Debate on maternal health in a global perspective

The Minister based his address on the following points (excerpts) (check against delivery):

 

 

Introductory remarks 

• Thank you for the invitation. Been to ISFIT before, very important meeting place and gathering. A pleasure to be an “honorary member” of “Samfundet”. 
• Columnist Nicholas Kristof in The New York Times: “... in several African countries, 1 women in 10 ends up dying in childbirth. It’s pretty clear that if men were dying at these rates, the United Nations Security Council would be holding urgent consultations, and a country such as this would appoint a minister of paternal mortality....”

 

Link between global health and foreign policy. Perspectives:

• Health security and protecting national public health: pandemics, national borders offer little protection against global health risks.
• Investing in global health in the developing world is not only morally right, but also an investment in our own national security.
• Poverty is a source of conflict, violence, terror. Improved health leads to economic development.
• Number of people on HIV and AIDS treatment a tremendous success history.
• Health beyond health ministries. Need to engage more in traditional foreign policy areas like trade, security, humanitarian issues and human rights.
  
  

Global health at the forefront in financial and political mobilisation for development

• The GAVI Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria showed the way forward through risk-taking innovations, broader and new partnerships and focus on results a decade ago.
• Vaccination is one of the main reasons why we today see a decline in child mortality.
• Dilemma – outside the UN – insufficient national investments in health.
• Similar innovative approaches are needed now to strengthen and empower young girls and to save the lives of new mothers and newborns.
• Global Strategy – come back to this later.

 

MDGs – in 2000 the world leaders agreed on the Millennium Development Goals 

• A promise was given to improve the livelihoods of millions of people. 
• An expression of our common humanity.
• A declaration of the world’s commitment to eradicating extreme poverty and hunger, achieving gender equality and extending hope and opportunities for better health, education and livelihoods to millions around the globe.
• Enormous progress has been made so far towards meeting the MDGs and we must recognise, celebrate, and support these achievements.
• We should credit citizens and governments of countries that have prioritised development and invested in the human development, health and education of their own people.

 

MDG 5 – maternal health

 

• Millions of lives have been saved through vaccination and improved health services, clean water and better sanitation.  
• MDG 5 – improving maternal health shows the least progress. Pregnancy-related deaths and morbidity include mortality resulting from unsafe abortions. 
• Brutal expression of discrimination: the day of birth still is the most dangerous day for woman and babies. 
• UNDP: the lack of gender equality and opportunities for women in many societies may be the most important single obstacle to the realisation of the MDGs.
• Particularly important is girls’ access to health, education and means of production.
• Gender equality and the right of women to make their own sexual and reproductive decisions are prerequisites for success.
• This is one of the reasons why Prime Minister Stoltenberg and our Government are engaged in promoting particularly the health-related MDGs. 
• We know what needs to be done – in contrast to some of the other global challenges. And: we are not talking about high-tech facilities. 
• Women in poor countries have to be empowered with the right and opportunity to decide if and when to give birth, and to give birth with qualified health workers and proper equipment. 
• Investing in girls’ and women’s health and education is an investment in the future. It is in fact well documented that this has a dramatically positive development effect not only for the individuals concerned, but also for their families, their communities and the nations at large.
• In other words, one of our main messages is that gender equality is not just a matter of rights; it is also economically beneficial.
• The Nordic social model, based as it is on equality, has shown that it can withstand changing economic and political conditions. This was one of the themes at the Economic Forum in Davos in January.
• Women’s health is not always a high priority for poor families. A woman’s husband and in-laws tend to have the final say in how limited resources are to be spent. Therefore the value of women and their position in the family and society must be recognised and strengthened.
• Inclusion of men at all levels for the benefit of women, children and men themselves is important. 
• 1325: in conflicts and post-conflict settings, women’s access to health services is even worse. At the same time, women in armed conflicts are vulnerable to gender-based violence, including sexual violence and rape. It is crucial that when the war is over, women participate in reconstruction and state-building. We know that women, when included in these processes, tend to prioritise basic services like health and education – political priorities that we believe contribute to a more sustainable and lasting peace.
  
  

Global Strategy

• Signs of progress. In 2010, for the first time, data showed that significant progress is being made not only in reducing child mortality, but also maternal deaths.
• Not the time to rest!  keep up the work, ensure continued high political commitment to and awareness of this issue
• Consolidated efforts to succeed in the implementation of the UN Secretary-General Ban ki-Moon’s Global Strategy for Women’s and Children’s Health.
• At the launch some 40 billion USD was committed.  One of the most promising elements was the substantial and explicit commitments made by leaders from countries with the greatest burden, taking the lead in making faster progress.
• Now it is time for the international community to deliver.

 

What’s new, you might ask – in my view the combination of the following four elements:

 

1. It unleashes unprecedented levels of financial, policy and delivery commitment from a broad range of stakeholders.
2. It ensures greater accountability for tracking commitments so that those most in need receive the benefits they have been promised.  
3. It gives new directions to international cooperation from partner countries, civil society and the private sector.
4. It focuses on innovations that will enable governments and organisations to get more health for the money and to connect the poorest billion people to the global economy.

 

How then do we make this happen?

• It is vital that 2011 will be the year of implementation on the ground. Coordinated support and leadership are needed from all stakeholders concerned.
• Some important steps and priorities from Norway and partners are:

1. Implementation of the Global Strategy at country level – coordination among UN agencies, including the recently established UN Women is a key success factor.
2. Develop a specific accountability framework with regard to both results and resources for women’s and children’s health. WHO in lead with the Commission on Information and Accountability for Women’s and Children’s Health.
3. Capture new opportunities in innovation. Follow the private sector. The one billion people living in extreme poverty and experiencing the highest burden of ill health is now becoming a target for the private sector with a view to connecting them to the global economy. An innovation working group has been established under the Global Strategy.
4. Develop effective mechanisms for funding critical priorities for women’s and children’s health, based on established institutions.

 

Challenges to face:

• Build up an effective health system – WHO code on ethical recruitment of health personnel
• promote gender equality policy
• investment in health
• need for a continued common effort and
• hold one another accountable for improving infant and maternal health.