. And it was women who put women at the centre in Cairo. So, the normative shift is not small. However, there is still unfinished business ensuring womens right to bodily autonomy and integrity, including the right to a safe abortion, when needed.

The big gain was that the Indian government signed up. We worked closely with them in Cairo so they would support the rights of women and girls and promote gender equality. After Cairo, the government said they would get rid of population targets. They changed the population policy. This was the big shift.

Because the norm has changed, we can keep pushing against the wrong actions and demand accountability. We are a highly class divided society. The middle class loves to think that it is not its consumption but that of others that does the damage. But one child of a middle-class parent does far more damage to the environment than the third child of a domestic worker. Also, there is demographic evidence that if you control for levels of income and education, childbearing of all religions is exactly the same.

We have to keep saying it. Ill give you an example. Some years ago, the then Chief Minister of Karnataka went to China and was very taken with the Chinese one-child norm, one of the most coercive population policies in the world. Even China has given it up. Anyway, he came back, and said Karnataka must have a policy like that because population growth needs to be reduced.

Some people came to me to ask how they could tell him it wasnt needed. I told them to simply tell him that Karnatakas population had already gone below the replacement level fertility.

No. This is why womens groups, human rights advocates, young people and the media are critical. They have to keep bringing it up. We have good health policies that are keeping with the norms. But the next steps implementation and resources, financial and human are lost somehow. We have to take everyone along and that means upholding peoples rights and making them believe it is their agenda. You can build toilets all your life but you cant make people use them if they dont believe in it or if there isnt enough water. You cant have a top-down approach.

In the southern states, some level of non-fulfilment of rights was there but, by and large, MMR has come down with increasing age of marriage, education and availability of services. Once women start reaching certain levels of education and income earning, they dont want to have many children. I think we need to do better if we have to fulfil womens rights in the area of provision of contraception services. We should follow a very different approach in terms of the information we give women and the services we provide, instead of rounding them all up and throwing them in (sterilisation) camps, like we have been doing all along.

The majority of the country is at or below 2.1 TFR (total fertility rate). So, someone is giving the wrong advice to the PM. The health ministry needs to tell him that the two-child policy is not needed. We have spent a lot of time explaining the population momentum to the health ministry. Even if people have one child, we will have population growth. We have known it for years now that more than 70% of our population growth is coming from this population momentum because India has a high proportion of people in the reproductive age group. What we need to do is raise the age of marriage, improve secondary schooling for girls, provide comprehensive sexuality education and implement the ICPD programme of action, including access to safe abortion services. The delay in tabling the Medical Termination of Pregnancy (MTP) (Amendment) Bill, 2019, is unacceptable. Reproductive rights of women are not up for negotiation.

Constitute an advisory group of researchers, academics, womens groups and young people to chart out a strategy for changing the system. Indias commitments at ICPD+25 will help us push harder for womens rights. Womens groups must hold the government accountable. There is much to do but Im optimistic because there are a lot of pressure groups, including the disability and LGBTQIA+ groups, that are willing to work together and bring the momentum back. I believe young people, who are as vocal on climate change as they are on sexual and reproductive health and human rights, will be crucial in bringing about this change.

The writer is an independent journalist writing on development and gender.

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Reproductive rights of women are not up for negotiation: Gita Sen - The Hindu