Global Maternal Newborn Health Conference

Melinda Gates
Global Maternal Newborn Health Conference
Mexico City, Mexico
October 19, 2015
AS PREPARED

Thank you. That was a very generous introduction and I’m excited to be here.

This morning I’m thinking of Sarah.

Sarah Briton is a remarkable young woman, just coming out of her teens, who I met this summer in Malawi when she was pregnant with her first child.

When Sarah’s own mother gave birth to her nearly 20 years ago, she did so inside her village home, like millions of other women around the world.

No medical attendant was present to help if something went wrong – fortunately, nothing did.

But Sarah’s experience of childbirth in Malawi this year was very different.

Late in her third trimester, she made the five-hour journey to the capital, Lilongwe, so she could be near a women’s clinic.

There, while she waited to give birth at a maternity home, she learned about the benefits of eating well, of breastfeeding, of family planning, of personal hygiene, and of immunizations.

She even joined a sewing circle, making baby clothes to keep, or to sell, so she could provide additional income for her family.

And – of course – when she went into labor, she knew that she and her baby would have access to lifesaving care.

Thankfully, it was not needed.

And as we meet here today, I picture Sarah looking down tenderly at her healthy infant son, Mphatso which means “gift”.

I think of Sarah because her story captures the human joy that your endeavor, your enterprise, and your expertise brings on a daily basis across the world.

Sarah and her child – and the millions of other mothers and babies who today are not only surviving but thriving – are the living legacies of your work.

They are also a powerful reminder of what the world can achieve if we are clear about what we want to accomplish and we work together to accomplish it.

There is no better evidence of this than the progress realized under the Millennium Development Goals.

Without a doubt, the MDGs can be considered a resounding success.

They focused our collective attention on some of the most serious challenges the world faced at the start of a new century.

And the concrete targets they set, enabling countries to track and measure progress, inspired large reductions in poverty, malnutrition, maternal and child mortality, and other problems affecting the world’s poorest people.

Several countries made extraordinary strides.

Rwanda’s recent progress reducing child mortality is the fastest in recorded history.

And look at Ethiopia. Ethiopia is on course to meet all its Millennium Development Goals.

We can take great encouragement from such transformations; just as we should be inspired by some of the other stunning achievements of the past generation.

We all know the headlines: Maternal deaths almost cut by half. Child mortality cut by half. Extreme poverty cut by more than half.

But that means, of course, that we are still only half way done.

For hundreds of millions of people in the developing world, life is much better – but we can’t stop until it’s better for everyone.

It is up to all of us – and I mean, quite literally, all the people in this room today – to finish the job.

It is up to us to make good on the ambitious and achievable Sustainable Development Goals that the world endorsed last month at the United Nations.

For every woman, child, and adolescent everywhere.

Specifically, for those at this conference, to make sure that we meet the targets enshrined in SDG3.

Targets this community fought so hard to have included.

That by 2030, we reduce:

• newborn mortality to at least as low as 12 per 1,000 live births;
• under-5 mortality to at least as low as 25 per 1,000 live births; and
• maternal mortality to less than 70 per 100,000 live births.

Given how far we’ve come I am genuinely optimistic we can succeed.

And it is fitting that the first major global development conference since world leaders ratified the SDGs should focus on maternal and newborn health.

Put simply, success on this agenda is fundamental to overall success.

Why do I say that?

First, because we need to get to the millions of people we haven’t yet reached — and for too long newborns have been the forgotten community of the development agenda.

And second because it is imperative that we put the health and wellbeing of women and children at the heart of all our collective efforts.

For all the headway we’ve made on so many fronts, the hard truth is that progress on newborn health has lagged behind.

In just the short time I will be speaking to you nearly 70 newborns will die – almost all from preventable causes.

Add to that about 800 women dying needlessly every day from causes related to pregnancy and childbirth and the scale of the challenge remaining becomes clear.

Because the health of newborns is inextricably connected to the wellbeing of their mothers.

