Egypt and Burkina Faso have the honour to deliver this statement on behalf of more than 100 countries, UNFPA and UNICEF.

FGM is a violation of human rights adversely affecting women and girls psychologically and physically, and governments and civil society must work together to accelerate the elimination of this practice. We strongly agree that FGM is a harmful practice and cannot be justified on religious or cultural grounds.

The harmful and dangerous impact of FGM on the health of young girls is well proven, as well as the health risks to women's health throughout their life course, including their mental, sexual and reproductive health. It is estimated that treatment of the health complications of FGM costs health systems 1.4 billion USD¹ per year. Eliminating FGM will have a positive impact not only on health, education and gender equality but also on the empowerment and full development of women and girls and of society as a whole.

We recognize the increased national, regional and international efforts and the political commitments at the highest levels, including in the 2019 Ouagadougou call to action on eliminating FGM and the 2019 Cairo call to action for the elimination of child marriage and FGM in Africa.

Nevertheless, we are deeply concerned that the progress in reducing the prevalence of FGM has not been up to the expectations, and we are concerned about evidence² in some regions suggesting an increasing involvement of health-care providers in carrying out female genital mutilation, in addition to the emerging cross-border practices. Review of the evidence on FGM medicalization shows that there are multiple reasons why health-care providers perform FGM: they are members of practicing communities subject to the same social norms; they are responding to a demand; they believe they are causing less harm than other practitioners; and there is a financial incentive.

Raising awareness on the adverse health consequences of FGM alone will not end the practice, and if this information is not communicated sensitively it can promote medicalization of FGM, on both the demand and supply sides. Moreover, there is no evidence that medicalizing FGM reduces immediate or long-term complications associated with the practice.

We therefore call on all stake holders to stop medicalization of FGM, which is an impediment to the abandonment of FGM with actions aligned with the Global Strategy to stop health-care providers from performing FGM.

We believe in the utmost importance of strengthening the understanding and knowledge of ministries of health, health-care providers and their professional associations and unions, as agents of change for ending FGM through different initiatives, including through the following:

• Establishing health policies and protocols advocating for the elimination of FGM whether performed in community or medicalized settings.
• Incorporating, more systematically, content on FGM prevention and management of health complications, in the curricula of health-care, education and training institutions.
• Empowering and enabling health-care workers to be agents of change in communicating against FGM in their interactions with their colleagues, patients, families, and communities.
• Strengthening coordination between legal and health systems, health regulatory bodies and health-care personnel in order to enforce the health professional code of conduct and country laws against this practice.
• Creating networks between professional associations and unions of health-care service providers and religious leaders to clarify that FGM is not a religious practice.
• Improving person-centered communication skills of health-care professionals to deal with social pressures from the communities seeking to continue with FGM and to challenge the harmful social norms perpetuating the practice.
• Reinforcing the unethical nature of the medicalization of FGM by issuing public statements and protocols, establishing codes of conduct and instituting accountability mechanisms to hold health-care providers accountable to their oath to do no harm and sanction wrongdoers .
• In addition to legal and administrative protection, empowering and enabling other forms of accountability mechanisms, such as parliamentary groups, National Human Rights Institutions and social accountability mechanisms to monitor and report on government efforts to eliminate the medicalization of FGM.
• Establishing and strengthening monitoring systems, including administrative data collection to track medicalization of FGM.

List of Countries

• Afghanistan
• Albania
• Algeria
• Andorra
• Angola
• Argentina
• Australia
• Austria
• Azerbaijan
• Bahrain
• Bangladesh
• Belgium
• Benin
• Bolivia
• Botswana
• Brazil
• Burkina Faso
• Burundi
• Cameroon
• Canada
• Cape Verde
• The Central African Republic
• Chad
• Chile
• China
• Comoros
• Costa rica
• The Congo
• The Democratic Republic of Congo
• Cote d'ivoire
• Croatia
• Cuba
• Czech Republic
• Cyprus
• Denmark
• Djibouti
• Ecuador
• Egypt
• Equatorial Guinea
• Eritrea
• Estonia
• Eswatini
• Ethiopia
• Finland
• France
• Gabon
• The Gambia
• Germany
• Ghana
• Greece
• Guinea
• Guinea Bissau
• Guyana
• Hungary
• Iceland
• India
• Indonesia
• Iran
• Iraq
• Ireland
• Israel
• Italy
• Jamaica
• Japan
• Jordan
• Kazakhstan
• Kenya
• Kuwait
• Kyrgyzstan
• Latvia
• Lebanon
• Lesotho
• Liberia
• Libya
• Lithuania
• Luxembourg
• Madagascar
• Malawi
• Malaysia
• Maldives
• Mali
• Malta
• Mauritania
• Mauritius
• Moldova
• Morocco
• Mozambique
• Namibia
• Netherlands
• New Zealand
• Niger
• Nigeria
• Norway
• Oman
• Pakistan
• Panama
• Paraguay
• Poland
• Portugal
• Qatar
• Romania
• Rwanda
• Sao Tome and Principe
• Saudi Arabia
• Senegal
• Seychelles
• Sierra leone
• Slovakia
• Slovenia
• Somalia
• South Africa
• South Sudan
• Spain
• Sri lanka
• Sudan
• Suriname
• Sweden
• Switzerland
• Syria
• Tajikistan
• Tanzania
• Togo
• Tunisia
• Turkey
• Turkmenistan
• Uganda
• Uruguay
• United Arab Emirates
• United Kingdom
• United States of America
• Uzbekistan
• Venezuela
• Yemen
• Zambia
• Zimbabwe
• The State of Palestine

¹ https://www.who.int/news/item/06-02-2020-economic-cost-of-female-genital-mutilation

² https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-017-0306-5