In 2010, UN Secretary-General Ban Ki-moon announced a new initiative of the Millennium Development Goals, intended to spur progress on maternal health and children’s health. Every Woman Every Child, says the UN Foundation’s Director of Millennium Development Goals Initiatives Anita Sharma, “is an unprecedented effort to write some of the wrongs, that in this day and age, women and children can die from preventable causes.” (For background on MDGs 4 and 5, the renewed focus on them, and the reasons that they’re lagging behind, read my 2010 post here.)
In a phone call with UN affiliates and later in a phone interview with TCW, Ms. Sharma, who leads the UN Foundation’s work on Every Woman Every Child (EWEC), spoke about what’s been accomplished by EWEC, what’s left to be done and the roadblocks to reaching their goals. “We’re hoping by the sustained and refocused education,” Ms. Sharma says, “that they become the driver of economic change and improvement in the world.”
Today, about 350,000 women die every year from giving birth, largely from preventable causes, such as preeclampsia. UNICEF estimates that 9.7 million children under 5 die every year from preventable causes; EWEC works to combat the major killers, including pneumonia, diarrhea, preterm birth complications, birth asphyxia, under-nutrition and malaria.
While the program places great weight on metrics, measurable outcomes and accountability –especially considering that an additional $50 million has been pledged over the past five years – EWEC also emphasizes the importance of allowing countries to make their own changes rather than impose change upon them. “Ultimately it’s the responsibility of those governments to provide better healthcare and those services to their people, and to make those services affordable,” Ms. Sharma states. “It’s actually the low and middle income countries that are making big contributions. It might not be big financial numbers, but it has been in terms of policy and service delivery. In a country like Ethiopia or Tanzania, medical care, even if it is basic medical care, is free. In Bangladesh, they are training and stepping up midwives and community health workers, so that in a country that has a shortage of doctors, at least these people will have access to a trained midwife or community health worker. They can get out into those areas where maybe a doctor just doesn’t want to go.”
Already, life-saving projects have emerged from the intersection of technology, government and the private sector. For example, the Maternal Alliance for Mobile Action (MAMA), developed by USAID, Johnson & Johnson, the UN Foundation, the mHealth Alliance and the Baby Center, provides low-cost, mobile phone access to pregnant women and mothers. The women receive text messages or voice mail alerts, targeted to their pregnancy or children’s ages, with relevant health information. The program is currently being piloted in Bangladesh, India and South Africa.
Despite achievements, MDGs 4 and 5 remain the “laggards” of the Millennium Development Goals, “Partly because they started at such a poor position, partly [because], for societal reasons, women are valued less in many of these countries,” says Ms. Sharma. In addition, it’s estimated that an additional $20 billion in funding is needed, a goal made more difficult by the fact that many countries that have traditionally been strong supporters of international development – Ms. Sharma cites Spain, Italy and Ireland – are in the throes of economic crisis. We spoke with Ms. Sharma about how EWEC is addressing these challenges and their goals for the next three years of the project.
In 2010 when this initiative was launched, you and others noted that “the political will is lacking.” Where does that stand today, both globally and in the U.S.? I’m thinking particularly about recent shifts in how we perceive women’s right to access to reproductive health in the U.S. and how that affects your EWEC goal.
We have about 200 partners on board. A lot of those partners come from heads of state and government. It’s really necessary that we have sustained engagement in those countries where the challenges are. Something like 53 low- and middle-income countries have made commitments. In some cases, they are using resources from UN agencies or governments like the United States to channel those resources more effectively to women and children’s health. In other cases, they are using their own domestic resources or making changes in policy to make access free…So I think you have seen increases in political will, but it needs to be sustained and accelerated.
A big challenge in the United States is that global health, and in particular women and children’s health, should not be a partisan issue. But when there is an economic crisis or austerity, there is a tightening of belts and a scrutiny of how resources are allocated. International development, especially in the United States, does not have a big constituency or the same kind of constituency that other causes issues have. Americans, if you ask them how much we spend on our foreign affairs budget, say about 25 percent. As we know, it’s less than 1 percent and of that, international development is an even smaller chunk. We make the case that it is a great return on investment: Investing in women and children’s health benefits you tenfold in terms of ensuring that countries are growing, are more stable and are more prosperous.
But it is a reality, it is a challenge that we can’t ignore. There is a financing gap. Money, whether from the United States or Europe or other donors, is going to be tight this year. What we are aiming to do is diversify the portfolio. That is engaging the private sector, creating more sustainable business models, asking them to lower pricing on drugs. The new model of Every Woman Every Child is that everyone has a role to play. Yes, the governments have the primary responsibility, but other actors, whether you are an NGO or in the private sector, can play an important part.
Part II of this interview will be posted on February 9, 2012. Check back then to learn about the role that online activism can play in preventing maternal and child deaths, and what needs to happen between now and 2015.
Above photo: Addis Ababa Fistula Hospital, Ethiopia, Africa. Both mother and baby are doing well thanks to proper prenatal and obstetrics care, which are the best ways to prevent fistula. April 2011.