Dr. Kanem’s three zeros agenda and its global impact on women’s health
Dr. Natalia Kanem, Having served as an Executive Director of the United Nations Population Fund (UNFPA) between 2017 and 2025, she guided the organization through a time of great change in the world. Her leadership was characterized by the so-called Three Zeros agenda which was positioned as a strategic objective that by 2030, zero preventable maternal death, zero unmet need of family planning, zero gender-based violence and harmful practices.
This was above an institutional vision. It was a human right-based appeal to move power in the direction of women and girls. This was her plan of altering systems that were declaring life threats on people daily and mostly in the poor and most unstable parts of the world.
The term of Kanem coincided with the pandemic of COVID-19, the increase in conservative thinking around the world and the severe lack of funds. All these issues determined the way the Three Zeros were adopted, evaluated, and felt in 2025.
Zero Preventable Maternal Deaths: Progress and Uneven Gains
Global maternal mortality trends
Decreasing maternal deaths was one of the fundamental problems the UNFPA encountered. By 2025 the number of premature women who are dying as a result of the complications related to pregnancy and childbirth is estimated at approximately 287,000 per year, with the majority dying in low-income countries. The programs implemented by UNFPA under Dr. Kanem contributed to an increase in access to emergency obstetric care in such regions as sub-Saharan Africa and Southeast Asia.
In Rwanda, maternal mortality decreased by 18% since 2018, and this is rather affected by community health initiatives facilitated by UNFPA. On the contrary, war-tired nations, including Yemen and South Sudan, have registered either no improvement or soaring maternal death cases because of collapse of health infrastructure.
Infrastructure and resource barriers
Nonetheless, serious obstacles still exist. A lot of areas are still deprived of well-trained health personnel, systematic referrals, and provisions. The COVID-19 came with even more pressure as the lockdowns took away services and repurposed resources toward pandemic management.
Kanem would talk a lot about these institutional failures. In a speech before the UN in 2024, she said that no woman must die giving life and that the only way to get this done was ensuring not only investments in hospitals, but also in roads, training and social support systems.
Zero Unmet Need for Family Planning: Expanding Access Amid Backlash
Family planning as basic health
Under Dr. Kanem’s leadership, the UNFPA positioned access to contraception not just as a health service, but as a human right. Millions of women were reached through campaigns and partnerships with national governments. The agency helped supply contraceptives to clinics in over 120 countries.
Such programs as UNFPA Supplies were further developed, offering an alternative to women in remote regions, who have never had it before. As an illustration, in Ethiopia, the use of modern contraceptives among married women improved by a rate of 40 percent in 2017 to 53 percent in 2025.
The 2025 funding crisis and political resistance
Even though there were these gains the zero unmet need had remained elusive. In 2025, there was a big blow after the USAID scale back its funding on reproductive health, citing changes in domestic policy. Competing crises in the world led to the reduction in other donors.
There was also political opposition that became stiff. In Poland, Hungary, and in some areas in Africa, leaders of the countries publicly opposed family planning programs as they were acts of foreign influence into country affairs. The social media misinformation further undermined the trust in reproductive health services.
It is worth noting that Dr. Kanem, in most of her speeches, always stressed that
“family planning is not population control but a sign of freedom and fairness.”
Her demands of rights-based language were fulfilled with equal measures of support and denusion, depending on politico-ideological leanings.
Zero Gender-Based Violence and Harmful Practices
Focusing on harmful practices and survivor support
The third outcome– zero gender-based violence and harmful practices required a radical cultural change. UNFPA increased its actions to put an end to female genital mutilation (FGM), child marriage, and intimate partner violence. In Egypt, FGM among girls ages 1519 fell by almost 20% since 2017 partly under the influence of awareness efforts supported by UNFPA.
In humanitarian contexts such as the refugee camps in Bangladesh of the Rohingya, UNFPA offered safe havens to women and girls, within which survivors of sexual violence received medical attention and psychosocial support.
Social resistance and legal gaps
Progress was patchy. In nations where there was no form of legal protection or where the law was not supposedly effective, the resistance at the community level was quite buoyant. Other governments, in spite of professed public promises of ending GBV, at the same time paid insufficient funds into shelters, police training, and legal aid programs.
Here, Kanem declared this challenge clearly in her 2023 address to the UN Security Council by saying,
“We are challenging the societies to look at their most fundamental norms. It is hard, delicate work, but work there must be.”
There was also an increase in online violence, mostly between the pandemic. Activists of the LGBTQ+ community and journalists, especially young women, were frequent targets, but still no global system is in place to combat digital harassment.
Organizational Shifts: Reform and Resilience
Rebuilding systems from within
One of Dr. Kanem’s lasting impacts was pushing for internal reform within the UNFPA. She introduced better data transparency, local leadership in field offices, and faster response tools for crisis zones.
Under her guidance, the agency began using digital tools to track contraceptive supply chains and maternal care services in real time. This helped reduce stock-outs and allowed for quicker responses to sudden needs.
Stronger partnerships and global standing
Kanem also fortified the relationships between UNFPA and civil society as well as the private sector. In 2022, she created the Global Innovation Fund for Reproductive Health that enabled smaller organizations to grow promising methods of health technologies. Other commercial companies, such as Bayer and Philips, were also doing digital health sharing under the umbrella of UNFPA.
However even new partnerships did not provide any guarantee about core funding. Leaving office in June 2025, Kanem said that
“vision without resources is but a hope,”
warning that good intentions should be followed by funds and policy.
Tracking the Numbers: Achievements and Gaps
Progress in maternal care
The results on countries supported by UNFPA displayed measurable gains on the maternal health indicators, but as it appeared, they were not as steady as these countries appeared to be. As is usual in such a case, a case in point, Nigeria has one of the worst, world globally, on maternal deaths yet there have been several programs supported by the UN.
Family planning coverage
The number of women taking modern contraception has ever increased. Nevertheless, unmet need remains a tremendous issue in such nations as Pakistan, the DRC, and some of the Latin American countries, and the supply chains, education, and local outreach must be supported.
Ending gender-based violence
Law reform and attitude change has been successful to an extent. Other countries were enacting new GBV law maybe under Kanem but Afghanistan under the regime of the Taliban was taking women back to lawless status. The gap between policy and protection remains wide.
Kanem’s Legacy and the Challenge Ahead
The Three Zeros plan of Dr. Kanem will probably go down in history as one of the most vested plans of UNFPA. It gave attention, urgency, and moral clarity to the issues that were always considered secondary. Her governing brought more awareness to maternal health, contraceptives, and the safety of violence all around the world.
Nevertheless, a lot of the objectives are unaccomplished. This timing of her agenda conveyed one of the most important realities, that there is always a danger of rights based progress which can be politically triggered, or through war, economic failure or lack of appreciation of the culture. Structural injustice cannot be solved by mere leadership. This should be accompanied by the investment, alliances as well as long-term pressure to change.
With the international community inching towards the year 2030, whether the Three Zeros will be attained will not be the only assessment but whether the attainment can be safeguarded once it is. It takes more than vision to win the battle over health and equality in a world marked by new adversity, whether climate catastrophes or digital disinformation. It also requires the willingness to act on a consistent level, and through adaptability.
It is not clear that the world will respond to that challenge. What the goals are, however, are still apparent, though incomplete.
