CSIS Women’s Global Health Event
March 7, 2013
Good afternoon, and thank you, Steve, for that introduction. I’m so pleased to be here today to speak with you about a top priority for the Obama Administration, and for me personally: the health of women and girls around the world.
When I visited our programs in East Africa in 2011, I was struck by the strength and resilience of the women I met there. And I want to start by talking about one amazing woman. In rural Kenya, there’s a woman living with HIV named Jemima. At one point, the effects of her illness became so bad that she wasted away to only 77 pounds. That’s when a volunteer brought Jemima and her family to a health clinic that had been supported by U.S. government investments.
Jemima went home with what’s known as a ‘Basic Care Package’—a bundle of low-cost health interventions developed by researchers from the CDC’s Global AIDS Program to prevent the most debilitating infections among people living with HIV.
Before long, Jemima was bouncing back. She regained a healthy weight. She recovered the strength to live and work again.
But she didn’t stop at getting back her own health. She became a health leader in her community. She founded a group that offers emotional and financial support 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 the same facility where she got help.
In Jemima, the investment we made didn’t just save one life, or one family. It gave a community back a leader, an entrepreneur, and a lifetime advocate for health.
When the President made women’s health a major focus of his Global Health Initiative, it wasn’t just about closing the huge gender disparities in access to care and treatment. It was also about recognizing a truth that Jemima’s story exemplifies. When we invest in the health of women and girls, it doesn’t just improve health outcomes for those individuals. It produces benefits that ripple through families, communities, and nations, creating enormous returns in economic growth, poverty reduction, and overall development.
No investment we can has a bigger payoff than women’s health. And thanks to the President’s leadership—and the leadership of Secretary Clinton and other dedicated officials—we’ve made great strides over the last four years.
Take HIV, which for many years was considered by many to primarily be a men’s health issue. Today, we know that women and girls make up more than half of the world’s HIV-infected population. And AIDS is now the leading cause of death for women of reproductive age worldwide.
That’s why we’ve bolstered initiatives like PEPFAR, and put a new focus on reaching women whose lives are touched by the global HIV crisis. And in the first half of this fiscal year, we’ve already reached more than 370,000 women with treatment, putting us on track to meet PEPFAR’s target of reaching an additional 1.5 million women by 2014.
We’ve also elevated women’s global health to the forefront of our foreign policy through the development of new initiatives, like USAID’s Gender Equality and Female Empowerment Policy, and through new appointments, including the first-ever ambassador for global women’s issues, Melanne Verveer.
And we’ve created new partnerships that have led to historic levels of global investment in family planning services, cervical and breast cancer screenings, and the prevention of sexual violence.
These accomplishments don’t belong to the Obama Administration alone. They’ve come with the support of many domestic and international partners, including many of the groups represented here in this room, and with the engagement of foreign governments. And we’ll continue to build those partnerships in the years ahead, because for all of the great work that’s been done, we know that there is still so much more to do.
One area where we need to do more is HIV prevention for mothers and children. We’re making progress on ending mother-to-child HIV transmission by providing antiretroviral treatment to infected mothers. And our scientists at NIH were heartened by the recent news that aggressive antiretroviral treatment in a Mississippi newborn may have completely removed the virus from her body. While we’re not yet ready to declare this a path to curing AIDS, it’s an important step forward.
We’re also continuing to work to reduce the social barriers that prevent women from getting the care they need. As more women receive treatment and return to health, the stigma surrounding HIV is melting away, community by community, increasing the willingness of even more women to get tested. That creates a positive cycle of awareness and treatment—one that’s strengthening local economies, protecting children from becoming orphans, and bringing us closer to achieving our goal of an AIDS-free generation.
A second cornerstone of our work this term will be reducing maternal mortality rates around the world. Every day, approximately 800 women die during childbirth worldwide—more than one woman every two minutes. And when a mother dies, her child is seven times as likely to die within 12 months.
Those risks are even greater in the developing world, where three out of every four women in need of care for complications from pregnancy do not receive it. Even in places where care is available, the demand is often so great that it stretches resources to their limits.
I had the opportunity to visit the maternity ward of the Mnazi Mmoja Hospital in Zanzibar, Tanzania in 2011. There were so few beds and nurses that some women had to share beds in the post-natal room. Others were discharged just hours after giving birth. The hospital was doing heroic work in the face of nearly impossible conditions. But even so, a heartbreaking number of women weren’t getting the care they needed.
Through new, international, public-private partnerships like Saving Mothers, Giving Life, we’re working to change that. By providing mothers with the essential care and resources they need during labor, delivery, and the first 24 hours after birth, we’re aiming to reduce maternal mortality rates by 50 percent in targeted countries. In Zambia and Uganda, that work is already underway.
A third area of focus is our work to reduce gender-based violence. Here in the U.S., we have a major milestone going on right now as I speak to you, with the President signing the reauthorization of the Violence Against Women Act.
But we know that around the world, many women face even greater risks for domestic and interpersonal violence. That’s why, in the second term, we’ll be implementing the first-ever U.S. Strategy to Prevent and Respond to Gender-Based Violence Globally, which provides for concrete action to support vulnerable women and girls through the State Department and USAID.
We can all be proud of the progress that’s been made over the past four years. Thanks to hard work and the efforts of dedicated partners at home and abroad, we’ve been able to put some important policies in place. And we’ve gotten some effective programs off the ground. Now is the time to ensure that we turn that groundwork into real results for women and girls everywhere.
And as we move forward, it’s heartening to see a wave of women moving into health leadership positions around the globe. Here in the Americas, 14 of our hemisphere’s health ministers – including the ministers of Canada and Mexico – are women, as is our newly elected Pan-American Health Organization regional director, Carissa Etienne.
In Africa, eight health ministers are women, as is the new Chair of the African Union, Dr. Nkosazana Dlamini-Zuma. And of course, the World Health Organization is led by Margaret Chan. I’ve had the opportunity as Secretary to get to know these remarkable women, and not surprisingly, have learned of their own deep commitment to the health and well-being of girls and women.
As we continue this fight for women’s health across the globe, we also cannot forget that ensuring equality in health starts here at home.
From his first days in office, through the passage of the Affordable Care Act, the President has made women’s health a centerpiece of his domestic agenda.
Because of that law, insurers will soon be forbidden from charging women higher premiums just because of their gender. Being a woman will no longer be a pre-existing condition in America; that practice will be gone for good.
We’re also ending the ridiculous double standard of treating Viagra like it’s an essential medication and birth control like it’s a rare luxury product. Because of the law, tens of millions of women can now walk into their doctor’s office and get contraceptive care and other critical preventive services without paying a dollar out of pocket.
And when new Health Insurance Marketplaces open for enrollment in October, every plan will be required to cover prenatal and maternity care, a welcome change from today’s market where this comprehensive coverage is the exception not the rule in far too many health insurance policies.
Women of all ages are benefitting from the Affordable Care Act. Young women under 26 are now eligible for coverage on their parent’s plans. Working women, who are less likely to receive insurance through their employers, are gaining greater access to affordable options. Older women who make up the majority Medicare enrollees are seeing the quality of their care go up even as their costs have gone down.
We’re going to spend the next term building on this progress—here and abroad. And though some of the faces in this Administration may change, this guiding principle never will: no woman—anywhere—should be denied the care and support she needs to live a healthy life. That’s a message you’re going to keep hearing from this Administration during the second term.
With your help, we have the opportunity over the next four years to touch millions of lives and improve the welfare of countless communities. It is our responsibility to use the time we have to see that mission through. And I look forward to working with all of you toward that shared goal.