The 1994 International Conference on Population and Development (ICPD) in Cairo marked a paradigm shift that took family planning out of a population control context and into the broader context of sexual and reproductive health and rights (SRHR). While progress has been made with increased access to family planning and a decrease in maternal deaths, we have not seen practical results for the majority of women and girls worldwide, who still experience unacceptably high rates of maternal deaths, unmet contraceptive needs and HIV infections. Three of the compromises made by governments at Cairo – integration, reproductive rights and resource allocation – hindered the fulfilment of women's and girls' SRHR. The post-2015 agenda must ensure that economic development and global health interventions are linked at the national and global levels; family planning, HIV, maternal health and other reproductive health services are integrated and delivered through primary health settings; and access to safe and voluntary abortion services is recognised as a human right. Non-governmental organisations and donors must move beyond siloed issue areas to challenge governments, multilateral agencies, the financial sector and each other to ensure that the promise of SRHR is realised.