G8 initiative will help cut maternal and child deaths, but who will be left behind?

The main highlight of this year’s overall disappointing (see our recent post) G8 summit in Canada was the announcement of an initiative to cut the number of women and children dying in pregnancy and childbirth in the world’s poorest countries.

Canadian Prime Minister Stephen Harper announced earlier this year that the focus of the G8 in 2010 would be maternal and child health. This was welcomed by the development community because the Millennium Development Goal targets relating to maternal, newborn and child health (MNCH) are among the least likely to be achieved.

Every year, at least a third of a million women die due to complications in pregnancy and childbirth. If a mother dies in childbirth, there is also a high chance that her child will die within a few months. Approximately 4 million child deaths occur within one month of birth.

Key points from this year’s G8 communiqué include the launch of the Muskoka Initiative, a ‘comprehensive and integrated approach to accelerate progress towards MDGs 4 and 5 that will significantly reduce the number of maternal, newborn and under five child deaths in developing countries.’ It is hoped the initiative will mobilise more than $10 billion up to 2015, of which $2.85 billion will come from the Government of Canada.

In a recent letter to a RESULTS advocate, Parliamentary Under-Secretary of State for International Development, Stephen O’Brien MP said that DFID welcomed the Canadian-led initiative and were working with G8 partners to make it a success. However, no specific commitments were made by the UK at the G8 conference to indicate how they would do this or whether additional resources for MNCH would be forthcoming.

On our May conference call, Christina Dendys, Executive Director of RESULTS Canada informed us that a package of known, cost-effective interventions focused on major killer diseases such as diarrhoea, pneumonia and malaria and delivered at the community level could save the lives of millions of women and children every year.

Christina had the opportunity to reinforce this message at a small meeting Prime Minister Stephen Harper held with leading advocates for child and maternal health just days before the G8 summit (which she had to leave the RESULTS International Conference early to attend). Following the announcement of the Muskoka Intiative, she told us that after a year of tireless advocacy by RESULTS and other organisations, she was pleased that “our collective call for investments in an integrated bundle of interventions delivered at the community level with a commitment to measuring impact and results is highlighted as core to the initiative”.

The Muskoka Initiative includes a number of elements such as antenatal care; attended childbirth; post-partum care; sexual and reproductive health care and services, including voluntary family planning; health education; treatment and prevention of diseases including infectious diseases; prevention of mother-to-child transmission of HIV; immunisations; basic nutrition and relevant actions in the field of safe drinking water and sanitation. We are particularly pleased that water and sanitation has been included in the package as this is something RESULTS has been pushing for in our previous actions.

No new initiatives are being created as part of the Muskoka Initiative but rather donors are being encouraged to choose existing mechanisms that have proven to be effective. In July, we will be encouraging the UK to significantly increase its contribution to the Global Fund to Fight AIDS, TB and Malaria which is an example of an effective, country-driven mechanism with a key role to play in not only addressing the three diseases but also in MNCH. It is encouraging to hear the UK talking about support for MNCH, but it is simply not enough – we now need to push them to do something concrete and commit significant additional funds to the fight.

We are pleased to see that the communiqué calls on G8 members to make the third voluntary replenishment conference of the Global Fund in October 2010 a success although no concrete commitments were made as to how much each country would contribute.

Although the Muskoka Initiative contains much to celebrate, the $5 billion committed is far from the amount really needed to meet the MDG targets for reducing maternal and child deaths. It is also unclear how much of this really represents new money. Save the Children estimate that even if the full $5 billion is paid, the G8 will only be half way towards meeting its share of the MNCH funding gap.

There are also questions about how aid money will be attributed. Since the initiative includes elements such as water and sanitation, education and nutrition, (which usually have their own budget lines and require additional resources in their own right) close monitoring will be required to ensure that commitments made in Canada will not just result in resources being taken from one department to fund another.

Whilst the recent G8 announcement means that more children will reach their first birthdays, millions of mothers and children – often the most marginalised and vulnerable – are going to be left behind. The UK and other donors need to follow the example set by Canada and use the UN MDG Summit and Global Fund replenishment meeting later this year to show that they are also serious about addressing maternal and child health.


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