A/HRC/47/38 ideological opposition to abortion as a lynchpin. The sexual and reproductive health rights of women and girls, including the options to prevent and safely terminate an unwanted pregnancy, must be fully recognized and supported at all times in order to guard against profound violations of their bodily integrity and autonomy.96 More recently, some States have misleadingly alleged that proponents of gender equality are advancing a harmful “gender ideology”, to deepen and instrumentalize the ideological divide and undermine legally guaranteed protections.97 49. The adoption of the so-called “Geneva consensus declaration on promoting women’s health and strengthening the family” in 2020 is an example of the harmful mobilization of States with conservative and anti-women’s rights agendas to undermine the well-established and globally recognized human rights of women and girls. 98 The Working Group welcomes the sustained commitment of many States to upholding the sexual and reproductive health rights of women and girls through joint diplomatic statements. 99 9. Additional challenges in times of crisis 50. Crises bring additional challenges to health systems that are already deficient in the provision of essential sexual and reproductive health services, including the collapse of or reduction in the functioning of health infrastructure, public transportation, water, sanitation, waste management and other underlying determinants of access to health care.100 Breakdowns in health systems that reduce availability and access can give rise to a loss of privacy in health-care settings and deter women and girls from seeking sexual and reproductive health care. 51. The availability of services is often disrupted by the inability of health-care workers to provide services due the breakdown of the health system and violence that may be directed towards them. Combined with sudden disruptions in the supply chain, the poor management of barriers and gaps considerably deepens the impact of a crisis on the sexual and reproductive health of women and girls. 101 A militarized response to a crisis, such as by handing over the management of a natural disaster to the armed forces, can lead to increased threats and acts of violence against women and girls. 102 52. Measures imposed during a crisis often set back crucial progress made on the sexual and reproductive health rights of women and girls. It has been estimated that, due to COVID19 containment measures, 2 million cases of female genital mutilation, which would otherwise have been averted, are likely to occur over the next decade, and an additional 13 million child marriages could take place by 2030.103 Unplanned pregnancies are projected to increase by several million.104 A one-third reduction in progress towards ending gender-based violence by 2030 is expected. 105 An increase in disrespectful maternity care and cases of obstetric violence has been observed, alongside a reduction in antenatal and childbirth services.106 53. Situations of crisis may be exploited to restrict access for women and girls to certain reproductive health services. During the COVID-19 pandemic, a number of countries restricted access to abortion services and suspended the operations of mobile outreach teams 96 97 98 99 100 101 102 103 104 105 106 14 See also Working Group, “Women’s autonomy”. Working Group, “Gender equality and gender backlash”. See https://geneva.usmission.gov/wp-content/uploads/sites/290/GenevaDeclaration.pdf. The new Administration of the United States of America has distanced itself from the declaration. See www.government.nl/documents/diplomatic-statements/2019/09/23/joint-statement-on-srhr-inuhc. Submissions by Ipas Pakistan and ECKO Greece. See submissions by Ipas Pakistan and Refugee Commission. See submissions by Latsi Nu Women Agency and Global Justice Center. United Nations Population Fund (UNFPA), “Impact of the COVID-19 pandemic on family planning and ending gender-based violence, female genital mutilation and child marriage”, 2020. See https://news.un.org/en/story/2020/04/1062742. UNFPA, “Impact of the COVID-19 pandemic”. See Working Group’s statement of 20 April 2020; and submission by Global Respectful Maternity Care Council.