Recommendation 1: Ensure Access to Sexual Health Services for All
- Make Health Canada’s Sexual and Reproductive Health Fund permanent, A-based funding.
- Invest in universal cost coverage for contraception.
- Implement a no-exclusions regularization program granting full and permanent immigration status.
- Revise Canada’s National Housing Strategy.
- Increase the amount of Canada’s international assistance that is dedicated to ensuring access to contraception, safe abortion, and comprehensive sexual health education.
Recommendation 2: Address Rising Mis and Disinformation
- Create an ongoing system within Health Canada to monitor and counter misinformation on sexual health.
- Invest in an ongoing national sexual health survey.
- Create a national strategy to advance the quality of Canada’s sexual health education.
Recommendation 3: Sustain Enabling Environments for the Protection and Advancement of Sexual Rights
- Create a sustainability fund for feminist and gender justice organizations in Canada.
- Increase investments in Canada’s human rights accountability infrastructure.
- Increase Canada’s overall international assistance.
Action Canada for Sexual Health & Rights[1] is a charitable human rights organization committed to advancing sexual and reproductive health and rights (SRHR)[2] in Canada and globally through policy advocacy, research, and health promotion.
Investing in sexual and reproductive health and rights is crucial for upholding a free and democratic society. By fostering an enabling policy environment that empowers individuals to make informed decisions about their bodies and reproductive choices, we promote a more just and equitable society that respects and protects the rights of all its members. In a global context where human rights and gender equality are under increasing attack, it is essential for Canada to remain clear, firm, and strategic in its investments in sexual and reproductive health and rights domestically and internationally.
Ensuring universal access to sexual and reproductive health information, education, services, and supplies will improve public health outcomes, reduce financial and structural pressures on the health care system, and contribute to narrowing the gap in health disparities among different populations. Investments in SRHR advance gender equality, support social cohesion, and increase educational attainment and economic participation.
In Budget 2024, we recommend that Canada make a series of concrete investments to: (1) ensure access to sexual health services for all (2) address rising mis and disinformation and (3) sustain enabling environments for the protection and promotion of sexual rights.
Recommendation 1: Ensure Access to Sexual Health Services for All
Investing in sexual and reproductive health services is cost-saving for the healthcare system. Sexually transmitted and blood-borne infections (STBBIs), unintended pregnancy, and sexual offences cost Canada over $6 billion annually[3]. Investments in proactive measures can significantly reduce this unnecessary spending. The Sexual and Reproductive Health fund, announced in Budget 2021 and renewed in 2023, has made a significant impact. It supports abortion care, centers Two-Spirit and Indigenous experiences, and promotes sexual health for Autistic youth. For example, Action Canada’s Access Line phone and text service supported over 3,000 callers from 2021 – 2022, 70% of whom faced major barriers to accessing abortion services[4]. Many callers who access our emergency financial assistance are from smaller, rural, and remote areas. They are disproportionately people of low socio-economic status, youth, racialized, facing intimate partner violence, coping with substance use disorders, living with disabilities, homeless, or in precarious immigration status[5]. Making the Sexual and Reproductive Health fund permanent A-based funding is crucial to avoid leaving marginalized groups without essential services.
Universal contraceptive coverage in a national pharmacare system is an evidence-based and cost-effective measure that allows for better family planning, a decrease in the number of unintended pregnancies, and improved social and economic outcomes for people who can be pregnant. Right now, about 46%[6] of pregnancies in Canada are unintended. The annual cost of investing in universal contraception coverage is estimated to be $157 million[7], and the savings are projected to be $320[8] million in direct medical costs generated by unintended pregnancy. Studies have shown that providing universal contraception coverage could see that entire amount saved in as little as six to twelve months[9].
Social determinants like immigration status and housing affect access to sexual health care. Migrants face barriers in accessing sexual health care due to lack of accessible information, migration status, isolated living and working conditions with poor labor protections, limited transportation, and exclusion from the public health system. Budget 2024 must guarantee the provision of sexual healthcare to undocumented people and migrant workers through a no-exclusions regularization program granting full and permanent immigration status.
