09 March 2011

U.S. and Partners Commit Science to Saving Mothers and Babies

Villagers in Senegal have improved care in "health huts" staffed by trained, but unpaid, health care workers.

By Charlene Porter
Staff Writer

Washington — Too many women and their newborns die in childbirth. The United States — joined by Canada, Norway and other partners — announced an initiative March 9 to commit science and technology to saving more lives in rural, underdeveloped villages around the world.

Secretary of State Hillary Clinton explained the U.S. commitment to the development initiative, Saving Lives at Birth, at a Washington press conference.

“It is simply unacceptable that millions and millions of people, women and children, die from conditions that we know how to prevent,” said Clinton. An estimated 150,000 women and 1.6 million infants die each year in labor, childbirth or the days shortly after birth, numbers Clinton called “shockingly high.”

Saving Lives at Birth: A Global Challenge brings together the U.S. Agency for International Development (USAID), the government of Norway, Grand Challenges Canada, the Bill & Melinda Gates Foundation and the World Bank. The partners are establishing a grant program for addressing maternal and infant mortality that will finance new ideas that are sustainable and effective in developing world settings. With an expected $50 million in funding over the next several years, the partners aspire to achieve a “transformative effect in the lives of pregnant women and their babies in the hardest-to-reach corners of the world,” according to a press release.

Clinton and the other partners emphasized that the campaign aims to inspire new approaches to solving these problems that won’t be found in a developed world model of health care. As she has moved from the world of information technology to international development, Melinda Gates, co-founder and co-chair of the Bill & Melinda Gates Foundation, said she has been puzzled about why the innovation and creativity pulsing through industry aren’t evident in global health. She offered the example of tuberculosis detection, where 100-year-old diagnostic methods are still in use.

“Could you imagine in the technology sector? You can’t even think about using something that existed 20 years ago,” Gates said. “Why would we do that in a medical setting in a poor rural setting? That just shouldn’t be. We believe that innovation bends the curve of history.”

A Senegalese mother settles in for a nap with her children under a protective bed net.

In some international development efforts, innovation has proven its value, said USAID Administrator Rajiv Shah, as he explained a program the agency developed in Senegal to deliver childhood vaccines and other basic care with the organization of 12,000 “health huts,” staffed by trained, but not professional, health workers. Shah said he recognized the importance of that effort just a few months ago when he and his wife had their third child, a boy born in a sophisticated hospital in Washington.

“When those kids [in Senegal] get those vaccines, they get the same basic critical care that my son gets, only they do it in a setting where there are no doctors and no hospitals.

“Local health efforts have been wildly successful when we break free from the Western medical model of care provided by doctors in hospitals, and when we deliver solutions that can work in communities,” Shah continued. The USAID administrator is a medical doctor himself, and worked on global health policy issues at the Gates Foundation before joining the Obama administration.

Clinton provided another example of the type of solution that the initiative hopes to inspire. She cited statistics that demonstrate the odds on mother and infant survival are significantly higher if a trained attendant or midwife is present at the birth. Kenya and Uganda have taken the step of providing paper vouchers to subsidize the cost a family pays to hire an attendant. Those vouchers could be distributed far more widely via text message, Clinton said.

“We could dramatically expand the reach of care, giving any woman with a cell phone a chance to deliver her child safely,” Clinton said.

Grand Challenges Canada is a nonprofit organization working with Canada’s government on a similar campaign to inspire new solutions, and it is also a member of the coalition that announced Saving Lives at Birth on March 9. Chief Executive Officer Peter Singer said when locally sustainable solutions in health care are found, their implementation can have broader effects. When the low-cost, low-tech solution of insecticide-treated bed nets was proven as a reliable method for preventing malaria, a source of the bed nets had to be found. Enter A to Z Textile Mills in Arusha, Tanzania, Singer said.

“It’s the largest manufacturer of long-lasting, insecticide-treated bed nets in Africa. It makes 20 million nets a year, and it employs 6,000 people,” Singer said. “[This is] people solving their own problems. It is particularly the innovators in low- and middle-income countries who know their challenges and are best situated to solve them.”

USAID is accepting proposals for funding at www.savinglivesatbirth.net. A press release says strong proposals will be “bold ideas,” reflecting innovation in new technologies, health service delivery and engaging communities.

(This is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://www.america.gov)