Political Will

Women and Children First: Or are they?

"For the notion of responsibility to be meaningful, it should ultimately reside in specific places and institutions, and with specific people. If everyone is responsible then no one is actually responsible."
 
         - Unknown
 
Lack of political will is cited as a main barrier in tackling maternal newborn and child death rates worldwide. For whatever reason, women’s health issues don’t bring dollars to the table. Why are the lives of women and children so neglected on the global agenda? Racism, sexism and classism have all been suggested, as has the enormity of trying to tackle challenges facing the developing world. The idea that investing in women is only an act of charity without economic benefits is contradicted by recent research. Studies presented at the 2007 Women Deliver conference pronounced that globally, women’s unpaid labour equals approximately a third of the world’s Gross National Product, and that women are the sole income earners for 25 to 33 percent of households.
 
While the issue is primarily one of human rights, women’s health advocates have reluctantly tried to measure the loss of women’s lives in dollars in an attempt to gain the political will and financial resources required to save them. In 2001, the United States Agency for International Development (USAID) estimated the global economic impact of maternal and newborn mortality at $15 billion in lost potential production per year. Investing in women benefits families, communities and nations, creating a ‘virtuous cycle’ of development with enormous returns on investment. Taking action is the right thing to do; yet even when backed by economic fact, financial resources fall short.
 
"Maternal health rarely gets the priority or attention that it deserves. Partly that's because the victims tend to be faceless, illiterate women who carry little weight in their own families, let alone on the national or world agenda."
 
         - Nicholas D. Kristof, New York Times, March 20th, 2004
 
At the Women Deliver conference in October of 2007, 35 cabinet ministers jointly stated that investing in women ‘pays off in terms of social and economic benefits for the family, the community and society at large’. Studies published in The Lancet estimated that an annual expenditure of $10.2 billion towards maternal, newborn and child health would save 6 million lives a year.  Various organizations have supported this number, and pushed leaders to make this commitment at the 2008 G8 summit held this past July in Hokkaido, Japan.
 
At the summit, eight world leaders gather to discuss various global issues. While promising more focus on Africa and the Millennium Development Goals (MDGs), the meeting fell short on women and children’s health. No financial resources were specifically allocated during the summit to achieving MDGs 4 and 5, which relate to maternal and child health. Considering the summit’s focus on the MDGs and the poor progress towards MDGs 4 and 5, the G8’s lack of commitment is striking.
 
The Countdown to 2015 for Maternal, Newborn and Child Health released arresting statistics at their meeting in Cape Town this past April. Only 16 of 68 priority countries are on track to reach MDG 4. For many, the situation is actually deteriorating, notably in sub-Saharan Africa. MDG 5 is faring the worst, with no significant improvement and, again, deterioration in many priority countries.
 
"Taken together, these analyses indicate that, despite isolated examples of welcome progress, national and global attention to maternal, newborn and child health is still strikingly inadequate. Children and mothers are dying because those who have the power to prevent their deaths chose not to act . . . It signifies an unbalanced world in which only those with money, military strength, and political leverage determine what counts and who counts."
 
          – Richard Horton, The Lancet
 
While the results of the G8 were disappointing, 2007 marked an acknowledgement of the lack of progress towards MDGs 4 and 5 and saw new attempts by some global leaders to respond. Despite these efforts, greater financial investment is necessary. Approximately $10.2 billion a year until 2015 is needed to attain the goals. Contextually, “[i]t would cost the world less than two-and-a-half-day’s worth of military spending to save the lives of 6 million mothers, newborns and children every year,” according to Thoraya Obaid, Executive Director of the United Nations Fund for Population and Development (UNFPA). Additionally, according to the UNFPA, each dollar spent on maternal health can save up to $31 in government social spending.
 

What has been done by Global Leaders for women and children lately?

The Global Campaign for the Health Millennium Development Goals (MDGs)

In September 2007, Norway, with other leaders like Canada and Britain, launched the Global Campaign for the MDGs. The following initiatives, focused on MDGs 4 and 5, are a part of this campaign,and strives to achieve four goals: more efficient collaboration; extension of essential services to reach more people, focusing on community outreach; finding the most effective ways of spending money; and the development of social health protection system.

Results-Based Financing Initiative

In November 2007, Norway and the World Bank launched the Results-Based Financing Initiative, aimed at determining the most effective ways of spending money.
 

Providing for Health Initiative (P4H)

This project, currently in preliminary phases, is led by Germany and France. P4H provides technical advice on health financing systems in developing countries and works to make health system financing more efficient.
 

The Catalytic Initiative to Save a Million Lives

In November 2007, Canada announced its leadership role in the Catalytic Initiative to Save a Million Lives, focused on MDGs 4 and 5. The project, with UNICEF, the Bill and Melinda Gates Foundation, the World Health Organization, the World Bank and other donor countries, places an emphasis on women and children through initiatives to improve health care, including building capacity of local health care systems to provide high-impact, cost-effective health and nutrition interventions for children and pregnant women in Africa and Asia. Canada is contributing $105 million to train over 40,000 health workers, mostly in child vaccine initiatives.
 

Deliver Now for Women and Children

Launched in September 2007, leading up to Women Deliver, the third decennial conference on maternal health, this initiative is also aimed at achieving MDGs 4 and 5. Deliver Now’s first projects have included advocacy for maternal, newborn and child health in India and Tanzania.
 

International Health Partnership (IHP)

Launched by British Prime Minister Gordon Brown, the International Health Partnership’s global compact was signed in September 2007, committing world leaders, donors, agencies, and aid recipient countries to collaborate for effective national health plans. This initiative represents half the world’s aid spending on health, at $14 billion, and involves most major aid agencies, donors, leaders and recipient countries.

Millennium Development Goal #4: Reduce Child Mortality

  • Reduce by two-thirds the mortality rate among children under five

 Millennium Development Goal #5: Improve Maternal Health

  • Reduce by three-quarters the maternal mortality ratio
  • Achieve, by 2015, universal access to reproductive health