1 SSC and ICPD

The year 2019 was a milestone year in the population field as it marked the 25th anniversary of the International Conference on Population and Development (ICPD) held in Cairo in September 1994. The international community reviewed the progress and achievements of implementation of ICPD Programme of Action in the past 25 years and reaffirmed the commitments for achieving the ICPD Programme of Action and the 2030 Agenda for Sustainable Development. The whole global community focused on the ICPD + 25 during the 52nd session of UN Commission on Population and Development held on 1–5 April 2019 at UN Headquarters in New York, the 16th International Inter-Ministerial Conference on South–South Cooperation in Population and Development held on 3–4 September 2019 in Tunis, and the Nairobi Summit on ICPD25 held on 12–14 November 2019 in Kenya.

ICPD is an integral part of the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) that highlights the importance of South–South cooperation (SSC) globally. In 1994, ICPD endorsed SSC as a key strategy for the implementation of its Programme of Action.Footnote 1 One of the important actions of the international community took for promoting and institutionalizing SSC is the establishment of Partners in Population and Development (PPD) by ten developing countries during the ICPD, and now PPD has become a worldwide recognized global inter-governmental organization of 27 developing countries from across Asia, Africa, Latin America, and the Middle East, representing 60% of the world population, and PPD has been playing a key role in promoting SSC in reproductive health, population and development in the framework of the ICPD.

At present, 83% of the world population is living in developing countries who have the same or similar challenges in population, reproductive health, and family planning, and share the same goal of implementing the ICPD and SDGs. Much progress has been made on SSC in population and reproductive health by experience sharing, strategic dialogue, capacity building, networking and transfer of technology. The experiences of SSC among the Southern countries, especially among the 27 PPD member countries in the past 25 years have proved that the SSC is an effective means in implementing the ICPD, MDGs and SDGs.

Though much progress and achievements have been made in the past 25 years, the ICPD Programme of Action remains as an “unfinished business”. The Declaration of the 52nd session of UN Commission on Population and Development held in April 2019 reaffirmed the importance of the implementation of ICPD Programme of Action for achieving the 2030 Agenda for Sustainable Development and pledged to undertake further actions to ensure its “full, effective and accelerated implementation”,Footnote 2 while the Tunis Commitments adopted by delegates from 27 developing countries, and representatives from United Nations Population Fund (UNFPA), UN Office for South–South Cooperation (UNOSSC) and other international organizations and academic institutions during the 16th International Inter-Ministerial Conference on SSC in Population and Development held in September 2019 reaffirmed the important role of SSC in this process.Footnote 3

The landscape of international development assistance in the current world has also changed significantly. The past few years have seen dramatic changes in the focus and aims of Official Development Assistance (ODA). Many of the development donors have reduced the size of the funding and the number of countries they provide funding for programmes. However, we also see some new opportunities for international development assistance, as some emerging economy countries, have become both international assistance recipient and provider countries. Chinese President Xi Jinping announced at UN General Assembly in New York in September 2015 that the Government of China would contribute USD 2 billion for South–South Cooperation towards the implementation of the 2030 Agenda for Sustainable Development. Indian government set up India-United Nations Development Partnership Fund in June 2017 to further deepen SSC for achieving 2030 SDGs.

The SSC has been playing increasingly important role in achieving the goals of the international development. The outcome document of the second High-level United Nations Conference on South–South Cooperation (BAPA + 40) held in Buenos Aires, Argentina on 20–22 March 2019, re-emphasized the role of SSC in achieving the 2030 Agenda for Sustainable Development.Footnote 4 As Dr Li Bin, the current Chair of PPD, said in her speech at the Ministerial Dialogue on SSC in Population and Development held in Beijing on 18 March 2013, “We are now in a golden age of South–South cooperation”. There is an immense wealth of knowledge to be shared among countries in the South, where innovations are being crafted to address the very particular challenges.Footnote 5

