Open letter to Human Rights and Social Affairs commissions of the Brazilian Federal Senate on access to telemedicine abortion | Figo – FIGO.org

Report on Telemedicine Abortion and its Alignment with Sustainable Development Goals

Introduction: The Role of Telemedicine in Advancing Global Health and Equality

The FIGO Committee on Safe Abortion has issued a formal call to legislators globally, urging the withdrawal or opposition of regressive policies that restrict access to telemedicine abortion. This report analyzes the critical role of telemedicine in providing safe abortion care and its direct contribution to achieving several key Sustainable Development Goals (SDGs). Despite robust scientific evidence and recommendations from the World Health Organization (WHO), political efforts to limit this essential healthcare service threaten progress on global health, gender equality, and human rights.

Telemedicine Abortion: An Evidence-Based Approach to Healthcare

Telemedicine has been proven to be a safe, effective, and equitable method for providing abortion care, with outcomes comparable to in-person, facility-based services. Its key benefits include:

• Safety and Timeliness: Provides timely access to care, which is crucial for health outcomes.
• Equity and Accessibility: Overcomes geographical and economic barriers, reducing unnecessary travel and costs for patients.
• Privacy and Confidentiality: Reduces the fear of stigma and discrimination associated with seeking abortion services.
• Autonomy and Empowerment: Empowers individuals to manage their reproductive health, supporting informed decision-making.
• Continuity of Care: Facilitates remote follow-up and support, ensuring a comprehensive care model.

Alignment with Sustainable Development Goals (SDGs)

Restricting access to telemedicine abortion directly undermines progress towards the 2030 Agenda for Sustainable Development. Safeguarding this service is essential for meeting the following goals:

SDG 3: Good Health and Well-being

Telemedicine abortion is a critical tool for achieving Target 3.7, which aims to ensure universal access to sexual and reproductive health-care services.

• It enhances access to safe abortion, a key component of comprehensive reproductive healthcare.
• By providing a safe alternative to in-person care, it helps reduce maternal mortality and morbidity from unsafe abortions.
• It promotes both physical and mental well-being by offering a private, less stressful method of care.

SDG 5: Gender Equality

Access to reproductive healthcare is fundamental to gender equality and the empowerment of all women and girls, as outlined in Target 5.6.

• Telemedicine supports bodily autonomy, allowing women to make decisions about their own reproductive lives.
• It removes systemic barriers to care, promoting equal access to health services regardless of location or socioeconomic status.
• Restricting access constitutes a regressive policy that disproportionately affects women and reinforces gender-based inequalities.

SDG 10: Reduced Inequalities

By its nature, telemedicine helps reduce inequalities in healthcare access (Target 10.2).

• It provides a vital service for individuals in rural or underserved communities.
• It mitigates financial barriers, making care more accessible to low-income populations.
• It ensures that marginalized groups can access confidential care without fear of discrimination.

Global Legislative Challenges

Despite the clear benefits and alignment with global development goals, a concerning trend of legislative restrictions on telemedicine abortion is emerging worldwide. Notable examples include recent or ongoing efforts in:

• Great Britain
• The United States
• Brazil

These actions contradict the global scientific consensus and international human rights obligations, posing a significant threat to public health and gender equality.

Call to Action for Global Legislators

In line with its commitment to promoting the highest standards of health and wellbeing, the FIGO Committee on Safe Abortion calls on legislators and governments to take the following actions:

1. Oppose and Withdraw Regressive Policies: Actively oppose and repeal any bills or policies that limit or ban access to telemedicine abortion.
2. Uphold Evidence-Based Healthcare: Align national health policies with the robust scientific evidence and WHO recommendations that support telemedicine for abortion care.
3. Honor Human Rights Obligations: Safeguard the right to health and bodily autonomy by ensuring access to a full spectrum of reproductive healthcare services.
4. Advance the Sustainable Development Goals: Recognize that protecting access to telemedicine abortion is integral to achieving commitments related to health, gender equality, and reduced inequalities.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article on telemedicine abortion connects to several Sustainable Development Goals (SDGs) by focusing on health, gender equality, and institutional justice.

