Thursday, 26 March 2009

An abbreviation a day. Maybe an acronym if you're lucky.

MNH: maternal and newborn health.
*A woman dies from pregnancy or childbirth-related causes every minute of every day
*Childbirth is the leading killer of young women worldwide
*Infants of mothers who do not survive the delivery are more likely to die within two years
*When a mother dies, enrolment in school for younger children is delayed and older children often leave school to support their family.
*Children without a mother are less likely to be immunized, and are more likely to suffer from malnutrition and stunted growth. The implications for girls tend to be even greater.

Millennium Development Goal #5 is to reduce maternal mortality rates by 75 per cent by 2015. It’s the MDG that has seen the least progress in the last decade.

The interventions that are needed are relatively low-tech and inexpensive: trained midwives at the local level, and obstetric care for emergencies. As far as I can make out, DFID has a fairly good record in this area; the country that needs to take a big lead is (inevitably) the USA. Its funding for maternal health programmes has consistently declined. The aim is to secure $3.9 billion per year for the next ten years (based on a World Health Organization estimate). This would enable significant progress towards providing universal access to maternal and newborn care.

The current orthodoxy is that to maximise effectiveness, the donor countries need to set up innovative funding channels so that, for instance, resources for countries or regions can be pooled. The High-Level Taskforce on Innovative International Funding for Health Systems met in London earlier this month to discuss such funding channels. The published note of the meeting contains some truly frightening predictions of mortality increases in developing countries as a result of the crash in the West. It also seems to place a depressing emphasis on the importance of the private sector, which has such a mixed record of providing vital services in developing country contexts.

Some of the proposals for raising the necessary funds are unedifying (optional levies on aeroplane tickets); some are potentially more interesting (an Italian proposal to ringfence a proportion of VAT income). The note also mentions a drive towards patent pooling of important drugs (such as the three drugs used to treat childhood HIV infection, each of which is currently under patent to a different company). Australia, apparently, is 'not interested in new taxes', but then I'm guessing most of its new mothers can confidently expect to return home with their babies in good health, so that's nice for them. The Japanese observer wisely emphasised the necessity for new funding, rather than channels that would simply replace existing development aid.

1 comment:

  1. Rowan,
    While the West is far from finished reaping the economic catastrophe we have so irresponsibly sewn in the past decade, it is, as always, the developing world that will suffer the most for our overindulgent blunders. At the G 20 summit it was clear that world leaders are concerned with the plight of developing nations, and yet it seems that their response is inevitably misguided and problematic. Instead of providing funding for microfinance organizations and local development projects, governments threw money at the International Monetary Fund, whose Structural Adjustment Programs and one-size-fits-all policy prescriptions offer mixed results at best and at worst create what Joe Stiglitz terms “beggar thyself” cycles of inescapable poverty. It seems to me that, in the efforts of helping the developing world, the G 20 should have been mindful of the UN’s Millennium Development Goals and provide more focused and directed investment to effective programs that support education and health initiatives. As you well note, the "crash in the West" will make for disastrous effects abroad. Oxfam has been particularly vocal about the need for continued aid and investment. Do you not believe, however, that Bretton Woods institutions are the wrong channels through which we should be funding our efforts to develop, educate and empower? I am a fervent proponent of more creative, grassroots efforts that remain honest, transparent and do not get immobilized by red tape and politics. Women's issues have proven particularly responsive to these initiatives. It was Michelle Obama's speech to a crowd of schoolgirls this week that I found the most grounded and promising moment of the Presidential visit to London. It is in the hands of girls and women where we must place our hopes and our trust. I am always surprised by man's inhumanity to man - that such statistics as the ones you present can exist. If this economic crisis shows us anything, it is that the models of the past are null and void. Moving forward means moving away from them and towards real and grounded solutions that put us all in closer contact with each other's humanity. Organizations such as Kiva are beautiful because those numbers become people in whose future we are implicated. It is by renewing these bonds, or perhaps forging them for the first time, that the developed and the devloping will come together to bridge and build a shared and just world.