World Medical Association
May 22, 2012
Every country in the world recognizes the huge benefits of investing in health. Healthy children are better students. Healthy adults are more productive workers. Healthy families can make greater contributions to their communities. And when we live longer, healthier lives, we have more time to do our jobs, play with our children, and watch our grandchildren grow up.
And yet, in too many countries, including my own, we fall short when it comes to the health of women.
One reason for this is that women are more likely to depend on a male partner to access health care. And they’re often less likely to have the resources they need to get care on their own.
Another obstacle is health systems that too often fail to consider the unique health needs of women.
In the United States, it wasn’t until the 1980s that women were even included in clinical trials. As a result, we had no idea what treatments or medicines were particularly effective for women. We didn’t know what might happen when a drug that had been tested on a 180-pound man, was given to a 110-pound woman.
Despite the progress we’ve made since then, disparities persist to this day. Women in America often pay more for health insurance, just because they’re women. And to add insult to injury, these plans often don’t even cover the basic care they need. In my country, just one out of 8 plans for those who buy their own insurance cover maternity care -- as if getting pregnant were some very rare condition.
The result is that far too many women, who often serve as the health care gatekeepers for their families, go without care themselves.
Of course, we see the same thing around the world. Every two minutes, a woman dies from complications related to pregnancy or childbirth. The risks are even greater if you live in the developing world -- where three out of every four women needing care for complications from pregnancy do not receive it.
Even in places where care is available, the demand is so great that it often stretches resources to their limits.
Last year I visited the maternity ward of the Mnazi Mmoja Hospital in Zanzibar, Tanzania. There were so few beds and nurses that some women had to share beds in the post-natal room. And others were discharged just hours after giving birth. The hospital was doing heroic work. And the women who were able to deliver there, were among the lucky ones. Yet, so much need still went unmet.
We know that when we under-invest in women’s health, whole families pay the price. When a mother dies the chance of her child dying within 12 months, increases seven fold.
So under President Obama, we’re putting a new focus on women’s health – at home and abroad.
In the United States, the key to those efforts is the Affordable Care Act, our most important women’s health legislation in years.
The health care law starts by ending discrimination against pre-existing conditions. Insurers are already prohibited from denying coverage to children because they have asthma or diabetes. And beginning in 2014, all women will be protected from being locked out of the market because they’re a breast cancer survivor, or gave birth by c-section, or were a victim of domestic violence.
In the past -- because they were worried about losing their health coverage -- too many women didn’t have the freedom to make important decisions like changing jobs, starting a new company, even leaving a bad marriage. Now that women know they can’t be turned away because of their health status, we’re taking those choices back from the insurance companies and returning them to the women where they belong.
Next, the law prohibits insurers from charging women more just because they’re women. To put it another way: this means that being a woman is no longer a pre-existing condition.
And the law helps women get the preventive care they need to stay healthy, from mammograms to contraception to an annual check-up where you get to sit down and talk with your doctor, as a basic part of any insurance plan.
These improvements are happening across the lifespan. Young girls now have access to the vaccinations they need stay healthy without their parents worrying about additional costs. And seniors are getting better care to help manage their chronic conditions.
Put all these changes together and they represent the most important and comprehensive American law affecting women’s health in decades.
Now, we’ve also made women and girls a priority for our Global Health Initiative -- a new approach to coordinating the US government’s global health work around the world.
With a focus on collaboration, and innovation, this initiative -- launched by President Obama -- allows us to maximize America’s own strengths and support other nations as they work to improve their people’s health.
We are integrating our programs across the U.S. Government so they can work together more effectively. And we are looking for new and better ways to work with international partners, multilateral organizations, NGOs and foundations to meet our common goals
Through it all, we’ve made women’s health a key priority – and that includes family planning. We know that access to contraception allows women to space their pregnancies and have children during their healthiest years. And delaying pregnancy beyond adolescence can reduce infant mortality and dramatically improve a child’s long-term health. Providing a woman the tools to plan how many children she has, and when she has them, is essential to her health and her family’s health.
Now, just as important is making sure that, when women are pregnant, they get the care and support they need to have a safe and healthy pregnancy and delivery.
The Global Health Initiative’s ‘Saving Mothers Giving Life’ campaign is a great example of these efforts. We know that for mothers and children at risk, the first 24 hours postpartum are the most dangerous. That’s when two out of every three maternal deaths, and almost half of newborn deaths occur.
So we’re working together with groups like Merck for Mothers, the American College of Obstetricians and Gynecologists, Every Mother Counts, and the Government of Norway, to make sure mothers get the essential care they need during labor, delivery, and those crucial first 24 hours, so they can survive and thrive.
We’re focusing on countries with the political will to bring about change. And with more than $90 million in generous support from our non-governmental partners, we have begun selecting pilot sites in the regions of Uganda and Zambia where women are facing some of the highest maternal mortality ratios in the world.
‘Saving Mothers Giving Life’ is just one example. But it illustrates an approach that runs throughout the Global Health Initiative. It starts by identifying the most urgent health challenges affecting some of the world’s poorest nations. Next, we identify the best people in the world with the specific expertise to solve these problems. Then we bring them together, and make sure they have the tools, resources and flexibility to take action.
For too long, too many women and girls have had their lives marred by illness or disability, just because they didn’t have access to health services. When we deprive women of the care and support they need to stay healthy or get well, we’re also robbing them of hope for the future.
That’s the moral argument for making women’s health a priority. But there’s a strategic argument too.
Women are gateways to their communities. Around the world, women are primarily responsible for managing water, nutrition, and household resources. They’re responsible for accessing health services for their families. Many of them are closely involved in actually providing health care for those around them.So by improving the health of women, we can improve the health of communities too.
Consider the story of Jemima, a woman living with HIV in rural western Kenya. At one point, the effects of her HIV got so bad she had wasted to 77 pounds. That’s when a volunteer brought Jemima, her husband, and her sick grandchild to a U.S. government-supported health clinic.
They went home with what is called a “Basic Care Package” – a bundle of low-cost health interventions, developed by public health researchers from our CDC Global AIDS Program to prevent the most debilitating, opportunistic infections among people living with HIV.
Jemima bounced back. She regained a healthy weight. And today she is a health leader in her community. She founded a group that offers emotional support and small loans to families touched by HIV. She sells health products to help support the eight sick and orphaned children she has adopted. And she has referred more than 100 HIV-infected men, women, and children to receive care at the same facility where she got help.
In Jemima, our investment saved not only a life, but a mother, a community leader, an entrepreneur and a health advocate.
What we know from our work with partners around the world is that improving the health of women and girls, unleashes powerful new opportunities – not just for them or their families – but for their communities and countries.
If we want to improve education, we should be giving our young women the healthy start they need to succeed in school. If we want to boost productivity, we can make sure women have access to health care, including family planning and other reproductive health services. If we want to build stronger communities, let’s enable women to teach their neighbors how to prevent disease and stay healthy.
Around the globe, our nations face many challenges. And investing in women’s health is one of the best ways we can address them together.