$50 Million Gift from Bill and Melinda Gates Will Fund Columbia Public Health Program to Prevent Maternal Deaths and Disability in Developing Nations

NEW YORK -- Columbia University's Joseph L. Mailman School of Public Health has been awarded $50 million from Bill and Melinda Gates for an international health program to prevent one of the most serious, but treatable health problems in developing nations—maternal death and disability.

Under the leadership of Allan Rosenfield, M.D. and Deborah Maine, Dr. P.H. of the School's Center for Population and Family Health, the grant will provide critical support to government programs, as well as national and international NGOs, and local and international women's groups whose aim is to prevent maternal death.

"The Gates Foundation gift is of critical importance because of the long-term impact it will have on millions of lives," said Columbia University president George Rupp. "With the combined efforts of a private foundation, a research university, and government and community-based assistance organizations, we have the best chance of improving health care in areas of the world where the need is greatest."

"I'm proud to be here today on behalf of Bill and Melinda," said William Gates, Sr., Foundation director. "Our family shares Columbia's vision of raising the standards of maternal care in developing countries. Dr. Rosenfield and his team here at Columbia are doing great work to build a program that will place permanently the resources to save the lives of hundreds of thousands of women each year."

Every minute of every day, a woman in Asia, Africa or Latin America dies due to the complications of pregnancy or childbirth. In some parts of Africa, maternal mortality claims 1 out of 12 women, compared to 1 out of 4,000 women in Northern Europe.

This is the largest discrepancy between developed and developing countries for any of the common public health problems. What makes this situation truly tragic is that medical practice has had the means, for nearly 50 years, to prevent these deaths-through emergency medical measures such as surgery, drugs, and blood transfusions.

A woman may die because she needs a Caesarean section, and the anesthesia machine in the local hospital doesn't work properly or because the one qualified surgeon has never learned the necessary procedure. Or a woman may die on the way to a distant city hospital because her local hospital is not open when she becomes ill.

Researchers Rosenfield and Maine shed light on this important public health problem in a groundbreaking article in The Lancet in 1985. They found that it is access to medical care and comprehensive emergency obstetrical services that are critical to reducing maternal death and disability.

Their research countered the conventional practice that emphasized prenatal and preventive care to reduce deaths. They demonstrated that routine prenatal care cannot predict life-threatening complications since they are true medical emergencies that arise without warning.

The Foundation grant will be used to help analyze, in partnership with local agencies, existing gaps in emergency health care in countries in Africa, Asia, and Latin America, and it will help to upgrade existing facilities, and provide personnel with better training, equipment, and supervision.

Once needed changes are made, there will be ongoing monitoring of services to ensure that improvements are maintained. Rosenfield and Maine intend to begin work in Egypt, Morocco, Mozambique, Nigeria, Uganda, Bangladesh, India, Pakistan, and Peru.

For more than a decade, the Center, in partnership with local organizations, has been involved in designing effective programs to reduce maternal deaths in West Africa, North Africa, and Asia. With this very generous grant from the Gates Foundation, Dr. Rosenfield and Dr. Maine will continue to build upon their important insight.

Allan Rosenfield M.D., who is also dean of Columbia University's Joseph L. Mailman School of Public Health said, "I want to express our deepest appreciation to the Gates Foundation for this extraordinary opportunity to help women around the world. We are honored by the trust that the Foundation has placed in us."

In early 1998, the Foundation made a grant to the Center for Population and Family Health of $1.36 million to fund programs to help prevent maternal mortality, bring effective health services to refugees, and integrate family planning with HIV prevention services to rural Ugandan women.

The only accredited school of public health in the New York metropolitan area and among the first in the nation, The Joseph L. Mailman School of Public Health of Columbia University provides instruction and research opportunities to 650 graduate students in pursuit of masters and doctoral degrees. Its students and 150 multi-disciplinary faculty engage in research and service in the city, nation, and around the world, concentrating on biostatistics, environmental health sciences, epidemiology, health policy and management, population and family health, and sociomedical sciences.