International
Maternal and Child Health
Building a strategy to ensure no child born with HIV
At the recent UN High Level Meeting on AIDS, world leaders made a critical step in the right direction with the launch of a global plan to eliminate new HIV infections among children by 2015 and to keep their mothers alive. Last year, ONE members tirelessly advocated for the Global Fund during our “No Child Born with HIV” campaign, and we’re pleased that this plan will help us work towards turning that goal into reality.
Tremendous gains have been made in recent years in reducing HIV infections among children and scaling up the prevention of mother-to-child transmission (PMTCT) of HIV, yet much work remains. In 2009, an estimated 370,000 new infections occurred among children, primarily in sub-Saharan Africa. The global strategy identifies two top goals: to reduce the number of new infections among children by 90 percent and reduce the number of AIDS-related maternal deaths by 50 percent. Under the plan, resources will be channelled to 22 priority countries, where nearly all HIV-positive pregnant women live.
The global plan identifies a four-prong framework for achieving these goals: preventing HIV among women of reproductive age through services related to reproductive health such as postpartum care; providing appropriate counselling and support to women living with HIV; ensuring HIV testing, counselling and access to treatment for pregnant women living with HIV; and HIV care, treatment and support for women and children living with HIV and their families.
We’re pleased to see that the global plan puts accountability at the helm and recognizes the critical importance of an integrated approach that connects an array of maternal and child health services across the health system. Additionally, the plan identifies the need for countries to be at the lead by providing political leadership, funding, effective strategies and strong monitoring and evaluation. While we applaud the effort to create this strategy, a plan is only so strong in so far as it has concerted political support and funding. Moving forward, if we hope to ensure no child is born with HIV by 2015, we need to see the following:
In answering the call to action at the launch of the plan, the United States President’s Emergency Plan for AIDS Relief announced an additional $75 million to prevention of mother-to-child transmission of HIV efforts. Additionally, private donors — including the Bill & Melinda Gates Foundation — pledged $40 million, Chevron pledged $20 million and Johnson & Johnson pledged $15 million.
During the high-level meeting, Ambassador Eric Goosby, the United States Global AIDS coordinator, summed up the need for this critically important plan: “Nearly every minute a child is born with HIV. Working together, we can reverse this tide as we have done in the United States and they are very close to doing in Botswana. Preventing new HIV infections among children across the globe is truly a smart investment that saves lives and helps to give children a healthy start in life.”
A reason to celebrate this Mother’s Day
As Mother’s Day is marked in the UK, Melinda Gates explains why we have an extra reason to celebrate.
Mother’s Day is usually a joyous occasion—and this year we have even more reason to celebrate. Mothers and their children are surviving today at higher rates than at any other point in history. In fact, just since 1990, the number of children who die before their fifth birthday has declined from more than 12 million per year to slightly over 8 million.
I feel fortunate because I get to see this progress firsthand. On a recent trip to Nairobi, I spoke with a group of women about their children. One mother told me, “I want to bring every good thing to one before I have another.” It reinforced what I always hear on my trips to different countries around the globe—that mothers everywhere have the same goal for our children, a successful future.
So, what’s behind this success? Over the past decade, innovators around the world have developed new tools and technologies– vaccines, drugs, and bednets to name a few—which have been integral in saving millions of lives.
But the innovation driving this success is not just limited to these stunning breakthroughs in science, in technology; it can be creative without being high-tech. I’m talking about pioneering ways of changing behavior, working with communities and sharing these new ideas with women in the poorest areas of the world.
Take breastfeeding, for example. Simply put, breastfeeding is a life-saving act. We know exclusive breastfeeding – when the newborn is fed only with breast milk and nothing else in the first six months – is one of the best ways to save baby’s lives.
When I was in Dowa, Malawi last year I visited the Dowa District Hospital. Exclusive breastfeeding is a core project of the government, one supported by Save the Children’s Saving Newborn Lives Program. The initiative encourages women to give birth in a health clinic and then provides them with three home visits from healthcare workers, in the weeks following the birth. These visits help mothers learn about how to care for their children, including exclusively breastfeeding. Programs like these aren’t created in a laboratory, yet help mothers realize they can significantly improve the health of their newborns without any new technologies.