2 Progress and achievements

To review the implementation of ICPD Programme of Action in the past 25 years, PPD in cooperation with UNFPA conducted a survey on SSC among 17 developing countries in 2018. Based on the salient findings of the survey, some of the main progress and achievements on SSC are highlighted as follows:

2.1 SSC has become more institutionalized in the implementation of ICPD and SDGs

According to the SSC survey, more than 80% of PPD member countries had a national agenda for RH, population and development, considering the commitment of ICPD and SDGs. About 76% of the countries had policy or strategy to address the ICPD and SDGs issues. Majority of the countries had established a national focal wing which addresses population issues through SSC.Footnote 6 UN agencies and international organizations pay greater attention to SSC. UNFPA established the Inter-country Cooperation Office in 2017 for SSC issues, put SSC as a programming strategy in its strategic plan, and built SSC into its country programmes. With the financial support from China, Bangladesh and other PPD member countries, PPD constructed its own six-storied office building in 2018, which laid a solid foundation for sustainable development of PPD and SSC in population and reproductive health.

2.2 International Inter-ministerial Conference (IIMC) on SSC in population and development has become an important global platform for experience sharing and policy dialogue

This annual global event which has been jointly conducted consecutively in the past 16 years by PPD, UNFPA and Southern countries, offering a unique opportunity to debate on critical and emerging issues in population and share solutions to accelerate the implementation of the global population and reproductive health-related objectives including ICPD Programme of Action. The first Conference was grandly held on 7–9 September 2004 in Wuhan, China, on the occasion of the 10th anniversary of ICPD.

2.3 Human resource development and capacity building are one of the main modalities for SSC

Southern countries like China, India, South Africa, Indonesia, Egypt, Brazil and others have made remarkable progress in providing both long-term and short-term training programmes for other developing countries. For instance, over the past 5 years, PPD and its member countries have provided over 2900 short-term training fellowships in the field of population and reproductive health. The training mainly focuses on population and sustainable development, reproductive health and family planning, women’s and children’s health, and HIV/AIDS prevention and control, population projection and sampling surveys, etc (see footnote 6).

2.4 SSC leverages on the wealth of intellectual and programmatic capacity through documentation and replication of good practices

According to the SSC survey in 2018, about 26 series of good practices in population and reproductive health have been jointly published by PPD, UNFPA, UNDP, UNOSSC and Southern countries in last 10 years. A series of international conferences, forums and seminars including China–Africa Conference on population and development have been conducted in recent years to exchange and disseminate success experience of developing countries in the field of population and reproductive health. SSC Roundtable which was first launched at the First International Conference on Family Planning (ICFP) in Kampala, Uganda on 15–18 November 2009, organized by Bill & Melinda Institute for Population and Reproductive Health and others partners, has been more and more influential, with the most recent one held during the ICFP in Kigali, Rwanda on 12–15 November 2018.

2.5 Technology transfer and commodity exchange in reproductive health is another area where SSC has made remarkable progress

The Government of China has donated several million worth of reproductive health medical equipment and supplies to some other developing countries. The Government of India contributed USD 1.2 million to construct 36 community clinics in rural Bangladesh to facilitate health care services to the hard-to-reach population. China Population and Development Research Center (CPDRC) with the technical assistance from UN Population Division and UNFPA developed PADIS-INT, a web-based population project software, and made it available to all developing countries for free use. A number of developing countries made bilateral agreements on the free flow of the life-saving medicine for maternal and child health.

2.6 SSC has contributed a great deal towards the achievement of ICPD and MDGs

Take PPD member countries for example, they have achieved better results in comparison with other Southern countries in terms of progress towards ICPD and MDGs. Over the past 25 years, the total fertility rates in PPD member countries kept dropping between 1994 and 2018 and will further decrease to replacement level by 2030. The maternal mortality rates fell by almost half between 1994 and 2018, and these PPD member countries are fully committed to achieve “three zeroes” by 2030, i.e., “zero unmet need for family planning information and services, zero preventable maternal deaths, zero sexual and gender-based violence and harmful practices against women and girls”. These commitments were reinforced with great consensus of participants during the Nairobi Summit on ICPD25 held on 12–14 November 2019 in Kenya.Footnote 7.