We cannot separate one from the other.

That may sound obvious.

Yet this is the first time, ever, that the maternal and newborn health communities have come together for a joint global conference.

So I congratulate the entire secretariat and the leadership of the many partners, scientists, academics, and advocates who are gathered here today for making this happen.

Special thanks to Saving Newborn Lives of Save The Children; the Maternal Health Taskforce at the Harvard Chan School of Public Health; and the Maternal and Child Survival Program of USAID.

This conference is a welcome turning point – an opportunity for you to start fully integrating your efforts, knowing that what’s good for one is good for the other; sharing what works and where we can do better.

There is much to build on.

At a global, national and regional level, the Every Newborn Action Plan is supporting developments in health programs for pregnant women, mothers, and their newborns.

This is improving and expanding care, reducing inequities, and tracking progress.

In-country, more communities are adopting simple, cost-effective interventions:

• Breastfeeding.
• Injectable antibiotics.
• Resuscitation.
• Drying and skin-to-skin contact.
• Umbilical cord care.

There’s good evidence that investments in self-help groups are also paying off as women encourage and support each other to adopt basic pre- and postnatal care routines.

And most importantly, it is clear that providing quality care at delivery facilities, like the one Sarah Briton went to, is saving the lives of many more mothers and newborns.

By continuing to ensure that they are staffed with skilled birth attendants – well supplied and well-trained – we can make childbirth even safer.

As we think about extending our efforts to forgotten communities, it’s also important to keep in mind the enormous disparities that exist within countries – not just between them.

Take my country, the United States of America.

The United States is the only country on this continent where maternal deaths increased between 1990 and 2013.

The truth is, pockets of extreme poverty persist everywhere. And where they do, poor health inevitably follows.

The Mesoamerica Health Initiative, which our foundation supports along with The Carlos Slim Foundation, the Inter-American Development Bank, the government of Spain and the governments of this region, was created to reduce inequities.

The scope of the program is deliberately ambitious.

We are supporting governments to improve the lives of the poorest 20% of the population in seven countries of Central America, and the state of Chiapas, here in Mexico.

Today, almost two million women and children are directly benefiting from the care and treatment they get at better-equipped clinics and health centers.

It is early days but there are some promising results.

In Chiapas, the percentage of health facilities which have reliably available resources for effective prenatal and postnatal care rose from 3.6% to nearly 46%.

In Honduras, the percentage of micronutrients available to children from six to 23 months – a critical intervention against anemia -- has gone from zero to 93.5%.

These and other advances are important because they are saving and improving lives.

But they are also important as the critical first step to building strong, prosperous communities.

The fact is, investing in the health and wellbeing of women and children is one of the smartest economic investments we can make.

And it’s essential that our efforts are aligned across the continuum of care.

A continuum that starts with family planning.

All the data proves that helping a woman plan and space her pregnancies is the most effective way to save mothers and newborns.

And we know it doesn’t end there.

If women space their pregnancies, they are more likely to have healthy babies.

If their babies are healthy, they are more likely to flourish as children.

When health improves, life improves by every measure.

Better health leads to better education, which leads to better economic opportunities, which lead to broader prosperity for communities and countries.

By integrating our efforts, not only does everyone benefit – those benefits last a lifetime.

A lifetime that begins with taking care of pregnant women and providing mothers with the chance to give their newborns the best possible start.

Sarah Briton knew this. She knew what was best for her and Mphatso.

And she knows from her own experience that extraordinary progress is possible within a generation.

It is now up to us to match Sarah’s optimism and determination with our own.

This is the time to step up our efforts and move even further, even faster.

This is the time to reach those left behind in the wave of progress we saw at the start of this century.

And that means making women and children the cornerstone of the sustainable development agenda.

Not only to help more survive, but to also make sure they thrive.

If we do, then by the time Mphatso reaches his 15^th birthday, his gift will be a world where there are healthier, brighter futures for everyone, everywhere.

Thank you.