The British government and citizens have been true leaders around these types of health innovations for women and children. I had the pleasure of meeting with Andrew Mitchell recently and was impressed with his remarkable passion. I’ve met with a lot of ministers over the years, but I don’t often see the dedication like that of Minister Mitchell. It’s also truly amazing to see the way Britain has stood by its international commitments on foreign aid in the midst of the current global financial crisis.
Investing in the health of women and children is the right thing to do. If we keep innovating, we’ll make faster and faster progress and achieve more with our investments. We’ll save the lives of mothers and their children in even greater numbers. And we’ll help make sure that motherhood is always a joy, for every mother, everywhere.
I can’t imagine a better way to celebrate Mother’s Day.
This post was first published on the UK Department for International Development (DFID) blog
Our take on Ban’s new Global Strategy
Initiatives worth $40 billion don’t often go unnoticed, so you may have seen that on Wednesday, U.N. Secretary General Ban Ki-moon launched the Global Strategy for Women’s and Children’s Health (PDF), a plan designed to accelerate progress toward Millennium Development Goals 4 and 5 by galvanizing global commitments around a comprehensive plan. The Secretary-General’s office announced that the commitments made so far will:
In addition to financial commitments, the Global Strategy promotes country-led health plans with sustainable investment, integrated delivery of health services, health systems strengthening, innovative approaches to financing and improved monitoring and evaluation of programs to ensure that maximum benefit will be derived from commitments made to women and children.
On paper, it sounds pretty incredible, and at ONE, we celebrate the renewed focus on maternal, newborn, and child health (MNCH) — an issue which we feel is long overdue. We’re also thrilled to see the diversity of partners (PDF) who have come together and have committed to achieving real outcomes in health — not just financial inputs.
It wasn’t just the usual crop of donor countries who made commitments (though many pledged substantially). Benin agreed to provide antiretroviral treatment to 90 percent of their HIV-positive pregnant women. Ethiopia pledged to increase the proportion of its children immunized against measles to 90 percent. Niger provided free care for maternal and child health. And NGOs and philanthropies of all sizes, UN agencies, members of academia and the private sector rounded out a true 21st century global partnership.
But now that the confetti has settled in New York City, what will the Global Strategy really amount to? To be frank, it’s hard to tell. Though each entity’s commitments were outlined, it was not clear how the $40 billion figure was calculated and how much of it was actually new money. We know that some of the $40 billion has been generated in the period “since April,” meaning chunks could have come through commitments made at prior forums, including this summer’s G8 Summit in Canada. And speaking of which, we’re having flashbacks to our analysis of the Summit’s Muskoka Initiative for MNCH, where money was pledged and the rhetoric was great, but ultimately, there was no great accountability mechanism established by which the advocacy community could measure commitments, progress or gaps.
While that’s frustrating for us, it’s a matter of life and death for the mothers and children depending on these initiatives for support. So at ONE, we will stay engaged and work to ensure that a monitoring body is established to ensure that these and other commitments made this week are kept.
How do you prevent mother-to-child transmission of HIV?
From online petitions to angry baby protests, it’s hard to miss ONE’s focus on the Global Fund and our goal to ensure that virtually no child is born with HIV by 2015. But throughout this campaign, many of you have rightfully asked, “How does this exactly work?”
It’s a miracle of modern medical technology that we’re able to prevent the mother-to-child transmission of HIV (PMTCT).
An HIV-positive mother can pass HIV on to her baby any time during pregnancy, labor, delivery and breastfeeding, so the transmission of the virus must be blocked at each stage. The 2010 World Health Organization guidelines recommend that HIV-positive pregnant mothers should go on a regimen of three antiretroviral drugs (ARVs) as soon as possible — and stay on these drugs until their infant is born and breastfeeding has concluded.
As soon as the infant is born, the baby should take nevirapine — a very inexpensive drug — daily for six weeks. The infant should be formula-fed rather than breastfed if possible, but it’s recognized that formula feeding is both expensive and difficult to do safely in resource-limited settings, so the mother is recommended to breastfeed her child exclusively for six months while continuing to take ARVs. In a recent study conducted by Harvard University in Botswana, mothers who adhered to this regimen reduced transmission of HIV to their babies by an amazing 99 percent.
