Message from the Director - continuing sexual and reproductive health and rights progress in turbulent times

We are living in a time when the promises that once grounded global cooperation are under strain, when power distorts, when rules bend and when a values‑based order feels increasingly negotiable. The consequences are visible across health systems: denied care, dismissed science, disrupted services and rights reduced to rhetoric. Health is treated as optional. Women’s bodies are contested. Children’s lives are at risk. In such a context, the work of advancing sexual and reproductive health and rights (SRHR) remains essential and urgently needed. 

Throughout this turbulent time, we must recalibrate to continue to progress. Our work has been guided by three concentric commitments that ground us. 

The first is our circle of concern: the shifting political and financing environment that deeply shapes outcomes but sits beyond our direct control. To navigate this volatility, we strengthened policy intelligence, expanded monitoring capacities and produced targeted analyses to support timely and informed decision‑making. 

The second is our circle of influence: the domain where collaboration can shift trajectories even under constraint. We intensified engagement with WHO regional and country offices, UN cosponsors, civil society and collaborating centres to align strategies, anticipate risks and preserve access to essential care in environments where policy space is narrowing. 

The third is our circle of control: the core work that defines our mandate to deliver rigorous evidence, setting global norms and standards and supporting countries to translate guidance into real‑world implementation. This is where scientific independence, technical excellence and accountability intersect. 

These commitments translated into clear achievements in 2025 documented in detail in our annual report. We consolidated the global guideline for the prevention, diagnosis and treatment of postpartum haemorrhage, establishing a unified standard for addressing the leading cause of maternal mortality. We released authoritative guidance on diabetes and sickle‑cell disease in pregnancy, closing consequential gaps in care quality. We launched the first global guideline on infertility, elevating a long‑neglected equity issue affecting millions. And we strengthened digital reliability by introducing a client‑facing content toolkit that equips health services to counter misinformation with accurate, accessible information. Together, these advances shift systems from fragmentation to clarity and from evidence to action. 

Recognizing that evidence alone does not change outcomes, we also invested in translation. Working with regional partners, we supported updates to minimum SRHR service packages and costed standards that enable more coherent budgeting, procurement and training. We contributed to improved measurement frameworks, updated maternal mortality estimates, and shared implementation stories that bring practical learning closer to frontline decision‑makers, including in humanitarian settings. These efforts help ensure that guidance is not only produced, but usable, scalable and anchored in accountability. 

The broader landscape remains challenging. Funding is more constrained, more fragmented and increasingly influenced by political conditionalities. While the push for expanded domestic financing is vital, many transitions are occurring amid austerity and debt burdens. Without careful design, such shifts risk redistributing vulnerability rather than addressing it, forcing an unnecessary choice between investment in SRHR and other health priorities, between commitment to prevention and acute response, and across already marginalized populations. At the same time, growing interest in private‑sector engagement presents both opportunity and risk. Clear guardrails are essential: alignment with rights‑based public health goals, transparency in financing, protections against exclusion and a firm expectation that private engagement must strengthen, rather than replace, public systems. 

A central concern moving forward is the widening gap between the evidence that exists and the realities it must speak to, particularly in fragile and conflict‑affected settings, where needs are highest and data are most limited. The task ahead is therefore one of precision, selectivity and discipline: focusing on evidence that protects access, upholds rights and delivers impact even under constraint. This includes safeguarding scientific independence, investing in research capacity and leadership in low‑ and middle‑income countries, and ensuring that every guideline and tool is designed for practical application in the contexts where stakes are greatest. 

These achievements, and the challenges we must confront, underscore the importance of partnership. The collective efforts of Member States, civil society organizations, professional associations, and our UN cosponsors: UNDP, UNFPA, UNICEF, WHO and the World Bank (including the Global Financing Facility), remain vital to sustaining technical rigor, independence and global reach. 

In a time where the global environment is uncertain, what we see here is clarity of purpose. Our commitment is clear: to deepen partnerships, scale impactful research and strengthen translation into policy and practice so that SRHR remains central to health, rights and equity worldwide. Despite the pressures of the past year, we have shown that progress is possible.  

We are part of a community that is serious about science, anchored in rights and committed to impact. I am confident because the collective commitment is strong. The way forward is to expand what can be achieved by standing firmly with science, insisting on rights and acting with integrity where it matters most.