• SDG 3: Good Health and Well-being: The core of the article is about ensuring access to safe abortion care, which is a critical component of sexual and reproductive health. It emphasizes that telemedicine provides “safe, timely and equitable access to abortion care” and promotes “physical, mental, reproductive, and sexual health and wellbeing for all women.”
• SDG 5: Gender Equality: The article addresses gender equality by focusing on women’s reproductive rights and autonomy. It highlights how telemedicine “supports autonomy and informed decision-making, empowering women to manage their reproductive health on their own terms.” Restricting this access is a matter of gender inequality as it disproportionately affects women and their ability to control their own bodies and lives.
• SDG 10: Reduced Inequalities: The article points out that telemedicine promotes “equitable access” to healthcare. It reduces inequalities by overcoming barriers such as distance and cost (“reducing unnecessary travel and costs”) and by offering privacy that mitigates the fear of stigma or discrimination, which often affects marginalized groups more severely.
• SDG 16: Peace, Justice and Strong Institutions: The article makes a direct appeal to “legislators” and “governments” to create just and effective policies. The call to “withdraw or oppose regressive bills and policies,” “align with the global scientific consensus,” and “honour their international human rights obligations” is a call for strong, accountable, and just institutions that uphold evidence-based laws.

2. What specific targets under those SDGs can be identified based on the article’s content?

Several specific SDG targets are relevant to the issues discussed in the article.

1. Under SDG 3 (Good Health and Well-being):
   • Target 3.7: “By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.” The article’s entire focus on ensuring access to safe abortion care via telemedicine directly supports this target.
   • Target 3.8: “Achieve universal health coverage, including financial risk protection, access to quality essential health-care services…” The article describes telemedicine as a method to provide safe, evidence-based abortion care that is more accessible and reduces costs, which are key elements of achieving universal health coverage.
2. Under SDG 5 (Gender Equality):
   • Target 5.6: “Ensure universal access to sexual and reproductive health and reproductive rights…” The call to oppose bills that limit abortion access is a direct effort to protect reproductive rights. The article frames access to abortion as a fundamental right that empowers women and supports their autonomy.
3. Under SDG 10 (Reduced Inequalities):
   • Target 10.3: “Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices…” The article calls for the withdrawal of “regressive bills and policies,” which can be considered discriminatory as they create unequal access to essential healthcare for women.
4. Under SDG 16 (Peace, Justice and Strong Institutions):
   • Target 16.b: “Promote and enforce non-discriminatory laws and policies for sustainable development.” The appeal for legislators to “uphold evidence-based policies” and reject restrictions on reproductive healthcare is a call to enforce non-discriminatory laws and policies in the area of health.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

The article implies several indicators that can be used to measure progress, primarily related to policy and access.

• Legal and Policy Frameworks: The article directly points to the status of legislation as a key indicator. Progress can be measured by tracking the number of countries or states that have “regressive bills and policies” versus those that have laws permitting and safeguarding access to telemedicine abortion. The mention of Great Britain making telemedicine permanent in 2022 is a positive indicator, while attempts to ban it there and in the US and Brazil are negative indicators.
• Access to Services: An implied indicator is the level of access to safe abortion care. The article states that telemedicine provides “safe, timely and equitable access.” Therefore, measuring the proportion of the population that can access abortion services through telemedicine would be a direct indicator of progress towards Target 3.7.
• Alignment with Scientific and Human Rights Standards: The article urges governments to “align with the global scientific consensus” (referencing the WHO) and “honour their international human rights obligations.” An indicator of progress would be the degree to which national health policies on abortion reflect recommendations from international bodies like the World Health Organization and adhere to human rights conventions.

4. Summary Table of SDGs, Targets, and Indicators

Source: figo.org