Experts Warn U.N. Merger Plan Puts Global Reproductive Health Rights at Risk

As heads of state and diplomats converge on New York for the 81st session of the United Nations General Assembly, an international group of experts is using the moment to raise an alarm about the future of sexual and reproductive health and rights (SRHR). Writing in a special collection published by The BMJ, they argue that a proposed merger of U.N. Women and the U.N. Population Fund (UNFPA) would weaken global commitments to gender equality by folding two institutions that have long anchored reproductive health work into a single, less focused entity.

The collection was developed in partnership with the CUNY Graduate School of Public Health & Health Policy (CUNY SPH) and brings together contributors from law, medicine, public health and political science. Across seven articles, the authors map a set of overlapping pressures — shifting U.S. policy, declining multilateral cooperation, deep funding cuts and an expanding anti-rights movement — and put forward practical proposals for building SRHR systems that are more resilient, equitable and accountable.

Why the Proposed Merger Is Drawing Scrutiny

U.N. Women and UNFPA are described in the collection as vital institutions for protecting sexual and reproductive health and rights, and the authors contend that combining them would dilute the specialized mandate each currently carries. UNFPA's work is closely tied to population and reproductive health programming, while U.N. Women focuses on gender equality and the empowerment of women and girls. The concern raised by the contributors is that a merged body would have less capacity — institutionally and politically — to hold governments to existing commitments.

The stakes are broad. According to the collection, SRHR encompasses access to contraception, safe and effective care during pregnancy and birth, and relationship education. Those services are framed not as a niche concern but as fundamental to health, gender equality and wider development. When commitments to them weaken, the authors suggest, the consequences ripple outward into national health systems, economies and the rights of individuals to make decisions about their own bodies and lives.

Seven Articles, One Shared Argument

The collection is deliberately multidisciplinary, pairing legal analysis with health policy, fiscal expertise and political science. Its contributors include scholars, advocates and practitioners who have worked directly on multilateral negotiations and civil society organizing. The papers are:

• "Reimagining multilateralism for global sexual and reproductive rights," by Clarisa Bencomo, Terry McGovern and Oriana López Uribe
• "Civil society resistance to anti-rights mobilization," by McGovern, Amy Meng, Maeve O'Rourke and Rima Athar
• "New York state resistance to federal regression of sexual and reproductive rights," by Danielle Greene, Diana Romero and Holly Farkas
• "International fiscal architecture for advancing sexual and reproductive health and rights," by Attiya Waris, Juan Pablo Bohoslavsky, Gorik Ooms and Rachel Hammonds
• "Central role of civil society in advancing sexual and reproductive health and rights," by Jaime M. Gher, Dana Zhang, Nana Abuelsoud and Naureen Shameem
• An opinion piece titled "United Nations reform must protect sexual and reproductive health and rights," by McGovern
• An editorial titled "Confronting financial and political headwinds against global sexual and reproductive health and rights," by Chelsea Clinton

In her editorial marking the launch, Clinton — vice chair of the Clinton Foundation and the Clinton Health Access Initiative — frames the moment as one in which financial and political forces are converging against the global SRHR agenda. Her contribution sets the tone for the collection: acknowledgement of real headwinds, paired with an argument that retreat is not inevitable.

Funding Cuts, Shrinking Cooperation and an Organized Opposition

The collection situates the merger proposal within a broader deterioration of the environment in which global health and rights work happens. Contributors point to U.S. policy shifts as one driver, alongside declining multilateral cooperation and deep funding cuts that have strained the organizations delivering reproductive health services.

At the same time, the authors describe an expanding anti-rights movement that has become more coordinated in its efforts to roll back sexual and reproductive health protections. Rather than treating these trends as separate problems, the collection presents them as mutually reinforcing: reduced financing weakens institutions, weakened institutions struggle to counter organized opposition, and diminished multilateral cooperation leaves fewer venues in which rights commitments can be defended.

Civil Society as a Counterweight

Several papers center on civil society, arguing that grassroots and advocacy organizations have become essential to preserving access to services when formal institutions falter. The authors examine how these groups have resisted anti-rights mobilization and how their role has shifted from supplementing government programs to filling gaps left by them. The collection also considers what civil society needs — resources, legal space and international allies — to sustain that work.

Resistance Closer to Home

One contribution narrows the lens to New York state, examining how subnational governments can push back against federal regression on sexual and reproductive rights. The article treats state-level policy as a laboratory for resistance, suggesting that jurisdictional differences may become increasingly important as national positions diverge. The authors also highlight the practical challenges of protecting access when funding and regulatory authority are contested across levels of government.

Rethinking the Money Behind Global Commitments

A separate paper tackles what the collection calls international fiscal architecture — the rules, institutions and financing arrangements that determine whether SRHR commitments are backed by actual resources. The authors argue that the current system leaves reproductive health programming vulnerable to political shifts and short-term budget decisions, and they explore structural alternatives aimed at making funding more predictable and accountable.

Read together, the seven articles move from diagnosis to prescription. They consider how multilateralism itself might be reimagined for sexual and reproductive rights, how fiscal mechanisms could insulate services from political volatility, and how accountability can be strengthened so that governments are answerable for the commitments they make at forums such as the General Assembly.

Launch and the Road Ahead

The collection was introduced at a special event in Manhattan on Sept. 15, 2026, timed to precede the UNGA 81 proceedings. By publishing during the assembly's opening, the contributors appear to be aiming directly at the delegations, ministers and negotiators who will shape the future of both U.N. Women and UNFPA.

What the authors are asking for is not simply the preservation of two agencies. Their argument is that the architecture of global reproductive health governance — the treaties, funding streams, monitoring mechanisms and advocacy networks built over decades — is only as strong as the institutions and political will behind it. As the merger proposal advances and multilateral cooperation continues to fray, the collection serves as both a warning and a set of blueprints for those who believe access to contraception, safe pregnancy and birth care, and relationship education should remain a global priority rather than a negotiable one.

This article is based on reporting by Medical Xpress. Read the original article.