3 China and South–South Cooperation

China has been always actively advocating and participating in SSC, and the Chinese government recognizes SSC as an important means for achieving the Sustainable Development Goals (SDGs). On 26 September 2015, the High-Level Roundtable on South–South Cooperation was co-hosted by the Chinese government and United Nations during the UN General Assembly in New York.

To institutionalize SSC and make it more sustainable, China established the Institute of South–South Cooperation and Development (ISSCAD) at Peking University in April 2016, established the South–South Cooperation Assistance Fund (SSCAF) in 2017, and set up China International Development Cooperation Agency (CIDCA) in March 2018 with the key mandate for promoting and coordinating SSC.

In the population and reproductive health, some of the main progress and achievements in SSC made by China are highlighted as follows:

3.1 China has hosted a number of high-level international conferences and seminars on SSC for experience sharing and policy dialogues

The most significant ones include the High-level Consultation Meeting on Up-scaling South–South and Triangular Cooperation held from 30 November to 1 December 2014 in Taicang, China, with the Taicang CommitmentsFootnote 8 as an outcome document on SSC. Another important event is the Ministerial Dialogue on South–South Cooperation in Population and Development held on 18 March 2016 in Beijing, China, with an outcome document Beijing Call for Action,Footnote 9 and in response to which, the Population and Development South–South Cooperation Centre of Excellence was set up at China Population and Development Research Center (CPDRC) on May 15, 2017, and China–Africa Conference on Population and Development was first established in 2017 and has been conducted annually, with the latest and the third Conference held in Accra, Ghana in June 2019.

3.2 China has become the largest SSC training providing country

Chinese government is currently providing training on population and reproductive health to over 400 policy makers, programme managers and service providers from other developing countries each year.

China Training Center of Reproductive Health and Family Care (CTC) alone is providing SSC training for over 100 participants from other developing countries annually. China has trained more than 4000 people from other developing countries between 2010 and 2019, which are fully funded by the Chinese Government.

3.3 Chinese government has signed and implemented a number of MOUs on SSC in population and reproductive health

In 2009, a special national budget line for South–South cooperation in population was set up at former National Population and Family Planning Commission of China (NPFPC). In recent years, China is shifting from an international assistance recipient country into a both assistance recipient and provider country. Quite a number of SSC projects for reproductive health and population funded by the Chinese Government have been carried out in other developing countries, especially in African countries. The innovation project for maternal and child health with the assistance of RMB 13.81 million (USD2.00 million) from the Chinese government was successfully implemented in six African countries and two Asian countries, namely Sierra Leone, Ghana, Cape Verde, Ethiopia, Malawi, Zimbabwe, Nepal and Cambodia during 2016–2017. The most recent SSC agreements were signed between China SSCAF and PPD and UNFPA respectively in December 2019 and in January 2020 to carry out SSC projects in Bangladesh, Sierra Leone, Zimbabwe and Mozambique with a purpose of improving reproductive health and reducing maternal mortality.

3.4 China has been an active member of PPD for SSC

China joined PPD in November 1997, is current the Chair country (2015–2020) of PPD, and was also the Chair country during the years of 2002–2007. China and the PPD successfully implemented the MOU on SSC (2006–2010); PPD China Programme Office was established in May 2006. The Chinese government donated USD2.3 millions for the PPD Office building construction during 2014-2018. Ever since China joined PPD, China and PPD have jointly organized a number of high-level international conferences, seminars and workshops on SSC. In 2018, China South–South Cooperation Assistance Fund (SSCAF) enlisted PPD as a unique inter-governmental organization of SSC in population in its roll-out of SSC projects. The next Inter-Ministerial Conference on SSC in Population and Development is expected to be hosted by China during the second half of 2020.