Similarly, people without stable homes face multiple barriers to accessing sexual health services, including abortion. Experiencing homelessness puts an undue amount of stress on the body, leads to lack of sleep and improper nutrition, which can lead to an irregular menstrual cycle and delayed awareness of pregnancies. For many unhoused people, surgical abortion becomes the only option, but it's limited and often requires travel, creating significant obstacles to access. Universal access to sexual and reproductive health depends on fulfilling the right to housing. Budget 2024 should expand low-barrier SRH care and revise the National Housing Strategy to address dramatic increases to the cost of living, the unaffordability of market-based housing, and the lack of tenant protections against displacement.
Unsafe abortions are a leading cause of maternal death and disability globally. If all women in low- and middle-income countries (LMICs) used the most effective contraceptives and received proper care, unintended pregnancies, unsafe abortions, and maternal deaths would drop by about two-thirds[10]. Meeting all women’s needs for modern contraception, maternal and newborn care, abortion services and treatment for the major curable STIs would cost $69 billion annually for LMICs, representing a $31 billion (83%) increase over the current annual expenditures towards SRH care [11]. Canada’s 10-year commitment to women and children’s health is a critical step towards meeting these extensive needs. Additionally, the SheSOARS initiative to dedicate a minimum of 350m a year of Canada’s 700m/year SRHR funds towards the most neglected areas of SRHR is an important step forward. Canada must continue growing its portfolio in this area and leverage its investments to encourage other donor countries to step up.
SRH Fund
$20 million
Annually
Universal Contraception
$157 million
Annually
ODA to Neglected Areas of SRHR
Incremental increase from baseline of $350 million / year
Annually
Recommendation 2: Address Rising Mis and Dis Information
Technology can democratize access to sexual and reproductive health information and services in places where access is limited or impossible. However, anti-rights actors are exploiting digital tools to prevent people from exercising their rights, to spread misinformation, and to divide communities[12]. Technology facilitated mis- and dis-information is causing real and tangible harm including: causing delays for people seeking abortion services[13]; dissemination of dis-information on the health risks of abortion, contraception and gender affirming care[14]; and the proliferation of misogynist, racist and anti-2SLGBTQ+ stereotypes and hate speech that inspires physical violence[15].
Canada must counter SRHR mis- and dis-information through infodemic management[16] including the systematic publication and promotion of accessible SRHR information and resources on Health Canada’s website. The information and resources must be evidence based, rooted in human rights, inform people of their rights to access SRH services, and regularly updated to respond to emerging trends in mis-and dis-information.
Canada must also invest in upstream interventions like comprehensive sexuality education (CSE). Such interventions support young people to engage more critically with digital platforms, identify mis- and dis-information, develop communication skills and the confidence to use them, prevent gender-based violence, and improve sexual health outcomes among many other benefits. A national approach to CSE is needed now more than ever. Provinces have different curricula, there is no system to monitor delivery or results, and educators receive little to no training to offer CSE to their students. Canada has received several recommendations, including by UN Special Procedures and the UN Committee for the Rights of the Child, to address the discrepancies in access to CSE across jurisdictions. As a first step, the government should establish an expert working group to advise on a national strategy to ensure that all young people have access to CSE in line with the Canadian Guidelines for Sexual Health Education.
Finally, dis-information and mis-information on SRHR cannot be effectively addressed without disaggregated data and evidence. Budget 2021 allocated $7.6 million over 5 years for the development of a national sexual health survey. Now in its development phase, this initial investment needs to be increased by $3 million in 2024 and 2025 to allow for a larger sample size. Additionally, Canada must commit $8 million for the period of 2026-2031 for the next iteration of the survey.
