What the Maternal Health Plan Should Be

Canada needs to articulate what it wants to achieve at the G8 and G20 summits.

Time is running out for Prime Minister Harper to articulate what he wants to achieve as the host of this month’s G8 and G20 summits in Ontario. Hope ran high when he announced earlier this year that one of the cornerstones of the summit would be reducing the appalling number of deaths among pregnant women and young children from entirely preventable or treatable causes. However, this optimism was dashed when the debate became bogged down in abortion politics. Harper and his key ministers rolled back the clock and said that Canada would not fund access to safe abortions as part of a comprehensive plan to reduce maternal mortality. This ignited a debate over abortion that diverted attention and effort from developing a plan that would save the lives of the most vulnerable people in the world.

There is still time for Canada to act with courage and vigor to save the lives of the nine million women and children who die every year from easily treatable causes. So what could Canada’s plan be for the G8/G20 summits?

The Challenge:

• Every year, 344 000 pregnant women die. Eighty per cent of these deaths are from five entirely preventable or treatable causes: sepsis, hemorrhage, eclampsia, obstructed labour, and as a consequence of a septic abortion.
• Ninety-five per cent of these deaths occur in developing countries.
• When a mother dies in a low-income country, more than half of her children under five years of age will also perish.
• 8.8 million children under the age of five also die each year from preventable or treatable causes, including malnutrition, pneumonia, diarrhea, malaria, measles, and HIV/AIDS.

The Plan:

• Invest in access to primary health care – i.e.: trained healthcare workers, basic medications (120 of the World Health Organization’s list of 130 essential medicines are off patent, which means that generic companies can freely make them), diagnostics, adequate nutrition (including micronutrients), clean water and sanitation, reliable power sources, and access to family planning and safe abortion services.

Funding:

• The G8 should create a new global fund for maternal and child health supported by $15 billion over the next five years.
• These resources could come from a wide variety of sources: countries’ development programs, multilateral aid agencies, development banks, foundations, and the private sector (it would be an opportunity for companies to exercise good corporate social responsibility). This could be modelled on the Global Fund for HIV/AIDS, Malaria, and Tuberculosis.

Implementation:

• The rollout of these assets to support primary care could be done by partnering with organizations that already have sites and reliable logistical systems in place. The World Food Programme, UNICEF, and other groups distribute food to vulnerable populations, and have the systems to reach people in need. Regions that suffer from food insecurity also have poor health care services. Supposing the G8 partnered with these organizations to use their feeding centres as a way to dispense basic health care, working with established systems would obviate the need to create new distribution mechanisms.
• Each G8 nation could take the leadership role in one of the inputs required to deliver primary health care. For example, the U.S. could take the lead in training health care workers, Canada could champion access to adequate nutrition (we could use the Micronutrient Initiative and others as partners), the French could lead in providing access to family planning and safe abortions where it is legal, etc.

Investing in reducing maternal and childhood mortality and morbidity also has a broader, more powerful effect on the entire population. With the assets available to treat the most common complications of pregnancy, you can also treat 80 per cent of the medical problems encountered in the emergency room, including the world’s major killers: gastroenteritis, pneumonia, tuberculosis, malaria, sepsis, and complications arising from HIV/AIDS.

For those unwilling to act on purely humanitarian grounds, there is a very strong economic argument to invest in this plan. Every dollar invested in primary care ultimately reduces health care costs by $4 and social costs by a staggering $20. Thus, investing in primary care also makes excellent economic sense. How can you work or study if you are ill? A healthy population is a productive population.

This year, G8 nations have a remarkable opportunity to make the most profound change in the health of the world’s poorest people that we have seen in decades. Canada has a chance to make this happen with strong, clear leadership that will support a plan driven by science, not ideology.

Prime Minister Harper, the ball is now in your court and the world is waiting.