These prevention guidelines have evolved over the years as scientists have learned more about how to most effectively reduce the risk of transmission while also working to minimize drug resistance for our most effective treatment tools. Many policymakers stress that access to effective contraception to prevent unintended pregnancies is also important for women who are HIV-positive.
For more details on the PMTCT process, including a chart that maps which drugs are used when and in what settings, visit AVERT’s handy guide. Also, be sure to check out WHO’s global strategic vision for 2015.
Mixed Bag for Mums and Babies
Every year, approximately 350,000 mothers die from complications during child birth and 8.8 million children die before their fifth birthday. We are desperately off track to achieving the Millennium Development Goals on child and maternal health and expectations were high for the G8 summit to deliver results.
Yesterday, the G8 announced the Muskoka Initiative on maternal, newborn, and child health. Although Canada deserves some credit for putting maternal and child health in the developing world on the G8 agenda this weekend, world leaders have not done enough to truly turn the tide on this vital issue.
At ONE, we campaigned for a robust maternal and child health initiative at this year’s G8 summit and for it to be accompanied by a concrete accountability framework. We also delivered a petition signed by more than 60,000 of you to world leaders to push them to deliver for the world’s more vulnerable – mothers and children.
While we were disappointed in the total G8 pledge of $5 billion to the Maternal and Child Health Initiative, our efforts elevated this issue, raised awareness, and will raise the bar for world leaders to address this and the other Millennium Development Goals at the UN Summit in September.
Petition Impossible: On the eve of the G8, the Canadian government is a bit busy…
ONE’s Mark Entwistle with our 58,000 signature strong petition
Yesterday, ONE’s Mark Entwistle delivered our 58,000 signature strong petition calling for 3.5 million new health workers to help mothers and children to the Prime Minister’s Office in Ottawa, Canada.
Unfortunately, photographs aren’t allowed within the Langevin Building, but we have it on good assurance that shortly after this photo was taken Mark was in the building to hand off the wishes of ONE members to the Canadian government.
This delivery presented some unique scheduling difficulties – on the eve of the G8, most senior members of the Canadian government are en route to Hunstville, Ontario, far away from the media centre for civil society organisations in Toronto where ONE will be based during the summit. So if we wanted to make sure the G8 heard our message before meeting, we needed to do it now, in Ottawa. But scheduling wasn’t easy given that the Prime Minister’s Office had quite a bit on their plates.
Luckily it all worked out for the best. In fact, it almost appeared that the fates were conspiring to test our resolve in delivering our petition as 20 minutes before the delivery Ottawa was hit by an earthquake which caused all parliamentary and government offices to be evacuated!
During the summit ONE will be on the ground, fighting to make sure this G8 has the strongest outcome possible for people living in poverty. We’ll be keeping you updated through our blog and twitter – so watch this space!
Liya’s Ethiopia Diary
When model Liya Kebede recently returned to her home country Ethiopia, she was shocked by the statistics on maternal health: 94% of women still give birth at home without a trained attendant, with more than 300,000 women dying each year around the world in pregnancy and childbirth.
Liya was kind enough to share this video diary of her trip with ONE:
ONE is running a petition ahead of the G8 meeting in Canada this week asking for a commitment of 3.5 million new health workers for countries who need them, like Ethiopia. It shouldn’t be a woman’s lucky day to survive childbirth.
Click here to sign the petition
To learn more about Liya’s work at The Liya Kebede Foundation, visit www.theliyakebedefoundation.org
ONE in Ottawa with Christy Turlington-Burns
On June 3, ONE hosted a parliamentary reception at the National Gallery in Ottawa, Canada to raise awareness on maternal and child mortality ahead of the G8 in Muskoka later this month. Featuring a special appearance by model and activist Christy Turlington-Burns, we showed a clip of her new documentary No Woman, No Cry.
Ottawa-based ONE member Kirika Bussell attended the screening, and sent us this great photo and blog update:
People often advocate for a cause because of a direct link to a situation, or because we know someone who has been affected. It was her health scare following the birth of her first child that prompted Christy Turlington-Burns to learn about and then advocate for maternal and child health. She survived a common post-partum complication because of timely access to quality medical treatment, but not all women are so fortunate. It was this experience that inspired No Woman, No Cry.
