June 4, 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.
But as you all know, too often when it comes to the health of mothers and children our efforts fall short.
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. And each year, over 7 million children die before their fifth birthday. Here in the United States 6 infants die for every 1000 born.
These tragic deaths cut lives down before they even begin. And the saddest part is that so many are preventable.
We know that 80 percent of maternal deaths could be averted with access to maternity and basic health services. And at least one third of infant deaths might be prevented with simple solutions like ensuring clean birth surfaces or keeping babies warm after birth.
If we could stop even half of these preventable deaths it would be one of the most significant global health achievements in our history.
But even though we have simple and often relatively cheap preventive measures, there are still basic questions we need to answer: How can we get proven birth practices to catch on in low-income nations? How can we improve nutrition in those nations to make sure infants grow up healthy? How can we get potentially life-saving postpartum medications into remote areas of the developing world?
We built the Global Network for Women’s and Children’s Health Research to answer these and many other questions that affect the health of mothers and children around the world.
In the 11 years since it began, the Global Network has made a huge difference. It now invests more than $6 million per year into six low and middle-income nations around the world – funds that have led to the production of more than 150 studies, reports and journal articles. And as a result of this work, we’ve already seen health breakthroughs that promise to save lives.
I saw one of these breakthroughs first-hand earlier this year when I visited a Global Network site in India.
At the JN Medical College Women’s and Children’s Health Research Unit at KLE University in Belgaum they had been searching for treatments to stop severe bleeding in women who had just given birth. This is a health issue that affects very few women in developed countries like the US. But statistics have shown that it causes nearly 60 percent of maternal deaths in the developing world.
Researchers in Belgaum suspected that they might be able to treat postpartum hemorrhaging with a low-cost oral drug commonly used for treating ulcers called Misoprostol. The problem was that they didn’t have the resources to test their theory.
So the Global Network gave the college the funding they needed to run clinical trials. And once the trials were up and running, researchers quickly found that the drug reduced postpartum hemorrhaging by up to 80 percent. Today, thanks to that first trial, Misoprostol is being used to keep mothers safe in India and 12 other nations, from Nepal to Mozambique.
Another Global Network research grant in India trained health workers around the country in neonatal resuscitation. As part of the trial, 1,100 Belgaum birth attendants were trained and provided with clean birth kits and resuscitation equipment. Once again the results were immediate. The Belgaum region saw an increase in newborn survival. And the trial has already been scaled up to train nurse midwives in five other Global Network sites.
This kind of promising research is going on in nations throughout the Global Network – from studies that seek to educate pregnant women on the dangers of tobacco use to trials in Pakistan on how to combat sepsis in newborns.
And what makes the network so powerful is that when these discoveries are made, they’re shared around the world. The Network has proven what many in this room already knew: Together we can fight disease more effectively than any country can on its own.
We have a lot to be proud of and none of it would have been possible without your hard work and dedication. But I believe the Global Network can accomplish even more if we follow four key principles in the months ahead.
The first is one that each of us in the public health world know well: That there is no such thing as inevitable progress. When we find success we need to make sure we drive it forward and not let up.
The second thing we need to do is become ambassadors for translational, community based research and the importance of truly international global health work. The more widely our discoveries are shared, the more power they have. So we need to work to get more funding from international governments, get more participation from our local communities, and create stronger partnerships with health institutions in each of our countries to turn findings into action.
The third thing we must do is expand our scope. As I said earlier, we’ve had great success fighting maternal hemorrhage, birth asphyxia, and many of the most visible health issues facing mothers and children. But there are issues outside of the delivery room that affect women and children around the world – from the impact of environmental issues like indoor air pollution or water-borne disease to the lack of preventive tests and measures for expectant mothers.
So we need to expand our research to those areas where not enough work has been done and where our skills and resources can do a lot of good. That means working to increase access to care like ultrasounds that can help doctors identify and begin to treat at-risk pregnancies. Or working with health providers to measure indicators like the fetal heart rate as a gauge of both the mother’s and the baby’s health.
Fourth and finally, we need to make sure our resources are going to the places they’re needed most. Going forward, the Global Network will focus resources on lower-income countries that need our help. Last week we released a funding announcement that will pick Global Network sites to do just that. The new sites will be expected not only to improve health, but also to help build research capacity that can be used to tackle other health challenges.
There’s no wiser health investment we can make than in mothers and children.
In our own country, we’ve continued to struggle with premature birth which is not only an immediate risk to infants, but also puts children at risk for lifelong health issues.
So in the US, we’ve launched the Strong Start Initiative. Partnering with non-profits and medical associations, we’re raising awareness of how important it is to bring pregnancies to full term. And we’re funding innovative strategies for reducing preterm births among women who are at risk for poor pregnancy outcomes.
We’ve also made maternal and child health a focus of our country’s work on global health through President Obama’s Global Health Initiative.
And I know many of you in this room have led innovative programs and initiatives like this in your own countries.
But our best chance to solve these challenges is by working together. I’ve been struck in my travels around the world that when we’re talking about trade or foreign policy, there are often areas of strong disagreement between nations. But when the discussion turns to tackling our biggest health challenges, there is a broad consensus that we must all work together.
The world’s health is not a zero sum game. What benefits one nation, benefits us all.
This is the principle at the heart of the Global Network and it’s why we’ve been able to accomplish so much in the face of very difficult circumstances.
But we know that even one preventable death is too many and that around the world there are many mothers and children who need our help. By building on the progress we’ve made in the last eleven years, we can save even more lives, strengthen even more communities, and make the world an even safer, healthier place in the years to come.