3.5 China has contributed to the progress in ensuring the RH commodity security

In the past 15 years or so, the Chinese government has donated RH commodities and medical equipment valued at more than USD 3 million to other developing countries, in addition to medical supplies and equipment donated for MCH. China has also donated over USD 1 million worth of contraceptives to other developing countries. Ever since 2016, Mifepristone, Misoprostol produced by Beijing Zizhu Pharmaceutical Company and Levoplant/Sino-implant(II) produced by Shanghai Dahua Pharmaceutical Company have obtained WHO Pre-qualification, which is milestone progress, providing better conditions for SSC with regard to RH commodity security in other developing countries.

4 Experience gained and challenges facing

By reviewing the implementation of SSC in the past 25 years, especially in recent years, the followings may be considered as valuable experience gained:

4.1 Political commitment is vital to the SSC

The evidence has shown that where there is a strong political commitment, there is more active SSC programmes, and this suggests that more effective advocacy should be put on the first priority for promoting SSC, especially among the policy makers at national and global levels.

4.2 A capable national focal points or task-force is one of the key determinants for effective and productive SSC

Evidence shows that countries who have made most remarkable progress in SSC are those who have invested in dedicated national SSC focal points and focal persons. The global SSC movement in population and reproductive health has benefited a great deal from the contribution and wisdom of these national focal points and focal persons ever since its initiation in the late 1970s. Capacity building is essential for national SSC focal persons.

4.3 Partnerships between government departments and Non-government organizations (NGOs) are important for promoting SSC

As the issue on population and development is a very complicated one, no single government or organization could achieve the goal by itself. While governments play a leading role, the active multiple partnership is essential for SSC. Governments and international organizations should consider making more commitments to SSC in the field of population and development, particularly emerging issues such as low fertility and ageing, youth development for harnessing the demographic dividend, health and poverty alleviation, SRH and FP services in hard-to-reach areas, sexual and gender-based violence, humanitarian and conflict situation and big data utilization (see footnote 6).

4.4 The principle of SSC established 40 years ago is still relevant and valid

The outcome document of the Second United Nations High Level Conference on South–South Cooperation in March 2019 emphasized that “SSC should continue to be guided the principle of respect for national sovereignty, national ownership and independence, equality, non-conditionality, non-interference in domestic affairs and mutual benefit”. “SSC should not be seen as Official Development Assistance”, and “SSC is not a substitute for but rather a complement to, North–South cooperation” (see footnote 4). SSC may be characterized by demand-driven and ownership-oriented. A win–win approach could make the SSC more sustainable.

4.5 Establishment of the SSC Center of Excellence is an effective method to advance SSC

It is essential to establish SSC Centre of Excellence in developing countries for effective knowledge management, research, innovation, networking, and scaling up good practices for translating the agendas of ICPD and SDGs into policies and programmes.

According to the 17-country SSC survey report, despite tremendous progress made in recent years, some critical challenges remain that have undermined the potentials of SSC.

The main challenges include: lack of well-defined national policies that need to be invigorated through national commitment; lack of harmony on implementation of the recommended SSC policies; lack of the combined efforts of the different actors and their capacities and resources; lack of knowledge and skill of national SSC focal points and persons; insufficient national budget allocation and donors priority funding for SSC; lack of strategic framework that promotes the role of SSC as an instrument for achieving of ICPD and SDGs 2030 Agenda; limited documented information on South–South success stories, and lack of sufficient tools to measure and evaluate SSC (see footnote 6).

The other main challenges of SSC are: institutionalization and operationalization of SSC; translating SSC into specific programmes and policies; improving capacity for documentation of good practices, and adaption and replication into the recipient country context; establishing SSC coordination mechanism at the national, regional and global levels; mobilizing more financial resources for SSC; and national level institutional and individual capacity building for SSC. These challenges need to be overcome to make SSC fully functional (see footnote 6).

