This largely preventable, but life-shattering medical condition affecting primarily the poorest and most marginalized women and girls has rightly been described as “a stark reflection of inequality at its worst".161 Its persistence in many developing countries reflects chronic health inequities and health-care system constraints, coupled with broader human rights violations facing women and girls, such as poverty, socioeconomic and gender inequalities, early marriage, early childbearing, and lack of schooling. Millions of women and girls need fistula treatment, but the lack of availability or access to services by skilled obstetric fistula surgeons prevents them from receiving it. In a bid to galvanize momentum to eliminate this medical injury, in October 2014, the report of the Secretary-General, supporting efforts to end obstetric fistula, was released with recommendations that could be implemented, primarily at the national level, to intensify these efforts, within a human rights-based approach.