No country today—even those considered the wealthiest and most developed—can claim to be fully inclusive, where all people have equal opportunities and protections, and fully enjoy their human rights.

Among the internationally agreed human rights central to human well-being is the right to sexual and reproductive health. This right was endorsed by 179 governments in the 1994 Programme of Action of the International Conference on Population and Development. The Programme of Action stated that individual rights and dignity—including the equal rights of women and girls, and universal access to sexual and reproductive health and rights— are necessary for the achievement of sustainable development.

Many gaps remain in meeting these commitments, however. Some of the worst are among women and girls already marginalized by other forms of exclusion—most notably, poverty. In many developing countries, women who are poor, in the bottom 20 per cent of the income scale, and particularly those who are in rural areas, are far less likely to have access to contraceptives and to care during pregnancy and birth than their wealthier urban counterparts.

Among adolescents, who face the extra vulnerabilities associated with being young, those in the poorest 20 per cent of households in developing countries have about three times as many births as adolescents in the richest

20 per cent of households. Those in rural areas have twice as many births as their counterparts in cities.

The many facets of inequality

Inequality is often thought of primarily as a lopsided distribution of wealth or income. However, it is a more complex phenomenon, reinforced by diverse forms of disparity— between the sexes, between races and ethnicities, and between urban and rural residents.

Inequality has many facets, each a symptom— and cause—of some other inequality. Multiple inequalities tend to feed on each other, locking people in a downward spiral of deprivation and lost human potential. Although some people have opportunities and abilities to interrupt this damaging trajectory, many do not have enough of one or the other, or both.

In recent years, economic inequality between countries has begun to close. But, in many countries, it has worsened.