Improving women’s and children’s health is critically important to almost every area of human development and progress. Healthy women and children help build healthy societies which are the foundation of successful economies, prosperity, political stability and social harmony. Unsurprisingly, the condition of children and women is a good indicator of progress on other development issues such as governance and equity.
Yet, across the globe, progress in improving reproductive health and reducing child and maternal mortality is uneven and must be accelerated if we are to achieve the Millennium Development Goals (MDGs). Every year, around 6.9 million children die of preventable causes, and more than 287,000 women die from complications of pregnancy or childbirth. In the developing world some 222 million women who want to avoid pregnancy are not using a modern method of contraception.
Global momentum is building to pursue bold and inspiring endgames. In his 2013 State of the Union Address, President Obama recently set forth a vision for realizing the greatest contributions to human progress in history — ending extreme poverty, creating an AIDS-free generation and ending preventable child deaths.
A steady drumbeat is already underway. The Global Strategy for Women’s and Children’s Health was launched by United Nations Secretary-General Ban Ki-moon. The Every Woman, Every Child initiative, a campaign accompanying the Global Strategy, continues to galvanize new commitments and, more importantly, focus on concrete action in this area.
Last June, the governments of the US, Ethiopia and India, in close cooperation with UNICEF, held a Child Survival Call to Action in Washington D.C. World leaders in attendance embraced the strategic shifts necessary to speed up progress in reducing preventable child deaths. Such efforts included increasing progress in the countries where most deaths occur; focusing on vulnerable populations like the very poor and investing in high impact solutions to address the main causes of mortality; investing in education and empowerment of women; and creating accountability including through the use of scorecards.
The Call to Action and the follow up work in Committing to Child Survival: A Promise Renewed demonstrate, global alignment around the vision of ending preventable child deaths in a generation. The goal of the Call to Action for all countries was to reduce child deaths by under 20 deaths per 1000 live births by 2035. Planning on a similar approach to ending preventable maternal deaths is underway since maternal mortality is linked so closely to under-five deaths and especially newborn mortality. A specific global effort is being made to address the problem of newborn survival — even in countries that make progress generally in addressing under-five mortality; neonatal progress often lags and so deserves particular attention.
We are less than 1,000 days to the 2015 goal post. Work to frame the post-2015 development agenda has surfaced, many good approaches, frameworks and considerations. Many see the wisdom of a new high-order vision for “wellness along the arc of life”. However life expectancy as an integrator is difficult to measure and communicate and is very sensitive to under-five mortality.
Structuring the agenda through a unifying framework of universal health coverage (UHC) provides a good mechanism for reaching our goals. It also will help prevent people from slipping back into poverty, as medical bills are often a major cause of going back into poverty.
As the world moves toward increasing health coverage and financial protection for more and more people through collaboration between the public and private sectors, work on health systems is a way to make a dramatic difference in health and development and to achieve universal health coverage. We must increase local capacity to reorganize and manage growing domestic resources.
Also, focused investments in “game-changing” innovations can dramatically improve health for the poorest by increasing their access to life-saving interventions and care, particularly at the community level. Low-cost innovations and scale up of effective and cost-effective commodities that are more easily administered by less-skilled health workers; point-of-care diagnostics; and approaches that use mobile phone technologies to provide services, information and monitor patient outcomes have the potential to vastly expand the reach of health-care workers and reduce some of the transportation, time and cost barriers that often prevent people from seeking care.
The past decade has been a period of learning for us. We have learned that there are lost-cost feasible solutions. We have learned how to deliver those solutions. We are committed to finding solutions to global health problems; for understanding the bottlenecks and barriers to quality care. Opportunities for market shaping and leveraging local leadership commitment are great ways to translate science into sustainable implementation at scale.
If we can find the courage to do things differently, and quickly deliver breakthroughs to the field, we will advance human progress—helping families escape devastating cycles of poverty and disease that drain vital health and economic resources, hold back communities and nations, and prevent young children from living up to their potential.