Infodemic Management of SRHR Disinformation
$10 million
Annually
National Sexual Health Survey
$14 million
Across 7 years
National Sex Ed Strategy
$20 million
Across 5 years
Recommendation 3: Sustain Enabling Environments for the Protection and Advancement of Sexual and Reproductive Rights
Feminist movements have historically strengthened democracies worldwide[17]. In a 2022 joint statement on resilient democracies, Canada committed to “Protecting civic space, upholding transparent, accountable, inclusive and participatory governance, including by advancing women’s full, equal and meaningful participation and leadership in civic and political life.”[18] To fulfill this commitment, investing in Canadian feminist organizations is crucial. Government must explore the potential of an external long-term sustainability fund for feminist and gender justice organizations in Canada.
Additionally, Canada's human rights infrastructure needs improvement, evidenced by the lack of outcomes from the 2023 Forum of Ministers responsible for Human Rights. As Canada campaigns for a seat on the UN Human Rights Council, our legitimacy as a champion of human rights is at serious risk if swift action is not taken. As an immediate step, the Government must build up the human resource capacity within the Department of Heritage and convene stakeholders and experts from the Office of the UN High Commissioner for Human Rights to develop a road map for a re-envisioned human rights infrastructure.
In a time of concurrent global crises, Canada must also play its part in supporting a more peaceful and just world through its international assistance. Budget 2023’s reduction in the overall international assistance envelope was a shock for Canadians and global partners. Canada must make good on its 2021 promise to increase the international assistance budget every year, starting by scaling up to reach $10 billion by 2025.
Increased International Assistance
Annual increase to meet $10 billion by 2025
Annually
[1] For more information, contact: Kelly Bowden, Director of Policy kelly@actioncanadashr.org
[2] Sexual and reproductive health and rights (SRHR) encompasses the full range of human rights related to sexuality, gender and reproduction, including sexual and reproductive health. SRHR is premised upon the human rights of all persons to make free and informed decisions about their sexual and reproductive lives without violence, coercion, and discrimination. SRHR includes not only the absence of illnesses, but also physical, emotional, mental, and social well-being related to sexuality and reproduction. Addressing the full range of SRHR needs of all people throughout their lives is essential to ensuring a just society and fulfilling everyone’s right to life, health, equality, and a life free from discrimination.
[3]Sex Information and Education Council of Canada (SIECCAN). Questions & Answers: Sexual Health Education in Schools and Other Settings. 2020, p. 38. https://www.sieccan.org/_files/ugd/1332d5_6506a2c46aba4bb2927143fda80ca…
[4] Action Canada for Sexual Health and Rights. Annual Report, 2021 – 2022. p. 7. https://www.actioncanadashr.org/resources/reports-analysis/2022-12-06-a…
[5] Action Canada for Sexual Health and Rights, and National Abortion Federation Canada. (2022). Trends in barriers to abortion care. https://www.actioncanadashr.org/resources/reports-analysis/2022-12-14-t…
[6] Bearak J, et al. Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015 – 2019. BMJ Global Health. 2022: 7(3).
[7] Morgan, S.G., Law, M., Daw, J.R., Abraham, L., & Martin, D. Estimated Cost of Universal Public Coverage of Prescription Drugs in Canada. CMAJ. 2015:187(7)
[8] Black, A.Y., Guilbert, E., Hassan, F., et al. The Cost of Unintended Pregnancies in Canada: Estimating Direct Cost, Role of Imperfect Adherence, and the Potential Impact of Increased Use of Long-acting Reversible Contraceptives. J Obstet Gynaecol Can. 2015:37(12).
[9] https://www.accessbc.org/_files/ugd/9fd619_5e84ed1e331649c199007a5081c2…
[10] https://www.guttmacher.org/fact-sheet/investing-sexual-and-reproductive…
[11] Ibid
[12] https://privacyinternational.org/long-read/3669/documentation-data-expl…
[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196890/
[14] https://www.arcc-cdac.ca/media/crisis-pregnancy-centres/cpc-website-rev…
[15] https://www.cbc.ca/news/canada/kitchener-waterloo/emergency-alert-unive…
[16] https://www.who.int/health-topics/infodemic#tab=tab_2
[17] https://www.foreignaffairs.com/articles/china/2022-02-08/women-rights-r…
[18] https://www.international.gc.ca/news-nouvelles/2022/2022-statement-g7-d…