ONE member Kirika Bussell and Christy Turlington-Burns at the event in Ottawa
Every minute a woman dies from preventable complications during pregnancy or birth. What is stopping us from keeping these preventable deaths occurring again and again? If the answer lies in education, compassion and understanding, then Ms. Turlington Burns has made the job of spreading the message more accessible, and more importantly, she has put a human face on what could simply be seen as another sad statistic.
At the screening I was fortunate enough to speak with Christy Turlington Burns about the concept that we all have a stake in the future of maternal and child health. She agreed that it doesn’t matter if you’re a man or woman, a father or mother, or if you’re childless- this is a universal issue.
When I volunteered to assist with the ONE’s screening at the National Gallery, one of my goals was to help maximize the opportunity to generate interest and keep the issue moving. Reflecting on this event after the fact, I can say my interest in this issue has only grown the more I’ve learned. I hope other ONE members come to feel the same way. Everyone’s reasons to act are different, but when we do act, together we can act as ONE voice for proactive, comprehensive change. The future is ours, but the choice to act is yours.
Kirika M. Bussell, Ottawa, Canada
If you’d like a sneak peak at Christy’s documentary, visit www.everymothercounts.org.
To sign ONE’s petition to the G8 for 3.5 million new health workers go to:
No one should give birth alone
Last week a couple of ONE staffers attended the Women Deliver conference in Washington D.C. In what was arguably the world’s largest conference on maternal health and empowerment in more than a decade. The 3 day event was essentially a global gathering to share stories, best practice and calls to action on the prevention of maternal deaths around the world.
It was at Women Deliver that Melinda Gates stressed the importance of maternal and child health as a global health priority.
At the conference we met Awatif Altayib Mohamad Hussein, a midwife from Sudan who was kind enough to share her story with us.
If you would like to sign ONE’s petition to the G8 asking for more midwives and health workers to be provided in countries that need it most, sign the petition here:
http://www.one.org/international/actnow/g8healthworkers
Melinda Gates: A New Vision for the Health of Women and Children
I’m speaking at the Women Deliver conference in Washington, D.C., today to highlight maternal, child, and reproductive health as a global priority.
Three months ago, I traveled to a village in the Indian state of Uttar Pradesh, where I met a young mother named Rukmini. Six days before, she’d given birth to a daughter she named Durga, after the Hindu goddess of power.
According to custom, Rukmini and Durga remained in the same room after the birth. Seven days later, Rukmini carried Durga into the light of day for a ceremony that celebrated the special bond between mother and child, called Chhathi. As their neighbors drummed and sang songs, Rukmini held Durga up to thank the sun god for a healthy birth and ask for his blessing.
I kept thinking about the overwhelming joy, hope, and optimism I felt when each of my three children was born. No matter who you are, no matter where you live, it is incredibly moving to hold a healthy baby in your arms.
But tens of millions of women never get to experience that moment of beauty. For these women, childbirth is filled not with joy, but with dread, pain, and sorrow. They know they might die during delivery. If they survive, they are terrified their baby might die.
The world is now coming together to save the 350,000 mothers and 3 million newborns who die every year. At Women Deliver, we are nurturing a vision that is changing the world.
- Donors will spend more on women and children, and those donations will be tracked.
- Developing countries will pass rigorous policies for women’s and children’s health, and fully fund their implementation, and health workers will have the tools and training they need.
- Communities will work together to gather solid evidence about the interventions that work best, and combine them into a comprehensive plan to save lives.
- Women everywhere will have the knowledge and power to save their lives and the lives of their babies.
We can make a new world for mothers like Rukmini. When she hugs her daughter Durga, she holds the future in her hands.
In the comments below, please share what you are going to do to bring about this vision of the world.
For more information, go to the foundation’s Women Deliver page or the Women Deliver website. In this recent blog post, I share more of what I’ve seen around the world, the success stories in Malawi and India, and the foundation’s approach to saving women’s and children’s lives.
-Melinda French Gates
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About the Blog
The International ONE Blog is a daily log of the anti-poverty movement. The site is operated by ONE staff, with guest contributions from ONE volunteers, members and allies.
The content of each post and each comment represents the views of that author and does not necessarily reflect the views of ONE. ONE does not support or oppose any candidate for elected office, and any post expressing support or opposition for a candidate is not endorsed by ONE.
TAGS: HIV/AIDS, Maternal and Child Health, Policy News