According to Bali Call for Action, an outcome document of the 15th International Inter-Ministerial Conference on SSTC held in Bali, Indonesia on 18–20 September 2018,Footnote 10 and the Tunis Commitments, an outcome document of 16th International Inter-Ministerial Conference on SSC in Population and Development held on 3–4 September 2019 in Tunisia (see footnote 3), the followings are identified as priority areas for SSC: (1) population dynamics and development; (2) universal access to reproductive health and family planning services; (3) women’s chidren’s and adolescent’s health; (4) healthy ageing; (5) migration; and (6) health and poverty alleviation; and (7) ending sexual and gender-based violence. Among these priorities for SSC, some are long-standing ones and some are emerging ones.

5 Considerations and recommendations

The 25th anniversary of the ICPD Programme of Action served a milestone platform for reviewing the progress, identifying the challenges and developing the future strategies for SSC in population and development. Post-Nairobi Summit is a very critical time period for SSC with both opportunities and challenges. Learning from the recent ICPD + 25 review and discussions, the following intervention efforts are recommended to make for deepening SSC in achieving the ICPD and the SDGs 2030 Agenda:

5.1 Further promote advocacy for more political commitments on SSC in population and development

The recent ICPD25 review exercises and the two surveys on SSC strongly suggest that there is still a great need for advocating and developing better understanding of the close inter-relationship between the population and sustainable development and importance to building SSC for fulfilling the goals of ICPD and SDGs. Compared with other social sectors, most SSC benefits in population and development are indirect and difficult to measure, and issues on population, family planning and reproductive health tend sometimes to be more politically sensitive. Hence, more political consensus and commitments, even among the alliance of population programme itself, are very much needed for greater advancement of SSC.

5.2 Strengthen the capacity building for the SSC national focal persons

The national focal persons are playing a key role in developing national SSC programme. More capable national focal persons could bring with more active and creative national SSC programmes. The result of SSC survey conducted by PPD in cooperation with UNFPA in 2018 (see footnote 3) shows the strong needs for capacity building of the national focal persons and hundred percent of the respondents strongly reiterated that “knowledge and skills are important and essential for becoming an efficient national focal persons for SSC”. UNFPA, PPD and other UN agencies involved in SSC could make more contributions in this regard.

5.3 Improve coordination and cooperation among various stakeholders for SSC

As the financial resources allocated to the SSC in population and reproductive health are quite limited, compared with other relevant sectors, the best way to make full use of those limited financial resources is to enhance coordination and cooperation among the stakeholders and partners. Coordinating groups at national, regional and global levels, officially or unofficially, is recommended to be set up. Sharing information and experiences and having coordination with each other is a good way to make more effective SSC programmes. Specific approaches or mechanism, not only general calls, for such coordination is needed.

5.4 Mobilize the required financial resources for SSC

Innovative approaches should be made to ensure national budget allocation and donors’ or international agencies’ priority for financing for SSC. Establishing and operationalising the National SSC Task Force and effective networking with research and training institutions and NGOs for identifying national level policy gaps and policy initiatives should also be a priority.

5.5 Accelerate the establishment and development of the Center of Excellence as an essential step for institutionalization and operationalization of sustainable SSC

To establish the Center of Excellence is to build a reliable task force for SSC. The role of the Center of Excellency can be not only a national task force to implement SSC activities but also to build partnership and networks with other stakeholders and partners. UNFPA and PPD are expected to provide technical assistance in this regard such as standard establishment, capacity building, partnership building and networking of SSC Centers of Excellence, and the governments are expected to provide its infrastructures, personal and financial resources.

5.6 Improve researches and evaluation on SSC

For more effective SSC, greater efforts need to be made to conduct more evidence-based researches, which may include the comparative advantages and innovative modalities of SSC, and appropriate linkages between South–South cooperation and North–South cooperation in population and development. Effective mechanism for monitoring and evaluating progress of SSC should be established at national and global level. Basic indicators such as national strategies, national task forces, regular national budget lines, and government-funded activities for SSC, as well as results indicators, could be established for monitoring and evaluation of SSC.